General Gynecology

Menstrual cycle alteration, menstrual pain & genital infections

Changes in the menstrual cycle, menstrual pain and genital infections are among the most common reasons to visit a gynecologist. These problems can appear separately or at the same time and they often raise questions and worry.

In Lisbon, Dra. Joana Faria offers consultations focused on menstrual health and genital infections in Portuguese, English, French, and Spanish. The aim is to understand your symptoms, identify the cause and build a clear and realistic plan together.

This page gives an overview of these topics. You can read more detail in the dedicated pages about menstrual cycle alteration, menstrual pain and genital infections.

What it is

Menstrual and genital problems can affect women at different ages. They may be linked to hormonal changes, benign diseases of the uterus or ovaries, infections or other medical conditions. The main groups are:

  • Menstrual cycle alterations cycles that are too short or too long, irregular bleeding, missed periods or very heavy flow.
  • Menstrual pain cramps or pelvic pain before or during periods, sometimes radiating to the back or legs.
  • Genital infections vaginal discharge, itching, burning, unpleasant odour, pain during intercourse or when passing urine.

These symptoms are frequent and many of them have simple explanations. At the same time, it is important not to ignore changes that persist, because they can occasionally be a sign of underlying disease.

Main symptoms and when to worry

Some changes in the cycle or discharge are expected at certain moments of life, for example around the first periods, after childbirth or near menopause. Others need evaluation, especially if they are new, intense or affecting daily life.

You should consider booking a consultation if you notice:

  • Cycles shorter than 21 days or longer than 35 days for several months.
  • Bleeding between periods or after sexual intercourse.
  • Very heavy periods, with clots or the need to change protection very frequently.
  • Menstrual pain that makes you miss work, school or usual activities.
  • Persistent pelvic pain that is not limited to periods.
  • Vaginal discharge that changes in colour, texture or smell, especially if combined with itching or burning.
  • Pain during intercourse or when urinating.

You should seek urgent care if you have very heavy bleeding with dizziness or fainting, sudden severe pelvic pain, fever with strong pain, or pain in the lower abdomen during pregnancy. These can be signs of emergency situations that need immediate attention.

Diagnosis: exams and what to expect

The first step is always a careful conversation about your symptoms. Many women feel anxious about gynecologic exams. Dra. Joana Faria explains each step in advance and adapts the examination to your comfort.

Depending on your situation, the consultation may include:

  • Clinical history
    Questions about your cycle, previous pregnancies, contraception, sexual life, other medical conditions and family history.
  • Gynecologic examination
    Inspection of the external genital area, speculum examination of the vagina and cervix and bimanual palpation of the uterus and ovaries.
  • Pelvic ultrasound
    Transvaginal or abdominal ultrasound to look at the uterus and ovaries, check the endometrium and identify fibroids, polyps, cysts or other changes.
  • Vaginal or cervical swabs
    Samples taken to study infections, including common causes of discharge, itching or burning.
  • Blood tests
    When appropriate, tests for anaemia, hormones, inflammation or other markers.

Not every woman needs all these exams. The plan is individual and depends on your age, symptoms and risk factors.

Treatment options and follow up

Treatment depends on the cause of your symptoms. For many conditions there is more than one option. The goal is to choose an approach that is effective, realistic and compatible with your plans for fertility and contraception.

Examples of possible treatments include:

  • Hormonal or non hormonal methods to regulate or lighten periods.
  • Specific pain management for menstrual cramps and chronic pelvic pain.
  • Targeted treatment of infections and advice to reduce recurrences.
  • Management of benign diseases such as fibroids, endometrial polyps or ovarian cysts, sometimes in collaboration with the gynecologic surgery team.
  • Referral for additional fertility or endocrine evaluation when indicated.

Follow up consultations are important to check how you respond to treatment and to adjust the plan when needed. If your situation changes, the approach can be adapted rather than starting again from zero.

How Dra. Joana Faria approaches these problems in practice

Dra. Joana Faria knows that menstrual problems and genital symptoms can be both physically and emotionally challenging. They can affect work, study, intimacy and self confidence. Her approach is based on listening and on clear explanations.

In daily practice she:

  • Creates space for you to describe your symptoms without minimising them.
  • Explains test results in simple language and clarifies what has been ruled out.
  • Avoids unnecessary treatments and antibiotics when they are not needed.
  • Coordinates care between general gynecology, surgery and fertility when problems are complex.
  • Encourages you to ask questions and to share what matters most to you when choosing between options.

For many patients, this approach turns a worrying set of symptoms into a plan that feels structured, understandable and manageable over time.

FAQ

Frequently Asked Questions


When should I worry about irregular periods?

Irregular cycles can be normal at certain stages of life, for example in the first years after the first period or around menopause. You should seek a gynecology consultation if cycles are shorter than 21 days or longer than 35 days for several months, if you have very heavy or prolonged bleeding or if periods stop for several months without pregnancy. A structured evaluation can identify causes such as hormonal changes, stress, polycystic ovary syndrome or other conditions and guide treatment.

Is severe menstrual pain always normal?

Mild cramps around menstruation are common. Pain that makes you miss work or school, that does not improve with simple pain relief or that worsens over time is not something you need to accept as normal. It can be related to conditions such as endometriosis, adenomyosis, fibroids or pelvic infections. A gynecology consultation can help identify the cause and offer effective options to reduce pain and improve quality of life.

How can I tell the difference between normal discharge and infection?

Some vaginal discharge is normal and can vary during the cycle. It is usually clear or white, without strong odour and without itching or burning. Discharge that is green, grey, very yellow, that has a strong smell or that is associated with itching, burning, pain or bleeding may indicate infection or another problem. Only an examination and, when needed, swabs can confirm the cause, so it is important not to self diagnose or self treat repeatedly without medical advice.

Can stress or lifestyle changes affect my cycle and symptoms?

Yes. Stress, weight changes, intense exercise, travel and changes in sleep or work schedules can influence hormones and the menstrual cycle. They can lead to delayed periods, lighter or heavier bleeding or more pain. Even when stress plays a role, it is still important to rule out other causes, especially if the changes are significant or persistent. Your doctor can help you differentiate what seems linked to lifestyle and what needs further investigation.

Is it safe to treat infections with over the counter products without seeing a doctor?

Occasional mild symptoms in a woman who already knows her usual pattern may sometimes improve with over the counter products. However, repeated self treatment without examination can mask underlying problems, delay appropriate diagnosis and contribute to resistance to some medicines. If symptoms are intense, if they keep coming back or if you are not sure of the cause, it is safer to have a gynecology consultation and targeted treatment.

Schedule

Book your consultation


In person

XClinic

Av. Eng. Duarte Pacheco, nº26 - Piso intermédio 1070-110 Lisboa (in front of Amoreiras Shopping)

Online

Video consultation

On zoom

photo gallery of Dra Joana Faria operating and performing lectures