Should I Be Worried?
First and foremost, I have to remind you that I am not a medical professional.I feel okay writing about menstruation because it is not a disease, itis in fact a sign of good health, and something generally dealt with privately,in the home, and not in a medical setting. However, problems with yourperiod can be symptoms of more serious problems that you need to see yourdoctor about. These guidelines are based on the suggestions that my HMOmakes in its handbook, and I figure they are a good place to start. Butyou know your body best, and if you think something is wrong, call yourdoctor immediately. Never, never be hesitant or ashamed to ask questionsabout your period. If you don't have health insurance, go to a women'sclinic, such as Planned Parenthood,where they have reasonable fees and/or sliding scale payments where youpay as much as you can afford.
Really, Really Bad Cramps
Cramps can be painful. They are caused by an overproduction of a hormonecalled prostogladin which overstimulates the uterus into heavy cramping.Check out the section on cramps in "Anwers"for general advice for dealing with cramps. Heavy cramps are also one symptomof endometriosis. The following are some reasonsto see your doctor about heavy cramps:
1) If your bleeding is extreme: more than one maxi pad or super tamponper hour for more than 6 hours, or if you bleed longer than 10 days.
2)If your cramps do not repond to home treatment
3) If your periods are closer than 21 days apart.
4) If you suspect your IUD of causing the cramps.
5) If your period is accompanied by sudden high fever, diarrhea or skinrash.
6) If your heavy cramping is a new thing after years of mild periods
7) If your cramping begins long before your period, and does not stopafter your period stops.
Irregular or Missed Periods
If you miss a period and you are sexually active, pregnancy is the firstobvious thing to check, but many other things can send your cycle a littleoff-kilter, including: stress; weight loss or gain; travel; heavy atheletictraining; various medications including steroids, tranquilizers and dietpills. Birth control pills, and Norplant etc. can cause irregular or missedperiods as well. If you are not pregnant, a missed period is really nothingto worry about, and chances are you will get regular again next month.
Also, the first years of menstruation (menarche) as well as the last(menopause) are marked by irregular periods. If you are just starting yourperiod, you can expect irregularity for a while, if you are over 45, youmay being starting menopause.
The following are reasons to see the doctor over missed periods:
1) If pregnancy seems possible.
2) If you have missed two regular periods and you are not pregnant,not in menopause, not dieting or exercising a lot, or under more than usualstress.
3) If you are an endurance athelete who cannot cut back on training.You may need supplemental calcium or hormones.
4) If you miss two or three periods while on birth control pills, andyou have not skipped any pills .
Please see my section in "Answers" on PMSfor general advice on dealing with PMS. Remember, you know it is PMS ifit starts 7 to 10 days before your period, and gets better when your periodstarts.
Call your doctor if your PMS symptoms(physical or emotional) are severeor make you feel out of control. Also, call the doctor if your symptomsdo not stop when the bleeding starts.