Menarche ( start of periods or menstruation) occurs usually in adolescence; and any time between 8 and 16 years old to start menstruating, “or have periods”, is normal. It occurs in response to the complex interplay of hormones relating to ovulation, or egg production. If an egg, released from the ovary, does not get fertilized, the woman will menstruate as the lining and unfertilized egg comes away from the inside of the uterus ( womb), in preparation for the next month, when the fertility cycle starts over again. Women normally cycle somewhere between 24-32 days. Women vary in their experience of the menstrual cycle. Not only in the frequency, length, pain and amount of bleeding but also in other cyclical symptom which accompany bleeding eg. headaches, bloating, mood disturbance, and breast symptoms.

Sometimes, a menstrual cycle may become less regular, frequent or even stop. There may be an underlying cause for this such as weight loss, or stress, or a physiogical change such as menopause. Occasionally, another health imbalance may be present such as hypothyroidism which can be easily diagnosed with physical examination or blood test.

Generally, women try to manage the changes that occur in response to menstrual cycle, but sometimes pain, amount or duration of bleeding can interfere with normal daily functioning.

Painful periods may respond to simple pain killers such as anti-inflammatory medication (NSAIDS), mefenamic acid ( ponstan), or a trial of the combined oral contraceptive pill.
If periods have been heavy or prolonged for several cycles, an iron deficiency anaemia may develop which can result in lethargy and breathlessness.

Mood changes which can accompany menstruation may also improve with treatment with the combined oral contraceptive pill. Sometimes, mood disturbance maybe due to an underlying depression or anxiety issue,which should be managed differently. We can help with provision of a Mental Health Care Plan, which enables Medicare rebate subsidy, if you need referral on for further support. For other menstrual cycle related symptoms, there may be an underlying issues, such as endometriosis, pelvic inflammatory disease, polycystic ovarian syndrome or fibroids. You may benefit from some simple investigations to assist with the diagnosis and management, such as an ultrasound scan, xray or blood tests.

For any menstrual related difficulty, it is likely that we will be able to provide you with advice and treatment after consultation with any of our consulting doctors at Gynaecare’s Chatswood (Sydney lower north shore) clinic with medication, or an IUS. If, in the unlikely event that you need an additional surgical procedure under General Anaesthetic, we will refer you on to an appropriate gynaecologist for further intervention.