Coping With Common Period Problems


Sometimes having your period can be a pain — literally. Most girls
have to deal with PMS, cramps, or headaches around the time of their
periods. These problems are usually normal and nothing to worry about.

Here are the facts on which period problems are common and normal —
and which ones might indicate there's something else going on.

What Is PMS?



Premenstrual syndrome (PMS) is the term for the physical and
emotional symptoms that many girls and women get right before their
periods begin each month. If you have PMS, you might experience:

• acne
  
• bloating
  
• fatigue
  
• backaches
  
• sore breasts
  
• headaches
  
• constipation
  
• diarrhea
  
• food cravings
  
• depression or feeling blue
  
• irritability
  
• mood swings
  
• difficulty concentrating
  
• difficulty handling stress
  
• feeling tense
  
• trouble sleeping
  

PMS is usually at its worst during the 1 to 2 weeks before a girl's
period starts, and it usually disappears when her period begins.Why Do Some Girls Get PMS?



Doctors have not pinpointed the exact cause of PMS, but many believe
it is linked to changing hormone levels. Following a girl's period, the
amounts of estrogen and progesterone (female hormones) in her body
increase. Then about 1 week before her period starts, levels of both of
these hormones begin to fall. The thinking is that these changing
hormone levels can lead to PMS symptoms.

It isn't clear why some girls develop PMS and others don't. It's
possible that those who develop PMS are simply more sensitive to the
changes in hormone levels. There are other theories as well. For
example, some believe that what you eat can affect how you feel,
especially during the couple of weeks before your period.

Luckily, you can do a few things to ease PMS symptoms. Eating a
balanced diet with lots of fresh fruits and vegetables and cutting back
on processed foods like chips and crackers can help. You might also want
to reduce your salt intake (salt can make you retain water and become
more bloated) and, believe it or not, drink more water.

Say no to caffeine (it can make you jumpy and anxious) and yes to
plenty of sleep. Getting enough calcium and taking a daily multivitamin
can be helpful. Also, daily exercise and stress-relief techniques like
meditation can help some girls.

When it comes to medicine, over-the-counter pain medicines like
ibuprofen can relieve achy heads and backs. But for really serious PMS
pain, see your doctor, who might be able to prescribe a different
medicine or birth control pills to help.

Also let your doctor know right away if you feel very depressed or have had any thoughts of hurting yourself.Why Do Some Girls Get Cramps?



Lots of girls have abdominal cramps during the first few days of their periods. Cramps are most likely caused by prostaglandins (pronounced: pross-tuh-glan-dinz),
chemicals your body produces that make the muscles of the uterus
contract. The good news is that cramps usually only last a few days. But
if you're in pain, medicine like ibuprofen might help.

Exercise also can make you feel better, possibly because it releases
endorphins, chemicals in the body that literally make you feel good.
Soaking in a warm bath or putting a warm compress on your stomach won't
make your cramps disappear but may help your muscles relax a little.

If you have severe cramps that keep you home from school or from
doing stuff with your friends, or if over the counter medications aren't
working, visit your doctor for advice.

Why Isn't My Period Regular?



It can take a few years from the time a girl starts menstruating for
her body to develop a regular cycle. Even then, what's regular varies —
girls' cycles can range from 21 to 45 days.

Changing hormone levels might make your period short one month (such
as 2 or 3 days) and more drawn out (such as 7 days) the next. You might
skip a month, get two periods almost right after each other, have a
really heavy period, or one so light you almost don't notice it. (If
you're sexually active and you skip a period, though, you should visit
your doctor or a women's clinic to make sure you're not pregnant.)

All this irregularity
can make planning for your period a real hassle. Try to keep track of
when your last period started, and guess that about 4 weeks from that
day you could be due for another. If you're worried about wearing that
cute dress and suddenly starting your period at school, just make sure
you pack protection. Carry a pad or tampon in your backpack, and wear a
pantiliner to handle the first wave.

When it comes to periods, every girl's body has a unique (and
unpredictable) timeline for getting on track. If your period still has
not settled into a relatively predictable pattern after 3 years, or if
you were having regular periods and then become irregular or have no
period for a couple of months, make an appointment with your doctor to
check for possible problems
Why Haven't I Started My Period Yet?



Everybody goes through puberty at different speeds. Some girls begin
menstruating as early as age 8 or 9; others don't get going until
they're 15 or 16. It all depends on your hormones — and your family.

Want to guess when you'll get your period? Ask when your mom and
grandmothers (from both sides of your family) started theirs. When you
start puberty is partly linked to genetics. So although there's no
guarantee that you'll follow in their footsteps, your relatives could
give you a clue about your own period.

One thing that can delay puberty — and your period — is excessive
exercising, usually distance running, ballet, or gymnastics, combined
with a poor diet. For exercise to be excessive, it means more than just
playing soccer a few times a week or working out once in a while with an
exercise video. To exercise so much that you delay your period, you
would have to train vigorously for several hours a day, most days of the
week, and not get enough calories, vitamins, and minerals.

