In a normal menstrual cycle there is regular hormone production and thickening of the lining of the uterus. This cycle primes the endometrium (uterine lining) for implantation of a developing embryo. If no implantation occurs, the lining sheds, resulting in a menstrual period. There are two phases in the menstrual cycle: the follicular phase and the luteal phase. The follicular phase occurs prior to ovulation and involves thickening of the lining of the uterus. This phase usually lasts 10 to 14 days. The luteal phase is the period of time from ovulation to the onset of menses when the lining of the uterus undergoes stabilization prior to menses. This phase usually lasts 14 days.

During the first 2 years after the onset of menstruation, cycles are often irregular. These early cycles are often anovulatory - there is no ovulation during the menstrual cycle and therefore the luteal phase does not occur properly. Because of this a woman will experience irregular bleeding. As long as the menstrual cycles are no longer than 40 days, no shorter than 21 days, and the duration of bleeding is no longer than 7 days, this is considered normal in a woman who has recently started menstruating.

If irregular bleeding lasts longer than 2 years or the blood flow is excessive, your physician may suggest further evaluation.

Migraine headaches that occur on a cyclic basis with the menstrual cycle are known as menstrual migraines. To classify as a menstrual migraine, the headache must begin anywhere from 1 day before to 4 days after the onset of menses. Approximately 15% of migraine sufferers are classified as having menstrual migraines.

Treatment of menstrual migraines is similar to that for standard migraine headaches. The one advantage for women with menstrual migraines is that they can start their treatment earlier, since they will be able to anticipate when their migraine will occur. Lifestyle changes such as increased exercise and diet low in salt, fat, and sugar has been shown to help alleviate menstrual migraines. Non-steroidal anti-inflammatory agents such as ibuprofen or naproxen are often a good first-line choice of medication. In women with severe migraines, sumatriptan (Imitrex) has been extremely effective. Women often experience relief within one hour of a subcutaneous injection.

Premenstrual Syndrome (PMS) is a disorder experienced by many women. This syndrome has many associated symptoms. One of these symptoms is bloating. This often begins approximately 1 to 2 weeks prior to menses and is characterized by bloating and weight gain. Often women notice a significant reduction in their weight immediately after menses.

Initial treatment for PMS is lifestyle changes such as exercise and changing your diet to decrease salt, caffeine, and chocolate intake. If you have a significant amount of bloating prior to your menses and it is affecting your daily life, your physician may prescribe a diuretic to be taken during the second half of your menstrual cycle. This is known as a “fluid pill” in lay terms and is often used to treat people with high blood pressure. A common diuretic used for premenstrual bloating is spironolactone. To date, studies on diuretics have been conflicting, and it is not clear if they truly help premenstrual bloating. Although no good studies support their use, many women report improvement in symptoms with the use of birth control pills.

What you are describing is a normal pattern of menstruation and a normal menstrual period. A normal menstrual period last about 5 to 7 days, the bleeding is heaviest during the first couple of days and then slows for the remaining 3 or 4 days. As your bleeding slows, the blood clots. This could be what you are seeing. Another possibility is that you are seeing a portion of the uterine lining (endometrium) which is the tissue that is shed during menstruation. In short, you should be reassured that your period is normal. Because you are of reproductive age, you should make certain that your diet is rich in folic acid and that you are getting enough calcium and iron. You might consider supplementing your diet with these vitamins and minerals.

Periods are also known as menstrual cycles. The onset of menstrual cycles (menarche) occurs during the teenage years. Menstruation continues until a women is in her 50s and reaches menopause. The average age for starting periods is 12 to 16 years of age, with a median age of 13. Primary amenorrhea is a condition where a woman fails to start her menstrual cycles. If you have other signs of puberty, such as breast development or pubic hair, but fail to start your menses by the age of 16, you should see a physician. If you have no signs of puberty by age 14, you should see a physician

Fibrocystic changes of the breasts are very common, especially from the ages of 20 to 50, and are thought to be directly related to estrogen. Fibrocystic breast masses usually occur on a cyclic basis in relation to the menstrual cycle. They can be quite painful and often appear rapidly with the onset of menses, and then disappear afterward.

The most important characteristic of a fibrocystic lesion of the breast is that it resolves on its own. If your masses/cysts do not resolve, especially after a menstrual cycle, you need to see your physician so that the mass can be further evaluated to assure that it is not a cancerous lesion. This evaluation may necessitate cyst aspiration or biopsy of the mass.

Often people with fibrocystic changes of the breasts notice associated breast tenderness. This pain may be alleviated by wearing a tight bra for support. Although there is no good evidence to support its use, many physicians advocate use of vitamin E and reduction of caffeine to alleviate some of the symptoms.

If you have cysts under the skin, rather than in your breast tissue, you may need other treatments. You should see your physician to exclude this possibility.

Stress affects our bodies in ways that we do not yet understand. Scientists know that many types of stress activate the body’s endocrine (hormone) system, which in turn can cause changes in the immune system, the body’s defense against infection and disease (including cancer). On the positive side for women, there is some evidence that women who breast-feed their infants produce lower levels of stress response hormones, such as Adrenalin and Cortisol, than do women who bottle-feed.

It is not at all unusual for it to take several months for your body to get back to normal after childbirth and surgery.

Most women ovulate approximately 14 days prior to the onset of their menstrual cycle. Therefore, if you have regular 28-day periods, you should be ovulating on approximately Day 14. The best chance of pregnancy is 3 to 4 days before ovulation and approximately 2 days after ovulation. Therefore, intercourse during this time frame would have the highest likelihood of being successful. There are ways to test for ovulation such as measuring your basal body temperature or testing your urine for a luteinizing hormone (LH) surge. This may help a woman determine the time of ovulation if her cycle is irregular.

Laparoscopy is a surgical procedure performed through very small incisions in the abdomen, using specialized instruments. The abdominal cavity is inflated with carbon dioxide gas (CO2) and distended. A pencil-thin instrument called a laparoscope is used; it has lenses like a telescope to magnify body structures, a powerful light to illuminate them, and a miniature video camera. The camera sends images of the inside of the body to a TV monitor in the operating room. Specialized surgical instruments can be inserted through the small incisions nearby. This type of surgery is called ‘minimal access’ because of the very small incisions used. Yet major procedures can now be performed using this technique.

Diagnostic hysteroscopy is used to look inside the uterus. If an abnormal condition is detected during the diagnostic procedure, operative hysteroscopy can often be performed to correct it at the same time, avoiding the need for a second surgery.

Yes, a patient who has undergone multiple operations in the past can undergo this procedure and if there are adhesion because of previous operations, they can be removed along with the laparoscopic hysterectomy, in the same sitting. It is easy to do laparoscopic adhesiolysis laparoscopically than traditional open surgery.

Yes, you will be able to lead your sexual life perfectly the same way as before sugery. The vaginal length is preserved during laparoscopic hysterectomy compared to routine abdominal hysterectomy and vaginal hysterectomy in which the vaginal length gets shortened and one experiences dyspareunia post operation.

No, unless both ovaries are removed. Then you will need to take only the oestrogen tablets, to replace natural hormones – and these only for a limited time.