7 Period Problems You Shouldn’t Ignore


Read this if your red tide wipes you out.
woman-lying-on-bed-period

There are some period problems that are unfortunately par for the course, like cramps, irritability, and bleeding more than you would like to be bleeding from your vagina.

But there are also some period problems that you should bring up to your doctor—just in case—because they’re a bit outside of what’s normally expected during menstruation. Here are some things to keep an eye out for.

1. You soak through a pad or tampon in an hour or less, your period lasts longer than seven days, or both.

The clinical term for an exceedingly heavy or long period is menorrhagia. These are basically horror movie-style periods, but some people don’t even realize this kind of bleeding is abnormal. “One of the biggest problems is someone being so used to heavy bleeding that she underplays the amount,” Lauren Streicher, M.D., an associate professor of clinical obstetrics and gynecology at Northwestern University Feinberg School of Medicine, tells SELF. “She’ll come in and say her periods aren’t too bad, then say she has to change her tampon every hour.” Passing clots larger than a quarter is also a sign your bleeding is too heavy, according to the Centers for Disease Control and Prevention (CDC).

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It’s not just that bleeding way too much or for too long is messy and inconvenient. Losing more than the typical two to three tablespoons of blood during your period or bleeding for longer than seven days can lead to anemia, the CDC says. If you have anemia, you lack enough healthy red blood cells to get oxygen to all your tissues, so you may feel tired and weak, according to the Mayo Clinic.

Bleeding too much can also be a sign of various health issues, like uterine fibroids, which are benign growths in and on the uterus that can sometimes come along with problems like pelvic pain and frequent urination. Uterine polyps, which are growths on the inner lining of the uterus, can also cause heavy bleeding, as can cervical polyps, which are lumps that emerge from the cervix. Both types of polyps are typically non-cancerous but, in rare cases, may contain cancer cells.

The hormonal issue polycystic ovary syndrome (PCOS) can also cause heavy bleeding. Worse, this bleeding can strike after months of an MIA period. This gives your uterine lining a chance to build up over time, leading to an abnormally heavy period when it finally comes, Mary Jane Minkin, M.D., a clinical professor of obstetrics, gynecology, and reproductive sciences at Yale Medical School, tells SELF. PCOS can also cause symptoms like excess face and body hair or severe acne, thanks to high levels of male hormones.

Heavy menstrual bleeding could even be a sign of a disorder that causes you to lose too much blood, like idiopathic thrombocytopenic purpura (ITP). ITP usually comes along with other symptoms like easy and excessive bruising or a rash of reddish-purple dots on a person’s lower legs.

Clearly, figuring out what’s causing your heavy bleeding won’t be easy on your own, so you should see your doctor. They’ll typically ask about your other symptoms and perform exams to determine what exactly is going on, and treatment will depend on what you’re dealing with.

2. Your period brings days of pain that make it practically impossible to leave your bed.

Dr. Streicher’s rule is essentially that if you’re experiencing even an iota of period pain beyond what you’re fine with, it’s too much. The first step is typically to take nonsteroidal anti-inflammatory drugs, since they block hormone-like chemicals known as prostaglandins that cause uterine cramping. If that knocks out your cramps, you’re good to go. If you’re still curled up in the fetal position after a few hours, that’s a sign that you need evaluation, Dr. Streicher says. You’re dealing with dysmenorrhea (severe menstrual cramps), and doctors can help.

There are many different causes of overboard menstrual cramps. Fibroids are a common culprit. So is endometriosis, a condition many experts think happens when tissue lining the uterus travels outside of it and begins growing on other organs. (Other experts believe that tissue is actually different in that it can make its own estrogen, which can create painful inflammation in people with endometriosis.) In addition to causing extremely painful periods, endometriosis can lead to painful intercourse, occasional heavy periods, and infertility, according to the Mayo Clinic.

Adenomyosis, which happens when the endometrial tissue lining the uterus grows into the muscular walls of the organ, can also cause terrible menstrual pain, along with expelling big clots during your period and pain during intercourse.

3. You never know when your period is going to show up.

Pour one out for all the times you thought you’d have a period-free vacation, only for it to show up right as you hit the beach. Fun! Irregular periods could be due to a number of different things that are (at least somewhat) in your control, like stress and travel, Dr. Streicher says. But they can also happen because of various health conditions.

