Abnormal Periods: Causes And Solutions

Premenstrual Syndrome

Premenstrual Syndrome (PMS) isn't just a "cute thing" women sometimes use an an excuse when they're feeling edgy, or a verbal weapon men who don't want to listen to women employ on occasion. PMS is a real syndrome made up by a range of emotional symptoms that may or may not be accompanied by physical symptoms. 

It's important to realize that there is a distinction between normal premenstrual symptoms and PMS. Women with PMS don't just feel crampy or a little moody sometimes. The luteal phase of their cycle is plagued by a pattern of symptoms that can include anxiety, irritability, feelings of deep sadness or unhappiness, mood swings, and emotional sensitivity. Headaches, severe bloating and cramps, acne, and even joint and muscle pain may be among their physical symptoms. 

The neurotransmitter beta endorphin declines in a significant percentage of PMS patients, and levels of the enzyme pseudocholinesterase — which is linked to anxiety — were found to be elevated. A family history of PMS, a history of depression, and even consuming too much caffeine are known risk factors. 

What can you do about PMS? Well, diagnosis is the first step. Antidepressants of the SSRI class, analgesics, and a range of vitamin and mineral supplements may be used as part of the treatment plan. 

Menorrhagia

Menorrhagia is the medical term used to describe abnormally heavy periods, often combined with prolonged bleeding. To qualify for a menorrhagia diagnosis, you may bleed so heavily you need to change pads or tampons every hour or more often for several hours, and probably use double "protection" to ensure you don't leak. You need to get up during the night to refresh your chosen method of menstrual care, and pass clots with your menstrual flow more than one day. 

The excessive bleeding women with this diagnosis experience can easily result in anemia, and symptoms like shortness of breath and heavy fatigue may accompany that. 

Though the cause of menorrhagia isn't always identified, hormonal imbalances, ovarian dysfunction, adenomyosis, uterine polyps, and cancer are all known to be possible culprits. Women who recognize themselves in menorrhagia symptoms should seek medical help as soon as possible. Testing may include a PAP smear, blood tests, an ultrasound, and an endometrial biopsy. 

The treatment of menorrhagia depends on the cause, if it's identified. It can range from iron supplements and pain medication to medications like hormonal contraception, tranaxamic acid, and progesterone. The latter work to reduce the severity of menstrual flow. In some cases, more invasive steps will be needed to achieve a reduction in symptoms. An endometrial ablation to "zap" the lining of the uterus, removal of uterine polyps, and even hysterectomy are all sometimes used to improve the lives of women with menorrhagia.

Since all the more invasive treatment methods come with serious disadvantages as well as benefits, women considering them need to discuss their options with their healthcare provider in detail. Endometrial ablation makes getting pregnant very dangerous, for instance, so it is not suitable for women who still want to have children. 

Dysmenorrhea

Dysmenorrhea refers to excessive, invasive painful cramps during and immediately preceding menstruation. We're not talking about the low-level pain and cramps most women of reproductive age go through occasionally — dysmenorrhea is severe enough to have a debilitating impact on a woman's daily activities. Primary dysmenorrhea exists for no obvious reason, while secondary dysmenorrhea can be attributed to a specific abnormality or disease. Both frequently coexist with menorrhagia. 

See Also: Bleeding Between Periods - Causes

Non-steroidal anti-inflammatory drugs may part of managing this condition, along with hormonal contraceptives such as the birth control pill. Rather than attempting to manage their pain all by themselves, women who recognize the life-altering symptoms of dysmenorrhea should see a doctor. The treatment of possible underlying causes — like endometriosis, polyps, and Pelvic Inflammatory Disease — can be the key to getting rid of those hellish periods once and for all.