Midsouth Wellness Guide

OB/GYN

What You Should Know About Your Period

By Riad Homsi, M.D., FACO
Just For Women How do you feel when your period comes each month? Is it a nuisance, a reassurance, a relief, or a disappointment that you are not pregnant? The average woman will have between 400 and 500 menstrual periods in her lifetime. So no matter how you feel about it, it is important to learn how your body works being longer than the average of 28 days. When a woman reaches her 40s the cycle lengthens, reaching an average of 31 days by age 49. Menopause is when women stop having periods. This usually happens around age 51, with any time from the mid 40s to mid 50s considered normal. Regular alcohol use and smoking and stressful jobs are risk factors for shorter cycles whereas excessive weight gain or loss can contribute to longer cycles. healthy. However, if the egg is not fertilized, it either dissolves or is absorbed. Estrogen and progesterone levels drop, causing the tissue lining in the uterus to pass out of your body through your vagina.

Menstrual cycle variations:

1-Amenorrhea-the lack of a menstrual period. This term is used to describe the absence of a period in young women who have not started menstruating by age 16, or the absence of a period in women who used to have regular period. Causes include pregnancy, breastfeeding, and extreme weight loss caused by serious illness, eating disorders, excessive exercising, or stress. Hormonal problems (involving the ovary,pituitary, adrenal or thyroid glands) or problems with the reproductive organs may be involved. 2-Dysmenorrhea-painfull periods, including severe menstrual cramps. In younger women, there is often no known disease or condition associated with the pain. A hormone called prostaglandin is responsible for the symptoms. Sometimes, a disease or condition, such as uterine broids (noncancerous growths in the uterus), or endometriosis (condition that occurs when uterinelining tissue grows on other pelvic organs), or ovarian cysts causes the pain 3-Menorrhagia-This is when you have very heavy and long periods. The condition is common for a few years after menarche and a few years before menopause. An occasional heavy or prolonged period is not unusual if your pattern then returns to normal. For excessive bleeding (ie, soaking a pad or tampon every hour, or bleeding for 10 days or longer) you should see your doctor. Fibroids, endometriosis, or an undetected pregnancy are some of the conditions that can cause menorrhagia. 4-Polymenorrhea-Very frequent periods.Routinely having periods more often than every three weekscounted from the rst day of one period to the day before the next one-may not signal a problem. However,it is a good idea to get checked, as you

What is a menstruation?
Menstruation is a womans monthly bleeding. It is also called menses, menstrual period, or simply period. The menstrual blood is partly blood and partly tissue from the inside lining of the womb. It ows from the uterus through the small opening of the cervix (Neck or mouth of the womb), and passes out of the body through the vagina. While most menstrual periods last from three to ve days, anywhere from two to seven days is considered normal. It should be noted, however, that about 5% of healthy women menstruate less than 4 days and 5% menstruate more than 8 days.

What happens during the menstrual cycle?

The parts of the body involved in the menstrual cycle include the brain with its pituitary gland, the uterus(womb),ovaries, fallopian tubes, and vagina. Body chemicals rise and fall during the month and make the menstrual cycle happens. The ovaries make two important female hormones, estrogen and progesterone. Other hormones involved in the menstrual cycle include follicle-stimulating hormone (FSH) and luteinizing hormone (LH), both made by the pituitary gland in the brain. Every month or so, your body prepares to become pregnant. In the rst half of the menstrual cycle, levels of estrogen rise and make the lining of the uterus (womb) grow and thicken while the follicle stimulating hormone (FSH) signals an ovum (egg) to develop in your ovaries. At about midcycle, the luteinizing hormone cues the egg to burst from the ovary; this is ovulation. Some women experience some pain called mittelschmerz or ovulation pain when this happens. This usually happens at around day 14 of a 28 days menstrual cycle. In the second half of the cycle, the egg begins a journey down one of your two fallopian tubes. Another female hormone, progesterone, thickens the lining of the uterus, preparing it to receive a fertilized egg. The egg survives 12 to 24 hours unless it is fertilized by a sperm while a sperm can survive up to 72 hours once it enters the fallopian tube. If the egg is fertilized, about two to four days later it moves from the fallopian tube into the uterus where it is implanted in the uterine lining, already prepared by the progesterone, and begins its nine month incubation. Estrogen and Progesterone levels increase to keep the pregnancy

Onset of Menstruation:
Menarche is the time when a girl gets her rst period. The average age of menarche in the USA is 12 years old, but anywhere between age 8 and 16 years is normal. Recent studies however set the time of onset earlier by about one year in Caucasian girls and two years in African American girls. Currently, the youngest possible age for normal puberty is 7 years old for Caucasians and 6 years old for African American, down from a previous low of 8 years for both. Evidence is pointing to the increasing incidence of childhood obesity as a major cause of the trend in early menarche onset. Environmental estrogens found in chemicals and pesticides are also suspects.

Length of Menstrual Cycle:

A menstrual cycle is the time from the rst day of one period to the day before the next one. An average menstrual cycle is about 28 days long, but anywhere from 23 to 35 days is normal. It can be irregular for the rst one or two years, usually

February 2007 Midsouth Wellness Guide

Midsouth Wellness Guide

may become anemic(low Iron)from such frequent periods. You may want to discuss options for lengthening your cycles. 5-Oligomenorrhea-This describes very light or infrequent periods. Stress, travel, or just life may cause an occasional missed period. Regularly, going for months without a period, may be a sign of polycystic ovary syndrome (PCOS) or other hormonal problems. 6-Intermensrual bleeding- Bleeding between periods. Some women may notice a few drops of vaginal bleeding or spotting around the time they ovulate. Heavy bleeding or many days of spotting between periods may indicate infection, noncancerous growths called polyps, or other conditions.

Just For Women

Riad Homsi, MD, F.A.C.O.G
Certified Menopause Practitioner A physician just for women of all ages

Treating Periods Problems

The treatment of problems related to your period depends on the cause. Your doctor will most likely give you a pregnancy test and perform a physical exam, a pap smear, blood test, infection check, and may perform an ultrasound. Dont be surprised if your doctor suggests using hormonal birth control methods-oral contraceptive, the patch, vaginal ring, birth control injection, or a hormone containing intrauterine device (IUD)-as treatment, even if you are not sexually active. Even if your periods are normal but you want the convenience of fewer, lighter or no periods at all, you have the option of using hormone birth control methods. Research has shown that it is safe to do so. However, women who are smokers over the age of 35, or women who had a history of stroke, heart disease or blood clot cannot use these hormonal methods.

In Conclusion
Whether welcome or inconvenient, menstruation is part of womens lives. Menstrual cycles vary from woman to woman, and at different times in each womans life. If you have questions about your menstrual cycle, you should discuss them with your doctor.

Specializing in General Obstetrics & Gynecology Services including: Pregnancy Family Planning Infertility Menopause Bladder Problems Bleeding Issues Abnormal Pap Smear Adolescent Gynecology

About The Author

Riad Homsi, M.D., FACO is a board certied Obstetrician/Gynecologist and Menopause Practitioner. He is the director of the practice Just For Women, located at 6025 Walnut Grove , suite 400,Memphis, TN 38120.For more information, please call (901) 50-STORK or visit www.justforwomendoc.com

6025 Walnut Grove, Suite 400 Memphis, TN 38120 901-50-STORK www.justforwomendoc.com

February 2007 Midsouth Wellness Guide