A normal cycle and its variations
Cycles vary from one woman to another and from one month to the next. What matters is a lasting change: periods that become further apart, stop, or become heavier or more painful.
Cycle disorders and contraception · Marrakech
Cycle disorders and contraception in Marrakech
Periods that change, hurt or are very heavy deserve an explanation, and choosing contraception is a decision made together. In Marrakech, Dr Oussama Rachid, an obstetrician-gynaecologist, sees women of all ages to understand a cycle disorder and choose the contraceptive method that suits them, in English, French or Arabic. This page is informational: it does not replace a consultation.
Go further
IUD insertionThe IUD (intrauterine device, or coil) is a small T-shaped device placed in the uterus, effective for several years. It comes in copper (hormone-free) and hormonal versions. Insertion is done at consultation and takes a few minutes; it is preceded by an examination and followed by a check. It can be removed at any time, and fertility returns quickly after removal.View the page
Contraceptive implantThe contraceptive implant is a small flexible rod, the size of a matchstick, placed under the skin of the arm under local anaesthetic. It releases a progestogen and protects against pregnancy for three years, with very high effectiveness. It can be removed at any time. Its main drawback is a change in bleeding, which is worth knowing before you choose.View the page
When to consult
Very heavy or very painful periods, no periods without pregnancy, bleeding between periods or after sex, persistent pelvic pain, an unusual delay: an examination looks for the cause.
The consultation
It covers your history, treatments and habits, a clinical examination and, as needed, an ultrasound or tests. The aim is to explain the cause and propose suitable care.
Choosing contraception
The pill, the IUD (intrauterine device), the implant, local methods or other options: the choice depends on your age, health, plans and preferences. Each method has advantages, limits and contraindications, explained before you decide.
After unprotected sex
Emergency contraception can be used as soon as possible after sex; its effectiveness depends on the delay and the method. It does not replace regular contraception: a consultation lets you discuss it.
The most common cycle disorders
A cycle is "normal" within a wide range, but some changes deserve advice:
- very heavy or long periods;
- periods that are very far apart, absent or, on the contrary, too close together;
- bleeding between periods or after intercourse;
- periods that hurt a lot or disrupt daily life;
- premenstrual syndrome that weighs on mood and sleep.
Causes vary: hormonal imbalance, thyroid disorder, polycystic ovary syndrome, fibroid, polyp, endometriosis, stress, weight changes. Hence the value of an examination rather than treating at random.
Useful tests to understand
After the history and clinical examination, the doctor may suggest a pelvic ultrasound and, in some cases, blood tests (checking for anaemia, hormones, thyroid). A pregnancy test is sometimes needed.
If bleeding remains unexplained, an examination of the inside of the uterus by hysteroscopy may be considered. Each test is offered because it answers a specific question, not out of routine.
Contraception methods
There is no ideal method for everyone: the right choice depends on your age, history, lifestyle and plans. The main options are:
- the pill (combined or progestogen-only);
- the implant under the skin;
- the IUD, copper or hormonal;
- the three-monthly injection, the ring or the patch, depending on availability;
- the condom, the only method that also protects against sexually transmitted infections;
- natural methods, which are less reliable;
- permanent contraception, reserved for those who no longer plan a pregnancy.
The doctor presents the advantages, limits and side effects of each, then you decide together.
Contraception and health: what to check
Some situations rule out or limit certain methods: a history of phlebitis or embolism, migraine with aura, high blood pressure, smoking after 35, some liver diseases or hormone-dependent cancers. This is why the consultation starts with your history and blood pressure.
Regular follow-up lets the method be adjusted if your situation changes and tolerance checked.
Contraception after birth and while breastfeeding
Ovulation can return before periods do: breastfeeding alone is not a reliable contraceptive. Several methods are compatible with breastfeeding and can be chosen before leaving the maternity unit or at the postnatal consultation.
Talk about it at the end of pregnancy so the choice is ready at the right time.
Follow-up
Contraception is reviewed over time: tolerance, change of plans, changes in your health. Regular check-ups are offered.
Procedures and examinations
The procedures and examinations linked to this care. Each is offered after a consultation, according to your situation.
Gynaecology consultation
Examination, listening and a care plan adapted to your situation.
- Gynaecological follow-up
- Pelvic pain
- Unusual discharge or bleeding
Contraception
Choosing the suitable method: pill, IUD, implant or other.
- First contraception
- Changing method
- After childbirth
Cycle disorder assessment
Understanding irregular, painful or heavy periods.
- Irregular periods
- Painful periods
- Bleeding between periods
Frequently asked questions
When should I worry about a period problem?
When the change lasts several cycles, or if periods are very heavy, very painful or absent without pregnancy. If in doubt, consult.
How do I choose contraception?
The choice is made at the consultation, according to your age, history, lifestyle and plans for pregnancy. No method suits every woman.
Is an IUD suitable for every woman?
It suits many women, including those who have not had children, but not all. The examination and your history show whether it is appropriate.
Do I need an examination before starting the pill?
Yes, a consultation checks your history (blood pressure, migraines, history of thrombosis, smoking) before choosing the most suitable pill.
What should I do after a missed pill or unprotected sex?
Act quickly: emergency contraception can be used as soon as possible. Ask a pharmacist or the clinic for advice, then consult to restart suitable contraception.
Are irregular periods normal in adolescence?
Often yes during the first two or three years after the first period. If periods are very heavy, very painful or absent beyond 15, it is useful to consult.
Does the pill make you gain weight?
Studies do not show major weight gain in most women, but tolerance varies. If you notice a troublesome effect, talk about it: another method may suit you better.
How long can an IUD stay in place?
Several years, depending on the model. The doctor tells you the duration of your IUD and when to change it, and can remove it at any time if you wish.
Can I get pregnant right after stopping the pill?
Yes, ovulation can return quickly. If you do not want a pregnancy, plan another method before stopping.
Also of interest
Gynaecological endocrinologyPolycystic ovary syndromeEndometriosisAdenomyosisOvulation calculatorPerimenopause and menopauseCervical screening and colposcopyContact and emergencies
Informational content: it does not replace a consultation. No outcome can be guaranteed.