Menstruation is part of the average woman’s life for about forty years – from early adolescence until menopause. That’s a lot of periods! While menstruation is a normal bodily function, dealing with the routine of your period can be a pain sometimes. It can be even harder when something is wrong with your period. Whether your periods are too heavy, too crampy, too unpredictable, or just seem off, it is a good idea to get checked out by your healthcare provider. It can feel awkward to talk about something as personal as your period, but please don’t worry – it’s our job to help with all aspects of your health. There are a lot of reasons abnormal menstruation can occur. The good news is that there are treatments that can help with abnormal periods. Here are five common reasons something could be off with your period:
- Problems with the uterus.
Sometimes, there is an anatomical or structural cause of abnormal bleeding. These can include different types of benign growths inside the uterus, including endometrial polyps and uterine fibroids. You can also have polyps of the cervix. These things might be diagnosed with an exam or imaging. There are also diseases such as adenomyosis, which involves inappropriate growth of glands into the muscle of the uterus, and endometriosis, which is when small pieces of uterine lining implant outside of the uterus.
- Problems with ovulation.
Normally, you should ovulate, or release an egg, about halfway through your cycle every month. If you are not ovulating regularly, this can cause problems with your period in addition to making it harder to get pregnant. Polycystic ovarian syndrome (PCOS) is a common disease that falls into this category. Thyroid disorders and other hormonal problems can also interfere with ovulation. It is also possible for the timing and regularity of ovulation to be affected by age, weight, exercise, and other factors.
- Bleeding disorders.
If you have abnormal periods, it is important to let your healthcare provider know if you have a known family history of bleeding disorders. You should also watch for other types of abnormal bleeding. For example, do you get frequent nosebleeds? Have you been told you bleed excessively after a surgery or dental procedure? Did you experience postpartum hemorrhage with the delivery of a baby? There are many clues that can point towards a bleeding disorder. The most common inherited (genetic) bleeding disorder is Von Willebrand Disease, which affects about 1% of the population. Many other bleeding disorders exist, so talk to your healthcare provider if you have a concern.
- Cancer and abnormal cell growth.
While we always hope that cancer is low on the risk of possibilities when something is wrong with our health, it is important to know that uterine cancer can be a cause of abnormal bleeding. Most cancers of the uterus come from the lining, called the endometrium. Endometrial cancer becomes more common with increasing age, excess weight, or long episodes of irregular bleeding Any vaginal bleeding after menopause needs to be evaluated by your healthcare provider. In addition, your healthcare provider can decide if abnormal or heavy bleeding could be a sign of noncancerous abnormal growth of the endometrium, which is called endometrial hyperplasia.
With some types of birth control, changes to your menstruation are common and expected side effects. For example, heavier bleeding is a known side effect of the non-hormonal intrauterine device (IUD), while the hormone-containing IUDs may make bleeding lighter. Your bleeding schedule may also change with some types of hormonal birth control. You should also know that certain medications can affect your menstruation. These include anticoagulants and some psychiatric medications. If you have questions about your medications and your bleeding, talk to your healthcare provider.
As you can see, there are a lot of things that can affect your period! This list is by no means comprehensive, and each topic mentioned above could have an entire textbook written about it. If you have any concerns about your menstruation and your health, please don’t hesitate to have a conversation with your healthcare provider. If you aren’t sure what is considered “abnormal” with periods, ask! Some women live with difficult periods when they do not have to, and we may be able to identify the cause of the problem. The proper evaluation and treatment of period problems is so important to a woman’s quality of life. As an OB/GYN Physician Assistant, I am especially passionate about helping women with their menstrual and reproductive health. It is such an important aspect of our lives that is sometimes overlooked. We are always happy to listen to your concerns, answer your questions, and help you manage your health.
If you have questions or concerns about menstrual bleeding please contact our office at 801-465-2559
By Alyssa Heath, PA
Canyon View Women’s Care