Menstrual cycles often bring about a variety of uncomfortable symptoms leading up to your period. Premenstrual syndrome (PMS) encompasses the most common issues, such as mild cramping and fatigue. However, the symptoms usually go away when your period begins. Other more serious menstrual problems may also occur. Menstruation that is too heavy or too light, or the complete absence of a cycle, may suggest other underlying issues affecting your menstrual cycle. Remember, a “normal” menstrual cycle varies for each woman. What’s regular for you might be abnormal for someone else. It’s crucial to stay attuned to your body and consult your doctor if you notice significant changes.
Premenstrual Syndrome (PMS):
PMS occurs one to two weeks before your period begins. Some women experience a range of physical and emotional symptoms, while others experience few or none. PMS symptoms can include bloating, irritability, backaches, headaches, breast soreness, acne, food cravings, excessive fatigue, depression, anxiety, stress, insomnia, constipation, diarrhea, and mild stomach cramps. Symptoms may vary each month, and their severity can differ. While uncomfortable, PMS is usually not concerning unless it interferes with daily activities.
Heavy Periods (Menorrhagia):
Another common menstrual problem is heavy periods, causing more bleeding than normal and lasting longer than the average five to seven days. Hormone imbalances, particularly in progesterone and estrogen, often contribute to menorrhagia. Other causes include puberty, vaginal infections, cervical inflammation, hypothyroidism, uterine fibroids, and lifestyle changes.
Absent Periods (Amenorrhea):
Amenorrhea occurs when women do not get their period. Primary amenorrhea is when the first period is absent by age 16, which may be due to pituitary gland issues, reproductive system defects, or delayed puberty. Secondary amenorrhea is when regular periods stop for six months or more. Causes include anorexia, hyperthyroidism, ovarian cysts, weight fluctuations, stopping birth control, and pregnancy. In adults, causes differ and can involve premature ovarian failure, pelvic inflammatory disease, breastfeeding, menopause, and more. A missed period could indicate pregnancy, warranting a pregnancy test for confirmation.
Painful Periods (Dysmenorrhea):
Apart from changes in flow, periods can also be painful. While cramps are common during PMS, some women experience severe pain, known as dysmenorrhea. This intense menstruation pain may relate to medical issues like fibroids, pelvic inflammatory disease, or endometriosis.
Diagnosis of Menstrual Problems:
Consulting a doctor is the first step in diagnosing menstrual problems. Your doctor will want details about your symptoms, duration, and cycle regularity. Bring notes about your menstrual cycle and symptoms to aid in assessment. A physical and pelvic exam will likely be conducted. A Pap smear might be done to rule out cancer. Blood tests can reveal hormonal imbalances, while pregnancy tests confirm pregnancy. Additional tests include endometrial biopsy, hysteroscopy, and ultrasound.
Treating Menstrual Problems:
Treatment depends on the underlying cause of menstrual issues. Birth control pills can alleviate PMS symptoms and regulate flow. Hormone replacement might restore regularity if hormonal imbalances are the cause. For dysmenorrhea, hormone-related or further medical treatments might be necessary. For instance, antibiotics address pelvic inflammatory disease.