Four renowned doctors share insights to help women take charge of their reproductive and menstrual health.

Managing Menstrual Health

Dr Chandrakant Sankalecha, MD, FICOG; Lead Consultant at Sankalecha Hospital and Maternity Home; Former President, IMA Nashik and Nashik Obstetrics and Gynecological Society

Menstrual health is a vital aspect of a woman’s well-being, evolving through different life stages. During adolescence, young girls may experience irregular cycles, cramps and hormonal fluctuations. Establishing healthy habits like maintaining a balanced diet, staying active and tracking cycles can help manage symptoms and support long-term reproductive health. In the reproductive years, cycles often become regular, but issues like PMS, heavy bleeding or irregular periods may arise due to stress, lifestyle or conditions like PCOS or thyroid imbalances. Prioritising nutrition, hydration and exercise, while monitoring changes, is essential. Women trying to conceive should stay attentive to their menstrual health, as irregularities may signal fertility concerns.

Approaching perimenopause in their 40s, women often face unpredictable cycles, hot flashes and mood swings. A nutrient-rich diet with calcium, vitamin D and omega-3 fatty acids can help ease symptoms. Regular gynecological check-ups remain important for monitoring changes.

After menopause, hormonal shifts can affect bone health, metabolism and cardiovascular health. Staying active, maintaining a healthy weight, and managing stress are crucial for overall well-being. Understanding menstrual health at every stage empowers women to take proactive steps towards better health and quality of life.

Ideal Nutrition During Perimenopause

Dr Bharathi Rajashekhar, President, KSOGA; MD, DGO, FICOG, FKCOG; IMA State Vice President.

Perimenopause, the transition leading up to menopause, usually begins in a woman’s 40s and can last several years. Fluctuating estrogen and progesterone levels can cause symptoms like irregular periods, hot flashes, mood swings, weight gain and decreased bone density. Proper nutrition plays a key role in managing these changes, supporting overall health, and reducing long-term risks such as osteoporosis and heart disease.

Key nutrients for perimenopause include calcium (found in dairy, leafy greens and almonds) to support bone health, and vitamin D (from sun exposure, fatty fish and fortified foods) to aid calcium absorption. Magnesium (nuts, seeds, whole grains) helps with bone strength, muscle function and mood regulation. Omega-3 fatty acids (fatty fish, flaxseeds, walnuts) reduce inflammation, support heart health and improve mood, while fibre-rich foods (whole grains, fruits, vegetables) aid digestion, weight management and blood sugar regulation.

Beyond essential nutrients, plant-based compounds like soy isoflavones (from black soybeans) mimic estrogen and may help reduce hot flashes, night sweats and mood swings. Black cohosh, a traditional herbal remedy, is known for alleviating hot flashes, sleep disturbances and hormonal fluctuations.

A nutrient-rich diet during perimenopause can help manage symptoms and promote long￾term well-being. Making these dietary adjustments, along with regular exercise and stress management, can help women navigate this transition with better health and vitality.

Understanding Premenstrual Syndrome

Dr Priya Gupta, MBBS, MS (Civil Hospital, Ahmedabad), FICOG; Gold Medallist, Diploma in Advanced Endoscopy and Urogynaecology (Keil, Germany); Sr Consultant Obstetrician; Gynec Laparoscopic Surgeon; Infertility Specialist at Kota Heart & Shriji Hospital, Kota (Raj).

Premenstrual Syndrome (PMS) affects millions of women worldwide, typically in the days leading up to menstruation. It involves a range of physical, emotional and behavioural symptoms that can vary from mild discomfort to severe distress. Hormonal fluctuations, particularly in estrogen and progesterone levels, along with serotonin imbalances, often contribute to symptoms like mood swings, irritability and anxiety.

Common symptoms include bloating, breast tenderness, headaches, fatigue, food cravings and difficulty concentrating. Some women may also experience sleep disturbances and heightened stress sensitivity. Lifestyle factors like poor diet, lack of exercise, high caffeine intake and inadequate sleep can worsen symptoms.

Managing PMS effectively involves maintaining a balanced lifestyle. A nutrient￾rich diet with foods high in magnesium, calcium and vitamin B6 can help alleviate symptoms. Reducing salt, sugar and caffeine intake may minimise bloating and mood swings. Regular physical activity, stress management techniques, and adequate sleep are also beneficial.

While PMS can be challenging, adopting healthy habits can significantly improve well-being. If symptoms become severe and interfere with daily life, seeking medical advice is essential for effective management and relief. Understanding PMS empowers women to take proactive steps towards better menstrual health.

Fertility Health

Dr Nibedita Roy, Gaheer Senior Obstetrician and Gynaecologist, Kolkata, with special interest in High-Risk Obstetric Care and Infertility.

Conceiving a child is a personal journey that can be challenging for some women due to lifestyle, hormonal imbalances or health conditions. Optimising fertility through healthy habits can significantly improve the chances of pregnancy. A nutrient-rich diet with folic acid, omega-3 fatty acids, antioxidants, iron and zinc supports reproductive health, egg quality and hormone regulation. Maintaining a healthy weight is essential, as both underweight and overweight conditions can disrupt ovulation and menstrual cycles.

Tracking ovulation helps identify the fertile window for the best chances of conception. Methods like ovulation predictor kits, basal body temperature tracking, and cervical mucus observation can be effective. Additionally, limiting caffeine, avoiding alcohol and quitting smoking can enhance fertility and reduce pregnancy risks.

Taking prenatal vitamins before conception, especially folic acid, vitamin D, and Coenzyme Q10, supports reproductive health. Women struggling to conceive for over a year (or six months if over 35) should seek medical advice. Conditions like PCOS, thyroid disorders and endometriosis can affect fertility, and early diagnosis ensures timely management.

By making positive lifestyle changes, women can improve their reproductive health. With patience, self-care and medical support, the path to conception can become a smoother and more hopeful experience