The menstrual cycle is the time from the first day of a woman’s period to the day before her next period. A woman's menstrual cycle lasts for an average of 28 days. It can be longer or shorter than this. The menstruation, that is period, continues for 3 to 7 days. A woman’s period can change and it does not always have to be a serious problem, but must be checked.

Missed Period

If you are sexually active, missing a period could mean that you are pregnant. The best way to exclude it is by taking a pregnancy test. If you are taking contraceptive pills, you may miss periods. There are several gynaecological problems which are treated with contraceptive pills, such as Polycystic Ovarian Syndrome(PCOS). Taking contraceptive pills for a long time may cause a period to be missed every now and then. Hormonal imbalances result into missed periods and you might want to get some help.

Fews other reasons for missed periods are:

• stress

• sudden weight loss

• intense athletic activity

• eating disorders such as anorexia and bulimia

• breast-feeding

Women nearing menopause can have missed period, as ovulation becomes less regular and there are imbalances in hormone. When period stops before 45 years, or continues even after 55, then you should go to a doctor.

Heavy flows

Some women may notice heavy blood flows and passage of blood clots. Regular excessive blood loss may cause anaemia, which is reduced blood in your body. The following cases cause excessive bleeding during period---

• Fibroid: a non-cancerous growth in the uterus

• Hormonal changes

• Large uterus, following pregnancy

• Obstruction to period blood flow

• Adenomyosis: tissue lining the uterus grows within the uterine muscles

• Endometriosis: tissue lining the uterus is found outside the uterus.

Temporary heavy blood flows may not be a concern but if it becomes regular, you might want to get a professional’s advice.

Menstrual cramps

Cramps are caused by uterus contracting to slough off the fertile layer of the uterus. Menstrual cramps are usually side effects of greater-than-normal uterine muscle contractions. The pain occurring during these contractions can be mild, moderate and severe. Menstrual pain, called dysmenorrhoea, may be primary where there are no underlying disease, or secondary where there is an abnormality. For those crazy menstrual cramps you just have to learn to deal with, try the following:

1. Stick to a healthy diet: Eat plenty of fresh fruit and vegetables and plenty of water. Plenty of fiber is particularly useful in cleansing the body of excess estrogen (which can lead to heavier and more painful periods and cramps). Avoid fatty foods, such as chocolates.

2. Take dietary supplements: Vitamin E, thiamine, calcium, zinc and magnesium.

3. Make sure to have regular health checkups to ensure health: Mention to doctors any menstrual problems you feel you might be having, and take into consideration how anemia makes you feel during menstruation. In addition, menstrual cramps can be caused by an underlying disorder such as endometriosis or fibroids, which need medical attention.

4. Painkillers: Ibuprofen, naproxen and acetaminophen are effective in pain during periods.  If over-the-counter NSAIDs do not help, your doctor may prescribe a prescription NSAID such as mefenamic acid.

5. Take hormonal birth control: Birth control pills contain hormones which prevent ovulation and reduce the severity of menstrual cramps. This is why your doctor may recommend birth control pills for menstrual cramps.

6. Lie in different positions: Laying on your side with your knees tucked into your chest can temporarily reduce the pain. Some people say to lay face down on the bed, with your face in a pillow. Stick your butt up in the air. This will relieve gas and help you feel better. Also try lying on your back, keeping your feet elevated by pillows.

7. Try placing a hot water bottle or heating pad on your abdomen: This helps ease your muscles. A hot wash cloth or even just a warm blanket can also help. This appears to be just as effective as over-the-counter pain killers. Also try a hot water bath.

8. Try to wear clothing that doesn't pressure your abdomen: Wear clothes that are comfortable, warm and help reduce period cramps caused by tight clothing.

9. Engage in stress reduction activities such as yoga, massage and meditation as they may ease the pain of menstrual cramps.

10. Use body's own painkillers: Distract yourself by socializing with good friends, reading a book, playing a computer game, or spending time on facebook. Get mild regular exercise as it increases your overall serotonin levels. Serotonin is the body's own painkiller, and also makes us feel happier.

Bleeding between periods or after sex

Bleeding between periods(intermenstrual bleeding) or bleeding after sex(post-coital bleeding) must be checked by a professional as it can be a sign of infection, abnormalities of the cervix(lower part of the uterus) or, in some cases, cancer. Intermenstrual bleeding or postcoital bleeding can be caused by harmless conditions, such as polyps, or infection, such as chlamydia. Contraceptive pills, when taken in low doses, may cause bleeding between periods.

Whatever the cause is, in such cases getting a check up done is very necessary. Women aged 25 to 49 must get screened for cervical cancer every 3 years and women aged 50 to 64, every 5 years.

Sudden changes

Any change in periods- heavy flow or reduced- get advice, especially if you are above 40 years. For those women below 40, slightly irregular bleeding is not abnormal, particularly those who are new to womanhood. For women over 40, if periods become much heavier, or are lasting longer,  this needs to be investigated. These may be the signs of pre-cancerous conditions which, when detected at early stages, can be treated.

Bleeding after menopause

If you did not have periods for several years, that is have reached menopause and is now bleeding, do not wait to see what happens next month. Immediately consult a gynaecologist, because it may be the sign of some cancerous conditions.

Vaginal Discharge

Vaginal discharge is normal and changes throughout a menstrual cycle. A clear, creamy discharge is normal, particularly during ovulation. When the discharge is greenish, blood-stained or smelly, seeing a doctor is an emergency!

This information is solely for informational purposes. IT IS NOT INTENDED TO PROVIDE MEDICAL ADVICE.