Healthcare for Her: When Should You Be Concerned About Your Period

Stepping into womanhood brings a unique monthly experience: menstruation. It's a hormonal roller coaster, with highs like increased energy during ovulation and lows like physical and emotional discomfort before your period. This journey is one all women share – a unique cycle we learn to navigate with strength and, perhaps, a little comfort food.

Menstruation is a natural part of the reproductive cycle characterized by the shedding of the uterine lining. This process typically occurs every 21 to 35 days and lasts for about 2 to 7 days.[2] During menstruation, the body undergoes hormonal changes, including fluctuations in estrogen and progesterone levels, which trigger the shedding of the uterine lining. The shedding of the uterine lining is the body's way of preparing for a potential pregnancy, and if conception does not occur, the cycle repeats itself.[3]

Menstruation is a natural and healthy process, yet it can bring discomfort like cramping, bloating, and mood swings.[3] While some discomfort is considered normal, it's essential to discern when these symptoms might indicate a more significant health issue.[2] Our recent interview with Dr. Joan Mangubat, an OB-GYN from Doctor Anywhere, offers valuable insights into this topic.

Menstrual Cycle Irregularities and When to be Concerned

"There are a few key signs to watch for when it comes to menstrual cycle irregularities. The first is changes in the interval between periods. If your cycles are consistently longer than 35 days or shorter than 21 days, it's important to consult a doctor."

Dr. Joan continues, "Another sign is the duration of your period. If your period lasts longer than a week, it's worth getting checked out. Finally, heavy bleeding that soaks through pads or tampons more frequently than usual also warrants a doctor's visit."[1]

It’s important to pay attention to changes in menstrual patterns. Irregularities in cycle length, prolonged bleeding, or increased menstrual flow could signify an underlying health issue and should prompt further investigation.[4]

Painful Periods: Regular Cramps vs. Underlying Issues

During your period, the uterus or muscles in your womb contract to shed its lining. These contractions can sometimes become very strong, squeezing nearby blood vessels and temporarily reducing oxygen flow to your uterus. This lack of oxygen is what causes the pain and cramping you feel.[5]

Differentiating between typical cramps and those indicating a more profound issue can be challenging. Dr. Joan provides insights, "There are telltale signs if there is an underlying problem that needs to be checked. First, if there is a constellation of symptoms present other than the usual menstrual cramps or pain such as painful defecation, dysuria or when you feel pain or a burning sensation when you urinate, dyspareunia or there’s pain during or after sex, and even difficulty breathing in rare cases." She adds, "The severity of the pain is also important. If the pain is so bad that it disrupts your daily activities and work life, it's definitely a cause for concern."[1]

Menstrual cramps can also be caused by a medical condition called endometriosis.[5] Dr. Joan explains endometriosis in simple terms. "Endometriosis is the implantation of the endometrial lining of the uterus outside the uterus. It could grow in the fallopian tubes, ovaries, peritoneum, and even in the lungs. While the exact cause is unknown, genetics are thought to play a role." There is also a theory proposed to explain the development of endometriosis called Sampson’s Theory.[6] “The development of endometriosis is also thought to be caused by the back flow of menstrual blood containing endometrial cells through the fallopian tubes and into the pelvic cavity during periods,” Dr. Joan shares.[1]

She then dives into the potential causes and the key signs to watch out for. Signs of endometriosis may include:

Chronic abdominal and/or pelvic pain
Severe cramps or dysmenorrhea
Painful sex
Heavy periods
Problems using the bathroom, like pain, urgency, or frequent urination or bowel movements
Abnormal uterine bleeding
Lower back pain
Feeling tired all the time
Trouble getting pregnant

The pain can feel dull, throbbing, or sharp and might happen on its own or with other symptoms,” Dr. Joan explains. She continues, “Having more symptoms increases the likelihood of having endometriosis compared to experiencing regular menstrual cramps.”[1]

When to Seek Medical Advice

So, when should you seek medical advice? Dr. Joan advises, "Any progressive worsening of pain or changes in your menstrual flow warrant a consultation. Don't wait if the pain is getting stronger and lasting longer, or if your periods become irregular or heavier. Early diagnosis and treatment of irregular periods and severe pain can help prevent complications like chronic pelvic pain, infertility, and even certain types of cancer."[1]

Your menstrual cycle is a unique part of your health journey. While it's normal to experience some variation in your period from month to month, knowing when these changes might signal a deeper issue is crucial. Talking to a doctor can help you understand your health and get the support you need. Download the free Doctor Anywhere app to access 24/7 video consultations with women’s health general practitioners or to schedule appointments with our diverse range of specialists, including OB-GYNs, all from the comfort of your home. Our video consultations with experienced general practitioners and specialists offer a secure and confidential environment for guidance and support. Simply open and use the DA app to start video consultations.

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