Women’s health in Singapore is supported by a strong healthcare system that prioritises preventive care, early diagnosis, and effective treatment. However, despite the availability of gynaecological services, many women in Singapore may delay seeking care for gynaecological issues, often due to a lack of awareness or misconceptions about the severity of their symptoms.
Gynaecological health is crucial for overall well-being, particularly when it comes to managing menstrual pain and heavy bleeding. These symptoms are not just a monthly inconvenience for several women. In many cases, they are indicators of underlying health issues that may significantly impact a woman’s quality of life. Ignoring these signs and delaying treatment can lead to complications such as infertility, severe anaemia, or even life-threatening conditions.
When period pain and heavy bleeding disrupts your life, it can significantly affect your overall well-being and daily functioning. Severe menstrual cramps, known as dysmenorrhea [1], can lead to debilitating discomfort that interferes with your ability to perform routine activities, such as work, school, or social engagements. This intense pain can cause you to miss days at work or school, resulting in decreased productivity and social isolation. Additionally, the physical symptoms, such as nausea, vomiting, diarrhoea, and fatigue, can further diminish your quality of life.
Chronic pain can also lead to mental health issues [2]such as stress, anxiety, and depression. Persistent menstrual pain and bleeding that disrupt your daily life often signal an underlying issue that needs medical attention. Seeking prompt evaluation and treatment can help manage the pain, improve your overall quality of life, and prevent further complications.
Persistent menstrual pain and heavy bleeding can also lead to chronic fatigue, decreased productivity, and emotional distress. In more severe cases, untreated conditions like endometriosis or fibroids can cause infertility or necessitate more invasive treatments, such as surgery. Therefore, seeking medical attention when symptoms arise is vital, rather than waiting for them to worsen.
Painful periods can significantly affect quality of life, including mental health symptoms such as depression.
Understanding Menstrual Pain and Heavy Bleeding
Risk Factors and Causes
Menstrual pain and heavy bleeding can be caused by a variety of factors, including hormonal imbalances, underlying medical conditions, and lifestyle influences. Risk factors may include a family history of gynaecological issues, obesity, a sedentary lifestyle, and certain health conditions like polycystic ovary syndrome (PCOS) or thyroid disorders.
Understanding the Menstrual Cycle
The menstrual cycle [3] is a natural, recurring process that prepares a woman’s body for pregnancy each month. It typically lasts between 21 and 35 days, with menstruation (commonly known as a period) occurring for 3 to 7 days within this cycle. The cycle is regulated by hormones, primarily oestrogen and progesterone, which control the thickening of the uterine lining to create an environment suitable for a fertilised egg. If pregnancy does not occur, the lining is shed during menstruation.
The menstrual cycle is divided into phases: the menstrual phase, the follicular phase, ovulation, and the luteal phase. Understanding this cycle is essential for recognising normal patterns and identifying any irregularities that may signal underlying health issues.
Understanding the menstrual cycle can help you identify irregularities and issues so that you can seek treatment.
Common Menstrual Issues
Dysmenorrhea (Painful Periods): Dysmenorrhea is characterised by severe menstrual cramps that can interfere with daily activities. It is often caused by the overproduction of prostaglandins, which trigger uterine contractions.
Menorrhagia (Heavy Bleeding): Menorrhagia is excessive menstrual bleeding that lasts longer than usual or involves passing large blood clots. It can lead to anaemia and fatigue.
Irregular Periods: Irregular periods can vary in timing, flow, and duration. They may indicate hormonal imbalances, stress, or underlying health conditions.
When to See a Gynaecologist for Menstrual Pain
You should see a gynaecologist for menstrual pain when the pain is severe enough to disrupt your daily activities, such as not being able to go to work or school, or does not improve with over-the-counter medications. Additionally, pain that is persistent, worsening, or associated with signs of hormonal imbalance should be evaluated by a gynaecologist to rule out serious issues. Early intervention can help manage symptoms effectively and prevent potential complications.
Consider seeing a gynaecologist if you commonly experience:
Severe pain and discomfort: If your menstrual pain is so severe that it disrupts your daily life, it’s important to seek medical advice. This could indicate conditions like endometriosis or fibroids. This includes pain that does not get better with medications such as pain relievers.
