Everything else.. Menstruation Matters: Your Period-Related Questions, Answered

Menstruation Matters: Your Period-Related Questions, Answered

2020 May 11


Where can I buy period supplies during curfew? Why are my periods irregular? Are there ways to consult a doctor online? How do I dispose my sanitary pads correctly during this time? Anuki Premachandra together with Dr. Rashmira Balasuriya from the Arka Initiative explored these questions and more, on matters relating to menstrual health, contraception and prenatal care.


Why are my periods so irregular?

Irregular periods can occur due to various reasons. “Especially during this lockdown period, some women may experience irregular menstrual cycles. This has a lot to do with stress and anxiety. The hormones responsible for regulating your menstrual cycle actually comes from a part of your brain known as the hypothalamus, which is extremely sensitive to stress,” explained Dr. Rashmira. However, if you find that your menstrual cycle is consistently irregular, it is better to consult a doctor as it may be a sign of an underlying condition.


Is it normal to have mood swings during my period?

Experiencing mood swings in addition to feeling tense and a little on edge is quite common during periods. Especially for teens, mood swings can be very common because their hormones drastically change during puberty. A condition known as Pre-Menstrual Syndrome or PMS results in emotional and physical discomfort that occur one or two weeks before your period. Apart from mood swings, tender breasts, headaches, irritability, insomnia and appetite changes are some symptoms.

However, Dr. Rashmira recommends getting help if your mood swings continuously interfere with your day to day life.



How can I buy menstrual supplies during the lockdown period?

As a result of curfew, many women in Sri Lanka have been prompted to ration their period supplies. Especially with the current situation, women tend to wear the same sanitary pad for longer hours. However, Dr. Rashmira recommends changing your pad once it is full or saturated on days that you have a heavy flow. Changing pads regularly is important because it helps your stay clean and hygienic and prevents the risk of infection or skin irritation.

Sanitary pads can be purchased online. In the event that you reside in an area outside Colombo, with limited access to online payment and delivery, call the pharmacies in your area. Most pharmacies deliver supplies during this period.


Image from https://thewirecutter.com/


What are other alternatives to sanitary pads?

Tampons are another common alternative to sanitary pads. However, the same rule on changing tampons regularly once full still applies. Dr. Rashmira recommends changing tampons at least every 6-8 hours. Menstrual cups and reusable pads are two other eco friendly alternatives. Not only are menstrual cups cost-effective and easy to use but there is also more time between uses. The cup holds more blood than other methods and can last up to 12 hours. Justgoodness.co is an online store that delivers these eco-friendly supplies right to your door (www.justgoodness.co).


With reduced visits by garbage collectors during the curfew period, how do I dispose of pads and used condoms the correct way?

“This is a very valid concern,” said Dr. Rashmira “if done the wrong way, incorrectly disposed sanitary pads may cause a foul odor and may even attracts rodents and other creatures to the garbage.” To avoid this, Dr. Rashmira recommends placing all used sanitary pads and used condoms in a garbage bag and sealing them tightly until the garbage trucks collect them.


What are some effective remedies for period cramps?

Hot water showers and placing a warm compress such as a heat pad or a hot water bottle on your lower abdomen can work wonders during painful period cramps as heat helps muscles relax. You may also find that over-the-counter medication such as mefenamic acid works as a short-term remedy for mild to moderate period pain.

However, Dr. Rashmira recommends refraining from such medication if you have allergies.


What are some common vaginal infections?

“What is important to know here is that most conditions have no symptoms. However, if you notice unusual pain, itching and vaginal discharge, for example, this may be a sign of vaginal infection,” pointed out Dr. Rashmira. Candida, an infection that is not transmitted through sexual intercourse, is one of the common forms of infections. If the colour, smell and/or consistency of your vaginal discharge has changed, it could be a sign of infection.

Women are also more prone to urine infection since their urethra is relatively shorter. As a general precaution, always maintain good hygiene and drink a lot of water.


How do I get access to contraception/birth control?

