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Every woman experiences their period differently, and some people might not realise their symptoms are serious until it’s too late. You might feel like you’re overblowing the pain or discomfort you feel during your period, but being aware of what problems to look ut for and when you might need medical attention can relieve the stress on your body.
Whether it’s heavy bleeding, or pain that leaves you curled up with a heating pad, you have to know your body well to know when to find a doctor.
What’s “Normal” When It Comes to Periods?
The first step in understanding menstrual problems is knowing what counts as normal. Most people have cycles that last 21 to 35 days, with their period sticking around for anywhere from 2 to 7 days. Blood loss during a period typically totals 20 to 80 mL—that’s about 4 to 16 teaspoons. And of course, some cramping or mild discomfort can be expected.
But here’s the thing: “normal” is different for everyone. Your cycle might not match your best friend’s or even your sister’s, and that’s okay. Try and remember the patterns you’ve had like maybe your cycle is five weeks instead of a month or you have intense back aches and cramps in the days before and after your period. See what’s normal for you, so you can compare your symptoms to a baseline if it suddenly changes one day. If it’s heavier, longer, or more painful—it’s worth taking a closer look.
Signs It’s Time to Call Your Doctor
Some menstrual symptoms are more than just an inconvenience.
1. Heavy or Prolonged Bleeding
If you’re soaking through a pad or tampon every hour for several hours in a row, that’s a clear sign something’s not right. Similarly, if your period lasts more than 7 days, it’s considered prolonged bleeding. This could be a sign of conditions like uterine fibroids, polyps, or even hormonal imbalances.
Heavy bleeding isn’t just annoying—it can lead to iron-deficiency anemia, leaving you feeling tired and weak. This is called menorrhagia, which can affect 1 in 10 women in Malaysia. If you notice symptoms like dizziness or shortness of breath, don’t wait. Get checked.
2. Painful Periods That Disrupt Your Life
Cramping is normal, but when pain keeps you home from work or school, then there might be a bigger problem. Painful periods, known as dysmenorrhea, can be linked to underlying conditions like endometriosis or pelvic inflammatory disease (PID). In a study of Malaysian women ages 18-25 found that 73.2% experience dysmenorrhea.
If your period pain has gotten worse over time or doesn’t improve with over-the-counter medications, that’s another reason to see your doctor.
3. Irregular or Unpredictable Cycles
Skipped a period? Or maybe you’re getting them every two weeks instead of once a month? Irregular cycles can be caused by stress, changes in weight, or conditions like polycystic ovary syndrome (PCOS) or thyroid disorders.
Spotting between periods or long gaps between cycles also deserve a mention to your doctor. They could signal anything from hormonal fluctuations to more serious issues.
4. No Periods at All
Missing periods isn’t always a cause for concern—pregnancy, for instance, is a pretty common reason. But if you’re not pregnant and haven’t had a period for three months or more, it’s known as secondary amenorrhea.
Primary amenorrhea, when someone hasn’t started their period by age 15, also warrants medical evaluation. Causes can range from hormonal imbalances to structural issues in the reproductive system.
5. Severe Premenstrual Symptoms
A little moodiness before your period? Totally normal. But if you’re experiencing severe emotional or physical symptoms—think debilitating mood swings, anxiety, or physical pain—it could be premenstrual dysphoric disorder (PMDD). Unlike PMS, PMDD can interfere with your daily life and may need medical intervention.
6. Other Unusual Symptoms
Finally, watch out for these less common but still important signs:
- Blood clots larger than a quarter.
- Periods that suddenly change after years of regularity.
- Fever or foul-smelling discharge during your period (which might signal an infection).
Possible Underlying Causes for Menstrual Problems
Why do menstrual problems happen in the first place? The causes can vary widely, from benign to serious. Some possibilities include:
Endometriosis
Endometriosis is a condition where tissue similar to the lining of the uterus (endometrium) starts growing outside the uterus. These misplaced tissues often implant on the ovaries, fallopian tubes, or even the bladder or intestines.
Endometriosis can cause severe pain, especially during periods, because the tissue behaves like uterine lining—it thickens, breaks down, and bleeds. However, since it has nowhere to go, it leads to inflammation, scar tissue, and adhesions.
Polycystic Ovary Syndrome (PCOS)
PCOS is one of the most common hormonal disorders, affecting an estimated 5-10% of women of childbearing age. It disrupts the normal hormonal balance, leading to irregular ovulation or even anovulation (no ovulation at all).
The name comes from the small, fluid-filled sacs—or cysts—that often develop on the ovaries. While the cysts themselves are not harmful, the hormonal imbalance they signify can lead to irregular periods, excessive hair growth, weight gain and more.
Uterine Fibroids
Fibroids are noncancerous growths that form in or around the uterus. These growths are quite common, affecting up to 70-80% of women by age 50. However, not all fibroids cause problems.
When they do, symptoms can include heavy bleeding, pelvic pain and the feeling of fullness or bloating in the lower abdomen. The size, number, and location of fibroids often determine their impact. For instance, fibroids located inside the uterine cavity are more likely to cause heavy bleeding than those on the outer wall.
Thyroid Disorders
The thyroid is a small gland located in your neck, but its impact on menstrual health is anything but small. It produces hormones that regulate metabolism, which also play a role in reproductive health.
Hypothyroidism (underactive thyroid): Can lead to heavier, prolonged periods or infrequent cycles. It may also cause fatigue, weight gain, and dry skin.
Hyperthyroidism (overactive thyroid): May cause light or absent periods, unexplained weight loss, and a rapid heartbeat.
Thyroid disorders are often confirmed through blood tests measuring TSH (thyroid-stimulating hormone) levels and can usually be managed with medications or other interventions.
When Should You Seek Emergency Care?
Certain symptoms shouldn’t wait for your next doctor’s appointment. Head to the emergency room if you experience:
- Severe, uncontrollable bleeding that makes you lightheaded or faint.
- Extreme abdominal or pelvic pain that doesn’t improve with rest or medication.
- Fever or chills alongside unusual menstrual symptoms, which could signal an infection.
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Find Out Why You Have Menstrual Problems
Menstrual problems can be frustrating, but they’re not something you have to live with. Whether it’s heavy bleeding, irregular cycles, or unbearable pain, your body is trying to tell you something. Don’t hesitate to listen and seek medical advice from our experienced doctor. One Pap smear appointment can give you the answers you need. After all, taking control of your menstrual health is one of the best ways to take care of your overall well-being.