Most girls can expect to start periods between the ages of 11 and 16.

Menstruation is a major stage of puberty in girls and refers to physiological changes happening in women at regular intervals of 21-35 days. Menstrual period prepares women for sexual reproduction and fertilization and having a regular menstrual cycle is a clear sign of a healthy individual. Any abnormalities such as delayed or early menstrual periods, or excessive pain & bleeding during the periods indicate that you might be suffering from certain gynaecological conditions and require immediate medical intervention.

Painful periods or “Dysmenorrhoea” can affect quality of life - women describe “lying curled on a couch” for 2-3 days, which takes away from work, study, sports and family.

This may be accompanied by “Menorrhagia” – excessive bleeding which lasts for 8 to 10 days

Frequent causes are:

• Uterine fibroids – Non-cancerous tumours observed in women of child bearing potential
• Endometriosis – With this condition tissues lining the uterus from inside grow outside the uterus (normally the tissue grows inside the uterus)

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.

Treatment includes

• For amenorrhea, medroxyprogesterone will be given
• For dysmenorrhoea, ibuprofen and naproxen are given to relieve pain
• For menorrhagia iron supplements and anti-prostaglandin medications are given.  In severe case of menorrhagia surgeries such as thermal balloon endometrial ablation, transcervical resection of the endometrium (TCRE), and hysterectomy will be done.
• For endometriosis, hormonal preparations and/or pain relievers will be given to shrink the tissues. Laparoscopic surgery is done to remove the tissues lining the uterus.

Fibroids can be treated by medications that can slow or stop the growth of cancer and will relieve you from pain. Surgery can also be done to remove the fibroids.