Unlocking Code Red: 6 Common Questions About Your Period

Is There Something Wrong with My Period?

There’s no such thing as a “perfect” period. We all feel puzzled by occasional irregularities. But does a subtle change mean something is off?

By Camille Platt

When it comes to ‘Aunt Flo,’ it’s hard to know what is normal. So we tackled six questions OB-GYNs often hear. Here’s a breakdown of what to expect and which symptoms might need your attention.


 

Is my flow too heavy?

If you have to change your pad or tampon more than five times in a day, it could be time to see your OB-GYN. “If you use super plus products and still soak through to your clothes or bedsheets, you are bleeding too much,” says Dr. Shevonda Sherrow, OB-GYN with Innovative Women’s Health Specialists. The same thing goes for passing blood clots larger than a quarter, heavy bleeding past day four, or bleeding more than seven days.


 

Per5Should I feel this moody?

As you approach ovulation, your body produces increasing levels of estrogen and progesterone. Then one week before your period begins, these hormones tank, which can trigger changes in the brain and prompt PMS (premenstrual syndrome) symptoms like cravings, bloating, acne, headaches, breast tenderness, and mood swings.
Most women suffer from some degree of PMS, so a certain amount of moodiness is normal during this time. But if your anxiety, depression, or anger grows extreme or disrupts your life, let your OB-GYN know. It’s possible you may suffer from a severe form of PMS called premenstrual dysphoric disorder (PMDD). Depending on the severity of your symptoms, you may benefit from taking birth control or an antidepressant.


 

Why is my period so painful?

In the first few days of your period, your body produces chemicals called prostaglandins. These make your uterus muscles contract, so the higher your levels, the worse you may feel.

Per1Intermittent cramping is normal – particularly in the first few days of your period as the uterus sheds its lining. However, cramps that wreck you are not. Many women think severe pain is just something they have to endure, but that simply isn’t true. “Severe pain should be discussed with your physician, especially if over-the-counter medicines don’t provide adequate relief,” says Dr. Stacy Boyd, OB-GYN with University Women’s Services.
If your pain isn’t relieved with ibuprofen or naproxen or often causes you to miss work or school, see an OB-GYN. He or she may recommend some form of birth control for pain relief. Your doctor can also screen for an underlying condition, like a uterine tumor or endometriosis. “Endometriosis irritates your bowels and muscles and can cause significant pain,” says Dr. Sherrow.


 

Why do I spot between periods?

Breakthrough bleeding, or spotting, is common and in many cases it’s nothing to worry about. For example, it’s a frequent side effect of being on low-dose birth control. Other women spot at ovulation due to the rapid surge and decline in estrogen mid-cycle, while still others spot under heightened stress.

If none of these apply to you and/or your bleeding persists for a few consecutive cycles or occurs after sex, talk to your OB-GYN.  Bleeding could also mean you have an infection or elevated estrogen levels have caused a uterine cyst or polyp. In rarer cases, spotting may be a sign of endometrial cancer.

Per2Track your spotting on a calendar to show your physician, and note if it coincides with cramps or sex. If your spotting is related to a hormone issue, your OB-GYN may recommend a higher dose birth control pill or an IUD. Polyps may need to be removed to check for malignancy, although this is rare in women under 50.


 

Sometimes I suffer from irritation during my period. What can help?

This is a common complaint, and it’s often related to normal changes in the vagina during your cycle. “Changes in pH and levels of ‘good’ and ‘bad’ bacteria can lead to irritating conditions like yeast infections and bacterial vaginosis,” says Dr. Robert Furr, OB-GYN and director at Women’s Surgery & Aesthetic Center.

If you wear pads, change them frequently throughout the day – wetness and limited airflow can lead to irritation and infections. If you prefer tampons, alternate with pads for optimum hygiene.

Be sure to avoid scented products and strong detergents too. “Pay particular attention to soaps, body sprays, shaving creams, razors, and perfumes as these can irritate these sensitive areas,” says Dr. Boyd.

Finally, consider switching your hygiene products. Hypoallergenic pads and tampons are made from 100% cotton and are less likely to encourage bacterial growth. Or, if neither pads or tampons are your thing, opt for a menstrual cup like DivaCup or Mooncup. A menstrual cup is inserted into your vagina via suction and can be worn for up to 12 hours. These are growing in popularity, and many women love them once they get the hang of it.


 

Why did I miss my period?

If you’ve ruled out pregnancy and aren’t nearing menopause, the list of potential culprits is long. It could be stress (which interferes with hormones), your medications, or an endocrine disorder. It could also be related to a hormonal imbalance. “Some women have a condition called polycystic ovary syndrome (PCOS) which causes problems with hormonal regulation,” says Dr. Sherrow.

Low body fat can also affect menstruation, so if you exercise for multiple hours a day (long distance runners, ballerinas) or struggle with disordered eating, your period may disappear. “It’s common for women with a very low BMI to miss periods,” says Dr. Furr.
It’s normal to miss one or two periods a year, but if you’ve missed several in a row, see your OB-GYN. He or she will perform a pelvic exam and order blood tests to look for underlying conditions.

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