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WOMEN'S HEALTH ADVICE
Dr Miriam says...

I suffer from very heavy periods which are painful, uncomfortable and at worst embarrassing. It's a real worry, and I'm sure it isn't normal. What can I do about it?

Heavier than normal menstrual bleeding is known as menorrhagia. It can take the form of an isolated bout of heavy 'flooding', or a period that lasts more than seven days, or periods that are very close together so that bleeding in any given month is excessive.

The difficulty in diagnosing heavy periods is deciding whether blood loss is heavier than what you're used to, or whether the amount of blood lost is abnormal. Between 30-50ml (1-2 fluid ounces) of blood is lost in a normal menstrual bleed compared with 80ml or more in an abnormal bleed.

Menstrual blood loss is controlled by the hormone progesterone. If levels of progesterone fall it usually means that you're not ovulating. The uterine lining will build up and eventually break down naturally with heavy, uncontrolled bleeding.

There are many treatment options available. One of the best solutions currently available is an IUD that's combined with the hormone progesterone. It provides virtually 100 percent protection against pregnancy and most women who are fitted with it have no bleeding whatsoever after six months.

If that doesn't suit you there are many more treatments you can try, so make sure you see your doctor who will refer you to a specialist if necessary.

Is it true that sex can give you cystitis? And is it good to drink cranberry juice when you have cystitis?

Yes. Unusual amounts of frequent and strenuous sexual intercourse can cause bruising to the urethra and lead to cystitis. Cystitis is inflammation of the bladder caused by bacteria - most commonly E. coli - spreading up the urethra into the bladder. Women are much more prone to cystitis than men because their urethra is much shorter. Most women get cystitis at some point in their lives, and it's not usually a danger to health. The main symptom is a burning, stinging sensation when urinating.

It's good to drink plenty of anything, provided it's bland. Avoid alcohol and strong coffee. Tea, milk and water are all ideal. Cranberry juice, though not bland, is a natural urinary antiseptic so may help to flush bacteria out of the bladder more quickly. It might be an idea to steer clear of other fruit juices as they are acidic. You should also consult your doctor who may take a urine specimen to confirm the infection and give antibiotics to treat it.