While you may not mind if your period goes MIA (never come back, please), some irregular symptoms should not be ignored. Skipped periods and other pesky menstrual problems like spotting and heavy bleeding could be signs of something more serious. These red flags mean it's time to make an appointment with your gyno, pronto:
1. Skipped Periods
If you miss two or more periods (and you know you're not pregnant), it could be due to a ton of different—not so good—things. Causes can include: a hormonal imbalance, thyroid problems, excessive exercise or dieting, stress or premature menopause. Without a period, the lining of the uterus could build up too much, leading to the growth of abnormal cells (a potentially precancerous condition), says Sharon Mass, M.D., a clinical assistant professor of obstetrics and gynecology at University of Medicine and Dentistry of New Jersey. Besides giving you a pelvic exam, your doctor is likely to order blood tests to check hormone levels and screen for a thyroid disorder, polycystic ovarian syndrome (or PCOS, a condition marked by high levels of androgens, or male hormones) and premature menopause.
2. Sudden Intense or Worsening Cramps
If your cramps make you want to die and you actually contemplate surgically removing your ovaries, you might be a silent sufferer of endometriosis. Endometriosis is a condition in which cells that grow inside the uterus begin to grow outside the uterus, causing serious pelvic pain. "Symptoms can start any time, but most women who are diagnosed with it have some history of painful periods from a young age," says Mass. Intense cramping could also be caused by a mass in the pelvis.
While spotting, or seeing blood in between your periods, can be perfectly normal (especially if you're on the pill), you should be checked out by your doc. It could mean that you have a uterine cyst or polyp, fibroids, an infection (like bacterial vaginosis) or a precancerous growth.
4. Heavy Bleeding or Periods that Last Longer Than 10 Days
So what is "heavy bleeding", exactly? Basically, if you're soaking through a tampon in an hour or less, you're a candidate. This could signal a medical problem (such as fibroids, polyps or adenomyosis, in which tissue from the uterine lining grows into the wall of the uterus) that could cause you to become anemic, explains Nanette Santoro, M.D., professor and chair of obstetrics and gynecology at the University of Colorado at Denver.
5. Unbearable PMS Symptoms
Are you a certifiable monster before your period? It could be premenstrual dysphoric disorder (PMDD), which is "like PMS times a zillion," says Michele Curtis, M.D., an associate professor of obstetrics and gynecology at the university of Texas Houston Medical School. Symptoms include binge eating, mood swings with periods of crying, severe anxiety, anger, and feeling out of control. These symptoms will seem to appear out of thin air the week just before your period and tend to get better once bleeding starts. It can be very debilitating, but medications—like taking antidepressants for two weeks a month or continuously—can make a big difference.
6. Raging Hormones
Turns out, things can get worse than just dealing with your period. (Seriously, body?!) If you've got asthma or irritable bowel syndrome and it seems to be a lot worse during the week or so before your period, it's probably not a coincidence. There's a phenomenon called premenstrual magnification in which a condition (including diabetes, depression and arthritis) may get worse right before your period. (Thanks, hormones!) Talk to your doctor about increasing the dosage of your medication just before you get your period, which can help you feel better.
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