When women’s health is your area of expertise, you hear a lot about the menstrual cycle and all of its variations. Many times when women report symptoms that seem normal to them, I become concerned as it is definitely not normal. Here are five things you should watch out for next time you get your period:
1) No period – this is an obvious one. If you’re not looking to become pregnant, where did it go? Some normal reasons include: flying, high stress, illness, menopause, and medications. Some abnormal reasons include: pregnancy (oops?), thyroid problems, hormone problems, and polycystic ovarian syndrome (PCOS).
2) Irregular periods – maybe it comes after 30 days, then skips out to 65 days before falling back to 45 days. This is not normal and warrants some bloodwork. Again, it could be a thyroid or hormone problem, but maybe you just got off the birth control pill or have PCOS or are perimenopausal.
3) Debilitating cramps – not fun! Every woman may expect to have some cramps, and sometimes you need to take something to help the pain, however the severe type that need strong drugs, or cause you to miss a day at work are an issue. The most common reasons are endometriosis and adenomyosis.
4) Bleeding through a tampon or pad every hour – how many of you want to stay near a toilet the first day or more? Causes of heavy bleeding are anemia, bleeding disorders, high estrogen, low progesterone, fibroids, polyps, and adenomyosis. As women enter perimenopause, the hormone shift often causes heavier periods, however it’s important to have an ultrasound as endometrial hyperplasia and endometrial cancer can cause heavy bleeding, especially post-menopausally.
5) Not ovulating – this is especially important if you are looking to become pregnant. Ovulation (when the egg is released) directs the corpus luteum to produce progesterone. If you don’t ovulate, you don’t have an egg and you don’t make progesterone leading to hormone imbalance. Why aren’t you ovulating? Unless you are peri-menopause (where it’s normal), it’s worth evaluation.
It’s important you talk with your health care provider and let him or her know the symptoms you’re having. Make sure your entire thyroid is checked (TSH, T4 and T3), your iron levels for anemia, your estrogen and progesterone and consider a pelvic ultrasound. If you have a family history of bleeding problems or suspect you have a bleeding problem then have that labwork done too. You may not have to live with a cursed period every month!