History of Menstruation

These are questions that will be asked by your doctor. It is very important in gynaecological disorders.

i)How old were you when the monthly periods (menstrual periods) began. This is the age of menarche.

ii) What is the date of your last period?Can you remember it. What the the period before the last one?

iii)How often do you have your menstrual periods?This is the average date between the periods. It is about 28 days on average.

iv)How regular are your periods?Are the regular or irregular?

v)How long does the menstrual periods last?How many days does it last?

vi)How heavy is the menstrual flow?How many pads or tampons do you use daily?Do you use more than one at a time?

vii)Do you have any bleeding between periods?

viii)Do you bleed after sexual intercourse?

ix)Do you have any pain or discomfort during your periods?If so what is it like? How long does it last?

x) In middle-aged and older women you may ask if she has stopped menstruating.

xi) In adolescent girls you may ask questions like, do you know about monthly periods?, How did you first learn about monthly periods? Have you been bothered sometimes that you periods got delayed?

In the United States girls begin to menstruate between the ages of 9 and 16. It often takes 1 year or more before it settles into a regular pattern.

The average interval between periods ranges from 24 to 32 days. The flow lasts from 3 to 7 days.

History of Menopause

Menopause is a retrospective diagnosis. It is the absence of menses for 12 consecutive months (usually between the ages of 48 and 55 years).

Ask for the history of associated symptoms.

Associated symptoms include hot flashes, flushing, sleep disturbances and flushing.

Have you stopped having your regular periods?

Have your periods stopped completely?

How do you feel about not having your periods anymore? Has this affected your life in any way?

Postmenopausal bleeding

Postmenopausal bleeding is defined as bleeding that occurs six months without periods. It warrants further investigations (because of the high risk of endometrial cancer).

Amenorrhoea

This is absence of periods. There are two types primary amenorrhoea and secondary amenorrhoea.

Primary amenorrhoea refers to a condition where the girl/woman has never had her periods (failure to initiate periods).

Secondary amenorrhoea refers to cessation of periods after it has been established.

However secondary amenorrhoea may also have normal (physiologic forms) such as in pregnancy,lactation and menopause.

Oligomenorrhoea

This refers to infrequent periods which may also be irregular.It occurs for about two years after menarche and also before menopause.

Dysmenorrhoea

This is pain during menstruation.

It is a bearing down, aching or cramping sensation in the lower abdomen/pelvis.

Premenstrual syndrome (PMS)

This refers to a complex of symptoms which usually occur about 4 to 10 days prior to the onset on menses. Symptoms include irritability, depression,mood swings,weight gain, edema, bloating,tenderness of the breast ,headache,nervousness and tension. These symptoms are usually mild.

Sometimes women may present with severe and disabling PMS symptoms.

Polymenorrhoea

This refers to abnormally frequent periods.

Metrorrhagia

This is bleeding in between periods. It is also known as intermenstrual bleeding.

Postcoital bleeding

This is bleeding after sexual intercourse or other forms of vaginal contact such as douching etc.

References:

Pages 432 to 435. Health History. The female genitalia. Chapter 12. Bates guide to physical examination and  history taking.9th edition. Lynn. S. Bickley.

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