Common Period Problems During Your Reproductive Years

Are you experiencing period problems? If so, you are certainly not alone. Most of us do at one time or another during our reproductive years. Women frequently experience a whole array of menstrual cycle disorders. Period-related problems can range from premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) to absence of menstruation, heavy periods, and menstrual cramps.

Once you find out the cause of your period problems, your healthcare provider has several treatment options that range from taking over-the-counter medications such as ibuprofen for menstrual cramps to something as dramatic and life-changing as having a hysterectomy for uterine fibroid tumors or other conditions.

Abnormal Uterine Bleeding

If you are experiencing abnormal uterine bleeding (AUB), several factors play a role in picking the appropriate treatment. These factors include the type of abnormal uterine bleeding you are experiencing, whether there is an underlying cause, your age, and if pregnancy is something you desire.

Treatments for abnormal uterine bleeding include:

• High doses of conjugated estrogens for amenorrhea, menorrhagia, and other types of abnormal uterine bleeding
• Surgical procedures such as dilation and curettage or D&C for severe, acute bleeding, endometrial ablation which may be performed during a hysteroscopy
• Hysterectomy when other treatments have failed to provide effective relief of symptoms and future childbearing is not an issue.

Hormonal Treatments for Menstrual Cycle Disorders

Hormonal contraceptives including the Pill, the patch, the vaginal ring, and the Mirena IUD offer effective relief for many women from menstrual cycle disorders including dysmenorrhea,​ anovulatory bleeding, and women who experience heavy menstrual bleeding, as well as other types of abnormal bleeding patterns. You should know that the Mirena IUD does not offer help for PMS or PMDD because you still ovulate when you have the IUD in place.

The Pill provides relief from and helps to regulate hormonal imbalances that occur in several types of abnormal uterine bleeding. The Pill is also helpful for reducing the symptoms associated with PMS and PMDD. Other hormonal contraceptives including the patch and the vaginal ring can help regulate the hormonal fluctuations associated with abnormal uterine bleeding patterns.

The Mirena IUD is particularly effective for women experiencing heavy bleeding and may provide relief for as long as five years. In fact, studies have reported a reduction in the amount of blood loss during menstruation by as much as 97% after one year of treatment. This is because this type of IUD slowly releases a progestin called levonorgestrel into the uterus which reduces blood loss.

Menstrual Cramps

Ibuprofen is often effective for reducing menstrual cramps. Ibuprofen offers another benefit to women experiencing heavy menstrual flow because it can help reduce the amount of blood loss that you experience. Other NSAIDS or non-steroidal anti-inflammatory medications such as naproxen also provide effective relief of menstrual cramps.

Alternative self-help measures that may relieve menstrual cramps include using heating pads to relieve pain.

PMS and PMDD

Oral contraceptives are often prescribed for PMS by physicians, although there isn't strong clinical evidence to support its usefulness in PMS and PMDD. However, several other therapies can provide effective relief from the symptoms of PMS and PMDD. These include:

• Eating a diet rich in complex carbohydrates
• Cutting out things that can make symptoms worse such as caffeine, alcohol, nicotine, salt, and refined sugar
• Taking supplements and/or increasing dietary sources of vitamins and minerals such as calcium, magnesium, B6, and vitamin E
• Antidepressants such as fluoxetine or sertraline, as well as a number of others
• Anti-anxiety medication
• Diuretics such as spironolactone for fluid retention and/or bloating
• Short-term therapy that lasts no longer than six months with GnRH agonists (an anti-estrogen drug) such as Lupron in combination with estrogen or estrogen-progestin therapy.
• While some women claim to get relief from the symptoms of PMS by using herbal supplements and natural hormones such as evening primrose oil and natural progesterone, the majority of current scientific evidence does not support the use of either of these commonly used products.

Finally, while exercise is not a treatment for abnormal uterine bleeding, it often effectively relieves the symptoms of PMS and/or PMDD, as well as helping to reduce menstrual cramping as previously mentioned. In fact, taking a 20- to 30-minute walk just three times weekly provides several other benefits to your health including:

• Increasing the chemicals in your brain which are responsible for mood and energy
• Decreasing levels of stress and anxiety
• Improving sleep quality
• Reducing your risk for a number of diseases including heart disease and several types of cancer.