From Kiran Gandhi, who ran a marathon on her period without a tampon or a sanitary pad, to celebrities taking the #RedDotChallenge and films like Padman, the conversation around the ‘flow’ is changing.

Periods are not dirty, but a normal body process of a healthy body. We spoke to Dr Ranjana Sharma, senior consultant, obstetrics and gynaecology, Indraprastha Apollo Hospitals, New Delhi to address everything you wanted to know about your period.

Duration of the period

On reaching adolescence, the body prepares for pregnancy. If no pregnancy occurs, the uterus, or womb sheds its lining. This happens in the form of normal vaginal bleeding that occurs as a part of your monthly cycle.
The menstrual cycle is triggered by the rise and fall of hormones in the body. Most people bleed for 3-5 days, but menstruation can even last till 7 days and it is considered normal. Normally, the amount of blood shed during a period is 50 – 80 ml (2-3 tablespoons).

Typical cycle length

The menstrual cycle is the duration between the onset of one menstrual bleeding to the next. It is calculated from the first day of your period. The length of the cycle varies from person to person, the average being 28 days. There is nothing to worry, and it is still normal if your menstrual cycle length is somewhere between 21 to 35 days.

Signs and symptoms of PMS

PMS or premenstrual syndrome occurs in about 75% of cases. PMS is the presence of physical or emotional symptoms that appear a few days before the period begins. “Chemical changes in the brain and the cyclic changes in hormones are common causes of PMS,” says Dr Sharma. You may experience emotional symptoms such as mood swings, anxiety, poor concentration, appetite changes or sleep problems. Physical symptoms include fatigue, tender breasts, cramps, muscle pain, headache, acne flare-up, constipation and abdominal bloating. “While it is not possible to cure PMS, we often advise lifestyle changes and supplements, if necessary,” says Dr Sharma. Some effective lifestyle changes include drinking plenty of fluids, having a wholesome diet containing fresh vegetables and fruits, doing appropriate exercises, and practicing relaxation techniques such as yoga and meditation.

Menstrual cycle and the skin

 

It is normal for the skin to change in response to the fluctuating hormones during the menstrual cycle. Some common changes observed include sensitive skin, excess hair growth, acne, and production of more sebum.

Period pain

Usually, menstruation is not painful, but some individuals do experience pain and discomfort. “For people who do experience pain and excessive menstrual cramps, doctors may prescribe some common over-the-counter pain relievers such as ibuprofen. It’s absolutely safe to use those painkillers,” says Dr Sharma. “But in cases where the pain is acute and there’s an urge to throw up, it is advisable to let a doctor know, and depending on the symptoms the doctor may prescribe further action.” For instance, in the case of endometriosis, your menstrual pain may be far worse than usual. In fact, there may be an increase in pain over time. There are certain effective treatments for endometriosis such as hormone therapy and surgery.

Clots in period blood

To notice clots in menstrual blood is perfectly normal. According to the journal BMC Women’s Health research done on a section of the population showed that normal blood clots were present in 54% of the women population. But if someone notices clots larger than a quarter, and if periods are heavier than the usual with a necessity to dispose of tampons/pads once in less than two hours, one should report to a doctor. “Other symptoms one may feel include tiredness, exhaustion, shortness of breath and fatigue,” adds Dr Sharma. The doctor may, then, recommend some blood tests, or imaging tests like Pelvic MRI or ultrasound to check for causes. With proper treatment and care, it is possible to control menstrual clots.

Delayed period

 

It is normal to possibly miss a period by a week if you are undergoing stress, experiencing a change of place or taking some medications,” says Dr Sharma. Some other possible reasons for delayed periods include PCOS (Polycystic Ovary Syndrome), thyroid issues, low/high body weight, hormonal contraceptives, or chronic conditions such as diabetes. “In such a situation, you can wait for 2-3 weeks and then see your doctor,” suggests Dr Sharma. You may also miss your regular periods if you are sexually active and the first natural reason could be pregnancy. Also, you do not have periods when you are lactating or approaching menopause, adds the doctor.

Medication to delay periods

A woman can choose to delay her period by using medication called Norethisterone. Dr Sharma says, “It actually causes no harm to take medications to delay periods, but one should always see a doctor before having them because it may not work to its fullest potential if combined with some antibiotics and other prescriptions.” She says that one should also share the existing medical history with a doctor to help decide whether or not to administer the medication. “You should note that once you begin to use a medication, your next period could be different from the one you had before. The bleeding can get heavy and the date will shift.” “You can just wait for your cycle to settle into a regular pattern,” says the doctor.

Tips for good menstrual hygiene

• Change pads or tampons every 3 to 4 hours. If you use a menstrual cup, take care to empty it at least twice a day. Not changing frequently can cause bacterial infections, itching or irritation.
• Always, keep some spare clean, hygienic sanitary towels or tampons handy
• Keep your vaginal area clean. You can use lukewarm water to keep yourself clean as often as possible. Check with your doctor before using vaginal washes. You do not need them, particularly because the bacteria in the vagina ensures self-cleaning.
• Wear comfortable, clean underwear during your periods. Avoid tight underwear that won’t allow your skin to breathe.
• Take care of your diet during your period. Drink a lot of water, consume water-rich fruits (watermelon, oranges, plums, apples) and include green leaves in your meals.