Menarche is a girl’s first period and marks the beginning of her reproductive life and continues until the menopause. A menstrual cycle is normally from 21-35 days and is regular every month. Any abnormalities such as delayed or early menstrual periods, excessive pain and bleeding during the periods indicates you may be suffering from an underlying condition that may require investigation and management.
Abnormalities in menstrual cycle of woman is called as menstrual irregularities. Various menstrual irregularities include:
- Amenorrhea – Can be if reached 16yo and never occurred (primary) or absence of menstrual period for 3 consecutive months without pregnancy (secondary)
- Dysmenorrhoea – Painful menstruation periods
- Menorrhagia – Excessive bleeding which lasts for 8 to 10 days
- Oligomenorrhoea – Extended periods of time (eg 60 days) without a period
- Premature ovarian failure – Normal function of the ovary is stopped
Symptoms observed in patients with menstrual irregularities include burning while urinating, fever, painful bowel movements, vaginal discharge, painful cramps, and lower back pain. Menstrual irregularities should be diagnosed early to prevent complications such as infertility (inability to get pregnant), anaemia, haemorrhage, and uterine cancer.
Understanding women's health, or questions and issues in regards to your cycle and your period, is absolutely critical for a specialist gynaecologist. I also believe it is critical that as women we get more comfortable discussing these women's health topics, among ourselves, with our loved ones, or with a specialist doctor. Part of my role is to create a nurturing and safe environment where it is okay to talk about your period, your cycle, or women's health in general.
Abnormal Pap Smears
A pap smear or pap test is conducted as part of a woman’s routine health examination, after the age of 21 years. It is not a diagnostic test, but is a screening tool used to detect any abnormal cells in the cervix. The cervix is the lower part of the uterus that opens into the vagina.
Pap smears help in early detection of any serious medical conditions such as cervical cancer.
A pap smear (papanicolaou) is a screening test that is routinely performed every 2 years on a woman to detect pre-cancerous or cancerous processes happening in the cervix (opening to the womb). This is first done at 18 years of age or 2 years post first sexual intercourse - whichever occurs latest. The last pap smear for a woman should occur at 70 years of age.
Causes of abnormal Pap Smear
An abnormal pap smear may indicate any of the following:
- An infection or an inflammation
- Dysplasia (abnormal cells that may be pre-cancerous)
- Recent sexual activity
- HPV (Human Papilloma Virus) infection; also called genital warts
How a pap smear is performed
A Pap smear is performed by opening the vaginal canal with a speculum> Then cells are collected at the outer opening of the cervix at the transformation zone. The collected cells are examined under a microscope to look for abnormalities.
Following an abnormal pap smear, the next step is further testing to confirm the cause of the abnormal cells. A repeat pap smear or test for human papilloma virus (HPV), a major risk factor for cervical cancer, may also be recommended.
Depending on the age of the patient and the type of abnormal cells, the doctor may recommend the following treatment options:
- Cryosurgery: It involves freezing the abnormal cells which are then surgically removed.
- Cone biopsy or LEEP procedure: In this procedure, a triangle segment of cervical tissue including abnormal cells is removed by specially designed instruments for evaluation.
- Laser: specialised treatment allowing management of widespread lesions on the cervix
Abnormal Pap Smear during pregnancy
A pap smear during pregnancy is very safe. In case of an abnormal pap smear, a colposcopy can be performed during pregnancy. However, further treatments are delayed until the birth of the baby. Often, the birth process washes away the abnormal cervical cells.
Menstrual Disorders Treatment
Learn more about what can be done about Menstrual Disorders.
Menstrual Disorders in Girls
When you’re an adolescent you have a menstrual disorder when you don’t have your period by the age of 15.
Learn more about Endometriosis, its causes, symptoms and how it is diagnosed.