When your monthly friend starts acting up, it says something about the state of your health and fertility…

Eeeek, your period is here again! Admit it ladies, we never look forward to Aunt Flo’s visits because they aren’t just super-inconvenient, it’s a messy business. What about when she starts dropping hints of her impending arrival in the form of cramps, bloating, heavy flow, mood swings and backache. *shudder*

While we may not enjoy having our periods, most of the time we are secretly happy when they arrive. In addition to letting you know whether you’re preggers, the flow, frequency, quantity and duration of your menses clues you in on other health issues, especially your fertility.

While what’s normal for one woman might not be normal for another, here are six period symptoms to look out for. These may signal that all may not be well with your reproductive system.

Symptom #1: Irregular periods
WHAT IS NORMAL? “The average menstrual cycle is between 28 and 30 days. Up to one week difference, between 25 and 32 days is still considered normal,” notes SmartParents expert Dr Christopher Chong, an obstetrician-gynaecologist.
WHAT IS NOT? You may need to follow up with your doctor if your cycle is out of this range. Skipping a period now and then is usually a sign that something else in your life may be off, too. According to Dr Chong, your body may be delaying ovulation as a response to stress, illness, intense physical exercise ― especially in the case of marathoners ― sudden weight gain or loss, eating disorders or severe depression. If you are skipping periods month after month, it may be an indication of a deeper problem, usually related to an imbalance in your hormones. Speak with your doctor and ask to have your thyroid hormone or prolactin hormone levels checked. One of the most common hormonal conditions is polycystic ovary syndrome (PCOS). This condition, which affects 1 in 10 Singaporean women, stops your body from ovulating and contributes to weight gain and infertility.

“A regular period should last four to seven days… If it’s too short it’s not ideal for conception to take place”

Symptom #2: Short, long or periods that happen too close together
WHAT IS NORMAL? “A regular period should last four to seven days,” notes Dr Chong. And your luteal phase ― the length between ovulation and your menstrual period ― should be between 14 and 16 days, give or take a few days. “If it’s too short, it’s not ideal for conception to take place,” adds Dr Chong.
WHAT IS NOT? According to Dr Chong, shorter, lighter periods may be due to immature eggs as a result of a hormonal imbalance and this is often linked to fertility issues. It could also be due to stress. Ask for help to manage your stress and your flow should return to normal. “When periods are too close together, there’s a worry about growths and cancer. If they are too far apart, the lining of the womb may thicken, and if left untreated, then cells may swell and these swollen cells may lead on to abnormal cells changes, including cancer,” he adds.

Symptom #3: Very heavy periods
“Heavy bleeding should only occur for the first two day,” notes Dr Chong.
WHAT IS NOT? If you’re soaking through your pads for more than two days, especially in the middle of the night, make an appointment with your gynae for a pelvic scan to check for uterine fibroids or ovarian cysts. Another reason for heavy periods could be an enlarged womb due to adenomyosis ― a condition in which the inner lining of the uterus breaks through the muscle wall of the uterus. Sometimes, heavy bleeding can also be a sign of early menopause. “Or the lining of your womb may be thicker than 1cm, which needs further management and monitoring, and sometimes even dilatation and curretage (D&C) to get the lining cells for examination,” adds Dr Chong. Heavy periods can also lead to the iron-deficiency condition anaemia, which can trigger round-the-clock, month-long fatigue, fogginess and mood swings. So, speak to your doctor and supplement with iron-rich foods and medication.


Symptom #4: Debilitating period symptoms

WHAT IS NORMAL?Breast tenderness, abdominal bloating, slight cramps, water retention and mood changes are common symptoms you have your period,” notes Dry Chong.
WHAT IS NOT? “Anything which affects your normal life and ability to function. Or when it’s so bad you need to see a doctor is abnormal,” explains Dr Chong. Intense period cramps ― those that render you bedridden and require you to call in sick ― can be a sign of fibroid growths, an infection, or the worst case scenario, endometriosis. This condition is caused by the endometrial tissues (cells from the lining of the womb) “spilling” over to other parts of the reproductive organs, such as the ovaries, back of the womb and fallopian tubes. Endometriosis is a major cause of infertility in women, but with early detection, surgery and the proper medication, it can be managed and conceiving is still possible.

“Spotting in between periods is also a sign that your luteal phase ― the time period between ovulation and your menstrual period ― is not ideal.”

Symptom #5: Spotting between periods
WHAT IS NORMAL? “Ideally you should not spot, but sometimes, one to two days of spotting is not an issue,” says Dr Chong.
WHAT IS NOT? Anything longer than two days of spotting or when your entire period is a series of spotting is not normal. Bleeding between your periods is a noticeable sign of uterine cancer or abnormal cell changes. This is usually accompanied by painful sex. “Another common reason is a polyp (benign) growth in the lining of the womb or an infection in the lining,” adds Dr Chong. If you’ve noticed any or all of the symptoms, speak to your doctor at once. “Spotting in between periods is also a sign that your luteal phase is not ideal,” warns Dr Chong. If spotting is shortening your luteal phase, your ovulation timing may not be so accurate for conception, and you may need help in the form of hormonal support or ovulatory pills.

Symptom #6: Non-existent periods
WHAT IS NORMAL? Periods that come regularly every month.
WHAT IS NOT? Unless you’re on a type of birth control that suppresses ovulation which also stops your periods, Aunt Flo going MIA is not good news. Common reasons for a cessation in your monthly flow ranges from excessive exercising, to an eating disorder such as anorexia or bulimia. In all these cases, your body goes into rescue mode to preserve energy and shuts down what it deems unnecessary for survival ― the first one being your reproductive cycle. “Sometimes, your period may stop after an abortion or D&C as well,” Dr Chong notes. “The cleaning of the womb can cause severe scarring of the womb lining, leaving it with no areas to bleed.” If you notice a gradual drop in your menses, and it’s coming further and further apart and finally disappearing, it could also be a sign of menopause.

Photos: iStock

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