Regular periods are a sign that your body is functioning normally. Most women experience menstrual cycles that last between 21 and 35 days, indicating a healthy reproductive system. However, not all periods are regular, and some issues can signal underlying health problems. Irregular, painful, or heavy periods can not only be uncomfortable but also affect …
Regular periods are a sign that your body is functioning normally. Most women experience menstrual cycles that last between 21 and 35 days, indicating a healthy reproductive system. However, not all periods are regular, and some issues can signal underlying health problems. Irregular, painful, or heavy periods can not only be uncomfortable but also affect fertility and overall well-being.
If you’re experiencing period problems, it’s essential to understand the possible causes and when to seek medical advice. This article will cover some common menstrual issues, their causes, and when to consult a healthcare professional.
Menstrual Pain (Dysmenorrhoea)
Dysmenorrhoea or menstrual pain, is a common issue that affects more than half of women who menstruate. While some may only experience mild discomfort, others suffer from severe cramps that interfere with daily activities.
Types of Dysmenorrhoea
Primary Dysmenorrhoea
- The most common type, usually caused by uterine contractions and inflammatory mediators called prostaglandins.
- Common in teenagers and young women.
- Often improves with age.
- Risk factors include early onset of menstruation, smoking, and high-stress levels.
Secondary Dysmenorrhoea
- Caused by underlying health conditions such as endometriosis, uterine fibroids, or ovarian cysts.
- Often worsens with age and lasts longer than primary dysmenorrhoea.
Symptoms to Watch For
- Severe cramps and pelvic pain.
- Pain radiating to the lower back and thighs.
- Nausea, vomiting, or diarrhoea.
- Blood clots larger than a quarter in menstrual flow.
When to See a Doctor
If over-the-counter pain medications like ibuprofen or naproxen don’t relieve the pain or if it interferes with daily life, consult your doctor. They may prescribe hormonal birth control or other treatments tailored to your specific needs.
Possible Treatments
- Over-the-counter NSAIDs (e.g., ibuprofen, aspirin (not to be taken in people under 16).
- Hormonal birth control (e.g., IUD, pill, shot).
- Surgery for severe cases linked to conditions like endometriosis or fibroids.
Irregular Periods
Irregular periods are when the menstrual cycle is shorter or longer than usual or varies significantly from month to month. This can make it harder to predict when your period will occur and may signal other health issues.
Causes
Hormonal Imbalances
- Conditions like polycystic ovary syndrome (PCOS) or thyroid disorders.
Lifestyle Factors
- Stress, significant weight changes, or intense exercise.
Other Conditions
- Eating disorders, pelvic inflammatory disease (PID), or primary ovarian insufficiency (POI).
Symptoms to Watch For
- Periods less than 21 days or more than 35 days apart.
- Skipping periods or having variable flow intensity.
When to See a Doctor
If your periods become irregular after having normal cycles, or if you experience periods more frequently than every 21 days or less frequently than every 35 days, consult your healthcare provider.
Possible Treatments
- Hormonal birth control to regulate cycles.
- Addressing underlying conditions like thyroid problems or PCOS.
Heavy Menstrual Bleeding (Menorrhagia)
Menorrhagia is characterised by abnormally heavy or prolonged bleeding during periods, affecting 1 in 5 women. This can lead to anaemia and other complications.
Causes
Ovulation Problems
- Hormonal imbalances can cause excessive buildup of the uterine lining.
Uterine Issues
- Fibroids, polyps, or adenomyosis can cause heavy bleeding.
Other Conditions
- Thyroid problems, bleeding disorders, or pregnancy complications.
Symptoms to Watch For
- Soaking through pads or tampons every hour.
- Needing to change sanitary products during the night.
- Passing large blood clots.
- Anaemia symptoms like fatigue or shortness of breath.
When to See a Doctor
Consult your doctor if heavy bleeding affects your daily life or if you experience anaemia symptoms.
Possible Treatments
- Hormonal birth control to regulate periods.
- Antifibrinolytic drugs like tranexamic acid to reduce bleeding.
- Surgical options for severe cases, such as fibroids or polyps.
Unusual (Abnormal) Bleeding
Abnormal bleeding is any bleeding different from your typical menstrual period, occurring when you don’t expect it.
Causes
Hormonal Changes
- Common during puberty or perimenopause.
Endometriosis or Ovarian Cysts
- Can cause unexpected bleeding.
More Serious Conditions
- Including uterine, cervical or ovarian cancer.
Symptoms to Watch For
- Bleeding after sex or during times other than your period.
- Heavy or prolonged bleeding.
- Bleeding after menopause.
When to See a Doctor
If you experience any unusual bleeding patterns, consult your healthcare provider for evaluation.
Possible Treatments
- Hormonal birth control to control cycles.
- Addressing specific underlying conditions.
- Further investigation for postmenopausal bleeding, as it may indicate more serious issues.
Missing Periods (Amenorrhoea)
Amenorrhoea refers to the absence of periods in women of reproductive age, affecting 3% to 4% of women.
Causes
Pregnancy or Breastfeeding
- Common and normal reasons for missed periods.
Lifestyle Factors
- Extreme weight changes or stress.
Medical Conditions
- PCOS, POI, or other hormonal imbalances.
Symptoms to Watch For
- No period for three consecutive months.
- Failure to start menstruation by age 15.
When to See a Doctor
If you’ve gone three months without a period and are not pregnant or breastfeeding, or if you haven’t started menstruating by age 15, seek medical advice.
Possible Treatments
- Hormonal therapies to restore menstrual cycles.
- Addressing underlying conditions like eating disorders or hormonal imbalances.
Menstrual Migraine
Menstrual migraines are severe headaches linked to hormonal changes during the menstrual cycle. Approximately 4 in 10 women experience migraines in their lifetime.
Causes
- Hormonal fluctuations affecting brain chemicals.
- Triggers like stress, anxiety, or bright lights.
Symptoms to Watch For
- Severe headaches around menstruation.
- Aura symptoms like seeing flashing lights.
When to See a Doctor
Consult your doctor if your headaches change or if treatments no longer work.
Possible Treatments
- Identifying and avoiding triggers.
- Medications like antidepressants e.g. amitriptyline, blood pressure medicines e.g. propranolol to prevent migraines.
- Over-the-counter or prescription drugs for pain relief.
Conclusion
Understanding menstrual period issues is crucial for maintaining reproductive health and overall well-being. While some irregularities are normal, persistent or severe symptoms should be evaluated by a healthcare professional. Early diagnosis and appropriate treatment can significantly improve the quality of life and prevent potential complications.
References
National Health Service. (2022). Heavy periods. NHS. https://www.nhs.uk/conditions/heavy-periods/
Office on Women’s Health. (2021). Menstrual disorders. U.S. Department of Health & Human Services. https://www.womenshealth.gov/menstrual-cycle/menstruation/menstrual-disorders#c
Royal College of Obstetricians and Gynaecologists. (2018). Information for you: Heavy menstrual bleeding. RCOG. https://www.rcog.org.uk/en/patients/patient-leaflets/heavy-periods/
Women’s Health Concern. (2020). Menstrual problems. Women’s Health Concern. https://www.womens-health-concern.org/help-and-advice/factsheets/menstrual-problems/
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