Take thyroid issues, for instance. Hypothyroidism, which is when your thyroid gland in your neck doesn’t produce enough hormones, can lead to an irregular period, according to the Mayo Clinic. It can also cause myriad other symptoms, like heavier than usual periods, fatigue, constipation, dry skin, weight gain, impaired memory, and more. Treatment typically involves taking medication that mimics the thyroid hormone.

On the flip side, hyperthyroidism, which is when your thyroid gland is overactive, can cause light or infrequent menstruation, along with issues like sudden weight loss, rapid heart rate, increased appetite, and more frequent bowel movements, according to the Mayo Clinic.

Irregular periods are also a sign of premature ovarian failure, which is when a person younger than 40 starts losing their normal ovarian function, according to the Mayo Clinic. It can also cause menopausal symptoms like hot flashes, night sweats, vaginal dryness, and difficulty conceiving. Doctors can offer estrogen therapy to relieve symptoms like hot flashes (typically in conjunction with progesterone to avoid the precancerous cells that may take hold if you take estrogen alone). They can also counsel you about the possibility of in vitro fertilization if you’d like to physically conceive and carry children in the future.

PCOS and uterine polyps be behind irregular bleeding, too.

4. Your period decides not to show up for a while.

While it’s true that you can sometimes randomly miss a period for reasons like stress, you shouldn’t just ignore a long-term missing period. Suddenly being period-free may feel blissful, but you’ll want to make sure there’s not a health issue going on, like PCOS, an eating disorder or excessive exercise affecting your menstruation…or, yes, pregnancy.

“If you’re menstruating normally then suddenly go months without a period, that’s not something to ignore,” Dr. Streicher says. If your period vanishes for three months or longer (this is known as amenorrhea), see your doctor for evaluation.

It’s worth noting that the use of some hormonal birth control methods—especially the hormonal IUD—can make your period basically disappear. Still, check with your doctor, just in case, when this happens.

5. You’re dealing with a lot of unexpected spotting between periods.

There are times when this is normal, like if you’ve just started a new type of birth control, or even if you’re pregnant (spotting can be totally fine during pregnancy), Dr. Minkin says. But if nothing in your life has changed and you start spotting between periods, call your doctor for an appointment.

It could be something that’s ultimately pretty harmless, like a benign uterine or cervical polyp that’s causing bleeding between periods. But spotting is also a hallmark of pelvic inflammatory disease (PID), which is the result of sexually transmitted bacteria from infections like chlamydia and gonorrhea spreading to reproductive organs like your uterus, fallopian tubes, and ovaries. In addition, pelvic inflammatory disease can cause issues like fever, strange vaginal discharge that smells bad, and burning when you pee.

If you have PID, your doctor will first address the STI in question with antibiotics, says the CDC, then treat your partner for an STI if necessary. Pelvic inflammatory disease is a leading cause of chronic pelvic pain and infertility in women, so if you suspect you have it, treatment is of the essence.

More rarely, spotting in between periods can be a sign of cervical cancer, according to the Mayo Clinic. Cervical cancer can come along with watery, bloody discharge that might have a bad odor and pelvic pain, including during intercourse. Even though this likely isn’t your issue, you’ll want to get checked out, just in case. Treatment for cervical cancer may involve a hysterectomy, radiation, or chemotherapy.

6. You experience debilitating mood issues before your period.

When your estrogen and progesterone drop before your period, you may experience the typical mood swings that mark premenstrual syndrome (PMS). (Bear in mind that this may not be as drastic if you’re on hormonal birth control, which stabilizes your hormones throughout your cycle.)

But if you deal with severe mood swings, irritability, anger, a lack of enjoyment in things you usually enjoy, and other symptoms that affect your life, you may have premenstrual dysphoric disorder (PMDD). PMDD happens when you experience these symptoms in the week before your period, then they start getting better in the first few days of bleeding, and disappear in the weeks after your period. It’s listed in the DSM-5, the most recent version of the Diagnostic and Statistical Manual of Mental Disorders, for good reason: This psychological issue can completely turn your life upside down.

