Menstrual Health: 5 Period Red Flags That Warrant Immediate Attention

Menstrual Health: Women are often unaware of when to consult a gynecologist regarding abnormalities in their menstrual cycles. Having a proper knowledge of what is normal in a period/menstrual cycle will help in contacting the doctor early when they notice changes in their periods.Also Read – Hair Care Tips: Struggling With Frizzy Hair? These effective home remedies can give smooth and shiny hair – see

Dr Geeth MonappaConsultant Obstetrician & Gynecologist at Fortis Hospital, Richmond Road, Bangalore shares 5 red flags you should not ignore. Also Read – What causes sinus headaches and how to treat them

What is a normal period/menstrual cycle?

Bleeding once in 21-35 days is considered normal. So, it’s okay if you don’t have a 28-30 day cycle as long as you bleed once every 21-35 days. Also Read – Hepatitis in children: Here’s what scientists have to say about the cause of the mystery outbreak

• Normal duration of bleeding:

A normal period lasts 2-7 days, the first 2-3 days are heavy with most women changing about 3 pads or emptying the menstrual cup 2-3 times a day. A normal period is often not associated with a clot.

Mild pain during periods that does not incapacitate you or prevent you from doing your normal work or does not require medication is normal.

A very clear sticky discharge noted before your period and around mid-cycle around ovulation is considered normal as long as it is clear, and not associated with itching or odor.

What are the red flags with periods that need immediate attention?

Bleeding that lasts longer than 7 days, or heavy flow that causes the woman to change pads/cups more than usual; Bleeding that is associated with clotting requires immediate evaluation by a gynecologist.

Causes of heavy bleeding can be:

1. Hormonal or endocrine abnormalities
2. Non-cancerous growths in the uterus such as fibroids and adenomyosis
3. infection
4. Cancer of the uterus or cervix

If not treated promptly, heavy bleeding can cause anemia that leads to extreme fatigue, palpitations and heart failure. Early evaluation helps in diagnosing the problem and starting treatment immediately, leading to better outcomes.

• Bleeding between periods / Bleeding during menstruation:

Any bleeding or spotting that occurs after your period is over requires further evaluation.
A woman may experience some spotting/bleeding in the middle of the cycle around the time of ovulation which lasts for a day or 2 which may be normal.

However, the onset and cessation of bleeding between the 2 periods requires immediate evaluation.

• Bleeding after intercourse:

Any bleeding/spotting noted after intercourse is considered abnormal and needs to be looked into to rule out cervical abnormalities and most importantly cervical cancer. Your gynecologist will examine you for changes or abnormal growths in the cervix and do a Pap smear to rule out cervical cancer.

Pain during or around the menstrual cycle that is severe; need medication; A woman unable to perform her usual tasks requires further evaluation. The causes of pain or dysmenorrhea are many; Endometriosis is the most common, especially in women with difficulty conceiving, fibroid uterus, adenomyosis and pelvic infection.

In women older than 40 years, pain during periods with or without other bleeding abnormalities needs to be evaluated to rule out uterine cancer and antecedent causes.

Young girls often experience severe pain during periods despite a normal ultrasound. This is often self-limiting, however, pain relievers will help them continue with their normal activities and studies.

Physical activity/exercise is known to reduce dysmenorrhea (period pain) and is recommended during periods as well as other days of the month.

Any vaginal discharge that is foul-smelling, profuse, itchy, curdled-white, yellow, or green in color requires immediate evaluation to rule out vaginal or uterine infection and cancer.

Women are fortunate to have symptoms such as bleeding abnormalities and abnormal vaginal discharge in the early stages of cervical and uterine cancer. This often leads to earlier diagnosis of these conditions and is associated with better survival.

Hence, it is imperative that these red flags are taken seriously and evaluated as soon as possible!