“PMS is super common, affecting around 48 per cent of women,” says GP Dr Ginni Mansberg. The jury is out on what exactly causes PMS (besides long queues and Nicholas Sparks novels) but risk factors include stress, smoking, and weight: women with a body mass index (BMI) of 30 or higher are three times more likely to suffer PMS.
“If your PMS is so extreme that you can’t function while it’s happening, you need help.” You could be experiencing premenstrual dysphoric disorder (PMDD), PMS’ much more alarming cousin, which strikes three to eight per cent of women. PMDD can prevent women from going to work, it can impact relationships, and in severe cases, PMDD can lead to suicidal thoughts. “Talk to your doctor about medications or other interventions,” urges Dr Mansberg.
“A normal period produces between 10 and 60ml per cycle,” explains Dr Mansberg. Heavy menstrual bleeding, a.k.a. menorrhagia, is defined as blood loss greater than 80ml – equal to 1/3 of a cup. “If you’re leaking through, passing clots [greater than a 50-cent piece], or bleeding onto your sheets through the night, chances are your blood loss is too heavy.
Sadly, one in five women between the ages of 35 and 49 have heavy periods, and 75 percent of them don’t seek medical help – often because they don’t realise it’s a problem,” says Dr Mansberg. “Apart from losing precious blood and risking anaemia, this excess bleeding might be a sign of a medical problem.” Think: polyps, fibroids, an underactive thyroid gland, or even endometrial cancer. See your doctor if you’re concerned or visit Wear White Again.
Normal periods can be anywhere from 27 to 34 days apart, says Dr Mansberg. “But once you start having periods every six or seven weeks, you need to check in with a doctor, who will examine you and order blood tests to look for common causes such as polycystic ovaries.”
Put simply, this is where 12 or more follicles are visible on one ovary, or the size of one or both ovaries has increased – which, when combined with high levels of male hormones and irregular periods, can be diagnosed as polycystic ovarian syndrome (PCOS). And PCOS, in turn, can lead to difficulty falling pregnant.
“Menstrual blood can smell weird but shouldn’t smell foul,” says Dr Mansberg. What you could be sniffing is, in fact, a urine infection – as foul smells usually come from bacteria, explains Dr Mansberg. “You might only notice it when you go to the toilet, and assume it’s connected to the period… Just because it doesn’t sting or hurt, doesn’t rule out a bladder infection.”
Another, more indelicate, cause of odour could be a forgotten tampon. If you’re also experiencing an unusual discharge, a temperature of 40 degrees or higher; itching, pain, swelling or a rash around the vaginal area, don’t attempt to remove it yourself but seek medical help.
Cramping that lasts for the first one or two days of your period, and can be alleviated with painkillers or the contraceptive pill, is considered normal. But if the pain has you confined to bed – or if it starts one or two days before the bleeding – then speak up.
The culprit could be endometriosis, where the cells that form the lining of the uterus grow outside the uterus. Endometriosis is best diagnosed with a laparoscopy: a thin tube (telescope) with a light is inserted through a small incision in the belly button, so gynaecologists can see if endometrial tissue is in the pelvis. If lifestyle changes (exercise, sleep, stress management) and pain meds don’t help, doctors may prescribe hormone therapy (contraceptive pill, synthetic hormones) or perform surgery to remove the tissue and repair any damage.
Brown isn’t bad
“Many of my patients worry about periods changing colour – especially when blood turns brown,” explains Dr Mansberg. But blood contains iron, which turns brown when exposed to oxygen. “This is why older blood is brown while fresh blood is bright red. Any period bleeding that is very light will be brown because the lack of volume means the flow slows, giving it time to oxidise.”
Don't suffer in silence because of heavy periods. Head to wearwhiteagain.com.au to find out how you can have the confidence to wear white again. If you experience heavy periods, we want you to know that you are not alone.