“If you suspect you have PMDD, the one thing I would encourage is keeping a daily record of the severity of your symptoms,” Dr. Minkin says. If these symptoms only rear their head the week before your period, PMDD might be your issue. If you realize you’re constantly dealing with them and your period just makes them worse, it might be premenstrual exacerbation, which is another way of saying you have a mental illness like depression that gets worse during your period.

Either way, a doctor can help. If you have PMDD, your doctor may have you take antidepressants in the timeframe when you usually experience symptoms, then stop once your period starts, Dr. Minkin says. (If you have premenstrual exacerbation, they may recommend staying on the antidepressants through the month and potentially upping your dosage in the week before your period.)

Or your doctor may suggest you go on birth control using a synthetic version of progesterone called drospirenone, Dr. Minin says, like Yaz and Beyaz. These are FDA-approved to treat PMDD. Though experts aren’t sure why they can be so successful in this arena, it may be because drospirenone reduces a person’s response to hormonal fluctuations. It’s also a diuretic, meaning it can flush out liquids that could otherwise cause fluid retention and contribute to annoying issues like bloating.

7. You have excruciating migraines before or during your period.

If migraines had any home training, they’d at least leave you alone when you’re about to get your period. Unfortunately, period migraines are indeed a thing.

It’s not that menstruation will just randomly cause migraines in unsuspecting people who have never had one, but women with a history of migraines may experience them before or during their periods, according to the Mayo Clinic, which adds that this may be due to estrogen fluctuations. “They tend to get the headache right as they go into their periods, and it seems to get better after they have had their menses for a day or two,” Dr. Minkin says.

If you’re dealing with this, your typical migraine medication may work for you. As you probably know if you’ve grappled with migraines, the treatment options are legion. They include pain-relieving medications to relieve symptoms ASAP and preventive drugs to ward off migraines altogether, according to the Mayo Clinic. In the former camp, you have choices like anti-nausea meds and triptans, which constrict swollen blood vessels and block pain pathways in the brain. In the latter, you’ve got meds like tricylic antidepressants, which affect brain chemicals like serotonin that may be implicated in migraines.

No matter what your period problem may be, you don’t have to suffer in silence.

You have no reason to feel embarrassed about your period—or the myriad problems that can come with it. After all, celebrities are out here talking about menstruation! Some pad commercials even—gasp—use red “blood,” these days! What a time to be alive.

If you’re having period problems, see your doctor for help. If they aren’t committed to relieving your symptoms, that’s a sign you should try to find a more sympathetic medical professional who can help you find the best treatment.

What to Expect After IUD Removal: Ob/Gyn Experts Explain


Breathe a sigh of relief: Getting it taken out is nothing like getting it inserted.
iud-removed_feature

Whether you have an IUD removal on the books or you’re just wondering what the procedure is like, you’ve come to the right place. IUDs, also known as intrauterine devices, are little T-shaped instruments that reside snugly inside the uterus and ward off pregnancy with a variety of mechanisms. The hormonal kinds release levonorgestrel, a synthetic form of the hormone progestin, to prevent ovulation, thicken cervical mucous, and thin the lining of the uterus, according to the U.S. National Library of Medicine. The non-hormonal IUD releases copper ions, which are toxic to sperm.

IUDs sound like some impressive sci-fi invention, but they’re real, and they’re giving women excellent control over their reproductive futures. But after a certain point, the IUD has got to go, whether you’re ready to start trying for a baby or it’s just reached its time limit.

If you’ve been through the insertion process, which usually ranges from uncomfortable to downright painful, you might think about your future removal date with at least a little trepidation. Good news: Chances are you’ve got nothing to fear. Here, ob/gyns explain exactly what to expect during the removal of your Mirena, ParaGard, or other kind of IUD—both in the moment and afterward.

When do I need to get my IUD removed?

The official recommendations are to remove Mirena, a common hormonal option, five years after insertion. The same goes for Kyleena, another hormonal option from the maker of Mirena. You’ll need to replace hormonal IUDs Liletta and Skylaa bit earlier (four and three years, respectively). As for the copper ParaGard, which doesn’t use hormones? You can keep that superstar in for up to 10 years.

But, of course, you can always get your IUD removed earlier than any of these benchmarks if you want to get pregnant or if you’ve decided another birth control option makes more sense for you.

What actually happens during the IUD removal?

