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Dublin: 18 °C Friday 3 July, 2020

PMS, periods and panic: When monthly changes are a cause for concern

We chatted with Dr McQuade of Dublin’s Well Woman Centre.

DESPITE WHAT YOU may have been led to believe as an adolescent, women don’t dedicate vast amounts of time to discussing their menstrual cycle with their friends.

shutterstock_639018343 Source: Shutterstock/La corneja artesana

As teenagers, many of us might have gotten a vague thrill out of relaying the various symptoms we were experiencing between double Maths and Home Ec, but this conversation soon tires, and interest quickly wanes.

As such, many women don’t feel as willing to casually discuss variations in their menstrual cycle as easily as they would have in the past, which often results in a feeling of isolation when they encounter changes throughout their period.

With that in mind, chatted with Dr Shirley McQuade from Dublin’s Well Woman Centre, who shed light on some of the main issues she encounters on a day-to-day basis.

“Bleeding problems are a large part of why women attend the clinic,” she told us. “Irregular periods are very common.”

If you’re concerned that your menstrual cycle has become irregular, Dr McQuade advises that you take external factors into account before panicking.

For example, not having a period for three cycles is not unusual, particularly if someone is under stress – exams, moving house, moving country. So I don’t start investigations unless it is at least three months of no periods. The only test – which the woman can do at home – is a pregnancy test, just in case.

“A late period or a heavy period can simply be because ovulation has not happened that cycle,” she added.

shutterstock_1076240678 Source: Shutterstock/Kaspars Grinvalds

So, now that we’ve covered absent and tardy periods, what about those ones that are all too keen to make themselves known?

“Three months of heavy bleeding warrants a visit to a doctor,” Dr McQuade tells us.

Bleeding in between periods or bleeding after intercourse may signify something more significant, so if either or both of these symptoms are happening then you should not wait three months, but get checked by a doctor sooner. 

“Irregular bleeding like this may be due to infection, a polyp on the cervix or irregular cells on the cervix all of which should be treated soon,” she said.

As well as deliberating over changes in flow, women are also forced to consider the symptoms which accompany it.

Anecdotal evidence suggests that despite the regularity with which they occur, some of us still have a hard time identifying the emotional symptoms that act as a precursor to the arrival of our period.

Failing to make a connection between a looming period and sudden tearfulness or heightened anxiety is pretty common, and sometimes it’s only when the physical symptoms kick in that the penny drops.

It might sound vaguely absurd to some, but for many women it’s the reality, and some of it comes down to the fact that symptoms of PMS tend to change as a woman gets older.

“Hormone changes are noticeable from mid thirties onwards,” Dr McQuade explained. “There is a natural decrease in hormone production from mid thirties until menopause.”

Emotional changes that occur in the second half of the cycle are more prominent than physical symptoms. Most women I see with PMS or PMDD tend to be mid to late thirties.

“Often women see changes like the period takes a few days to start and then tapers off rather than the very clear start and stop to bleeding that younger women have,” she continued. “There is also a drop in fertility from mid thirties.”

So, what can you do if the symptoms to which you have become accustomed are gradually replaced by less familiar ones?

Dr McQuade explained that various factors are up for discussion in this case.

Work / life balance, stressors, diet and exercise all need to be reviewed. Sometimes taking a contraceptive pill can help by stopping the cyclical changes but medication to increase serotonin levels may be required.

“For some, taking the medication in the second half of the cycle is enough to stop the problem,” she added.

What about you? Have you noticed that your PMS has changed the older you’ve gotten?

Poll Results:

Yes, now my experience is more emotionally-focussed. (491)
Yes, now my experience is more physically-focussed. (239)
Nope, not really. (234)
Yes, but that's because all my symptoms have lessened. (104)

If you’re concerned about your reproductive health or want to discuss changes in your cycle, do not suffer in silence.

Make an appointment with your practitioner, who will advise you on the steps you can take to address the issue.

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About the author:

Niamh McClelland

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