Heavy periods, painful periods, long periods, smelly periods, frequent periods.. These are some menstrual abnormalities that all of us commonly face. Here are reasons as to why they happen and the severity of each.
1. Why is my menstrual flow much heavier than usual?
It’s important to note what is considered “heavier” in terms of menstrual flow here. Normally, women lose about 10 to 35ml of blood per period, which roughly translates to fully soaking through 2 to 7 regular pads per period. Usually, if you are able to soak through 9 to 12 regular-sized products in a period, you would be said to have abnormally heavy flow.
While heavy menstrual flows are still not well understood, it is said that abnormally heavy periods are caused by higher levels of estrogen, coupled with lower levels of progesterone. This hormone pattern is particularly common in teens who have just started getting their periods, or older women who are nearing menopause. Higher levels of estrogen means that the uterine lining has become even thicker than usual, and hence more likely to shed, while lower levels of progesterone means that the lining will not be maintained, and broken down easily, leading to heavier flows.
Abnormally heavy flow can also be attributed to fibroids, which are noncancerous growths on the uterus, and are very common in women. However, if your heavy flow is prolonged, or occurs for multiple periods, then it is best that you visit a medical practitioner to make sure that you don’t experience anaemia, which is caused by excessive blood loss.
2. Why does my period that last longer than seven days?
The main cause of prolonged bleeding is due to excessive blood. Menorrhagia is the medical term for heavy menstrual flows that result in bleeding that lasts longer than 7 days. There are a few causes of menorrhagia.
- Ovary dysfunction: this occurs when your ovaries can’t release an egg, i.e. you are unable to ovulate. It can occur at any time during your productive years, but it is more common for women over the age of 40. When your ovaries don’t release an egg, it means that your body doesn’t produce enough progesterone as it would normally during the menstrual cycle. Like what we mentioned above, lower levels of progesterone means that the uterine lining is broken down easily, causing heavier and longer flows.
- Adenomyosis: sometimes, the endometrial tissue (the tissue that lines the uterus) grows in the muscular walls of the uterus. The displaced endometrial tissue also thickens, breaks down and bleeds like your uterine lining, causing heavier and prolonged flow. This condition may cause severe cramping and sharp pains during menstruation, and it is more likely to occur in middle-aged women who have had children. Blood blots during menstruation and pain during intercourse are also symptoms of adenomyosis.
- Birth control side effects: nonhormal intrauterine devices (IUD) has a well-known side effect of causing menorrhagia. If IUDs are the cause of prolonged bleeding, you may need to stop using it. Hormone-based birth control pills can also change the duration, frequency and flow levels of periods. Switching between types and brands of birth control can also cause this change. Every female body is different, so be sure to discuss birth control pills with your doctor before using any.
- Uterine polyps: these are small benign (noncancerous) growths in the lining of the uterus. Uterine fibroids are tumors that attach to the wall of the uterus. There may be one or several fibroids that range from as small as an apple seed to the size of a grapefruit. These tumors are usually benign, but they may cause heavy bleeding and pain during periods. If the fibroids are large, they might put pressure on the bladder or rectum, causing discomfort.
Excessive and prolonged bleeding may be the secondary effects of other diseases and ailments so always check with your doctor to diagnose the real cause of long-lasting periods. Do not assume your own causes!
3. Why is my period always accompanied by pain, cramping, nausea, or vomiting?
There could be an indication of a serious condition. Nausea is a symptom of endometriosis, a disease where tissue that normally grows inside the uterus grows outside of it. The main symptoms are pelvic pain and infertility, with up to 70% of women affected reporting pain during menstruation, but nausea, diarrhoea, fatigue and headaches are also symptoms of endometriosis.
However, in some women, the change in the levels of hormones can stimulate their stomach to secrete more gastric juice which also contains hydrochloric acids. These hydrochloric acids present in the gastric juice can in turn produce any symptoms from a mild degree of heartburn and nausea, to full blown vomiting.
Specifically for pain, the prostaglandins which are released from the inner wall of the uterus during the menstrual period can lead to painful contractions in the uterus. Following these contractions, the stomach can be aggravated further to secrete more gastric juice which contains hydrochloric acids. This in turn causes a feeling of nausea, as well. – See more here.