You know those strings hanging out of the bottom of your IUD? This is their time to shine. “The vast majority of the time, [IUD removal] simply involves doing a simple exam much like a Pap smear,” board-certified ob/gyn Antonio Pizarro, M.D., tells SELF. “If the strings are visible, the doctor grasps them using an instrument called ring forceps and gently pulls the IUD out.”

“Usually patients get really worked up, then when it’s done, they say, ‘Oh, that’s it?'” Jacques Moritz, M.D., an ob/gyn at Weill Cornell Medicine and NewYork-Presbyterian Hospital, tells SELF. The ease of removal comes down to a few major things, he explains: The doctor isn’t using an instrument to push past your cervix (the way they do during insertion), the IUD’s wings don’t have to open up in your uterus (ditto), plus the IUD’s arms just fold in on themselves when it’s being removed, so it’s as small as possible.

Is it painful to have an IUD removed?

“Anyone who has an IUD basically paid the price when getting it—the pain happens during insertion,” Dr. Moritz says. Keep in mind that even when rating the experience as terrible, many women say the pain of getting an IUD was well worth it since they provide such stellar protection against pregnancy.

“Everybody gets nervous about [removal], but it should almost not be felt. Just one deep breath, and it’s done,” Dr. Moritz says. Can’t you practically feel your uterus relaxing at this very welcome news? Even better, depending on your insurance, the entire cost of the removal may be covered.

Are there any IUD removal complications?

Most often, the process only takes a few minutes, then you’re good to go. But in the rare case that the doctor can’t find the strings, removal becomes a bit more involved. The IUD strings can shift a bit, sometimes curling up around the cervix so they’re harder to access, or maybe they were cut too short in the first place. In those instances, doctors can try to “tease” them out using some instruments, and it won’t exactly feel pleasant, Dr. Moritz says. “It’s not super painful, but definitely uncomfortable,” he explains. He gives himself a cutoff of 10-15 minutes to try teasing the IUD out. If that doesn’t work, other measures will.

“Rarely do IUDs become dislodged or the strings get lost,” Dr. Pizarro says. But on the off chance that something like that happens, doctors may use an ultrasound or hysteroscope (a thin lit tube that allows a doctor to see inside the uterus) to locate the IUD so they can remove it, potentially with anesthesia depending on the situation. “Even then, it’s limited invasiveness,” Dr. Pizarro says.

What kind of IUD removal side effects should I be prepared for?

You might feel a cramp as it the doctor pulls it out (again, it shouldn’t feel anything like the one some women experience during insertion) or you might not even realize it’s happened, Dr. Pizarro says. You may also experience some residual cramping or a little bleeding after an IUD removal, but as long as it isn’t severe and goes away in a few hours or, at worst, a couple of days, you don’t have anything to worry about.

One thing to really think about is that your period may change. The specific way it might change after IUD removal depends on what kind of IUD you had and how the device changed your cycle over time. Hormonal and non-hormonal IUDs change periods in different ways. You might enjoy lighter, less painful periods on a hormonal IUD like Mirena—or they may stop completely. So, when you get a hormonal IUD removed, your period will probably revert to what it was like without hormones, Dr. Moritz says.

As for the copper IUD, it’s all about how your body adjusted to it over time. Copper IUDs can make periods heavier and crampier at first, but for some women, that abates, while others deal with more intense periods the entire time. After getting a copper IUD removed, your period might become lighter and less annoying or not change much at all, the experts explain.

How long does it take to get pregnant after an IUD?

“Fertility is possible immediately,” Dr. Pizarro says. If you’re not ready to have kids yet or ever and your removal was normal, it might make sense for you to get another IUD in the same visit (this is often easier both time-wise and mindset-wise).

If you decide not to get a new IUD for whatever reason and you’re not interested in making babies, be sure to find another solid form of contraception you can rely on to keep you childfree.

Is It Really Normal to Have Nipple Hair?


Read this before feeling weird about your nipples.
Nipple hair

If you’ve ever noticed a rogue nipple hair, it probably prompted an array of emotions including confusion (um, hi, what are you doing here?) and annoyance (what does one even do about unwanted nipple hair?). But, in most cases, having hair around your nipples is actually perfectly ordinary. Think of it this way: You have hair all over you body, so your breasts shouldn’t be any exception.

