Pink Prescriptions: Periods & Cramps

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Can weight loss or excercise affect my period?

Excessive exercise and low body weight can result in the loss of period, called amenorrhea. According to the Mayo Clinic, excessively low body weight, approximately 10 percent below what is normal for your height and build, can disrupt hormones, and halt ovulation. Excessive exercise, activities that require rigorous training, such as ballet, may disrupt menstrual cycles, as well. Several factors combine to contribute to the loss of periods in athletes, including low body fat, stress and high-energy expenditure. On the other hand, exercise can be beneficial during your period. It is important to engage the right type of exercise. Rest and recovery are important for our bodies during our menstrual cycle, especially during the early phases. As a result, activities such as restorative yoga, stretching programs and light aerobic activity are appropriate during this stage and can help reduce the severity of cramping and headaches. In the later stages of your period, the last day or two, you can begin to return to a more rigorous exercise routine.

-Rachel Mullen, MPT Physical Therapist, New River Wellness Institute

Is it normal to get my period twice a month?

It can be normal to get your period twice within a month on occasion, but if it continues every month, it could indicate a possible problem with your uterus (uterine fibroids, polyps, precancerous tissue), a hormonal imbalance (too much estrogen, not enough progesterone), a bleeding abnormality (maybe from too much aspirin or ibuprofen), or a problem with the cervix (polyp, infection). An occasional intermenstrual cycle can just be from not ovulating that month or incomplete menses from previous cycle. If you continuously get two periods a month for more than a couple of months, visit your gynecologist for a pap smear and maybe a pelvic ultrasound to check the uterus and uterine lining. If you are postmenopausal you shouldn't have any vaginal bleeding or spotting at all.

-Eve Ashby, D.O., Beaufort Memorial Lowcountry Medical Group, Beaufort

Why does my period hurt?

Most women experience some pain with their periods and learn how to manage it. Most pain is caused by uterine contractions or cramps. These contractions are stimulated by the release of various prostaglandins. Nonsteroidal anti-inflammatory drugs, such as Motrin or Aleve, block the release or production of these prostaglandins and can help decrease menstrual pain. Another potential cause of menstrual pain is the delayed passage of menstrual blood or clots through a narrow cervix. This causes distention of the uterine cavity and increased contractions. Dilating or opening the cervix often relieves this pressure and contractions. Other less common causes for menstrual pain include endometrial polyps, fibroids, adenomyosis,
and endometriosis. Pain becomes a medical problem when it is not relieved by over the counter medications or begins to interfere with the patient's activities of daily living. Dysmenorrhea is the clinical term used for excessive painful menstruation. There are several ways to determine the underlying causes for menstrual pain or dysmenorrhea and a variety of treatment options. Your gynecologist has the knowledge and tools to help you with this common problem.

-Gregory Miller, M.D., FACOG, Beaufort Memorial Obstetrics & Gynecology Specialists, Beaufort and Bluffton

I missed a period, is that normal and what should I do?

It can be normal to have a missed period once in a while. At least 30 percent of women have an irregular cycle during their childbearing years. An irregular period is one that comes more frequently than every 21 days or is consistently later than 35 days. It is also considered an irregular period if bleeding lasts more than eight days, starts and stops during the same cycle or only spots. First, if you have been sexually active during the month, a home pregnancy test should be taken. If the test is positive, you have the answer and should see your doctor. If the pregnancy test is negative, then wait and see if your period comes next month. If it doesn’t, and pregnancy testing is again negative, follow up with your doctor for further evaluation. If a woman is not pregnant, there are many factors that can affect her period and cause her to skip a month:

- Age: Girls just starting their periods or women in the perimenopausal years, who are winding down their periods, can have irregular periods due to hormone fluctuations.

- Excessive weight gain or weight loss, extreme exercise or dieting. Athletes in training season often can miss their periods.

- Stress: This can be chronic stress or short term anxiety due to a specific situation (unfortunately most women have stress at some point in their life!)

- PCOS or polycystic ovarian syndrome, which interferes with ovulation and can lead to infertility, increased risk of weight gain, diabetes, acne and facial hair growth

- Thyroid disorders: Both a too fast or a too slow thyroid function can affect periods

- Other illnesses: If a woman is undergoing chemotherapy or radiation for cancer this can often stop her periods (sometimes temporarily and sometimes permanently)

- Breast feeding: Some women do not get a period while breast feeding, while others can have irregular periods.

Using birth control can also make your period different. The pill, Mirena IUD, Depo provera, Nexplanon implant , Nuvaring or the patch can cause a skipped period, spotting or a very light period. While taking the pill, if you have missed any pills then you may experience spotting or an irregular period. (If you have missed more than 1 or 2 pills, make sure you take a pregnancy test.)

-Tracy Ann Blusewicz, M.D., F.A.C.O.G, OB/Gyn Advanced Women’s Care

I have an appointment with my gynecologist and I just started my period, should I keep the appointment? 

If the appointment is for an annual examination with a pap smear it depends on a few things. If your period is light, you should be fine. If your period is heavy, it will be difficult for the lab to read the results. If the results are unable to be read, you would have to return for a repeat pap smear. If you don't want to risk having to possibly repeat the pap smear, or if you are uncomfortable getting examined while you have your period, you should reschedule. Rest assured, your gynecologist will not be bothered by the sight of your period. However, they want you to be comfortable with your visit and will understand if you reschedule. If the reason for your appointment is irregular or heavy periods, then you should keep your appointment. Bottom line: It depends on your comfort level, how heavy your period is and the purpose for the visit. A quick call to the doctor's office can help you make your decision.

-Tracy Ann Blusewicz, M.D., F.A.C.O.G, OB/Gyn Advanced Women’s Care

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