What its like dating a medical girl

Regular periods are a sign that your body is working normally. You should have regular periods unless you are pregnant, breastfeeding, postmenopausal, or have a medical condition that causes your periods to stop. Irregular, painful, or heavy periods may be signs of a serious health problem. Irregular periods also can make it harder to get pregnant. Your doctor can work with you to help get your periods more regular.

Period problem: Menstrual pain (dysmenorrhea)

Pain that you get with your menstrual period is called dysmenorrhea (dis-men-uh-REE-uh). Pain is the most common problem women have with their periods. More than half of women who have periods get some pain around their period.² Some women may get just a feeling of heaviness in the abdomen or tugging in the pelvic area. Other women experience severe cramps different from premenstrual syndrome (PMS) pain.

A majority of period pain can be relieved by over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) such as naproxen, ibuprofen, or aspirin.³ Starting an over-the-counter NSAID medicine when your period first starts may also lessen heavy menstrual bleeding⁴ and help control the pain better.

There are two types of dysmenorrhea:

• Primary dysmenorrhea. This is the most common type of dysmenorrhea. The pain is usually caused by contractions of the uterus (womb). The uterus contracts during your period to help the uterine lining leave the body. Teens may get dysmenorrhea soon after they get their first period. For most women, primary dysmenorrhea gets less painful as they get older. But some women get severe menstrual pain. Your risk for dysmenorrhea may be higher if you:⁵
  • Got your first period before age 11
  • Have longer or heavier periods
  • Smoke
  • Have high levels of stress^6,7

• Secondary dysmenorrhea. This type of dysmenorrhea is usually caused by another health problem. Pain from secondary dysmenorrhea usually gets worse as you get older. It also lasts longer than normal menstrual cramps. Problems that cause secondary dysmenorrhea include:
  • Endometriosis. This condition happens when the lining of the uterus grows outside of the uterus where it does not belong. In response to monthly changes in levels of the hormone estrogen, this lining breaks down and bleeds outside of the uterus and can cause swelling and pain.
  • Uterine fibroids. Fibroids are tumors that grow in or on the wall of the uterus. They are almost always not cancerous. Some women with fibroids experience pelvic pain and vaginal bleeding at times when they do not have their period.
  • Ovarian cysts. Cysts are fluid-filled sacs on the ovary. Ovarian cysts usually don’t cause any symptoms, but some can cause pain during your period or at ovulation.

When to see your doctor

Talk to your doctor or nurse if over-the-counter pain medicine, such as ibuprofen or naproxen, does not help or if the pain interferes with daily activities like work or school. Your doctor or nurse will ask you questions and do some tests, including possibly a physical exam, to rule out any other health problem. Keeping track of your symptoms and periods in a diary or calendar can help your doctor or nurse diagnose any health problems.

See your doctor to rule out other health problems if:

• You have blood clots in your menstrual flow that are larger than a quarter.
• Your pain happens at times other than just before your period or during your period.

Treatment depends on what is causing your pain. Your doctor may prescribe hormonal birth control, such as a hormonal intrauterine device (IUD),⁸ the pill, shot, or vaginal ring,⁹ to help with pain from endometriosis, fibroids, or ovarian cysts. Hormonal birth control is sometimes prescribed by doctors for women’s health concerns other than preventing pregnancy. You may also need surgery, as a last resort, if one of these conditions is causing your pain.

Period problem: Irregular periods

Your periods are considered irregular if your menstrual cycle is shorter or longer than average. This means that the time from the first day of your last period up to the start of your next period is less than 24 days or more than 38 days.

Your periods can also be irregular if your cycle length varies by more than 20 days from month to month.¹⁰ An example would be your cycle jumping from a normal 25-day cycle to a 46-day cycle the next month and then back to a 25-day cycle the following month.

Irregular periods are normal for teenage girls and perimenopausal women. Teen girls’ periods may be irregular for the first few years before becoming more regular. During the transition to menopause, called perimenopause, menstrual cycles may become more irregular over time.

Causes of irregular periods include:

• Eating disorders. Irregular or missed periods can be signs of eating disorders, most often anorexia nervosa. But any eating disorder, including bulimia nervosa and binge eating disorder, can cause irregular periods.
• Thyroid problems, such as hyperthyroidism (hy-pur-THY-roi-diz-uhm). Hyperthyroidism, or overactive thyroid, causes your thyroid to make more thyroid hormone than your body needs. Hyperthyroidism can also cause fewer and lighter menstrual periods than normal.
• High amounts of prolactin in the blood. This condition is called hyperprolactinemia (hy-pur-pro-LAK-te-nee-me-uh). Prolactin is the hormone that causes breasts to grow during puberty and makes breastmilk after childbirth. It also helps control the menstrual cycle.
• Certain medicines, such as those for epilepsy or anxiety
• Polycystic ovary syndrome (PCOS), a condition that usually causes multiple ovarian cysts, hormonal imbalance, and irregular periods. About 1 in 10 women with irregular menstrual cycles has PCOS.¹
• Primary ovarian insufficiency (POI).