Manage periods and understand endometriosis
Periods are a fact of a woman’s life. They should not interfere with your daily activities.
- combat period pain and diagnose endometriosis
- moderate heavy menstrual loss
- understand ovulation and fertility
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Dr Morton's Test Kit© for anaemia
Don't allow problematic periods to spoil your life
A period is the bleeding that accompanies the shedding of the uterine lining when it realises through a hormonal message from the ovaries that a woman's egg has not been fertilised.
The length of a menstrual cycle varies in different women and in different species of mammal.
Sometimes periods are unhealthily and unacceptably heavy and painful. Different women have different period problems at different phases of their lives.
Symptoms
- having to change protection during the night
- period pain that keeps you awake or wakes you up
- period pain that stops you being able to work
- bleeding in between periods
- bleeding after sex
- bleeding after menopause
- infrequent periods
- periods stopping altogether before the age of 45
Dealing with heavy periods can be challenging. For many women the contraceptive pill allows them to take charge of their periods and reduces their symptoms dramatically.
Over-the-counter pain killers such as paracetamol and ibuprofen can help. If your pain is more severe then medicines containing codeine may be more effective for short-term relief.
For women who have completed their family and who do not need contraception, an endometrial ablation may be the answer.
When to contact a doctor
If over-the-counter medicines prove ineffective, our doctors may be able to prescribe mefenamic acid which is good for painful periods and reducing heaviness (by up to 30%) and tranexamic acid which can reduce bleeding by up to 80%. This is a prescription that only a doctor can issue. We can arrange for it to be dispensed and delivered to your door. You will be asked a number of questions to determine if it is suitable for you before we can do so. Another alternative is a progesterone (hormonal) medicine which can be used to stop bleeding or to prevent a period when it would be inconvenient. It should stop bleeding within 24 hours and can be used to prevent a period coming as long as it is taken one week before the period is due. The next bleed will start 48 hours after stopping the tablets.
Some contraceptive measures such as the progesterone only pill (POP), 3-monthly hormone injections, the hormone implant (LARC) implant and certain types of contraceptive coil, can stop the periods all together, completely reversibly.
The most important thing is to be sure that the symptoms are within the range of normal and they are not a symptom of a bigger problem. It is also important to check that heavy bleeding has not caused anaemia. Occasionally periods become heavy because the thyroid gland has become underactive so this may require checking. You can visit your local GP and ask for either of these tests but if you want to find out in confidence for yourself first then you may want to purchase
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Understand endometriosis
Endometriosis is a condition where some uterine-lining cells (endometrium) are found in other places, particularly in the pelvic area and on the ovaries. Every time there is a visible period there is bleeding from the endometriosis which is responding to the cyclical hormones in exactly the same way as the endometrium in the uterus. This causes periods to be very painful (called dysmenorrhea) but does not affect the heaviness or pattern of bleeding. It typically develops in women in their 30s who have not had children. Endometriosis can make it harder to get pregnant, which is ironic as pregnancy and breast feeding, which stop menstruation, is the best treatment.
Adenomyosis is a variety of endometriosis where endometrial cells are in the wall of the uterus, so during a period there is bleeding in-between the muscle fibres of the uterine wall. This is intensely painful. A certain type of coil can be very helpful, but is contraceptive so inappropriate for women who are trying to conceive. Endometriosis causes sex to be painful and can make it painful to open your bowels during a period.
Trying to get pregnant
Pregnancies are 'dated' from the first day of the last menstrual period (LMP) even though there is no actual pregnancy in the first two weeks or so. This is because many domestic mammals such as dogs are fertile when they are 'on heat' and bleeding and historically it was assumed that it was the same in humans. We now know that this is not the case but it is nevertheless helpful to know this date if you are trying to get pregnant and want to know when you are due to ovulate.
Ovulation is heralded by a change in cervical mucus as it becomes more watery to allow sperm to swim through. This produces a discharge that looks like the egg-white when you crack an egg and you can't get the last drips of white to fall from the shell into the bowl. It may be lightly tinged with blood.
If you are trying to get pregnant you should have sex on alternate days before, on and after your calculated ovulation day.
Ovulation calculator
Timing of ovulation is calculated by subtracting 14 from the length of the menstrual cycle as follows:
1. Calculate the average length of your menstrual cycle. Your menstrual cycle length is the number of days from the first day of one period to the first day of the next. It is normally 28 days, but yours may be different - so for improved accuracy track it for 3 months to find out first.
2. Record the first day of your last period. Enter this information below and we will help you calculate your next ovulation dates by working out when your next period is due and subtracting 14 days.
| Example: | Menstrual Cycle = 28 days | Ovulation day = 28 - 14 = Day 14 |
| or... | Menstrual cycle = 31 days | Ovulation day = 31 - 14 = Day 17 |
With Dr Morton's - the medical helpline© you can contact our doctors at any time for more information, reassurance or advice.