Menstruation is a normal part of being a woman, which tells us much about our reproductive health. A period can tell you when something is wrong, or if you have an underlying problem. Most of these telltale signs of there being a problem come in the form of menstrual issues. These issues range from missed periods to more serious conditions such as brain tumors. Gyn LA specializes in women’s health in Los Angeles. We help women and young girls to identify and deal with menstrual issues such as PMS, amenorrhea, dysmenorrhea, menorrhagia, among others.
Overview of Menstrual Issues
Menstruation is the monthly shedding of the endometrium. The woman’s body operates on a monthly cycle during which the lining of the uterus prepares itself for pregnancy by thickening. When fertilization does not happen, the body will shed the lining.
Menstruation varies from woman to woman in frequency and the amount of flow. The average woman has a period every 28 days, and the flow lasts for three to five days. Other women have shorter or longer cycles. Therefore, when detecting issues with a woman's period, the first step is identifying her "normal." How often do you experience your periods? How heavy is the flow? Most women understand their cycles, know what to expect every month, and may, therefore, be concerned when they notice a difference. For others, menstrual issues are a part of their periods.
Menstruation is a process controlled by progesterone and estrogen. These hormones are produced in different amounts and at different times during the cycle. They are responsible for the production and release of the eggs from the ovaries, the thickening of the uterine walls and the shedding of the endometrium.
In addition to hormones, diet, stress levels, and underlying medical conditions can affect menstruation leading to certain issues such as:
Premenstrual Symptoms (PMS)
Premenstrual symptoms are the uncomfortable symptoms you experience shortly before your period - about two weeks or a few days before your period. For most women, these issues do not affect them greatly. However, for some, PMS can interrupt your daily activities.
PMS symptoms last until your period begins. They may include:
- Constipation or diarrhea
- Tender breasts
- Depression, moodiness, anxiety and angry outbursts
- Feeling overwhelmed
- Muscle aches
- Swelling in the hands and feet
- Joint pain
- Loss of focus and concentration
- Food cravings
- Changes in appetite
PMS is thought to be caused by the changing hormones in your body. It is manageable through exercise, getting enough rest and sleep, stress management, over the counter medication, and a higher intake of calcium.
Gynecologists recommend keeping a journal of your PMS symptoms to make it easier to identify the possible condition and the management measures to take.
When PMS involves disabling symptoms such as depression, feelings of being overwhelmed, tension, poor concentration, and irritability, you might be experiencing premenstrual dysphoric disorder.
Abbreviated as PMDD, premenstrual dysphoric disorder is believed to arise due to an abnormal reaction to the hormones that control menstruation. PMDD may include symptoms of PMS in addition to hot flashes and decreased interest in activities you normally enjoy.
The treatment for PMDD may include antidepressants, hormone therapy using birth control pills, changes in your diet and lifestyle, vitamin supplements, anti-inflammatory medication, relaxation techniques such as meditation and yoga for stress management, and exercise.
Having a period is irritating for most women. However, it is a necessary part of your reproductive health. Amenorrhea is a condition whereby you miss one or more periods or have never had a period, and you are at least 15.
Amenorrhea can occur naturally due to pregnancy, breastfeeding, or menopause. Other causes include:
- Use of birth control
- Medication such as antipsychotics, antidepressants, blood pressure, and allergy medications
- Low body weight which affects the proper functioning of your hormones
- Excessive exercise, which results in high energy use, low body fat, and stress
- Mental stress which affects the functioning of the hypothalamus ( and hormones)
- Hormonal imbalance due to polycystic ovarian syndrome, thyroid malfunction, pituitary tumors, and premature menopause
- Structural problems with your reproductive organs such as uterine scarring, absence of reproductive organs abnormality of the vagina
Amenorrhea can result in infertility and osteoporosis. A pelvic exam is the main tool used in diagnosing amenorrhea. Your doctor will examine your breasts, and genital for abnormalities and to assess the growth and development of the organs if you are going through puberty. In addition, he or she will conduct tests such as thyroid function tests, ovary function tests, prolactin test, male hormone test, and a pregnancy test.
You may also receive imaging tests that examine the state of your reproductive organs and other tissues in the body. If your doctor cannot find a cause for the condition, he or she will conduct a hysteroscopy to examine the inside of your uterus.
The form of treatment the doctor will administer depends on the underlying condition. The treatment options include:
- Medications to correct thyroid disorder
- Surgery to correct any structural abnormalities
- Hormonal therapy using birth control pills
- Readjustment of your lifestyle including your dietary and exercise habits
Note that factors such as your family history, eating disorders such as anorexia, and athletic training increase your risks of developing amenorrhea.
A heavy prolonged menstrual period can be a problem. They can be an indication of an underlying condition that needs to be treated or managed. Menorrhagia increases the risk of developing anemia. Menorrhagia could include periods that last more than seven days, with the woman soaking a pad in two hours. In addition to heavy bleeding, menorrhagia may be accompanied by blood clots larger than a quarter, cramps and pain.
