Most women in their reproductive years find menstruation troublesome enough when it’s predictable. But for women who never know when their periods may arrive, who have heavy periods or who have their periods more often than every 28 days, menstruation can be a real problem. If your periods are painful or otherwise problematic, don’t despair. Most menstrual irregularities can be corrected.
Below, you’ll find a description of the most common menstrual irregularities. Primary dysmenorrhea is treated with medications that affect hormone levels. Other menstrual irregularities usually can be resolved by treating an underlying medical condition.
Primary dysmenorrhea, or painful periods with no underlying medical cause, is most common among young women who have never had children. Half of menstruating women experience cramps before or during their periods, and 10 percent of those women have pain severe enough to keep them away from their daily activities for one to three days each month.
Primary dysmenorrhea occurs when the hormone prostaglandin is released as the cells of the uterine lining shed each month. Prostaglandin stimulates contractions in the uterus, which reduce blood supply to that organ, causing cramps. These cramps are felt primarily in the pelvic area but may radiate to other parts of the body. Other symptoms might include nausea, vomiting, diarrhea, headache, dizziness and fatigue.
For women with primary dysmenorrhea, medication that inhibits the production of prostaglandin is recommended. Some of these medications, including aspirin and ibuprofen, are available over the counter. Others, such as birth control pills, require a prescription. Although over-the-counter drugs are available for painful periods, don’t take them without checking with your healthcare provider. Painful periods can be caused by other conditions that require medical attention.
When painful periods are caused by another problem, the condition is referred to as secondary dysmenorrhea. Secondary dysmenorrhea usually occurs in older women and can be caused by several conditions including endometriosis, pelvic infection, benign fibroid tumors and ovarian cysts. Treating the underlying problem usually reduces menstrual pain.
Heavy or lengthy periods may indicate an underlying health problem, such as tumors of the pelvic organs (which are rarely cancerous), polyps (small growths attached to the wall of the uterus), endometrial cancer or hormonal disturbances. Treatment varies, depending on the cause and extent of the problem. The best tool for diagnosis is hysteroscopy, an in-office procedure, but surgery or dilation and curettage (D&C) may also be recommended.
If you have a period during which you use two or three sanitary pads or tampons more than you usually do each day, report the problem. You should also make an appointment if a period lasts more than seven days.
Usually, women menstruate about every 28 days. If your cycle is significantly shorter (periods fewer than 21 days apart), talk to your healthcare provider. Possible causes of short cycles include hormonal imbalances, approaching menopause and thyroid problems.
When a young woman doesn’t get her period by age 16 or 17, she is said to have primary amenorrhea. In most cases, the problem is nothing more than an unusual delay. For some young women, however, primary amenorrhea may signal one of many possible underlying health problems, including abnormal hormone levels or an abnormal uterus.
Secondary amenorrhea is the term used when a woman who normally menstruates doesn’t get her period for at least three months. Possible causes include pregnancy, tumors, cysts, thyroid problems, a significant change in weight, failure to ovulate and stress. When pregnancy is ruled out, hormones may be prescribed to bring about the return of menstruation.