Menorrhagia – Heavy Bleeding
Menorrhagia is the most common bleeding problem in women and is diagnosed when the menstrual period lasts more than 7 days or if a woman bleeds more than 80 cc in a menstrual period. This typically equates to more than 8 soaked pads or tampons in a day. Bleeding is also considered heavy if a woman soaks more than a pad or tampon per hour for several hours in a row. In addition to stress and embarrassment, heavy periods can cause painful cramping and anemia. There are many causes of menorrhagia including hormone imbalances, abnormal growths in the uterus, blood clotting disorders, infections, endometriosis or certain medications. If left untreated, menorrhagia can result in other health problems like anemia. If you suffer from menorrhagia, you should see a gynecologist to diagnose and treat the cause.
Dysmenorrhea – Painful Cramping
Menstrual cramps often accompany a woman’s period, but severe menstrual cramps, or dysmenorrhea, can disrupt a woman’s daily activities. Cramps are felt in the lower abdomen and the pain may radiate to surrounding areas such as the lower back. When cramps are painful enough to interfere with everyday activities, an evaluation by a gynecologist should be considered. These intense cramps may be caused by several different abnormalities such as endometriosis, fibroids, endometrial polyps, pelvic inflammatory disease, or adenomyosis. A visit to a gynecologist can result in a quick diagnosis and treatment plan to help you regain your healthy activity levels.
Frequent periods are another form of irregular bleeding that may be a sign of a more serious problem. Typically, menstrual periods follow a 28-day cycle, though they can be as few as 21 and as many as 35 days apart. Menstrual cycles occurring more often than every 21 days are considered too frequent. This is known as polymenorrhea and it may indicate the presence of conditions such as endometriosis, adenomyosis, endometrial polyps, infections or fibroids or they may be a symptom of hormonal changes. If you suffer from polymenorrhea, it is important to see a gynecologist to identify the cause so that it may be treated.
Infrequent periods, or oligomenorrhea, consist of periods that occur more than 35 days apart. Common causes of infrequent periods include excessive physical or mental stress, eating disorders such as bulimia or anorexia nervosa, polycystic ovarian syndrome, hormone problems such as thyroid problems, excessive levels of the hormone prolactin or perimenopausal hormone changes or certain birth control medications. When women suffer from oligomenorrhea, other problems such as precancerous and cancerous changes of the uterus can develop. It is important to see a gynecologist if you suffer from oligomenorrhea.
Signs and Symptoms of Menopause
A few of these bleeding problems can be signs of menopause. Menopause is an actual event – the last menstrual cycle of a woman’s life. It occurs when the ovaries no longer contain any functional eggs. This usually occurs after the age of 40 with the average age of menopause being 51. It is often preceded by “perimenopause” which typically consists of lighter and less frequent menstrual bleeding. However, the bleeding patterns may be quite unpredictable during this phase of life as the hormone production from the ovaries becomes less predictable due to less functional eggs being left in the ovaries.
The other symptoms that may accompany menopause and perimenopause can be quite uncomfortable and disruptive.
Hot flashes and night sweats are the most common symptoms and are experienced by about 85% of menopausal and perimenopausal women. Hot flashes are usually of a sudden onset and are usually accompanied by sweating, a flushed appearance with red blotchy skin and a rapid heart rate and may be followed by feeling chilled as the hot flash subsides. They are most common at night and they vary in frequency from one or two per day to many per day and usually last a few minutes. They usually occur for more than a year, but typically subside within 4-5 years. These flashes are likely caused by the lower estrogen levels of menopause affecting an area of the brain called the hypothalamus which is the portion of the brain responsible for regulating and sensing temperature. If hot flashes are disruptive, discuss this with your gynecologist as there are several treatments available to alleviate this menopausal symptom.
Vaginal dryness is another common perimenopausal and menopausal symptom experienced by about half of women. As estrogen production declines and eventually stops during this time of life, several changes happen to the vagina. The vaginal walls become thinner and the natural vaginal lubrication is reduced. This can lead to uncomfortable sensations such as itching, burning and discharge as well as discomfort during sex. If vaginal dryness occurs, there are several treatments that your gynecologist can prescribe to alleviate this symptom.
Mood swings are also quite common during perimenopause and menopause. As estrogen and progesterone levels decline some women will experience fluctuating moods, especially depressed moods. Additionally, the physical changes in a woman’s body may also lead to anxiety and depression. If mood swings become disruptive, a gynecologist can discuss numerous treatment options to smooth out these symptoms.
Osteopenia and Osteoporosis
Osteopenia and osteoporosis are common problems associated with menopause. They are caused by rapid bone loss due to the lower estrogen levels. The lower estrogen levels result in an imbalance between the bone-making and bone-absorbing cells which causes bone loss due to a decrease in the activity of the bone making cells. As this activity declines, the bones become weaker resulting in brittle bones and an increased risk of bone fractures, even from minor accidents.
With such potentially devastating consequences, it is important to try to prevent osteopenia and osteoporosis. Prevention is most successful by living a healthy lifestyle long before menopause happens. This includes a healthy diet with adequate calcium and vitamin D intake coupled with weight bearing exercise to increase the baseline bone strength. The stronger your bones are prior to menopause, the lower your risk to develop these problems. These supplements and exercise should be continued beyond menopause, too, to help maintain the bone strength. Hormone therapy has proven useful in protecting the body from increased bone loss, though screening is still necessary. As bones become increasingly brittle the risk of fractures due to minor accidents rises, and as people age the ability to recover from severe breaks lessens.
Screening for osteopenia and osteoporosis can be done easily with a bone density test and should be performed at the onset of menopause and then at later intervals based on the results. If these problems are present, there are treatments available to help reverse these changes in order to reduce fracture risk because bone fractures, especially hip fractures, can have devastating effects after menopause, including disability and death. If these problems are identified, it is very important to consult with your gynecologist to develop a plan to strengthen your bones.
Florida Woman Care of Jacksonville is a practice where patients can feel comfortable communicating their concerns about menstrual and menopausal issues in order to work with doctors toward desirable solutions.