Every month, like clockwork, you’re irritable, exhausted and curled up in your bed with cramps. But sometimes your period arrives with unfamiliar symptoms.
Stress and normal hormonal changes can trigger extreme pain or irregular bleeding. But these symptoms can also have a more serious cause.
“If you always have regular periods and suddenly become irregular, there may be a medical problem,” says Mary Gallenberg, M.D., a gynecologist at the Mayo Clinic in Rochester, Minn.
Some are easily treated with diet changes or over-the-counter remedies, but others may require a doctor’s care or even surgery.
Here, experts explain how to identify and treat the five most common menstrual problems.
1. Heavy periods (menorrhagia)
How it feels: If your period lasts more than seven days, produces large blood clots, soaks through a pad or tampon every hour or has you up at night to change protection, you may have menorrhagia.
“It’s the most common gynecological compliant,” says Robin Miller, M.D., an internist and Lifescript women’s health expert.
Besides being frustrating and embarrassing, it can increase your risk of anemia, which causes fatigue, shortness of breath, chest pain and fainting.
Why it happens: The most likely cause is a menstrual cycle without ovulation, Miller says. That prevents the body from making enough of the hormone progesterone; without it, estrogen builds up the uterine lining more, which results in heavier periods.
Other pelvic problems that can also cause excessive bleeding:
* Endometriosis – When the uterine lining grows outside, on the ovaries or bladder, leading to cysts and infertility
* Polyps or fibroids – Possibly painful, noncancerous growths that develop in the uterus
* Pelvic inflammatory disease (PID) – An infection of the reproductive organs (uterus, fallopian tubes, ovaries, cervix) that could cause infertility
* Adenomyosis – A painful condition that occurs when endometrial tissue grows into the uterine wall
Other potential reasons for heavy bleeding include a hormonal imbalance, underactive or overactive thyroid, liver and kidney failure, or a blood disorder.
Medical treatments: First, see your doctor to identify an underlying condition. Treating that will usually stop the excessive bleeding.
If the blood loss has made you anemic, your doctor may also prescribe iron supplements.
Medications such as birth control pills, oral progesterone, the hormonal IUD (Mirena) and nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil) can lessen menstrual flow.
If they don’t reduce the bleeding, your doctor may recommend surgery. In a dilatation and curettage (D&C), tissue from the uterine lining is scraped out to reduce menstrual flow. If bleeding remains heavy, the procedure may need to be repeated.
Endometrial ablation and endometrial resection destroy or remove the uterine lining, which dramatically reduces menstrual flow. These procedures are becoming a more common alternative to a hysterectomy (removal of the uterus), Gallenberg says. These can reduce your ability to get pregnant.
Natural remedies: Getting enough rest and avoiding aspirin, which stops blood from clotting, can ease symptoms. Acupuncture will also lessen heavy bleeding for some women, Miller says.
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