Menstruation is a fact of life.
Each month from the ages of about 13 to 50 years, a woman will have bleeding from the vagina. Over the centuries mankind has dreamed up a variety of stories to explain this phenomenon.
Perhaps it is because women have periods and have babies, that women are seen as being more early than men, and more in touch with the cosmos.
Why do women menstruate?
Menstruation becomes more understandable if we see it in a purely biological context in terms of its basic purpose.
Image you are expecting a guest in your home. You would certainly lie in stocks of food for the visitor. If, after and interval of time, the visitor failed to arrive, you would throw out the extra stocks and empty the larder.
The period is in essence, the same. Each month, in anticipation of the arrival of a little visitor, the inner lining of the womb becomes thick and juicy. If the woman becomes pregnant and the little visitor arrives, the thick juicy lining inside the womb will “feed” the fertilized of course there will be no conception and no little stranger; and there will be no need for the extra food. The lining therefore breaks down and is expelled from the body through the vagina. As the lining breaks away, blood vessels within the lining are torn and there is also bleeding. This is the period.
The manner in which Nature controls the period is a wonderful piece of natural engineering. Hormones produced in the ovary in response to messages from the pituitary, which is a small gland in the brain, control the process. These hormones cause the inner lining of the womb to grow and mature.
If the level of the hormones decreases, the lining cannot be maintained and it breaks down. The period is thus due to this sequence of events. The hormones make the lining grow thick, the levels of hormones drop and the lining breaks down and comes away; that is the period.
Contrary to what many women believe, the period has absolutely nothing to do with getting rid of poisons or excess blood from the body.
Here then is a phenomenon that plays a central role in the lives of women. Every 28 days, year in and year out, for about 30 years of her life, a woman will menstruate.
The system is finely balanced, and it is not surprising that most women will have problems relating to the periods at some time in their lives. Let us now consider some of them.
Bleeding Too Much
Excessive bleeding at the period may be due a number of factors:
- The uterus may be longer than normal. This may be due to conditions such as fibroids or adenomyosis.
- The inter play of the hormone with each other and their effect on the lining of the womb may be abnormal.
- A foreign body such as an IUCD may be present in the womb.
- The lining of the womb may be healing too slowly after each period (thus following the period to go on too long).
- Abnormality in the blood clotting mechanism may allow excessive bleeding.
- Pregnancy problems:
In the first months of pregnancy, complications can arise which may cause vaginal bleeding. This type of bleeding is not really a period but will be seen as such if the patient or her doctor are unaware that she is in fact pregnant.
Common causes of bleeding in early pregnancy include abortion, tubal pregnancy and molar pregnancies. These all require urgent medical attention.
Too Little Bleeding & Loss Of The Period
When a woman reports that she is not having her periods ‘we immediately think of pregnancy; but there are many other causes for this including:
- Inadequate or inappropriate production of hormones, especially by the ovaries.
- The general health of the patient may be impaired; particularly in regard to factors such as stress and weight loss. Loss of periods is common in young women or girls who have anorexia nervosa.
- The use of certain medicines can interfere with the periods. These include the Pill, contraceptive injections, and tranquilizers.
- The lining of the womb may be unable to respond to the hormones. Infections such as TB can cause this and scarring due to other causes.
Bleeding After Intercourse
Bleeding after intercourse is not really a period. It is an important sign and indicates that there may be a problem in the vagina or neck f the womb. It must be reported to your doctor. There is a variety of causes for such bleeding and the doctor will have to decide the precise cause in each case.
Do not ignore bleeding after intercourse. See your doctor.
How the doctors treat these problems
If you consult a doctor for one of these problem she will first take a careful history to exclude one of the factors mentioned above. A full clinical examination will be made and thereafter special investigations will be undertaken.
The purpose of all this is to determine the cause of the problem prior to starting treatment. There is no place for a “let’s try a bit of this and a bit of that” approach.