My periods are heavy and longer

To some women, a period may have clots as a common occurrence that may not indicate any medical problems. File photo

Dear Doctor: My periods last two weeks and the flow is heavier than usual since I stopped using contraceptives (injection), one and a half years ago. Will I get pregnant? I am surprised that I bleed excessively after I got off the injection.
Prossy Lubwama

Dear Prossy: At some point in her reproductive life, a woman may experience a heavy menstrual period.

The period normally occurs every 21 to 35 days and lasts four to six days with a blood loss of about 40cc. As such, it may not be the same every month or for other women.

Teens and women approaching menopause (times when women’s oestrogen female hormone levels tend to be higher and progesterone lower), those who have had children or those who are taller, bleed heaviest. Menorrhagia refers to losing 80 cc or more of blood during one period.

In a normal period, a balance between the female sex hormones, oestrogen and progesterone regulates the growth of the lining inside the womb (endometrium), which is shed during the period.

Depo Provera, a long-acting progesterone-only contraceptive may upset this balance leading to irregular, and sometimes prolonged periods or heavy bleeding which usually abates after one year of contraceptive use. Lack of a period becomes increasingly common with longer use.

When one stops using Depo Provera injections, the period normalises within three to 10 months. But it may take an average of nine months to a year for one to become pregnant.
It is common for some women to get off Depo Provera, have normal periods only for them to become irregular after some months.

Though in your case, Depo Provera may be to blame, visit your gynaecologist to investigate other causes of bleeding such as a miscarriage and fibroids, which become more likely when a woman takes longer to reproduce.

A routine PAP smear to rule out cancer of the cervix should be carried out. The doctor will also investigate your fertility because an older couple may be less fertile, other factors being equal.

Dear Doctor: I am pregnant but I feel very weak and sleepy. Are there drugs I can take to recover?

Annet Bugingo

Dear Annet: Pregnancy may first be suspected when a woman feels weak unexpectedly and as a result of this weakness, sleeps too much.
Weakness is thought to be part and parcel of pregnancy; due to hormonal changes in the early stages. And later, because pregnancy puts a lot of physical and psychological energy drain on a woman accommodating another human being.

In the second trimester, a lot of blood is taken away towards the womb and placenta to nourish the unborn.

During this time, general weakness is associated with a drop in pressure because meagre amounts of blood are available to the rest of the body making a woman short of her usual strength.

Many pregnant women may feel weaker because of conditions such as anaemia resulting from short intervals between pregnancies or hookworm infestation, poor diet and malaria.

Such conditions can be detected at an antenatal clinic which you should attend immediately.

At the clinic, you will be given health advice, tetanus immunisation and iron supplements, among others, to boost blood.

Otherwise, adequate rest will be refreshing. Take enough fluids earlier in the day so that you do not keep waking up to urinate at night. Moderate exercise such as walking to increase your energy levels and avoiding stressful situations can help too. Eating foods that have iron (except liver) and protein can help boost energy.

Taking vitamin supplements is advisable because food may not provide enough nutrition given morning sickness and poor appetite, among others. However, Vitamin A supplements that carry a risk of abnormalities in the unborn should be avoided.