Menstruation FAQs

While menstruation is generally defined as occurring over a regular 28-day cycle, the truth is that it differs -  within parameters - for every woman.  Here are some of the most frequently-asked questions about period pain, spotting, heavy flows and contraception.

Q:  Spotting before period

For the last few months, I've been spotting around 3 to 4 days before my period starts. It's brown and I get stomach cramps with it. Then the cramps get REALLY bad when my period does start - pain medication doesn't help and I have to take a day off work.

My doctor suspects I have endometriosis. Would that be the cause of the spotting? I'm very concerned as my husband and I want to start trying for a baby. I'm 29 now, so I'm scared we won't be able to get pregnant

A:  Endometriosis is a certainly a possibility, but the symptoms you're experiencing could also be caused by a uterine polyp. It's important that you see a gynaecologist for a confirmed diagnosis and whatever treatment is required.

Q:  Mirena and periods

I had my mirena removed on the 3rd Feb. I bled a little when it was removed, but this stopped by about the 6th or 7th. I am now anxiously awaiting my period. Any idea on how long it should take to appear? When should I get concerned about it not appearing? I had no periods whatsoever on the mirena - and that has been for the last 8 years.  I have done a HPT - but that is negative.

A:  As the Mirena thins the womb lining, it could take a few months for this to regenerate and for you to have regular period cycle.

Q:  Still menstruating

I will be 54 years on my next birthday this year, and I am still having my periods - not heavy ones, sometimes it is just a show.  Is this something I should see a gynae about or should I not worry?

A:  You should definitely be having yearly gynae check-ups at this age.

Q:  Irregular bleeding

I am on Nordette and have been for 5 years. I finished my period a week and a half ago. Yesterday I started light spotting (it wasn't even necessary for a sanitary pad) and I didn't worry too much.

Today I am bleeding like I have my period again and now I'm worried. I haven't missed any pills, or done anything out of the ordinary, so this is inexplicable. What could it be? I'm getting married in 2 and a half month's time, and my mother says that it could be because I'm under stress with the plans and my hormones could just be out of whack.

A:  This could vey possibly be due to stress. If this is the first time it's happened, I would suggest you do nothing and see if it recurs next month.

Q:  Bleeding while breastfeeding

My youngest child is now 5 months old and my period has just returned, even though I am breastfeeding exclusively. I am VERY disappointed as previously my period only started after I weaned my first 2 babies at 13 and 7 months respectively. The only thing that's different is that I gained some weight? What else could be the cause?

A:  This is not cause for concern as it can vary from woman to woman, and even from child to child.  Make sure to bring it up with your gynae on your routine follow-up visit if you are still concerned.

Q:  Cycle length

I find that my cycles each month differ. One month I am 28 days, then 31 days, and then 27 days and 31 days again. What could be the reason? This confuses me, and I'm battling to calculate my ovulation date. Is this normal?

A:  This is normal. Many people have a variation in cycle of 3-4 days. You will have to take an average for ovulation of Day 13-17.

Q:  Period after D & C

It has been 5 weeks since I had a D & C after a miscarriage. The pregnancy ended at about 7 weeks, and my hcg level at the time of the procedure was about 24000. When can I expect my period again? Should I be concerned or just wait longer?

A:  It can take up to 8 weeks for your cycle to return to normal.

Q:  Unending menstrual flow

I'm 38 years and I've had a problem with my menstrual cycle since January. My cycle normally runs at about the middle of every month but only last month did it start earlier than that. It started on the 4th very lightly and skipping days, then at mid month it normalised and took the normal 3 days. After the 3 days it subsided until I had intercourse and it went away. I started spotting again until on the 1st of February when it normalised again. Right now it is subsiding like I am finishing but I am not sure it will stop completely. This is all happening with no feelings of pain, just blood flow.

During last month I went to see my Dr and I told her about the problem and she attributed it to hormonal causes. I just want to find out from you if there could be a different explanation to this. I am an active person (I run every day and do some body stretches before I go to work). I am also very careful what I eat. In general I am very healthy, I am not on any chronic medication either.

A:  You don't say whether your doctor did an internal examination and pap smear. It would be important to have these done as problems with the uterus, cervix or ovaries can cause abnormal bleeding, as well as peri-menopause or other hormonal causes.

Q:  Cycle is confusing me

Please help. Every month I have my period 5 days earlier than the previous month. This month I started 10 days earlier, do I need to be concerned?

A:  Having a period 5 days earlier each month means your cycle is about 26 days. This is normal. As this is the first time your period has been 10 days earlier, watch and see if it happens again.

Read more:

For more information, visit the Menstruation Centre, and send your questions to GynaeDoc

(Joanne Hart, Health24, February 2011)

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