Common Period Problems
Whatever issue you are facing, it helps to jot down a list of symptoms of various menstrual disorders and see how they do or don’t align with your regular period. After this initial step, your doctor may investigate further with a variety of options, including a pelvic exam, blood test, biopsy, hysteroscopy, or ultrasound.
Period Pain
Generally, there are two types of period pain – one is common and usually eases over time; the other is a sign of a medical issue that requires more attention.
In the case of primary dysmenorrhoea, you feel uncomfortable as your uterus contracts to get rid of its lining. Most women find this more painful during their teenage years, then report having it less severely as they age. However, for some women, it never clears up completely. The risk is usually higher if you started menstruating before you turned 11, have long or heavy periods, smoke, or have a lot of stress in your life.
If you have pain that gets worse with age or lasts longer than monthly cramps, you may be experiencing Secondary Dysmenorrhoea:
- Endometriosis – Swelling and pain caused by the lining of the uterus growing outside the uterine wall. As your estrogen levels change each month, the lining breaks down and bleeds.
- Uterine Fibroids – If you have pelvic pain or bleeding after your period ends, you may have these (usually non-cancerous) tumors in or on the wall of your uterus.
- Ovarian cysts – These fluid-filled sacs can be painful during your period or ovulation.
You should see your doctor if your pain becomes unmanageable and begins to interfere with your ability to work or go to school. Track your symptoms and how they coincide with your periods to help your doctor to get to the bottom of what is causing your pain.
You should definitely make an appointment if your menstrual flow contains blood clots larger than the size of a 10p coin or if your pain persists after your period ends.
Some possible treatments are hormonal or surgery-based methods of contraception.
If your mum has experienced heavy and painful periods, whether due to hormonal or other causes, then you are more likely to suffer from Primary and Secondary Dysmenorrhoea as well.
Irregular Periods
If the time between your periods lasts 24 to 38 days, then you are on track. However, if your cycle changes from month to month by more than 20 days, you may be new to menstruation or facing perimenopause (the transition into menopause).
If you don’t fit into either of these groups, you may be facing one of these issues related to irregular periods:
- Eating disorders
- Thyroid problems
- Increased amount of prolactin, the hormone that stimulates breast growth and breastmilk production
- Medicines treating epilepsy or anxiety
- Polycystic ovary syndrome, a condition that affects 1 in 10 women, causing multiple ovarian cysts and hormonal imbalance
- Primary ovarian insufficiency, a condition where your ovaries stop working normally
- Pelvic inflammatory disease, an infection of the reproductive organs often caused by a sexually transmitted infection (STI).
- Stress
- Uncontrolled diabetes
- Obesity
Call your doctor if your periods become irregular, or if your cycle is shorter than 24 days or longer than 38 days.
Heavy Periods
Heavy bleeding makes periods more painful and more likely to disrupt your day-to-day activities. However, they are also a sign that your body is producing and releasing a lot of life-giving blood.
Some possible causes of heavy periods are:
- Ovulation or uterine lining problems that lead to build-up or irregular bleeding of the uterine lining from month to month
- Thyroid problems
- Uterine fibroids, as described above
- Uterine polyps
- Blood thinners or other medications
- Miscarriage or an ectopic pregnancy
- Inherited bleeding disorders that affect 1 in 5 white women and 1 in 20 black women
- Obesity
- Chronic fatigue syndrome
You should see your doctor if:
- Your period lasts longer than eight days
- You bleed enough to use one or more pads or tampons every hour or two
- You feel dizzy, lightheaded, weak, or tired, or show other signs of anaemia
- You notice menstrual blood clots larger than the size of a 10p coin
- Your period is starting to impact significantly on your personal or professional life.
Your doctor may prescribe over-the-counter pain medication to alleviate inflammation, hormonal contraceptive methods or, in extreme cases, surgery.
Missed Periods
If you have missed three periods in a row or have not started menstruating by age 15, you may have a condition called amenorrhoea. This affects 3 to 4 percent of women who produce lower levels of estrogen. You should see a doctor if you fall into this category, if breast growth has not started by age 13, or if your period has not started within three years after breast growth.
Possible causes of a missed period are:
- Pregnancy
- Breastfeeding during the first six months after giving birth
- Eating disorders or extreme exercise
- Low body weight
- Hormonal imbalances due to lifestyle factors, including stress
- Certain medications or birth control
You should also see your doctor if you notice any other symptoms, such as abnormal breast growth or changes in hair growth.