Associated symptoms: Nausea, vomiting, diarrhoea, dizziness, or irregular menstrual cycle alongside pain can be red flags that require medical evaluation.
Signs of hormonal imbalance: Symptoms like unexplained weight gain, acne, and fatigue may indicate a hormonal imbalance that needs to be addressed and treated.
When to See a Gynaecologist for Heavy Menstrual Bleeding
You should see a gynaecologist for heavy menstrual bleeding or if you notice bleeding between periods. These symptoms can be signs of underlying conditions like fibroids, polyps, or hormonal imbalances, which require professional evaluation and treatment. Ignoring heavy menstrual bleeding can lead to complications such as severe anaemia, fatigue, and in some cases, more serious health issues. Early diagnosis and treatment can help manage your symptoms and improve your overall quality of life.
It’s advisable to consult a gynaecologist if you commonly experience:
Heavy and prolonged bleeding: If you soak through a pad or tampon every hour for several consecutive hours during your period, this is considered heavy bleeding and warrants medical attention. Prolonged bleeding for more than seven days can lead to significant blood loss and should be evaluated by a healthcare professional.
Bleeding between periods: Spotting or bleeding between periods can be a sign of hormonal imbalances, polyps, or other conditions that should be investigated.
Passing blood clots: Passing large blood clots [4] during your period may indicate a serious condition like fibroids or polyps.
Possible Causes of Menstrual Pain and Bleeding
Several conditions can cause menstrual pain and heavy bleeding:
Endometriosis: A condition where tissue similar to the lining of the uterus grows outside the uterus, causing pain and irregular bleeding.
Uterine Fibroids: Noncancerous growths in the uterus that can cause heavy bleeding, pain, and pressure on the bladder or rectum.
Polyps: Small growths on the inner wall of the uterus that can cause irregular or heavy menstrual bleeding.
Adenomyosis: A condition where the inner lining of the uterus breaks through the muscle wall of the uterus, leading to heavy bleeding and pain.
Hormonal Imbalances: Conditions like PCOS, thyroid disorders, or menopause can disrupt normal hormone levels, leading to menstrual irregularities.
Pelvic Inflammatory Disease (PID): An infection of the reproductive organs that can cause severe pain, heavy bleeding, and potential fertility issues.
Polycystic Ovary Syndrome (PCOS): A hormonal disorder that can cause irregular periods, heavy bleeding, and other symptoms like acne and weight gain.
Ovarian Cysts: The presence of ovarian cysts can disrupt the normal menstrual cycle, leading to irregular periods and increased menstrual pain.
Chronic period pain and heavy bleeding may be an indicator of severe menstrual conditions that may worsen and cause infertility if left untreated.
Diagnosing Menstrual Pain and Bleeding
To diagnose the causes of menstrual pain and heavy bleeding, your gynaecologist may recommend:
Medical history and physical examination: A thorough review of your symptoms and medical history, followed by a physical examination.
Ultrasound: A non-invasive imaging test that uses sound waves to create pictures of the uterus and ovaries, helping to identify fibroids, polyps, or other abnormalities.
Hysteroscopy: A procedure where a thin, lighted tube is inserted into the uterus to view the inside and identify issues like polyps or fibroids.
Blood tests: These tests can check for anaemia, thyroid issues, or hormonal imbalances that might be causing your symptoms.
Biopsy: A sample of uterine tissue may be taken for further examination if cancer or other serious conditions are suspected.
Treatment Options for Menstrual Pain and Heavy Bleeding
Treatment for menstrual pain and heavy bleeding varies depending on the underlying cause and severity of symptoms:
Medications:
Pain Relievers: Over-the-counter NSAIDs like ibuprofen and paracetamol can help reduce pain and inflammation.
Hormonal therapies: Birth control pills, hormonal IUDs, or hormone replacement therapy can regulate periods and reduce bleeding.
Surgical treatments:
Laparoscopy: Used to diagnose and treat conditions like endometriosis or remove small fibroids.
Hysteroscopy: Can be used to remove polyps or fibroids from inside the uterus.
