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From teenage to menopause women may experience some menstrual issues like heavy or irregular bleeding, premenstrual tension syndrome, no periods or very scanty periods or painful periods. Repetitive occurrence of such issues can be very distressing. There could be some underlying conditions that need to be ruled out. There are many effective and simple treatments for most of these issues.
If you have persistent problems with your menstruation, you need further assessment with a view to perform more investigations and treatment if required.
Please contact to arrange a consultation.
A menstrual cycle is typically 28 days. It could vary between 21 to 35 days and is still considered to be normal. This depends upon the health and age of the individual. As the female ages there are lengthier menstrual cycles. Each menstrual period lasts for around 5 to 6 days. But in some healthy females it could last for 4 or slightly above 6 days. Menstruation begins in a female when she is typically 12 to 13 years of age.
The whole process of menstruation quite intricate and is controlled by number of hormones starting from the pituitary and hypothalamus gland in the brain which stimulates ovaries. This stimulates ovulation. Menstruation occurs in a monthly cycle when pregnancy does not happen.
Menstrual Disorders
Menstrual disorders are seen if the cycle is less than 21 days or more than 3 months. Also if the period of menstruation is more than 10 days it becomes worrisome.
Some of the common menstrual disorders and their symptoms and line of treatments is given below.
1. Painful Periods:
During menstruation, for first 2 to 3 days some lower abdomen pain, cramps and discomfort are common. The cramps could spread to the lower back and the thighs. The contraction in the uterus is the cause for the cramps.
Some women experience more severe pain which may not be manageable with simple treatment like heat pads or simple painkillers. If the pain interferes with day to day life, you may require further investigation like an ultrasound scan and hormonal treatment,
2. Periods with Heavy Bleeding
Some women could experience heavy bleeding during menstruation days. This is more common during two extremes of reproductive life, puberty and premenopausal age. If it is interfering with her daily life, further investigations and treatment are required. The causes could be hormonal, polycystic ovarian syndrome, adenomyosis, polyp or fibroid.
There are effective treatment options like Insertion of an intrauterine device which releases hormones, medicines which contain progestin or tranexamic acid, surgical methods to resect polyps, fibroid, ablation of womb lining or hysterectomy as a last resort.
3. Missing Or Absent Periods
There are number of reasons why your periods can stop. Most common ones are pregnancy, stress, sudden weight loss or weight gain, being overweight, too much of exercise, menopause, pills, polycystic ovarian syndrome and other conditions like heart diseases, uncontrolled diabetes and underactive thyroid.
4. Premenstrual Syndrome (PMS)
These symptoms are generally seen a week before the actual periods. They are physical, emotional and behavioural traits and can be seen all through the reproductive years. The symptoms of PMS include irritability, backache, bloating, acne, headaches, depression, anger, mild cramps in the stomach, constipation, diarrhoea, breast tenderness, tiredness etc.
The major cause of PMS is attributed to hormonal imbalances. Oestrogen levels are found to vary during a menstruation cycle which causes mood swings and other menstrual symptoms. These symptoms are found to disappear within 4 days of onset of periods.
Treatment options are simple measures like exercise, relaxation technques, yoga and meditation and with severe cases medical treatment like antidepressants and combined pill can be considered. If you suffer with severe PMS you may seek consultation.
Diagnosis of Menstrual Disorders
You will require detailed history taking. It is good to track your menstrual cycle so that any problems can be picked up.
Depending on your symptoms, you will require some blood tests and a scan.
If you are experiencing any abnormal symptoms with respect to menstruation please contact so that you can get correct help.
Please contact us. if you have such issues and you want to discuss more.
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Overactive Bladder (OAB) is a sudden and compelling need to relieve the bladder which is difficult to put off, often associated with the frequent need to go to the toilet during the night or the day, and may result in incontinence.
People experiencing these symptoms should not feel ashamed or embarrassed to talk to their doctor, because help is available. OAB can have a huge emotional and physical impact on people.
About 1 in 6 adults experience some symptoms of an overactive bladder. About 1 in 3 people with an overactive bladder have episodes of urge incontinence.
Normally, the bladder muscle stay relaxed as the bladder gradually fills up. However, in people with an overactive bladder, the bladder muscle seems to give wrong messages to the brain. The bladder may feel fuller than it actually is. The bladder contracts too early when it is not very full, and not when you want it to.
Untimely contractions lead to symptoms like Urgency where you cannot wait to go to urinate, increased frequency more than 7-8 times a day, Night time frequency (nocturia) of more than 1-2 times every night interfering with your sleep and Urinary leakage mainly happening on the way to the toilet or without any warning. You may pass quite small volumes of urine.
Try these top tips to help you control your symptoms:
Bladder training (sometimes called bladder drill)
Bladder training is a very simple but effective treatment. It works in up to half of cases and makes it important part of the treatment. The aim is to slowly stretch the bladder so that it can hold larger and larger volumes of urine. For more information see the “Bladder Drill” section on this website.
Medication
If there is not enough improvement with bladder training alone, medicines also help. There are number of medicines available. They work by blocking certain nerve impulses to the bladder, which relaxes the bladder muscle and so increases the bladder capacity. Medication improves symptoms in some cases, but not all. The amount of improvement varies from person to person. Click here to know about medication.
Posterior Tibial Nerve Stimulation
This treatment involves inserting a very fine needle (like acupuncture) into a specific point near the ankle. A specific kind of electrical impulse is delivered to the patient through the lead set. The electrical impulses travel along the tibial nerve to the nerves in the spine that control pelvic floor function. For more information on this treatment please look at the “Tibial nerve stimulation” section on this website.
Surgery
Surgery is used in very limited cases of overactive bladder where symptoms have not responded to above mentioned treatments and symptoms are too bothersome.
Treatment with botulinum toxin A
This is an alternative treatment to surgery if other treatments including bladder training and medication have not helped your symptoms. It has not been licensed (approved) for the treatment of overactive bladder syndrome in the UK. Make sure that you discuss this procedure fully with your doctor and understand all of its risks and benefits before you go ahead with it. Click below to know more about this treatment.
Further help and information
www.bladderproblem.co.uk provides accessible information on how you can help to manage bladder conditions.
If you have any further questions, to make an appointment please contact.