From the Editor's Desk
Dr. Saravana Bharathy. S. P
Consultant
Internal Medicine
Internal Medicine
When the Cycle Speaks: Decoding Menstrual Irregularities
Menstrual health is a vital sign, yet it remains one of the most overlooked aspects of women’s healthcare in India. Studies reveal that up to 87% of Indian women report menstrual disorders, with dysmenorrhea (painful periods) affecting nearly 46% overall and reaching 70% among adolescent girls. These staggering numbers highlight the urgent need for awareness, diagnosis, and timely medical intervention.
Key Issues at Play:
- Irregular Cycles: A cycle is irregular if it’s shorter than 21 days, longer than 35 days, varies by more than 20 days, or if menstruation lasts more than 7 days.
- Painful Periods (Dysmenorrhea): Between 33% and 80% of Indian women report period pain. For 11% of adolescents, the pain is severe enough to disrupt school and daily life.
- Chronic Pelvic Pain: Affecting up to 81% of women, this is often linked to conditions like endometriosis, which remains widely underdiagnosed.
When to See a Doctor
Seek medical advice if you experience:
- Heavy or prolonged bleeding (>7 days), cycles too frequent (<21 days) or too sparse (>35 days)
- Severe cramps that cause fainting, vomiting, or disrupt daily activities
- Spotting between cycles, missed periods for more than 3 months, or sudden cycle changes after years of regularity
Why Timely Care Matters
Ignoring symptoms can delay diagnosis of underlying issues such as:
- PCOS, thyroid disorders, fibroids, or pelvic inflammatory disease (PID) – reported in up to 64% of women with menstrual abnormalities in India
- Endometriosis, a key contributor to pain and infertility, often overlooked due to normalization of menstrual suffering
Treatment: Medical vs Surgical—A Tailored Path
Scenario | Medical Approach | Surgical Options |
|---|---|---|
Hormonal imbalance, PCOS, early fibroids | Hormonal contraceptives,
NSAIDs, iron supplementation
| Reserved if medical treatment fails, e.g., myomectomy |
Painful dysmenorrhea | NSAIDs, lifestyle changes, heat therapy, hormonal therapy | Optional laparoscopy if suspicion of endometriosis |
Heavy or prolonged bleeding, structural lesions | Hormones, antifibrinolytics, iron | Curettage, endometrial ablation, or hysterectomy for refractory cases |
