Source: Central Jersey.com
Too many women accept abnormal periods as something they just have to live with, much like their mothers and grandmothers did. But menstruation that is heavy or doubles you over in pain doesn’t have to go hand-in-hand with being a woman!
While a typical menstrual cycle is 28 days with a period that lasts four to seven days, menstrual cycles can range between 21 days and 35 days with bleeding that lasts two to seven days.
Moderate bleeding is expected during a period. Heavy bleeding, however, could be a signal something is amiss. Bringing extra clothes to work or school; changing protection more than every four hours; or using the highest absorbency products and still soaking through defines heavy bleeding.
While pain and cramps often accompany menstruation, they should be easily managed with over-the-counter pain relievers. Pain so severe it causes missed work or school, or is accompanied by nausea, vomiting, diarrhea or constipation is cause for medical attention. So are intermittent bleeding, bleeding or spotting after sex, unpredictable periods, or bleeding after menopause.
The causes behind abnormal bleeding typically fall into two categories: hormonal and structural.
Many factors can influence hormonal changes that lead to heavy bleeding or irregular and missed periods, including:
• Thyroid imbalances
• Polycystic ovarian syndrome (PCOS)
• Perimenopause
• Life stress
• Exercise
• Dietary changes
Structural conditions that can cause abnormal bleeding include:
• Uterine fibroids
• Endometrial polyps
• Ovarian cysts
• Endometriosis
• Certain types of cancer, such as of the uterus
Diagnosing abnormal uterine bleeding typically begins with a physical exam and complete medical history. It is helpful if women track their cycles and any related symptoms. Today, there are several easy-to-use apps that can help analyze this information.
In many cases, with a physical exam, doctors can detect fibroids or ovarian cysts. Blood tests to measure thyroid function and hormone levels may also be recommended. Doctors may use ultrasound as well as MRI to examine the uterus, ovaries and other reproductive organs to identify structural issues.
If the cause of abnormal bleeding is determined to be hormonal, doctors may recommend lifestyle changes and a low-dose birth control pill or an intrauterine device (IUD). If the cause is structural, surgery may be necessary.
By Shyama S. Mathews, M.D., a board certified gynecologist, minimally invasive gynecologic surgeon, and member of the medical staff at Penn Medicine Princeton Health. To find a physician with Penn Medicine Princeton Health call 888-742-7496 or visit PrincetonHCS.org.