When you first got your period you probably experienced a combination of excitement — "I'm a woman!" — and dread — "Ugh, is this going to suck every month?" And if you are lucky, your cycle has been a regular and predictable ever since you wore your first maxi pad, but for many of us, our periods can become an outright problem.
I delivered my daughter via C-section and have had two D&C's (dilation and curettage) due to miscarriages, and after the last D&C I noticed my periods weren't the same. While I had always had lighter periods than some of my friends, they had a consistently normal flow lasting around three days and came every 27-28 days. Suddenly, it was as if my period came and went in two days and then only occasionally, and I would spot for days on end afterward. Wondering to myself what the problem could be, I started to go through the three questions a woman might ask if her period was light or absent:
1. Was my fitness routine adversely impacting my weight and health?
Nope. My body fat percentage is lower than average in the "athletic or fit" category, but it wasn't below the common, essential fat range of a woman in her 30s. My weight also hadn't changed in two or so years since I had my daughter. My clothes fit the same, and while my cycle was light, it did come every month albeit a bit sooner than normal for me (every 25-26 days).
2. Was I stressed?
I laugh even typing that. Of course I was stressed. I was, and am, going through the divorce process, but at this juncture of the process, we are almost done and my life has settled. I have a new "normal." By now, my period should have gotten back to normal, too.
3. Was it my hormones?
Nope. I got a blood test to check my hormone levels and all were appropriate for my age.
Determining the True Problem
The one YES I had, was that I had quite a few procedures involving my uterus. After a family member was diagnosed with uterine cancer, I decided that enough was enough, and I called my ob-gyn asking for tests. We suspected I might have Asherman's Syndrome, when the uterine cavity develops adhesions (scar tissue), which can develop after uterine surgery. The syndrome can cause infertility among other things. After an ultrasound, uterine biopsy, another D&C and a hysteroscopy (when a medical professional uses a thin viewing tool to study the lining of the uterus), we discovered that I had fibroids and simply, a patch of "bad" tissue with polyp fragments but thankfully, not Asherman's Syndrome. I am glad that I didn't sit and wonder, after running through basic hormone blood panels, what was going on with me. Instead, I got answers and I am grateful that they weren't serious issues.
It's not enough to simply count on our doctors to point out when something is wrong. As women, it is up to us to say, "You know, I don't feel right about this" and ask for the medical tests or treatments we may need. It's not uncommon for doctors, especially male doctors, to discount a female patient or tell her she's being anxious or emotional. I had a terrible resident at a hospital tell me my hyperemesis gravidarum (extreme and persistent nausea and vomiting during pregnancy) was due to anxiety, despite the fact that I had serious medical issues, symptoms, and other professionals to back up my legitimate health concerns. I am grateful that my regular ob-gyn is thorough and listened to my concerns without downplaying them. Every woman should have the same quality of treatment.
So in other words, ladies, if something seems off with your period, don't wait for someone else to notice the issue before it becomes a pressing problem. Here are concerns you should look out for when dealing with your monthly friend.
If it's abnormal for you
Not every woman's cycle fits the predictable 28 days, and some women have periods that last a week and others, like me, three days. If your period is acting out of the ordinary for you and for more than one month, call your doctor.
No period: amenorrhea
No period? Could you be pregnant? Stressed? Low body weight? Thyroid disorder or ovarian dysfunction? Are you overweight? There are many reasons for amenorrhea and if you're in your 20s and 30s, this could be a big problem. As you hit towards your 40s and later, it can be a sign of perimenopause or menopause. Speak up!
Spotting between periods
I was spotting for quite some time and for me, that was a new thing. Spotting can possibly indicate an issue with your birth control pill or something serious like an ectopic pregnancy or cancer. This is one symptom you don't want to hold back from your doctor.
Painful or heavy periods
Periods can be uncomfortable, but if you're having an excruciating time with your periods called dysmenorrhea, such as vomiting, inability to get out of bed, headaches, or diarrhea, this can be due to fibroids (something rather common — 70-80 percent of women will have these noncancerous growths before age 50) or endometriosis.
If your period is so heavy that you're going through sanitary items at breakneck speed and changing every hour or few hours, it is a signal you need to see your doctor to schedule the appropriate testing. While periods are meant to cause bleeding, heavy bleeding is not a sign of a normal cycle. The moral of this menstrual story is if something isn't quite right, speak out! Whether it's blood work to check your hormones or a more evasive procedure such as a D&C to get on top of the issue at hand, be an advocate for your health and reproductive system. No one else will do that for you!