4. Why do I bleed or spot between periods?
Abnormal uterine bleeding may apply to a variety of menstrual irregularities, including: a heavier menstrual flow; a period that lasts longer than seven days; or bleeding or spotting between periods, after sex, or after menopause.
Causes that are more serious are polycystic ovary syndrome and infection of the pelvic organs.
- Polycystic Ovary Syndrome (PCOS) is a hormonal imbalance that interferes with normal ovulation, resulting in abnormal bleeding. Most women with PCOS grow small cysts on their ovaries. They are not harmful but lead to the hormonal imbalances. Because it is a hormonal condition, physical changes such as facial hair and acne can also occur, but the reason why it causes bleeding or spotting between periods is because the hormones affect ovulation, which in turn affects bleeding.
- Infection of the pelvic organs, such as the vagina, cervix, uterus, fallopian tubes or ovaries. The infections are commonly caused by sexually transmitted infections (STI), and may cause vaginal bleeding, especially after intercourse or douching. FYI, douching means to wash out the vagina, usually with a mixture of water and vinegar. The mixture usually comes in a bottle or bag and is sprayed with a tube upward into the vagina. Though women who use it claim that it makes them feel cleaner, most of the research done on it has found significant downsides to it, including vaginal infection. So don’t douche!
There can be cases where spotting or bleeding between periods is completely normal, and that’s when you ovulate – when your ovaries release an egg. Since ovulation occurs before your period starts, you might experience spotting between periods. You an find out more about spotting here.
5. Why did my period come more than once a month?
A typical menstrual cycle should last around 28 days, and if you bleed more than once during that cycle, it would be considered to me abnormal. Having a period come more than once is most commonly caused by hormonal imbalances brought about by things like dramatic weight loss (or gain), excessive exercise, and stress. If you are undergoing any of these changes in your life, then more than likely your cycle has been disrupted because of them. Certain medication may also alter your cycle, talk to your doctor about stopping or switching medication if you think this is happening.
However, if you don’t fit any of the above cases, then the cause for your abnormal cycle may be more serious, such as polyps, cysts, fibroids, or tumors (which can be benign or cancerous). STIs can also cause bleeding between periods, which can be mistaken for a period, and should be met with medical treatment. Having a thyroid problem may also cause you to bleed more than once, as thyroid disease can cause a thickening of the uterine lining. Having your period more than once a month can also be a reaction to contraceptive methods, such as the pill, which can result in a change in your cycle.
If you suspect that your lifestyle is not the factor that is causing the frequent periods, then consult your doctor to check if there are other factors that are causing you to have more than one period a month.
6. Why does my discharge have a bad smell?
Vaginal discharge abnormalities usually occur when there is an infection.
- Pelvic inflammatory disease (PID) is an infection of the uterus, fallopian tubes or ovaries. While some people who have PID may not display any symptoms at all, but abnormal vaginal discharge can be one of the symptoms. This is when the vaginal discharge is yellow or green in colour and has an unusual odour.
- Bacterial vaginosis is caused by an imbalance in the growth of bacteria that is normally present in the vagina. This typically produces a discharge that is thin and greyish-white in colour, accompanied by a foul, fishy smell.
- Trichomoniasis is an infection caused by the single-cell parasite, trichomonas vaginalis and is transmitted by sexual contact. This produces a frothy, yellow-green discharge with a strong odour.
- Gonorrhea is due to the bacteria chlamydia trachomatis, and is also transmitted by sexual contact. Infected women may not display symptoms, but abnormal vaginal discharge may occur. This produces a yellow discharge accompanied with redness or swelling of the genitals.
- Yeast infection occurs when there is an overgrowth of yeast in the vagina, and is usually caused by antibiotic use. The candida species of yeast is the most commonly responsible yeast for infection. This usually produces a thick, white vaginal discharge with the texture of cottage cheese.
We aren’t able to cover every single cause of every single abnormality in your period, but if anything feels out of the norm, you should consult a doctor. Don’t put your health at risk!