Every 28 days or so – the "Menstrual cycle" – the lining of the womb prepares itself to receive a fertilized ovum. If this is not fertilized, the womb lining is shed and this causes the bleeding of the period ("Menstruation").

ARE HEAVY PERIODS NORMAL?

The duration of a cycle and the amount of blood lost vary a lot from one woman to another. Periods of up to 7 days are normal for some women. What is more important is the changing pattern of the blood lost during your periods.

WHEN SHOULD ONE SEE THE GYNAECOLOGIST?

You will need medical advice if your periods are longer, or bleeding gets heavier month by month – so if you find you need more pads, you may be having "Menorrhagia". This is not a disease, just a medical term for abnormally heavy (but regular) periods. You should also see your Gynaecologist if your periods are heavy and irregular or if your periods have started occurring at shorter intervals. If you have bleeding in between periods or following intercourse, you must see your Gynaecologist straight away.

WHAT CAUSES HEAVY PERIODS?

The cause is likely to be an alteration in the balance of the female sex hormones, which control the cycle of changes in the womb. The hormone balance is delicate and complicated and is known to go out of balance by either ill health or personal worries. Hormonal axis

There are many other organic causes of heavy periods, which your Gynaecologist should be able to exclude first. These, amongst others, may be small innocent tumors in the womb or even some precancerous conditions.

HOW CAN THE GYNAECOLOGIST HELP?

Fortunately there are medicines that help to make periods normal again. But before your Gynaecologist decides on treatment, he/she may need to know more about the length and heaviness of your periods and ask you to use the "Menstrual Calendar". You may also be questioned about your health and clues to rule out other possible causes. There will be an internal examination and if necessary even routine tests.

Sometimes heavy periods make you anemic. This may make you feel tired – or you may be short of breath. Your doctor may prescribe iron tablets to correct or prevent this. In addition, the Gynecologist may be able to give you specific treatment after establishing the cause of the period problems.

MORE IMPORTANT IS, HOW CAN YOU HELP YOUR GYNAECOLOGIST?

• If your Gynaecologist asks you to use the "Menstrual Calendar", be sure to mark it everyday.
• If your Gynaecologist prescribes treatment straight away, follow the instructions faithfully
• Tell the Gynaecologist if your period gets worse between visits, or if you have severe pains or other problems.
• Do not stop treatment till you are asked to do so.