Menstrual cycles often bring about a wide array of uncomfortable symptoms leading up to your period. Premenstrual syndrome (PMS) encompasses the most common issues, such as mild cramping and fatigue, but the symptoms usually go away when your period begins.
However, other, more serious menstrual problems may also arise. Menstruation that is too heavy or light, or a complete absence of a cycle, all signal issues that can contribute to an abnormal menstrual cycle. It is important to stay in tune with your body and call your doctor right away if you notice any significant changes to your menstrual cycle.
PMS occurs one to two weeks before your period begins. Some women experience a range of physical and emotional symptoms. Others experience few symptoms or none at all. PMS can cause:
- breast soreness
- food cravings
- excessive fatigue
- feelings of stress
- mild stomach cramps
You may experience different symptoms every month, and the severity of these symptoms can also vary. PMS is uncomfortable, but it is generally not worrisome unless it interferes with your normal activities.
Another common menstrual problem is a heavy period. Also called menorrhagia, heavy periods cause you to bleed more than normal. You may also have your period for longer than the average of five to seven days.
Menorrhagia is mostly caused by imbalances in hormone levels, especially progesterone and estrogen. Other causes of heavy or irregular menstrual bleeding include:
- vaginal infections
- inflammation of the cervix
- underactive thyroid gland (hypothyroidism)
- noncancerous uterus tumors (fibroids)
- changes in diet or exercise
In some cases, women may not get their periods. Amenorrhea occurs when you don’t get your period by the time you reach the age of 16. This may be caused by an issue with the pituitary gland, a congenital defect of the female reproductive system, or a delay in puberty.
Another common problem with teens is secondary amenorrhea. This occurs when you start your cycle, but it suddenly stops for three months or more.
Common causes of amenorrhea and secondary amenorrhea include:
- overactive thyroid gland (hyperthyroidism)
- ovarian cysts
- sudden weight gain or loss
- stopping birth control
The causes of a lack of periods differ in adults. These may include:
- premature ovarian failure
- pelvic inflammatory disease (a reproductive infection)
A missed period could mean you’re pregnant. If you suspect you could be pregnant, be sure to take a pregnancy test. Drugstore pregnancy tests are the least expensive way to determine whether you are pregnant. To get the most accurate results, wait until you have missed your period by at least one day before taking the test.
Not only can your period be lighter or heavier than normal, but it can also be painful. Cramps are normal during PMS, and they also occur when your uterus contracts as your period begins. However, some women experience excruciating pain. Also called dysmenorrhea, extremely painful menstruation is likely linked to an underlying medical problem, such as:
- pelvic inflammatory disease
- abnormal tissue growth outside of the uterus (endometriosis)
The first step in diagnosing menstrual problems is to see your doctor for a pelvic exam. Your doctor can tell if your vagina or cervix is inflamed at this time. A Pap smear will also be performed to rule out the possibility of cancer or other underlying conditions.
Blood tests can help determine whether hormonal imbalances are causing your menstrual problems. If you suspect that you may be pregnant, your doctor or nurse practitioner will perform a blood or urine pregnancy test during your visit.
The type of treatment your doctor recommends depends on what’s causing problems with your menstrual cycle. Birth control pills can help relieve symptoms of PMS as well as regulate heavy flows. If a heavier or lighter than normal flow is related to a thyroid or other hormonal disorder, you may experience more regularity once you start hormone replacements.
Dysmenorrhea may be hormone-related, but you may also require further medical treatment to address the problem. For example, antibiotics are used to treat pelvic inflammatory disease.
Irregularities between periods are normal, so the occasional light or heavy flow is generally not something to worry about. However, if you experience severe pain or a heavy flow with blood clots, you should call your doctor right away. Getting medical attention is also recommended if your periods occur less than 21 days apart, or if they happen more than 35 days apart.