Pretty much everyone has some level of hair on their breasts.

What people typically call “nipple hair” usually isn’t on the actual nipple at all. Instead, this hair often pops up on the areolae, aka the pigmented circles surrounding your nipples, and other non-nipple breast skin. “It is extremely common for women to have hair around the nipples,” Joshua Zeichner, M.D., a New York City-based board-certified dermatologist and director of cosmetic and clinical research in dermatology at Mount Sinai Medical Center, tells SELF.

The exact percentage of how many women have breast hair isn’t known, since this isn’t something that has been studied at large or that women usually report to their doctors. Still, women’s health expert Jennifer Wider, M.D., agrees, telling SELF that breast hair is “very common.”

But…why does it exist? Biologically speaking, humans likely developed body hair for many reasons, some of which scientists haven’t yet fully pinpointed. Hair around your nipples may be a holdover from when body hair was an important part of regulating your temperature, Dr. Zeichner says. Since things like air conditioning, heaters, and fuzzy sweaters can do that now, the hair around your nipples doesn’t seem to serve any present-day purpose. Consider it boob decoration.

There are a few factors that can determine how much (or how little) hair you have on your boobs.

Like any other kind of body hair, breast hair can vary in amount, thickness, and color from person to person. Similarly to your pubic hair, it can also look different from the hair on the rest of your body, Dr. Zeichner says.

You may notice more hair growing around your nipples if your hormones are fluctuating more than usual, like during pregnancySherry A. Ross, M.D., a women’s health expert and author of She-ology: The Definitive Guide to Women’s Intimate Health. Period., tells SELF. The pregnancy-induced surge of estrogen can prolong your hair’s growth phase, so just like the hair on your head can seem especially long and lush when you’re expecting, so can the hair on your breasts, Dr. Wider explains. It’s all normal.

If you notice that you’re producing a lot more hair here than you used to, it could be a sign of a condition like polycystic ovary syndrome (PCOS), which can cause excessive hair growth on your face and body. This type of hair growth is known as hirsutism and can happen because of elevated male hormones, like testosterone, which are a common characteristic of PCOS, Dr. Ross says.

Keep in mind that having hair around your nipples without any other symptoms isn’t a sign of PCOS, Dr. Wider says. But if you’re noticing a lot more than usual and you’re also getting hair on your face, coupled with symptoms like bad acneand irregular periods, it’s worth flagging for your doctor. They can evaluate you and, if necessary, recommend treatment like birth control or other medications to prevent excessive hair growth.

Bottom line: Hair surrounding your nipples is usually just a part of having breasts.

There’s no reason to feel weird about it, or like your breasts need to be as smooth and hairless as a baby dolphin. But if you really can’t stand having breast hair, you can pluck it just like you would pluck your eyebrows (and it might hurt, just like it can with your eyebrows). The skin around your nipples is delicate and can be easily irritated, Dr. Zeichner says, so razors and wax are dicier options than simply tweezing.

If you have more hair around your nipples than you care to pluck, a dermatologist can talk to you about electrolysis (a procedure that involves inserting a tiny needle into the hair follicle and sending in an electric current to destroy the root) or laser hair removal, Dr. Zeichner says. (Just keep in mind that laser hair removal runs the risk of creating skin discoloration or other side effects, so you want to make sure you see someone who knows what they’re doing.)

Again, having hair around your nipples is super normal and not something you need to stress about or consider removing if it’s not bothering you. But, if it does bother you or it seems like a sign something’s up with your health, talk to your doctor to discuss ways you can nip any bothersome breast hair in the bud.

Contraception may change how happy women are with their husbands


Choosing a partner while on the pill may affect a woman’s marital satisfaction, according to a new study from Florida State University and Southern Methodist University.

In fact, the pill may be altering how attractive a woman finds a man.

In a new study published in the Proceedings of the National Academy of Sciences, researchers examined 118 newlywed couples for up to four years. The women were regularly surveyed with questions asking them about their level of satisfaction with the relationship and their use of contraceptives.

The results showed that women who were using hormonal contraceptives when they met their husband experienced a drop in marital satisfaction after they discontinued a hormone-based birth control. But, what’s interesting is how the change in their satisfaction related to their husbands’ facial attractiveness.

