Managing Menstrual & Uterine Bleeding

Throughout your lifetime your experiences of menstrual periods will change. If you experience discomfort related to menstrual or vaginal bleeding, you have options.

 

Are my bleeding patterns normal?

Everybody experiences bleeding patterns differently. Try to be aware of your own body and routine, so that you know what is normal for you.

 

Menstrual Bleeding

Menstrual bleeding relates to the reproductive cycle of hormones, ovulation and menses. Menstrual bleeding occurs when ovaries have released an egg (ovum), but conception and implantation has not occurred. A few days later the uterus lining sheds, and the unfertilised egg is passed from the body, with tissue, blood and mucus passing out of the vagina as menstrual bleeding.  

Any person who ovulates may be able to experience menstruation. This includes young girls, older women, intersex, queer and trans people. Menstrual bleeding has many alternative names, including ‘period’, ‘bleeding’, ‘rags’ or ‘visitor’.

 

Uterine Bleeding

Uterine bleeding is when the uterus lining sheds for a reason other than menstruation. There are many reasons why uterine bleeding may occur including, stress, a change in diet, weight gain or loss, medications including contraceptives, an infection, a medical condition such as polycystic ovarian syndrome, or even very serious conditions such as cancer. If you experience uterine bleeding it may or may not look or feel the same as menstrual bleeding. It is important to seek health advice if you experience uterine bleeding to clarify the cause and ensure your health.

Managing Discomfort

There are ways to manage discomfort due to menstrual or uterine bleeding. Hormonal contraceptives can be used to influence regular bleeding patterns, reduce the amount of blood tissue lost during a bleed and reduce cramping and pain. Non-hormonal options can be used to increase overall physical and mental health and to reduce swelling and tension.

Discomfort  Hormonal Options Non-Hormonal Options
 Headaches or migraines  Consider:

  • Hormonal IUD

  • Contraceptive Injection

  • Contraceptive Implant

  • Contraceptive ring

  • Daily Contraceptive pill

  Consider:

  • Stay hydrated

  • Low to moderate intensity exercise 

  • Sleep right – too little sleep can be a trigger, but so can excessive sleep or shift work.

  • Reduce stress in your life

  • Head and neck massage or physio can be helpful.

  • Consider food and environmental triggers – caffeine, alcohol, computer screens, humidity, loud noises and bright lights

  • Talk to a chemist or a doctor about anti-inflammatory medication  
Cramping, bloating, nausea, vomiting or diarrhoea  Consider:

  • Hormonal IUD

  • Contraceptive Injection

  • Contraceptive Implant

  • Contraceptive ring

  • Daily Contraceptive Pill

  Look after yourself:

  • Use a hot water bottle or heat pack on your abdomen or lower back

  • Talk to a chemist or a doctor about anti-inflammatory or anti-nausea medication 

  • Consider dietary factors – keep well hydrated but limit salt, caffeine, alcohol and processed foods.  

  • Low to moderate intensity exercise
 Irregular bleeding  Consider:

  • Hormonal IUD

  • Contraceptive Injection

  • Contraceptive Ring

  • Daily Contraceptive Pill (combined or progestogen only)

 Seek advice and assessment from a health professional.
 Heavy bleeding  Consider:

  • Hormonal IUD

  • Contraceptive Injection

  • Contraceptive Implant

  • Contraceptive Ring

  • Daily Contraceptive Pill (combined or progestogen only)

 Seek advice and assessment from a health professional.
 Sexual activities  Consider:

  • Hormonal IUD

  • Contraceptive Injection

  You can still have sex providing you feel comfortable:

  • Sexual stimulation can be enhanced due to increased sensitivity

  • Menstrual or uterine blood flow often reduces during sexual stimulation to make way for vaginal fluid

  • If you are worried about staining sheets, put a towel down first or have sex in the shower

  • Consider methods of sexual activity that don’t involve vaginal penetration
 Other  The full range of hormonal menstrual management options include:

  • Hormonal IUD

  • Contraceptive Injection

  • Contraceptive Implant

  • Contraceptive Ring

  • Daily Contraceptive Pill (combined or progestogen only)

 Every woman experiences menstruation differently. Use the resources around you:

  • Talk to other people in your life who also menstruate about what methods they use 

  • If you don’t like buying pads and tampons consider a menstrual cup or cloth pads

  • Map your health in a diary to identify patterns and help you to predict and plan for days of discomfort

  • Visit a reproductive and sexual health clinic for advice

 

How do hormonal options work?

Hormonal contraceptives cause the lining of the uterus to thin and stabilise, resulting in lighter menstrual bleeding and less intense menstrual symptoms such as pain or bloating.

Some hormonal contraceptives also block ovulation, and allow a person to control when the shedding of the lining of the uterus occurs, scheduling the bleeding for a convenient time, or deferring the bleeding indefinitely.

 

When to ask for advice

It is important to seek medical advice if you are experiencing a change in your regular bleeding patterns. It may involve heavier bleeding, bleeding in between the periods, bleeding during or after sex, increased abdominal pain, or migraines.

 

Where to get further advice

Make an appointment with a reproductive and sexual health clinic. Clinical staff will undertake a thorough health assessment to understand why you are experiencing discomfort. If you are interested in hormonal options we can discuss your various contraceptives choices. If you want to avoid hormonal options we can discuss alternative methods of menstrual and uterine bleeding management.

 

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