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When Your Period Signals a Problem

Pain, bleeding, and missed periods may be signs that something is wrong.

By Dulce Zamora
WebMD Feature

Reviewed By Brunilda Nazario

In her 20s, Theresa Lauigan experienced heavy bleeding and painful cramping during her menstrual cycle. Her doctor told her she had fibroids, noncancerous growths in her uterus, and termed it a "wait and see" situation. A few years later, when the menstrual pain became unbearable, Theresa pressed her doctor to further investigate the matter.

Turns out, she has endometriosis -- a gynecological condition in which the lining of the uterus, which is usually shed monthly, is present outside of the uterus. The condition is associated with chronic pelvic pain and can be associated with infertility.

Theresa has had two surgeries to take care of the problem.

Theresa's menstrual pain is now more manageable, but wishes the endometriosis was found earlier. Because of complications that developed, doctors say her ability to have children is impaired. Her best bet for pregnancy is in vitro fertilization within the next few years.

"If the endometriosis was found earlier, I might have planned my life better," says the 33-year-old, who urges women with severe menstrual problems to speak up. "If a woman feels like something is really going on (with her body), she should really push her doctor more on it."

Many women experience menstrual problems such as heavy bleeding, severe pain, and irregular cycles. Most of these problems aren't usually serious and most are temporary. However, in some cases the ailments may actually signal problems in the body.

"For a woman, the menstrual cycle is a really good indicator of her overall health status," says Saralyn Mark, MD, senior medical adviser for the Office on Women's Health, a division of the U.S. Department of Health and Human Services.

Women with eating disorders may not have periods. "The body senses that it's not a good time to get pregnant," says Mark.

WebMD compiled a list of common menstrual problems, and asked the experts whether they should be causes of concern for women.

But first, it's helpful to know what's considered "normal," and what women could do to help their doctor better pinpoint trouble.

The Healthy Zone

A regular menstrual cycle means different things to different women. Age, for example can affect what's described as a normal pattern. When adolescents first get their periods, they can expect irregular cycles for a year or two as sex hormones stabilize. The menstrual cycle becomes erratic again around the perimenopause. During this time, just before menopause, ovarian hormone levels begin to fluctuate. Woman again experience irregular cycles.

Yet between adolescence and perimenopause, women can expect to have regular monthly cycles. That is, of course, barring pregnancy, illness, medications, stress, and other problems (such as cysts) that may change the pattern.

It's also not uncommon to have a variation in one month.

Menstruation that occurs between 22 and 40 days apart falls within the norm, says Robert Shenken, MD, president of the American Society for Reproductive Medicine. The first day of the menstrual cycle is counted from the first day of vaginal bleeding.

The pattern, however, should not vary tremendously. "If a woman was having a 40-day cycle, and all of a sudden, she's having a 22-day cycle, that would be a concern," says Shenken. "The cycle links should be within plus or minus five days."

A significant change could be sign of a problem. Many experts interviewed by WebMD, say it's best to observe your periods over a three-month before becoming overly worried.

Menstrual bleeding time or an actual period, is usually two to eight days long, and anything outside of that is a cause of concern, says Shenken.

The best way to figure out if something is wrong is to visit a doctor, who can evaluate your symptoms.

Pinpointing Menstrual Trouble

Want to find out if something is wrong with your cycle? Do the work yourself. This does not mean diagnosing yourself, but keeping a menstrual diary helps.

"The hardest time to try to figure something out is when someone comes in and hasn't really tracked anything -- they know something's abnormal but they don't know how abnormal or when," says Roger Lobo, MD, a member of the Endocrine Society, and a professor and chair of the department of obstetrics and gynecology at Columbia University in New York. "The more detailed the information [you record], the better."

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