Women who stopped taking a hormonal contraceptive and became less satisfied with their marriage tended to have husbands who were judged as less attractive. The women who were more satisfied after stopping contraceptive use had husbands who were judged as good looking.

“Our study demonstrated that women’s hormonal contraceptive use interacted with their husbands’ facial attractiveness to predict their marital satisfaction,” said SMU psychologist Andrea L. Meltzer, a co-author on the study.

Specifically, women who met their relatively more attractive husbands while using hormonal contraceptives experienced a boost in marital satisfaction when they discontinued using those contraceptives, said Meltzer, an assistant professor in the SMU Department of Psychology.

In contrast, women who met their relatively less attractive husbands while using hormonal contraceptives experienced a decline in when they discontinued using those contraceptives, she said.

Hormonal processes may be at work, said Michelle Russell, a doctoral candidate at Florida State and lead author on the study.

“Many forms of hormonal contraception weaken the hormonal processes that are associated with preferences for facial attractiveness,” Russell said. “Accordingly, women who begin their relationship while using hormonal contraceptives and then stop may begin to prioritize cues of their ‘ genetic fitness, such as his , more than when they were taking hormonal contraceptives. In other words, a partner’s attractiveness plays a stronger role in women’s satisfaction when they discontinue hormonal contraceptives.”

In contrast, beginning a hormonal contraceptive after marriage did not appear to have negative or positive impacts on a woman’s satisfaction, regardless of her husband’s looks.

In the United States, 17 percent of women ages 17 to 44 were on pills in 2010, according to the Guttmacher Institute. Nearly 5 percent more used other methods such as injections or a vaginal ring.

Psychology Professor James McNulty, who is Russell’s adviser and one of her co-authors, noted that it is important to understand that this is only one factor affecting satisfaction.

“The research provides some additional information regarding the potential influences of hormonal contraceptives on relationships, but it is too early to give any practical recommendations regarding‘s family planning decisions.”

Contraception helps lower U.S. abortion rate.


If opponents of reproductive rights are eager to see a drop in the national abortion rate, the movement should be pleased with the recent progress.

Image: US-POLITICS-ABORTION-FILES

The abortion rate and the number of abortions has fallen 13%, with just 1.1 million abortions in 2011, according to a new study by the Guttmacher Institute.
Just 16.9 per 1,000 women between the ages of 15 and 44 got an abortion in 2011.
It’s the lowest rate since the year the Supreme Court legalized abortion nationwide, 1973. Guttmacher has been periodically surveying abortion providers since the 1970s and surveyed four years for the current study, looking at abortion from 2008 to 2011.
The entirety of the 12-page Guttmacher Institute report is online here (pdf). Note that similar data for 2012 and 2013 is not yet available, so we can’t say with confidence whether or not the trend is continuing.
Because the sharp drop in the abortion rate occurred after the 2010 midterms, when conservative lawmakers at the state level launched an unprecedented campaign to restrict women’s access to abortion services, it may be tempting the plunge is directly related to new state policies. In other words, opponents of abortion rights were elected; they immediately got to work on new restrictions; and the drop in the abortion rate is proof their efforts succeeded in their intended goal.
But that’s not what the researchers found. “With abortion rates falling in almost all states, our study did not find evidence that the national decline in abortions during this period was the result of new state abortion restrictions. We also found no evidence that the decline was linked to a drop in the number of abortion providers during this period,” says Rachel Jones, lead author of the study.
In fact, in states with fewer abortion restrictions, the rate dropped just as much, if not more, than in states imposing new restrictions.
So what explains the sharp reduction?
Guttmacher Institute researchers pointed in part to the weak economic recovery, which drove the overall birth rate down, but also stressed access to contraception.
Jane Timm’s report added, “[C]ontraceptives themselves may be lowering the rate of abortion, due to the availability of highly effective long-term contraceptive, like the IUD. During the four years of the study, long-term contraceptive use rose from 4 to 11%.”
Given results like these, it’s curious that so many conservative lawmakers have been so aggressive in trying to limit access to contraception, with support for litigation and legislation intended to empower religious employers to cut off employees’ access to birth control.
If the goal is to reduce unwanted pregnancies and lower the abortion rate, it would seem the right would want more access to contraception, not less.
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