Myomectomy: A surgery to remove fibroids while preserving the uterus.
Hysterectomy: The removal of the uterus, which is considered for severe cases where other treatments have failed.
Lifestyle changes:
Dietary changes: A balanced diet rich in iron and vitamins can help manage symptoms.
Exercise: Regular physical activity can reduce stress and improve overall health.
Stress management: Practices like yoga, meditation, or deep breathing can help alleviate stress, which can exacerbate symptoms.
An ultrasound can help diagnose certain menstrual conditions as the gynaecologist will be able to see cysts, polyps, or other abnormalities.
Preventive Care
Preventive care is crucial for maintaining gynaecological health. This includes:
Annual gynaecological exams: Regular check-ups help detect potential issues early, before they become serious.
HPV Vaccine: Protects against the strains of HPV most commonly associated with cervical cancer and genital warts.
Tips for Managing Symptoms
Managing symptoms of menstrual pain and heavy bleeding is essential for maintaining a good quality of life. While medical treatment is crucial, there are also strategies you can implement at home to help alleviate discomfort and manage your symptoms more effectively. From pain management techniques like heating pads and medications to making dietary adjustments and incorporating stress-relief practices, these tips can help you take control of your menstrual health. Understanding and adopting these practices can empower you to navigate your menstrual cycle and reduce the impact of symptoms on your daily life.
Here are some tips to manage menstrual pain and heavy bleeding:
Pain management: Over-the-counter pain relievers, heating pads, or warm baths can help alleviate pain and discomfort.
Diet: Consuming a diet rich in fruits, vegetables, and lean proteins while increasing hydration can support overall health and reduce symptoms. Limiting caffeine, alcohol, and processed foods during your period can also help reduce symptoms.
Contraceptives: Birth control pills or IUDs can help regulate periods and reduce heavy bleeding.
Home remedies: Herbal teas, such as chamomile or ginger, may help soothe cramps and reduce inflammation.
Light exercise: Light exercise can be effective in alleviating period pain. This includes low-impact activities such as walking, yoga, and swimming.
Lifestyle and diet changes can help greatly in improving symptoms such as period pain and heavy bleeding.
Finding a Gynaecologist in Singapore
When searching for a gynaecologist in Singapore, consider the following factors:
Specialisation: If you have specific concerns, such as pain related to endometriosis or adenomyosis, or bleeding problems related to fibroids, look for a gynaecologist who specialises in those areas.
Recommendations: Ask for recommendations from friends, family, or your general practitioner.
Expertise: Consult a gynaecologist who has experience and expertise on women’s health and menstrual conditions.
How to Prepare for Your Appointment:
Make a list of your symptoms, their frequency, and any questions you have.
Bring a record of your menstrual cycle if possible.
Questions to Ask During Your Visit:
What could be causing my symptoms?
Are my symptoms normal?
What tests do I need to determine the underlying cause?
What are my treatment options?
At the Centre For Endometriosis & Fibroids in Singapore, conveniently located in Mount Elizabeth Novena Medical Centre, our specialists offer holistic and specialist gynaecology care for women. Book an appointment here.
Conclusion
Regular gynaecological care is essential for maintaining reproductive health and preventing serious conditions. By understanding the signs and symptoms of menstrual pain and heavy bleeding, and knowing when to seek medical advice, you can take proactive steps to ensure your well-being. Don’t hesitate to schedule regular exams and consult a gynaecologist if you experience any concerning symptoms.
Frequently Asked Questions
Is it normal to have painful periods?
Mild discomfort during periods is common, but severe pain that interferes with your daily life is not normal and should be evaluated by a gynaecologist.
Can lifestyle changes help manage menstrual pain?
Yes, maintaining a healthy diet, regular exercise, and managing stress can help alleviate menstrual pain.
When should I get a Pap smear?
Women should start getting Pap smears at age 25 and continue every three years, or as recommended by their doctor.
What are the risks of delaying treatment for menstrual issues?
Delaying treatment can lead to complications such as infertility, severe anaemia, and chronic pain. By staying informed and proactive about your health, you can better manage your symptoms and maintain a high quality of life.
