Menstration
Women's Health Care of New England • August 1, 2019
The menstrual cycle is a normal monthly cycle, occurring in women during their reproductive years, in which the lining of the uterus builds up to support a fertilized egg. If no pregnancy occurs, this extra lining separates, passes through the cervix, and is “your period.”
Day one of your menstrual cycle is the first day of your period, and women’s menstrual cycles can range from 21 days to over 35 days. As a woman approaches menopause, the time between periods gradually gets longer.
WHEN TO CALL YOUR OB GYN PROVIDER:
- Your period has stopped for 3 months or longer
- Periods less than 21 days apart or more than 45 days apart
- Severe abdominal or pelvic pain occurs during menstruation or sexual intercourse
- Menstruation has not started by the age of 16
- Menstrual bleeding is excessive (more than one pad or tampon per hour for several hours)
- Menstrual periods lasting longer than 7 days
- Bleeding or spotting between periods
- Fever, vomiting, or weakness occurs after using tampons
- PMS symptoms that are disrupting your life, or cause you to feel out of control
NORMAL MENSTRUAL BLEEDING
Periods usually last about 5 days. Some women have shorter periods and others have them longer. Heavy bleeding often is accompanied by clots and cramping.
The average blood loss from menses is a juice glass amount of blood, approximately 4 ounces or 8 tablespoons. It may be normal for some women to experience heavier bleeding, up to twice the “average” amount and still be within the normal range. Most sanitary products are saturated with 2 tablespoons (1oz.) of fluid.
Many women experience one “heavy” day during their period, but this is preceded and followed by lighter flow days. If at any time, you are experiencing consistent heavy bleeding, clots, cramping, and regularly soaking your sanitary protection once or twice an hour, you should contact your physician.
CRAMPS (DYSMENORRHEA)
To some degree, most women experience menstrual cramping in the lower abdomen, lower back, thighs, and hip areas. The pain does not dominate more on one side and the severity of symptoms varies between individuals. 1 in 10 women do experience severe cramping associated with diarrhea, nausea, vomiting, weakness, and headache.
Cramps come from contractions of the uterus, which is a smooth muscle. Menstrual cramps arise from the action of prostaglandin, a hormone on the smooth muscle of the uterus. Prostaglandin is abundant in the uterine muscle and increase in amount just before menses. These chemicals stimulate the uterus to contract, or cramp. As menstrual flow continues, the prostaglandin is released with the discharge. It tends to be that high flow days are crampiest, and then this subsides as the flow lightens.
RELIEF MEASURES FOR MENSTRUAL CRAMPS
Apply heat, either with heating pads against the lower abdomen or a weighty and warm hot water bottle against the crampy area.
Rest either with bent knees curled toward the belly, or supported beneath the knees with 1 or 2 pillows.
Analgesics, over the counter medication can be very helpful, but it is most beneficial if taken before the cramping symptoms increase.
Ibuprofen, along with other non-steroidal anti-inflammatory medications, has an action that decreases prostaglandin activity and relieves symptoms. There are cautions relating to its potential to be harsh on sensitive stomachs – so read the label of these products thoroughly and consult with your physician when necessary. Acetaminophen is another over the counter medication that has analgesic effects and may help to relieve symptoms.
Prescriptions for oral contraceptives have been shown to decrease cramping. Your health care provider can advise the best option for your specific needs.
Our WHCNE family is growing. Can’t wait to meet our newest members. Congratulations to the two Mamas-To-Be, Amanda and Dr. Plaisimond!
Happy St. Patrick’s Day from the WHCNE family! Wishing you a joyful and festive St. Patrick’s Day! At Women’s Health Care of New England, we celebrate the spirit of community and care. Our dedicated team is here to support you with quality, compassionate healthcare. Enjoy the day in good health and happiness!
Fairfield County's Top Doctors 2022
We are honored that five of our doctors were awarded TOP DOCTOR in 2021 in Obstetrics & Gynecology by Fairfield Living, Greenwich, New Canaan-Darien, Westport, and Stamford Magazines. Each year Moffly Media selects doctors using criteria provided by the physician-led experts at Castle Connolly, a medical data research firm.
It is always remarkable when a member of our staff is recognized for outstanding performance and excellent patient reviews. We are proud Dr. Hedayatzadeh has been on our team of top-notch doctors and clinicians since 2009.
Women’s Healthcare of New England is seeing patients and actively screening each patient to ensure they do not expose our office or patient community to any illness. If you have a medical emergency, please do not show up at our office or at the hospital, but instead call ahead and find out the recommended course of action. Following appropriate guidelines and practicing proper technique will benefit both patients and clinicians and better prevent the further spread of the COVID-19 virus. The most important thing to do is to remain calm and think clearly. Key guidelines to stay safe: • Wear a mask • Limit your interactions, and keep a 6 foot distance from others. • Wash your hands (for at least 20 seconds) often throughout the day • Don’t touch your face • Keep surfaces clean These steps will help to reduce the spread of the virus and hopefully prevent further exposure in uninfected individuals. On a larger scale, the government’s response to the coronavirus (COVID-19) outbreak is constantly evolving, we recommend that you stay up-to-date on information from verified sources. Learn more online from the Centers for Disease Control and Prevention (CDC) https://www.cdc.gov/coronavirus/2019-ncov/index.html State of Connecticut https://portal.ct.gov/Coronavirus. By phone, you may contact 1-800-CDC-INFO, call 2-1-1, or text “CTCOVID” to 898211 for more information. To receive updates about the virus and how the government is responding to it, you may subscribe to the CDC’s Subscription Service https://www.cdc.gov/Other/emailupdates/.
