Personal hygiene, exercise and good diet key to menstrual health | Sunday Observer

Personal hygiene, exercise and good diet key to menstrual health

14 May, 2021

The spotlight has increasingly fallen on women’s health following the Covid- 19 pandemic where the impact of the pandemic both on the physical and mental health of women is now being looked at closely by various medical professionals. In addition to this, medical professionals are also seeking to bring out of the closet long hidden issues and requirements essential to all women especially those working outside their homes such as disposable sanitary napkins to ensure their menstrual health and hygiene .

The Sunday Observer spoke to the resident gynaecologist at a leading hospital in Colombo, Dr Ravinie Wijeweera to share her views on this sensitive issue drawing on her hands on experience in dealing with menstrual related issues common to women and girls irrespective of race or creed.

Excerpts …

Q. Menstrual health and hygiene has come into focus recently emerging from the curtains that had long hidden any open discussion on this long sidelined issue. Problems related to it were discussed at a public forum by stakeholders supported in the presence of several top officials of the Health Ministry recently. Do you think this is a welcome step forward ?

A. Absolutely. It is not only welcome but also perhaps long overdue. Menstruation happens monthly for all females in the reproductive age group.

Women or girls having their period require certain basic facilities when they venture out of their homes in order to put in a days’ work. In the modern world where women are not confined to homes and are expected to perform like their male contemporaries some consideration should be provided for this requirement.

Q. Fems “Aya” an innovative initiative to educate women on menstrual health and hygiene and provide equal access to high quality napkins to all women, was also launched by a private firm on women’s international day in March. Do you think this fulfills along felt need of Sri Lankan women?

A. It is a good start and once a start is made it could be the basis of assessing the real need and developing along those lines.

Q. As not many women know what exactly Menstrual Health is, tell us first what menstruation means .

A. Once the female reproductive system is mature enough to reproduce, the hormonal changes bring about a thickening in the lining of the womb.This is in anticipation of a pregnancy.In the event that a pregnancy does not occur this lining sheds to give us a menstrual period.

Q. What is menstrual health? What is the link ?

A. The regularity the duration the amount of bleeding in a menstrual period can vary between people and even in an individual person monthly. Knowledge regarding what is normal, when to seek advice and first and foremost how to take care of ones self during menstruation and how not to let it impact your life negatively encompasses menstrual health.

Q. Why is it so important?

A. Normal menstrual cycle implies a normal reproductive system which in turn results in normal fertility. If menstrual cycles are abnormal this sets the stage for issues such as anaemia sub fertility even loss of economic productivity.

Q. What do our periods tell us about our health?

A. It tells us that we have overall good health. Our endocrine system which relates to reproduction is functional , that very likely the person is fertile and is maintaining a good weight and diet.

Q. What is menstrual hygiene ?

A. Personal cleanliness for the duration of a period which will give the woman or girl confidence to go about her normal activities is the hygiene that I refer to. It includes disposal of used sanitary products appropriately.

Q. How do we improve the health of our periods?

A. In two very important ways. We need to have regular exercise and maintain a good diet. This in turn ensures a normal body mass index and helps with regulating period problems.

Q. Today we are living amidst a Covid- 19 pandemic with the added risk of a variant virus which spreads transmission much faster and also causes more fatalities than the previous Covid- 19. It has also been said that young adolescents are more at risk of being infected by the virus than older people. Bearing these risks in mind, can this this highly infectious virus affect a woman’s menstrual health? If so what age group are we looking at in the case of girls and women? .

A. Not a lot is understood about the Covid-19 virus and its impact on the menstrual cycle. Scientific study and data are limited and I express an opinion that severe physical stress or even mental stress could disrupt the menstrual cycle. Therefore, it is not a surprise that many women have reported menstrual problems due to the viral infection. The age group affected would be girls over 13 and women under 51 years being the group in the reproductive age.

Q. Will it impact on her menstrual cycle?

A. Yes it is possible. The menstrual cycle could be impacted by delayed periods and irregular cycles. Furthermore, if there are factors affecting the clotting system the bleeding could be heavy.

Q What about her ability to conceive and have children?

A. It is likely that the disturbances brought in by the viral infection is short lasting. Therefore, a more permanent effect on conception and having children is extremely unlikely.

