Bloody chronicles- What you should know about periods

I remember the times from when I was a child and the extended family used to gather at the ancestral home for festivals like Diwali or Ganpati. Sometimes, an older cousin, an aunt, would be made to sit separately from the rest. She wouldn't be allowed remotely near the Gods, or places of worship. She would have food in a separate plate, wash her clothes separately.

As an inquisitive child, I hadn't understood why, and kept asking the adults for answers. They had just brushed me off by saying 'She's touched a crow!' Now that, was even harder for me to fathom! Who was this pesky crow who managed to touch some woman time and again, and why didn't it ever touch me or my brother?

Finally, my mother sat me down and explained about periods. I took a while to digest the information, but once I did, the irrationality of the whole ‘touch-me-not’ game infuriated me!

Having been brought up by my mom, an extremely level- headed, open- minded iron lady, it definitely seemed illogical to ostracize a woman for a few days every month, call her ‘impure’, and make an issue about something that was as natural a process as breathing or sleeping!

However, periods, even till date, are fraught with several myths and beliefs which have been handed over from generation to generation, just because nobody has bothered to ask ‘why’, or ‘how’! Buying a pack of sanitary napkins from a shopkeeper is akin to asking for a pound of cocaine! The shopkeeper shifts uncomfortably, wraps it in a newspaper, double wraps it in a black plastic bag and then hands it over to you, discreetly (so he thinks), while the guy next to you who’s there to buy a Paracetamol ogles at the pack in your hand as if you are indeed, carrying a bomb!

When will we grow up? It is time we started dealing like adults, with the taboos in our mind, and treating periods and women who are on them, as normally as anyone else!

The first step to that would be to educate ourselves with the right information about this phenomenon and thus dispel myths surrounding it!

Why do women get periods?

Periods are a result of the endometrium, or the lining of the uterus, being shed off. Every month, under the influence of the female hormones estrogen and progesterone, the uterine lining is built up. It thickens, and gets ready to implant a baby, in case pregnancy does occur. However, if there is no conception, the built up endometrium sheds off as menstruation. Menstruation marks the beginning of the next cycle.

How long does a normal period last? When should I be worried about the frequency, cyclicity and flow of my periods?

The average length of a cycle is between 21- 35 days. The flow may last for around 3-5 days on an average, but a few women may have very short cycles or may bleed for upto 7- 8 days as well. A few days, more commonly the second or the third day, have a heavier flow, and women may need to change upto 3- 4 pads on an average.

You need to consult a gynaecologist if you get your periods too frequently, say once in 15 days, or you don’t get them at all for 2- 3 months. You also need to get checked if your flow is very heavy, with passage of big clots.

An occasional cycle may be different from your usual pattern due to stress or other factors, however, you need to ask an expert if you experience a sudden persistent change in the cyclical pattern.

What could a missed period signify?

The most common cause of a missed period is pregnancy.

However, certain other causes such as hormonal imbalance, either in the female sex hormones or others like the thyroid hormone or Prolactin may cause periods to get prolonged. A commonly experienced lifestyle- related condition is Polycystic Ovarian Syndrome or PCOS, one of the symptoms of which is delayed or absent menses. Some hormone- secreting cysts in the ovaries may sometimes be a cause for missed periods.

In the present day scenario, diminishing ovarian reserve and premature menopause afflicting young women is also a concern that needs to be addressed.

What are the healthy practices I should follow during my periods?

During your periods, it is important that you stay adequately hydrated. Drink atleast 3-4 litres of liquids. Ensure you change your pads once in every 3- 4 hours, even if they are not completely soaked, to avoid infections. Wear loose cotton clothing to avoid perspiration and fungal infections around your groin. Ensure you change your undergarments twice a day. In case you are using tampons or menstrual cups, ensure hygiene while inserting and removing them, and do not keep them in for too long. A healthy diet with fresh fruits and vegetables is always advisable, since it provides your body with free radicals. Exercise of any form is allowed, however, if you feel too tired, avoid over- exertion. There are no ‘donts’- travel, routine work, exercise, your usual diet is all permissible.

As socially responsible adults, there is also another practice that we should follow. While disposing off sanitary waste, ensure it is wrapped properly and discarded in the proper bin. A few institutions also provide sanitary pad disposal bags at a nominal cost. The workers who handle garbage sometimes literally have ‘blood on their hands’ for no fault of their own! We owe this to them!

The author is a Gynaecologist and Infertility Specialist who practices in Pune.