Unless compulsive exercise has postponed your period, there's nothing
you can do on your own to hurry things along. If you haven't started to
menstruate by the time you're 16, consult your doctor. He or she will
examine you, and may do a pelvic exam and take a blood test to determine
the hormone levels in your body. Different treatments are available
depending on what is causing the delay in your period.Menstrual Problems



Even if it seems strange to you, most of the stuff that goes along
with a girl's period is completely normal. But a few conditions can be
more serious. If you suspect you have any of these problems, see your
doctor for advice.

No Periods



Amenorrhea is the term doctors use for absence of
periods. Girls who haven't started their periods by the time they are 16
may have primary amenorrheaamenorrhea, usually caused by a hormone imbalance or developmental problem.

There's also a condition called secondary amenorrhea, when a girl who
had normal periods stops menstruating for at least 3 months. Low levels
of gonadotropin-releasing (pronounced: go-nad-uh-troe-pin) hormone (GnRH), which controls ovulation and the menstrual cycle, frequently bring on amenorrhea.

Stress, anorexia, weight loss or gain, stopping birth control pills,
thyroid conditions, and ovarian cysts are examples of things that can
throw your hormones out of whack. To get everything back on course, your
doctor may use hormone therapy.

If a medical condition is affecting your monthly cycles, then
treatment of the condition will help to resolve the problem. As
mentioned earlier, lots of strenuous exercise combined with a poor diet
can also cause amenorrhea. Cutting back on exercise and eating a
balanced diet with more calories will help correct the problem, but be
sure to talk with your doctor too.

Heavy Periods



Menorrhagia (pronounced: men-uh-ray-jee-uh)
is the term doctors use for extremely heavy, prolonged periods.
Menorrhagia is more than just 1 or 2 days of a heavier-than-average
flow. Girls who have menorrhagia soak through at least a pad or tampon
an hour for several hours in a row or have periods that are more than 7
days long.

The most frequent cause of menorrhagia is an imbalance between the
amounts of estrogen and progesterone in the body. Because of this
imbalance, the endometrium (pronounced: en-doh-mee-tree-um),
which is the lining of the uterus, keeps building up. Then when the
body gets rid of the endometrium during a period, the bleeding is very
heavy.

Many girls have hormone imbalances during puberty, so it's not
uncommon to experience menorrhagia during the teen years. Other possible
causes of heavy bleeding include thyroid conditions, blood diseases, or
inflammation or infections in the vagina or cervix.

To help figure out the cause of abnormal bleeding, a doctor may do a
pelvic exam, a Pap smear, and blood tests. If you do have menorrhagia,
it can be treated with hormones, other medications, or removal of any
extra tissue in the uterus that may be the cause of excessive bleeding.

Extremely Painful Periods

Dysmenorrhea (pronounced: dis-men-uh-ree-uh) is the medical term for very painful periods. Primary dysmenorrhea — painful periods that are not caused by a disease or other condition — is more common in teens than secondary dysmenorrhea (painful periods caused by a disease or condition).

The culprit in primary dysmenorrhea is prostaglandin, the same naturally occurring chemical that causes cramps. Sometimes, prostaglandin can cause nausea, vomiting, headaches, backaches, diarrhea, and severe cramps when you have your period.

Fortunately, these symptoms usually only last for a day or two. Doctors usually prescribe anti-inflammatory medicines to treat primary dysmenorrhea. As with cramps, exercise, hot water bottles, and birth control pills might also bring some relief.

Some of the more common conditions that can cause secondary dysmenorrhea include:

* endometriosis, a condition in which tissue normally found only in the uterus starts to grow outside the uterus
* pelvic inflammatory disease (PID), a type of bacterial infection usually caused by a sexually transmitted disease
* fibroids or growths on the outside, inside, or in the wall of the uterus

All of these conditions require that a doctor diagnose the problem and then treat you appropriately.
What to Do if You Suspect a Problem

When you have questions about your period or anything else related to your development, talk to your doctor. This is particularly true if you notice a change in your menstrual cycle. Though most period problems turn out to be nothing to worry about, it's always good to be safe.

See your doctor if:

* You feel very depressed or hopeless, or have thought about hurting yourself. A severe form of PMS could cause this, and you should get help immediately.
* You have not started your period by the time you are 16. The doctor can evaluate you to figure out why you haven’t gotten your period yet.
* You stop getting your period or it becomes really irregular after it has been regular for several cycles. This can be a sign that you may have a hormone imbalance or a problem with nutrition.
* You have very heavy or long periods, or get your period more frequently than every 21 days. Lots of blood loss can cause anemia (low blood levels) and leave you feeling really weak and tired.
* Your periods are really painful. The doctor can help figure out why your periods are painful, and treat you so that you are more comfortable.

Chances are that your painful or irregular periods are nothing to worry about. But if there is something going on, the quicker you get it taken care of, the sooner you'll be on your way to feeling great again.

Reviewed by: Larissa Hirsch, MD
Date reviewed: September 2010