Different Strokes Charity - Support for Working Age Stroke Survivors UK
Different Strokes Charity - Support for Working Age Stroke Survivors UK

Why has my period changed since my stroke?

It’s long been a discussion topic in our closed Facebook group that those who have periods may find that they change after a stroke. From bleeding more heavily to increasing pain. We asked GP, Different Strokes Trustee, and fellow stroke survivor Satinder to shed some light on why this could be and importantly, what to do if you are suffering.

Picture of Dr Satinder Sanghera

Dr Satinder Sanghera

Satinder has been a GP in the North East of England for over 25 years. She is a Different Strokes Trustee and a fellow stroke survivor after surviving a stroke aged 20

What causes changes to menstruation after a stroke?

The stroke itself should not have caused any changes including the heaviness of your period but it is possible that it has changed due to other adjustments you have made because of the stroke. Have you started any new medications or stopped taking the oral contraceptive pill? Blood thinners such as Warfarin or possibly clopidogrel can cause heavy periods. Are you at the age where menopause is a possibility? Stress and depression can also affect your periods by either stopping them or causing them to become more heavy and painful.

What advice would you give to survivors suffering with heavier and more painful periods?

The most important thing to do first is to understand the reasons behind why your periods have become heavier and more painful. They can sometimes be heavy at different times, like when you first start your periods, after pregnancy, or during menopause.

Sometimes, they can be caused by:

  • conditions affecting your womb, ovaries, or hormones, such as Polycystic ovary syndrome, fibroids, endometriosis, and pelvic inflammatory disease
  • some medicines and treatments, including some Anticoagulant medicines including warfarin or clopidogrel and chemotherapy medicines
  • Stress and depression can also affect how heavy and painful your period becomes, both of which can become more prevalent after a stroke

Often survivors mention feeling embarrassed to mention it to their doctor, as a GP what would you say to this?

As a female GP who has been working for 30 years I have seen thousands of women with these complaints. It is common and most importantly treatable. significantly improving the woman’s quality of life. As clinicians we do not consider any area of the body as embarrassing or taboo. As a GP we simply view this as a clinical problem which affects the patient. Our primary focus is to improve the situation for that person.

What might a doctor advise or do to help with this issue?

Drugs can be prescribed to reduce painful and/ or heavy periods. If mostly painful, then anti-inflammatory painkillers like ibuprofen can help when needed. If you can’t take this, paracetamol, codeine and a hot water bottle can help.

In some situations and depending on the type of stroke you had, hormone therapies may be an option and the Mirena intrauterine device can be fitted for most types of stroke. I have fitted hundreds of these over the years and it is considered the best non-invasive treatment for heavy periods.

Surgical treatment depending on the cause includes:

  • Endometrial ablation, is an operation to destroy or remove most of your womb lining
  • Myomectomy is an operation to remove fibroids without removing your womb.

What would you advise someone whose doctor isn't taking their concerns seriously?

This is a concern which the health profession and government recognise as causing distress to women. Some doctors don’t see enough of these problems and are therefore uncomfortable managing them. Find out which GP at your surgery has an interest in women’s health. You may have to wait longer to get an appointment but it will be worth it. 

On a positive note, the government recently appointed Dame Lesley Regan,  professor of obstetrics and gynaecology at Imperial College London, as the first women’s health ambassador for England. This new role has been created to help close the gender health gap. She is passionate about women’s health and improving services specifically for women beyond maternity care.

She will also ensure that undergraduate training at medical school includes compulsory training in women’s health issues.

GP-led family planning clinics used to be available in a number of surgeries. I ran such a service as a GP partner in Weardale for 20 years and the service was provided to women on a Monday evening where we covered all their issues related to menstrual disorders, pelvic pain, pessary fitting for vaginal prolapse, and any contraceptive requirements including the fitting of long-acting contraceptive devices. Sadly a lot of these services became outsourced. Hopefully, our new ambassador with her seat at the health department’s table will be able to reinstate this service within general practice. It’s on her to-do list and as you know women’s lists do get completed!

A huge thank you to Satinder for answering these questions. We hope you find them useful!

If you want to chat with fellow stroke survivors join our online group by clicking HERE

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