According to a poll run by Pulse, 66% of respondents said they had no access to contraception during the curfew period in Sri Lanka. Some of the contraception methods available are condoms, the oral contraceptive pill, emergency contraceptive pill and IUCD. Condoms and oral contraceptive pills are the most common and can be ordered through your local pharmacy or online store. However, if you are going on the pill for the first time, Dr. Rashmira recommends getting medically evaluated first as certain people may be at higher risk of getting clots due to oral contraceptive use. The chances of you being at risk are high if you’re an underlying smoker or have other health conditions, therefore, getting tested is highly recommended.

The emergency contraceptive pill as the name suggests, is only to be used in an emergency, such as after unprotected sex. Postinor-I and Postinor-II. It is a hormonal method and should not be used regularly as it may cause side effects.


Do products like pH-balanced vaginal washes actually serve a purpose?

The vulva and vagina already have bacteria that self-cleanses. “The moment you begin to use other artificial washes, you end up killing this good bacteria. So therefore, myself and other doctors do not usually recommend using such pH- balanced vaginal washes that are available in the market,” she said.


I have had a 45 day gap between my periods. Is this normal?

Especially for teens (whose bodies are still adjusting during puberty), a gap of 21 to 45 days between periods are often normal. The older women get, their menstrual cycles become shorter and more consistent. A longer gap between periods may also indicate an underlying condition such as Poly-cystic Ovarian Syndrome (PCOS), thyroid or some other disorder. Seek a medical evaluation if you think that this is the case. A long gap can also be a sign of pregnancy. In such an event, you can purchase a pregnancy test from your closest pharmacy.

How can pregnant mothers ensure proper prenatal care during the lockdown period?

Dr. Rashmira recommends contacting an OB-GYN to ensure that you get consistent evaluations and ultrasound or dating scans. You can always change your OB-GYN later if necessary. A recent government issued gazette states that pregnant mothers are advised to contact their mid-wife or local MoH office for any concerns. The World Health Organisation in Sri Lanka has also set up a 24-hour hotline for pregnant mothers (+94710301225).

Dr. Rashmira also pointed out that pregnant mothers as well as women who plan to become pregnant must take folic acid to ensure a healthy pregnancy as it helps prevent birth defects.


How can I consult a doctor during the lockdown period?

Various measures have been put into place to ensure that consultation with doctors for different health concerns take place as usual. The oDoc app is a digital platform that users can access to video and audio consultations with a doctor over the phone. More information can be found on their website: https://odoc.life/.

Another “Doctor Call” service by MyDoctor.lk and Dialog offers users a chance to consult a doctor online. To access this service, Dialog users can type MD and send an SMS to 2407 or call 011 724 7000 to speak to a doctor.



Busting Myths on Menstruation and Contraceptives

1. Myth – You cannot buy contraceptives if you are not married.

This assumption is completely false. Everyone has access to contraceptives regardless of their marital status. Remember that you do not owe an explanation to the pharmacist in order to purchase contraceptives. It is also worth noting that methods such as oral contraception is used for many other reasons apart from having safe sex. They are also used as a remedy for painful periods, etc.

2. Myth – Wearing tampons will damage my hymen.

Unfortunately, many women are held back from wearing tampons due to the cultural and societal construct of virginity. “Inserting a tampon does not damage your hymen,” confirms Dr. Rashmira.

3. Myth – The emergency contraceptive pill results in weight gain.

There is no proven study to confirm that contraceptive pills makes one gain weight. According to Dr. Rashmira, the only proven study that shows a correlation between weight gain and contraception is the depot contraceptive injection. However, women who use oral contraceptives may find that they feel bloated or full at times. This is due to fluid retention.

4. Myth – You cannot become pregnant if you have sex during your period.

This assumption is false. Sperms can survive up to 06 days inside a female reproductive system. Therefore, there is a chance of becoming pregnant from unprotected sex during menstruation.

5. Myth – Only married women are supposed to visit a gynecologist.

Women and girls of any age should visit an OB-GYN at the right time. So when is the right time? This may be when you first become sexually active, if you are experiencing unusual pain in your vaginal area or when you are planning a pregnancy.

Most women in Sri Lanka tend to hold back from visiting a gynecologist since most of them are male. “Women should not be ashamed to ask for medical help. In fact, the Arka Initiative is working on making a list of non-judgmental and highly recommended OB-GYNs,” said Dr. Rashmira.

Additionally, it is important to go for frequent pap smear tests at either a government or private hospital. Doctors recommend doing the test at least every three years or  every five years for older women.