Maintain a menstrual diary to track irregular periods: experts  

A webinar on ‘Management of Heavy Menstrual Bleeding’ as part of The Hindu’s “Healthy India, Happy India” initiative in collaboration with Naruvi Hospitals, Vellore.

Experts have underlined the need for women to maintain a menstrual diary to keep track of irregular periods.

Speaking at a webinar on ‘Management of Heavy Menstrual Bleeding’ as part of The Hindu’s “Healthy India, Happy India” initiative in collaboration with Naruvi Hospitals, Vellore, senior consultant in Gynae-Oncology at the hospital Abraham Peedicayil emphasised the importance of maintaining haemoglobin levels through iron supplements or blood transfusions if necessary.

He highlighted key indicators of abnormal menstrual bleeding, such as cycles lasting more than seven days, heavy clotting, frequent periods occurring within 21 days, delays beyond 35 days, and post-coital bleeding. Three expert doctors from Naruvi Hospitals provided insights into the causes, diagnosis, and latest treatment options for this condition, aiming to raise awareness and enhance women’s health.

Dr. Peedicayil emphasised that a woman’s menstrual cycle involves both the ovarian and uterine cycles, not just the period itself. Breaking down the phases of the menstrual cycle, he explained that a typical cycle lasts between 21-35 days, with menstruation occurring for 2-7 days. “Menopause generally occurs around the age of 50,” he added.

He also stressed the importance of menstrual hygiene, recommending regular changes of menstrual products, wearing breathable clothing, and maintaining proper genital hygiene to prevent infections and control odour.

Regarding perimenopausal bleeding disorders, he noted that irregular vaginal bleeding was common during the transition to menopause. “If your periods are excessively heavy or delayed by more than three months, it is crucial to consult a doctor,” he said. Symptoms of perimenopause include irregular cycles, mood swings, vaginal dryness, and a decreased libido.

Menopause, he explained, is defined as the absence of menstruation for at least six months, once pregnancy has been ruled out. Any postmenopausal bleeding is considered abnormal and requires immediate investigation to rule out potential cancer risks. He also outlined common diagnostic procedures, including cervical smear tests, endometrial assessments, and ultrasound scans.

P.B. Akilasree, senior consultant in Obstetrics and Gynaecology at Naruvi Hospitals, addressed the issue of heavy menstrual bleeding in adolescents. She explained that normal blood loss during a cycle is around 30-40 ml. However, if blood loss exceeds 80 ml or requires more than one pad per hour, it is classified as heavy menstrual bleeding.

She highlighted major causes of excessive bleeding in adolescents, such as anovulation, hormonal imbalances, and thyroid dysfunction. The condition often leads to school absenteeism and emotional distress.

For treatment, she recommended non-hormonal medication, iron supplements for anaemia, and, in some cases, surgical intervention for fibroids. “Using high-absorbency sanitary products and consuming iron-rich foods can help manage symptoms,” she advised. She also urged young women to seek medical attention if they experience severe cramps, excessive bleeding, or anaemia-related symptoms.

Jeyasheela Kamaraj, consultant in Obstetrics and Gynaecology at Naruvi Hospitals, discussed heavy menstrual bleeding in women aged 19 to 45. “One in four women experiences heavy menstrual bleeding,” she noted. She emphasised the importance of a detailed medical history to determine the underlying cause. “It is essential to identify whether the bleeding is due to infections, and whether it stems from structural or non-structural issues,” she explained. Treatment options include iron supplements, tranexamic acid, and combined oral contraceptive (COC) pills. For more severe cases, surgical options include hysteroscopy, myomectomy, endometrial ablation, and hysterectomy.