NovaSure is a quick, safe, and simple procedure to lighten or stop your periods, without the side effects of hormones or the risks of hysterectomy. NovaSure Endometrial Ablation is a one-time, 5-minute procedure that gently removes the lining of the uterus. The NovaSure procedure can reduce or stop bleeding altogether. About one third of all patients who undergo the procedure achieve complete amenorrhea, while the other two thirds most often experience a lessening or lighter flow. The procedure is done in the office with little to no anesthesia. The NovaSure probe is inserted into the uterus and a gentle radio frequency is applied. This radio frequency removed the lining of the uterus and it takes about 5 minutes to do. Immediately after the NovaSure procedure, some women may experience some cramping, mild pain, nausea, and/or vomiting. Most women feel back to themselves and can resume normal activities within a day or so. A watery or bloody discharge following the NovaSure Endometrial Ablation procedure is normal. In a clinical study, 12 months after the NovaSure procedure 95% of patients were satisfied with the results and 97% said they would recommend NovaSure to a friend.
GOOD NEWS With early detection screening, you can lead a wonderfully full life without necessarily, the need for a mastectomy ONE SIMPLE GUIDELINE Everyone should start annual screening mammograms at age 40 regardless of risk factors and family history. Connecticut Law States "If your mammogram demonstrates that you have dense breast tissue, which could hide small abnormalities, you might benefit from supplementary tests, which can include a breast ultrasound screening or a breast MRI examination, or both, depending on your individual risk factors." (Senate Bill 458) At Women's Health Care of New England, every mammogram requisition gets marked "Follow with breast ultrasound for dense breasts or other masses". Yearly breast imaging is not just for you, it's for your whole family. Jay Ugol, MD Staff Member at Women’s Health Care of New England Fellow of The American College of OB/GYN
Types There are several different types of incontinence. The two most common in women are stress incontinence and urge incontinence. Stress urinary incontinence is the loss of urine when a women coughs, sneezes, laughs or exercises. It is caused by a weakening of the tissues that support the bladder or the muscles of the urethra. Urge incontinence is the leakage of urine caused by overactive bladder muscles that contract too often or problems with the nerves that send signals to the bladder. People with a combination of both stress and urge incontinence are said to have mixed incontinence. In addition to leaking, some women may experience urinary urgency, frequency, pain or increased voiding during hours of sleep. Causes Incontinence may be caused by a variety of different factors such as urinary tract infections; medications; bladder growths; fistula formation; pelvic support problems or neuromuscular problems. Diagnosis Incontinence can be diagnosed by several methods. You may start by discussing your symptoms with your provider and undergo a pelvic exam in the office. Your physician may ask you to keep a voiding diary for a few days and to return for urodynamic testing. Urodynamic testing is an office procedure in which the bladder is filled through a catheter to see how much urine your bladder can hold and what makes you leak. Treatment There are many options for treatment such as lifestyle changes, bladder training, physical therapy, a vaginal pessary, medications and surgery. Some of the lifestyles changes that may help include weight loss, avoiding constipation, limiting caffeine and alcohol and smoking cessation. Bladder training can help you learn to go to the bathroom less frequently by retraining you bladder to hold more urine. The goal is to increase the time between voiding to a normal interval, every 3-4 hours. Kegel exercises tone your pelvic muscles. They can be done at home or with a physical therapist using a technique called biofeedback. A pessary is a silicone devise that can be placed in the vagina to help pelvic support. Your provider and fit you for the appropriate size and shape. There are several medications that help control unwanted bladder contractions associated with urge incontinence. Your provider can help you decide which medication would work best for you. Surgical options are also available and offer the highest cure rate for stress incontinence. Often treatments are most effective when used in combination. Summary Although leaking urine can be difficult to talk about, it is not normal at any age and is often treatable with simple measures. Talking about it with your healthcare provider is the first step in getting help for this problem that is affecting your lifestyle.
Cervical cancer screening is used to find changes in the cells of the cervix that could lead to cancer. Screening includes the Pap test and, for some women, testing for human papillomavirus (HPV). Cervical cancer screening is important because it usually takes three to seven years for high-grade cervical changes to become cancer. Regular screening gives patients and ob-gyns time to find cervical cell changes and discuss possible treatment before the cell changes become cancer. For guidelines on when and how often to screen, read the Cervical Cancer Screening FAQ .
