What are Menstrual Problems?
Menstrual cycles often bring about a variety of troubling symptoms that date back to your time. Premenstrual syndrome (PMS) covers the most common issues, such as mild cramping and fatigue, but symptoms usually go away when you start them.
However, other, more serious menstrual problems can also occur. Periods that are too heavy or too light, or the complete absence of a cycle, may suggest other problems are contributing to the abnormal menstrual cycle.
Remember that a “normal” menstrual cycle means something different for every woman. A cycle that is regular for you may be abnormal for someone else. If you notice a significant change in your menstrual cycle, it’s important to stay in tune with your body and talk to your doctor.
There are several problems you may experience.
PMS occurs one to two weeks before your period starts. Some women experience a variety of physical and emotional symptoms. Others experience few or even none of the symptoms. PMS can cause:
- back pain
- chest pain
- food cravings
- feeling of stress
- insomnia disease
- mild stomach cramps
You may experience different symptoms each month, and the severity of these symptoms can also vary. PMS is bothersome, but usually not a concern unless it interferes with your normal activities.
Another common menstrual problem is a heavy period. Heavy periods, also called menorrhagia, cause you to bleed more than usual. Also, your average duration may be longer than five to seven days.
Menorrhagia is most often caused by imbalances in hormone levels, particularly progesterone and estrogen.
Other causes of heavy or irregular menstrual bleeding include:
- vaginal infections
- inflammation of the cervix
- under-reduced thyroid gland (hypothyroidism)
- noncancerous uterine tumors (fibroids)
- changes in diet or exercise
In some cases, women may not menstruate in their cycle. This is called amenorrhea. Primary amenorrhea is when you don’t get your first period until age 16. It can be caused by a problem with the pituitary gland, a congenital defect of the female reproductive system, or a delay in puberty. Secondary amenorrhea occurs when you stop getting your regular periods for six months or longer.
Common causes of primary amenorrhea and secondary amenorrhea in young people are:
- overactive thyroid gland (hyperthyroidism)
- ovarian cysts
- sudden weight gain or loss
- stopping birth control
When adults do not menstruate, the common causes are often different. These may include:
- premature ovarian failure
- pelvic inflammatory disease (reproductive infection)
- stopping birth control
A missed period could mean you are pregnant. If you think you might be pregnant, be sure to take a pregnancy test. Pharmacy pregnancy tests are the most expensive way to determine if you are pregnant. For the most accurate results, wait until you’ve missed your period at least one day before taking the test.
Not only may your period be lighter or heavier than usual, it may also be painful. Cramps are normal during PMS and also occur as your uterus contracts when your period starts. However, some women experience incredible pain. Extremely painful menstruation, also called dysmenorrhea, is linked to an underlying medical problem such as:
- pelvic inflammatory disease
- abnormal growth of tissue outside the uterus (endometriosis)
Diagnosing Menstrual Problems
The first step in diagnosing menstrual problems is seeing your doctor. Your doctor will want to know about your symptoms and how long you’ve had them. You can come prepared by taking notes about your menstrual cycle, how regular it is, and whether you’re experiencing any symptoms. Your doctor can use these notes to find out what’s abnormal.
In addition to the physical exam, your doctor will likely perform a pelvic exam. A pelvic exam allows your doctor to evaluate your genitals and determine that your vagina or cervix is not inflamed. A Pap smear is also done to rule out the possibility of cancer or other underlying conditions.
Blood tests can help determine if hormonal imbalances are causing your menstrual problems. If you suspect you may be pregnant, your doctor or nurse practitioner will order a blood or urine pregnancy test during your visit.
Other tests your doctor may use to diagnose the source of your menstrual problems include:
- endometrial biopsy (used to remove a sample of your uterine lining that can be sent for further analysis)
- hysteroscopy (a small camera is inserted into your uterus to help your doctor find any abnormalities)
- ultrasound (used to produce a picture of your uterus)
Treating Menstrual Problems
The type of treatment will depend on what is causing the problems with the menstrual cycle. Birth control pills can relieve PMS symptoms and also regulate heavy flows. If a heavier or lighter-than-normal flow is associated with a thyroid or other hormonal disorder, you may experience more regularity when you start hormone replacements.
Dysmenorrhea may be hormone related, but you may also need further medical treatment to fix the problem. For example, antibiotics are used to treat pelvic inflammatory disease.
Irregularities between periods are normal, so the occasional light or heavy flow is usually nothing to worry about. However, if you are experiencing severe pain or a heavy flow with a blood clot, you should call your doctor immediately. It is also recommended that you seek medical advice if your periods occur for less than 21 days or more than 35 days.
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