Period management

Menstruation is a normal biological function. Beginning in puberty and continuing until menopause, most women experience a menstrual period about once a month. For some women, menstruation is irregular, painful, or disruptive, and can significantly reduce their quality of life. 

As many as 14 percent of all women experience irregular menstruation or abnormally heavy menstrual bleeding. Period management is the use of medical interventions to address these issues. 

If you are experiencing irregular or heavy periods, our gynecologists at Dignity Health are here to offer personalized care. Find a Doctor near you and make an appointment today. 

Symptoms 

The need for period management encompasses two broad areas – management of the flow itself and management of menstrual symptoms. Our gynecologists have years of experience and can help you when you have symptoms, such as: 

• Painful menstrual periods 
• Irregular or light menstrual periods 
• The absence of menstrual periods 
• Menstrual periods that last longer than seven days 
• Abnormally heavy bleeding (soaking a tampon or pad in one hour or less during your period) 
• Vaginal spotting or bleeding between periods 
• Vaginal discharge that is abnormal or smells bad 
• Abnormally intense premenstrual syndrome symptoms (such as mood swings, depression, and irritability) 
• Physical or developmental disabilities that make it challenging to manage menstruation 

You should also see your doctor right away if you experience nausea or vomiting during your period, have a high fever, or are experiencing symptoms of toxic shock syndrome. 

Causes 

There are a number of potential causes of irregular periods, delayed periods, and other menstrual issues. These include: 

• Hormonal imbalance 
• Uterine fibroids (abnormal tissue masses on and within the uterine wall) 
• Endometriosis (tissue that usually lines the uterus growing outside it) 
• Problems with ovulation 
• Structural problems 
• Extreme weight loss 
• Stress 
• Infection 
• Bleeding disorders 
• Pregnancy or miscarriage 
• Certain medications or contraceptives 
• Autoimmune disorders 
• Thyroid disorders 
• Cancer 

Types 

There are a number of types of menstrual disorders that may require management. These include: 

• Painful cramps – Known as dysmenorrhea, pain can occur in the lower abdomen, lower back, and sides. 
• Heavy bleeding – Known as menorrhagia, the bleeding is heavy enough to soak a menstrual pad every hour and/or last more than seven days. 
• No menstruation – Known as amenorrhea, this is when a period does not occur. In many women, this is due to caloric intake that is too low and/or intensity of exercise that is too high. 
• Infrequent menstruation – Known as oligomenorrhea, this is when periods happen more than 35 days apart. 
• Light menstruation – Known as hypomenorrhea, this is when a woman’s period is exceptionally light, most common during a girl’s first year and the year or two before menopause. 
• Premenstrual dysphoric disorder – A medical condition characterized by severe depression, tension, and irritability about a week before a woman’s menstrual period. 

Risk factors 

There are a number of factors that can put you at higher risk for irregular periods and other menstrual disorders. These include: 

• Family history 
• Weight (being overweight or underweight can cause menstrual irregularity) 
• Exercise or athleticism (too high an intensity can cause menstrual irregularities) 
• A high number of past pregnancies 
• Stress 
• Smoking 

Prevention 

It may not be entirely possible to prevent abnormal menstruation, but there are steps you can take to care for yourself and potentially minimize symptoms. These include: 

• Eating a healthy diet full of fresh, whole foods and limited amounts of processed and refined foods 
• Getting plenty of exercise, including both cardio and strength training (if you are an athlete, you may need to cut back on the intensity of your training as this can cause irregular periods) 
• Getting enough rest every night (seven to nine hours is recommended) 
• Managing your stress with techniques such as deep breathing, meditation, and journaling 
• Ensuring you use your chosen method of contraception as directed 
• Changing your menstrual pads or tampons every four to six hours 
• Going for regular checkups with your doctor