Q. Health officials often refer to menstrual cycle. What is it?

A. The menstrual cycle is the cyclical shedding of the lining of the womb . It occurs every 28 to 30 days for most women. It is a recurring process from the start of the first period till menopause which is the final period. Along with menstruation there are cyclical changes in the hormones and in the other organs of the reproductive system.

Q. Are there different phases in a woman’s menstrual cycle?

A. Yes there are two phases. The first phase is follicular phase where a fresh lining grows in the womb. Once the oocyte or an egg is released from the ovary the process we call ovulation the second half of the cycle begins.

This is brought about by hormonal changes in the body and we call it the luteal phase. During this phase the lining of the womb thickens and matures until finally menstruation happens.

Q. Are the phases the same for all women? Do all women bleed the same way at this stage ?

A. The phases may be altered depending on hormonal factors. The bleeding pattern that women experience varies a great deal.. It is fair to say that no two women are likely to have the same experience of a period.

Q. Symptoms and discomforts experienced during this first phase ?

A. A Generally the first phase is as the period starts. When the initial pain and discomfort of the period is over the woman should have no symptoms or discomfort .

However the period it self can be painful with cramps aches in the lower abdomen, constipation, diarrhoea, nausea, headaches, back ache, joint pains. and even episodes of fainting

Q. Home remedies? Are they advisable?

A. Controlling the symptoms and pain is recommended because this is unnecessary distress to the girl or woman. Ensuring there are no other underlying problems is also a must. Simple home remedies are invariably the first step if practicable and effective. Measures such as a hot water bottle to ease cramps can be helpful on occasions.

Q. The ovulation period - what happens to a woman’s body at this phase?

A. Two weeks before an expected menstrual period ovulation takes place. It is usually at the middle of the monthly cycle. A woman may experience pain in one side or the other in the lower abdomen, a little stain of blood or nothing at all. Hormonal changes also take place that increase the chance of a pregnancy

Q. What are the symptoms and signs of early pregnancy to look for?

A. The first sign is of course that the monthly period does not take place. Having said that there is a small group of women who experience bleeding at the start of the pregnancy.

If you experience an unusual period the possibility of a pregnancy should be considered. The symptoms could include nausea, breast tenderness , tiredness, burping belching need to pass urine frequently amongst many others

Q. It is said that our periods become irregular closer to menopause. Is this correct?

A. Yes it can become irregular lighter heavier shorter or longer closer to menopause. Only very few of us will experience an abrupt stop following a normal menstrual period.

Q. Polycystic ovary syndrome (PCOS) is also said to cause irregular menstrual cycles and missed periods. What is PCOS?

A. Polycystic ovarian syndrome is a common disorder where there is a menstrual disturbance due to hormonal imbalance.

It has a wide range of concerns which are beyond the scope of today’s topic. Correcting the period aspect of the condition may need hormonal intervention. However, priority in treatment is exercise and diet.

Q. Uterine fibroids is also said to cause periods to last longer and heavier than usual. Is this correct?

A. Yes uterine fibroids may cause heavier bleeding during periods. It must be noted that not all fibroids do so as it is very much dependent on the location and size.

Q. What about eating disorders like Anorexia and Bulmia which I ‘m told can disrupt the menstrual cycle . Can they make the periods stop?

A. Yes they can and that is where a good diet and a normal weight is an important aspect of having good menstrual health.

Q. Birth control pills – do they impact on one’s periods ?

A. Birth control pills override the natural system using hormones within them.

They suspend the process of ovulation and cause a lighter bleed. Their effects are not long lasting and they mimic a normal menstrual cycle

Q. In a future where there will be a growing number of sexual health conscious young people looking for ways to be responsible despite the obstacles, living in a digitalised world, what is the message you would like to give them?

A. Empower yourselves with prior knowledge and remember that each of us have a choice. We can choose to be safe , seek expert advice, treatment and maintain good health.

Q. Your message to all young girls and women on the importance of menstrual health and hygiene?

A. Become aware of the cyclical changes which take place in your body so that you could recognise any changes or deviations from your normal. Understand that menstruation need not bring about suffering pain limitations or humiliation.

It can be controlled and managed to be almost like every other day of the month. The key lies in how you manage your menstrual health and hygiene.