When I was a teenager I used to ask my mum, rather I used to complain to her about how unfair it is that only women have to face the monthly pain of menses and men have no such issues. She always told me to look at the positive side of things and remember that our body is preparing us for motherhood in the future and we are lucky to be able to bring another life into this world.

Today on the show I spoke to Dr Mahadeo Bhide who is a very experienced gynaecologist about the monthly menses cycle, he said that it depends on the age, the periods start around the age of 13 or 14, but nowadays periods are starting earlier, even 11 year old girls get their periods due to various factors. But the ovulation that is the release of the egg from the ovaries starts at the age of 15. The periods is a reflection of the endometrium, the layers of which build up every month and then are subsequently lost. After the production of the egg starts in the ovaries that is at the age of 15 or 16, that’s when the periods start to get painful but the cycle starts to become regular. IF the periods are heavy every month then Dr Bhide said that the concern would be either of the following

  • that your ovaries are unable to make the egg or release the egg
  • there might be fibroids in the uterus
  • maybe the size of the uterus is larger than normal
  • you be nearing menopause
  • mental stress

Having irregular periods is the classical manifestation of anovulation where the egg is not produced every month in the ovary but there is a gap of 2 or 3 months in the production of an egg.

The most common cause of the ovaries being unable to produce eggs is the polycystic ovaries syndrome where there are eggs present in the ovaries but the process of the maturing of a single egg every month and the subsequent release of that egg does not take place and their periods will also be irregular said Dr Bhide. Around 15 or 20 % of the population has PCOS but if the periods are irregular then the chances of that woman having PCOS are increased by 50 % he said.

A woman who has irregular periods may also face problems with getting pregnant at a later stage in life. Dr Bhide said that there are 4 deciding factors that control the chance of pregnancy and a problem with any one of them may reduce the chance of conceiving normally, they are

  • The uterus
  • The sperm
  • The eggs
  • The fallopian tubes

Out of the above the most common one is the production of the eggs.

Speaking about the white discharge Dr Bhide said that it’s very common for women to have it during certain stages of their monthly cycle. If the white discharge is happening in the middle of your monthly cycle — around the 14th day — then it is the physiological excessive secretion by the neck of the womb that’s the cervix. But he also said that if the white discharge is of a different colour or it has a very bad smell and there is itching in the area due to it then there might be an infection and the woman must go to see a doctor. But for somebody who is aged, it’s not normal to have white discharge as at the age of 70 or more there is not too much of oestrogen in the body which controls the amount of white discharge.

Dr Bhide said that ovaries are the main source of oestrogens and that stops around the age of 50 or 55. Oestrogen is manufactured by cholesterol which we are all running away from. Dr Bhide said that without the cholesterol we would not exist, when kept in control it has a lot of uses. Hormones are primarily derived from the 27 carbon cholesterol molecule. Even the testosterone, oestrogen, progesterone and cortico steroids or gluco corticoids are all derived from cholesterol. The primary production site for oestrogen are the ovaries but the fat layers below the skin, produce a weak type of oestrogen called oestrone. In women who are a little over weight and nearing their menopause, they will have a larger supply of the type of oestrogen.

Talking about one of the most common and annoying problem that women face which is the PMS- premenstrual syndrome Dr Bhide said that the symptoms are divided in two categories, the physical symptoms and the physiological symptoms.

He said that no woman can feel absolutely normal and comfortable during their periods, there is a decrease in the level of the hormones and the woman can feel upset all of a sudden, basically there is some type of a mood change. But if there are extreme mood swings or there are too many physical symptoms like bloating, backache, constipation which happen normally in the 2nd half of the menstrual cycle then they need to get help. If you have a 28 days cycle then the egg is normally released on the 14th day and that creates the second set of hormones called progesterone, until that there is only oestrogen. Dr Bhide said that the hormone progesterone is the culprit that causes PMS. So normally if you get PMS then it happens at a fixed time in the cycle which is always in the 2nd half.

  • The oral contraceptive pill is straightforward answer to treating PMS if it is beyond control
  • Mood elevators are given in certain cases

But he said that the best way to deal with PMS is to try and be stress free. Some type of a relaxation technique is helpful. He said that taking a pill to solve the PMS would be an easy way out but not the best option according to Dr Bhide.

When taking birth control pills to avoid pregnancy or to regularise the periods Dr Bhide said that there are a few side effects of pills that need to be taken into consideration:

  • Putting on a bit of weight
  • Nausea
  • Water retention
  • Liver problems
  • Acne
  • Deep vein thrombosis

I had a great time learning about the female reproductive cycle and the changes that a woman’s body undergoes during the monthly cycle. We all know how we feel during those days in the month but knowing exactly what happens inside the body at that time was very interesting.