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Menstruation

        MENSTRUATION
Women's menstrual cycles are almost as individual as they are — there's a large variation in what is 'normal'. The cycle can take from 24 to 35 days (counting the day you start bleeding as the first day); bleeding can last for between two and seven days; and the amount of blood lost can range from 10ml to 80ml (the average being around 35ml). If blood loss is heavy it can lead to anaemia (iron deficiency).
To familiarise yourself with what is 'normal' for you, it's a good idea to keep a menstrual dairy. Some women are extremely regular, others less so, but once you get a feel for your usual pattern, you can be more alert to 'abnormal' variations.
Heavy periods (also called menorrhagia) may be caused by things like fibroids, pelvic inflammation, hormonal disturbances, tumours, and IUDs, but there may also be no apparent cause (this is known as 'dysfunctional uterine bleeding'). If your periods become much heavier than what's normal for you, you should seek advice from a health practitioner as it may indicate an underlying problem.
Shortages of iron, zinc, Vitamin B6 and Vitamin A have been suggested as causes of excessive bleeding, so supplements may help (but beware of taking large amounts of Vitamin A without supervision). Food intolerance may be a factor for some women, and if you're being treated for candidiasis, your periods may get heavier for a while before settling down again. Make sure you eat plenty of iron-rich foods such as green leafy vegetables and lean meat to counteract the possibility of anaemia. Among the herbs, bayberry, raspberry leaves, golden seal, sage or shepherd's purse may be useful, and supplements of dolomite (calcium and magnesium) taken for a few days before and during the period have been reported as effective.
Period pain (dysmenorrhoea) varies greatly among women. There are two types: primary dysmenorrhoea is related to the uterus actually contracting under the influence of prostaglandins (hormones); secondary dysmenorrhoea tends to extend outside the time when you are actually bleeding and can be caused by problems such as cysts, fibroids, polyps, infections or tumours.
You should investigate the cause if you feel you are experiencing secondary dysmenorrhoea, but there are many self-help treatments that can help relieve the pain. A hot water bottle against the abdomen can be soothing, as can a warm bath or shower. Exercise, especially swimming or yoga may help. Try massaging the uterus directly — pressing into your abdomen just above the pubic hairs; or experiment with acupressure — direct pressure on the Achilles tendon behind your ankle. Eat plenty of fresh fruit and vegetables, vegetable juices, fish and liver. Useful supplements may include magnesium, calcium and potassium; and the herbs crampbark, cimicifuga, chamomile, golden seal and raspberry leaf.
Amenorrhoea — absence of periods — is most commonly the result of pregnancy or breast-feeding. But if this is not the case, you should consult a health practitioner to try and track down the reason. Amenorrhoea can be caused by hormonal imbalances, extreme loss of weight (for example, as a result of a disorder such as anorexia nervosa — see separate entry), or by some drugs used to treat high blood pressure or cancer.
Cessation of menstruation is known as menopause.
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