Menorrhagia interferes with the quality of your life and can arise from a variety of factors, including:
- Ovarian dysfunction which causes hormonal imbalance
- Hormonal disturbance
- Uterine fibroids
- Having an IUD
- Pelvic inflammatory disease
- Complications during pregnancy
- Cancers of the reproductive system
- Genetic bleeding disorders
- Medications such as anticoagulants
- Thyroid disorders
- Liver or renal diseases
The treatment of menorrhagia depends on the underlying condition causing the problem. Potential treatment methods include:
- Iron supplements, which help in improving the level of hemoglobin to prevent or control anemia
- Hormonal therapy using birth control pills to reduce the duration and quantity of menstrual flow
- Oral progesterone to control hormone imbalance and excessive bleeding
- Medication to boost the blood clotting properties
- Dilation and curettage to remove the uterine lining
- Treatment of fibroids through surgery, hysterectomy or uterine artery embolization
- Endometrial ablation
Polymenorrhea is a condition characterized by periods that are less than 21 days apart. It is a form of abnormal uterine bleeding that may be caused by structural problems in your reproductive system, hormonal imbalances, PCOS, bleeding disorder, STIs, and other illnesses.
The doctor will mostly examine whether the condition is increasing your risk of developing anemia. If you are at risk, he or she will begin an iron supplementation to increase your hemoglobin level.
Other related conditions include:
- Infrequent or light periods (oligomenorrhea)
- Metrorrhagia or bleeding between periods
- Postmenopausal bleeding
Menstrual cramps (dysmenorrhea) are a common albeit annoying part of menstruation in most women. They are caused by the contraction of the uterine wall. If fertilization does not occur, the uterine wall contracts to shed off. The contractions usually begin a few days before or when the period begins. The pain subsides gradually as the period progresses.
The intensity of the pain varies and could be insignificant, annoying, or disabling. Severe pain that interferes with your daily activities can result from:
- Uterine fibroids
- Pelvic inflammatory disease
- Cervical stenosis
Dysmenorrhea is common in women who:
- Are aged below thirty
- Had their first period at of before the age of 11
- Experience heavy periods
- Have irregular periods
- Have a family history of dysmenorrhea
When dysmenorrhea results from the period only, the problem resolves itself after the period and has no long-term effects. You can use over the counter pain medication to experience relief from the pain. However, if an underlying condition such as fibroids, endometriosis, Adenomyosis, PID, and cervical stenosis, you will have to visit your gynecologist for treatment.
Some of the treatment options include pain medication, hormonal birth control, surgery, and exercise, use of heat, dietary supplements, stress management, acupuncture, TENS, herbal medicine, and acupressure.
The changes in hormones before and during a period can result in migraines. Menstrual migraines are those that occur about two days before the onset of your period and continue for up to three days after your period starts.
The major causes of menstrual migraines include:
- The pill (the pill may minimize menstrual migraines in some women)
- Hormone replacement therapy
The migraine is characterized by:
- An aura before the headache starts
- Throbbing pain on one side of the head
- Light and noise sensitivity
The treatment for menstrual migraines includes Triptans, non-steroidal anti-inflammatory drugs, acupuncture, biofeedback, butterbur, ice, massage, and relaxation techniques.
Conditions that Cause Secondary Menstrual Issues
Menstrual cramps, heavy bleeding, and irregular periods can be a result of primary conditions such as hormonal and diet changes. However, they could be an indication of serious illnesses such as:
Endometriosis is one of the leading causes of menstrual pain that is often dismissed. Endometriosis is a condition that occurs when the uterine tissue grows outside the uterus. Endometriosis typically causes heavier and longer periods with more pain that regular periods. It increases the chances of developing anemia due to heavy blood loss.
The symptoms of endometriosis rarely improve with time. The pain keeps growing for most women due to the buildup of tissue shed during each cycle. When the endometrial tissue is shed, the blood accumulates in the surrounding tissue leading to the spread of the condition and scarring.
Uterine fibroids are a form of uterine growth that can interfere with your menstrual cycle. They are known to cause irregular periods, heavy bleeding, and pain in the pelvic region and lower back. In addition, fibroids may cause pelvic pressure and constipation, which can worsen your period problems.
Ovarian cysts are pockets of fluid that form in the ovary. Most of these cysts are harmless and symptomless. However, some may cause discomfort, including bloating, a feeling of fullness in the abdomen, and pelvic pain. The cysts can result in irregular periods, spotting, and pelvic and lower back pain during your period.
Polycystic Ovarian Syndrome
Polycystic ovarian syndrome (PCOS) occurs when the ovum does not develop well and is not released due to hormonal imbalances. PCOS results in infertility, irregular periods, and development of cysts in the ovary.
The condition can result in acne, hirsutism (too much hair on the chest, face or chin), weight gain, skin tags, darkening of the skin and balding (in a style similar to balding in men). PCOS is thought to develop due to high levels of androgens and insulin in the body. In addition to causing menstrual problems, PCOS increases the risk of diabetes, heart attack, and stroke.
The thyroid gland directly affects your menstrual cycle. Hyperthyroidism is a condition in which the thyroid gland is overactive, leading to an increase in the hormones that result in reduced or absent menstrual periods. When the thyroid is underactive (hypothyroidism), you will experience heavier and longer periods.
Find a Menstrual Health Expert Near Me
Menstruation is an important part of the reproductive health of women between puberty and menopause. The nature and consistency of your periods, as well as the accompanying symptoms, say much about your overall health, and underlying conditions you may be suffering from. At Gyn LA in Los Angeles, we specialize in providing gynecological care to women of all ages. We educate teenage girls about menstruation, what to expect, and the warning signs they should look out for. Our team is experienced in conducting pelvic exams and other diagnostic procedures to detect the presence of underlying conditions that could be causing your menstrual issues. We also offer different treatment alternatives to regulate your periods. Contact us today at 310-375-8446 if you have any questions about menstrual issues.