Menstruation is the periodic discharge of blood and mucosal tissue from the inner lining of the uterus through the vagina. Hormones in the body regulate the thickening and shedding of the endometrium wall. Increase in hormones causes the wall to thicken to prepare for fertilisation. If the egg does not get fertilised, the wall sheds (which causes the blood and tissues) to leave the body. This process is called menstruation. Women usually get their first period at 11 - 12 years of age. It signals the start of puberty. During pregnancy, women will not get their periods. Menstruation ceases at around 45 - 55 years of age after menopause. It means that women will no longer be able to bear children. Irregular menstruation is more commonly experienced when girls first get their periods and when women are close to menopause. 

Fellow sisters may think menstruation blood is dirty therefore will try to irrigate or insert pills into the vagina. In fact, menstruation is normal to every woman. What you need to do every month is, to keep you private part clean, change your pads (sanitary napkins) frequently, do not leave tampon inside your body for more than 8 hours and take shower as usual. 

When having your period, you can still work out and it is better for you to stay in a good mood. You should not irrigate the vagina or insert pills into the vagina.

What is menorrhagia (heavy periods)?

Menorrhagia refers to unusually long or heavy menstrual bleeding:

  • More than 7 days (most women’s periods last 2 to 7 days). Similarly, fewer than 2 days is considered abnormally light period. 
  • Having to change pads every 1 to 2 hours even when ultra-long or highly absorbent pads are used.
  • Large blood clots. 
  • Sudden passage of large volume of blood soaking through your underwear and clothing. 
  • Having to change multiple pads at night.
  • Disruptions to work, family and social life due to heavy periods. 
  • Light-headedness, difficulty breathing and fatigue during or after your period.

What’s menstrual pain?

Menstrual pain refers to slight to severe lower abdominal pain prior to and during menstruation.

  • Pain is usually worse when flow is heavier. 
  • It can be accompanied by discomfort in the digestive tract, such as vomiting and loose stool, etc. 

There are two main types of menstrual pain.

Non-disease related menstrual pain
Disease-related menstrual or abdominal pain
  • It occurs frequently in young girls who have just started menstruation. 
  • As you age or experience childbirth, pain will usually diminish or disappear.
  • It can be caused by endometriosis, pelvic inflammatory disease, and the use of intra-uterine device.
  • Lasts 1 – 3 days.
  • Pain does not only arise before or during menstruation. 
  • It can be accompanied by foul-smelling vaginal discharge or fever. 
  • Apart from menstrual and abdominal pain, you may also experience pain during sex. 
  • Warm compression or regular pain medication are adequate in soothing pain.
  • Regular exercises can lessen period pain.
  • Pain medications are unable to suppress the pain. 
  • Appropriate treatment of relevant gynaecological diseases can lessen pain. 

Reminder: If you experience the following symptoms, please seek immediate medical attention!

  • Menstrual pain
  • Menorrhagia
  • Sudden changes to menstrual cycle
  • Menstruation has not started after your 16th birthday
  • Spotting (i.e., bleeding) between periods
  • Vaginal bleeding after sexual intercourse 
  • Vaginal bleeding one year after menopause 
  • Menstrual pain that is new after turning 40 
  • Less than 21 days between two cycles of menstruation 
  • Severe menstrual and abdominal pain
  • Menopause before the age of 45