When Your Period is Actually a Health Problem

Your period is more than reassurance that you’re not pregnant — it can act as a barometer of your overall health. A cycle that’s too long or too short might indicate a hormone imbalance, while heavy or painful periods can signal a below-the-belt medical problem like fibroids or endometriosis. All are conditions that can affect your overall health if left untreated. Here, five period signs you should always get checked out:

Heavy periods

Heavy menstrual bleeding affects about one in five American women, according to the CDC. One of the most common causes is fibroids, benign tumors in your uterus. But it can also indicate a hormonal problem, like hypothyroidism.

What to do: if your period lasts longer than a week and/or the bleeding is so heavy for most of it that you’re changing your pad or tampon every one to two hours, see your gyno. They can run blood tests to check hormone levels and do a physical exam and an ultrasound to look for fibroids. Sometimes, heavy bleeding can be easily treated with hormonal birth control such as the pill, shot, vaginal ring, or a hormonal IUD. But if birth control doesn’t help, you may need to have the fibroids surgically removed.

Irregular periods

Believe it or not, a regular menstrual cycle can be as short as 24 days or as long as 38. But anything longer or shorter than that can indicate a problem such as polycystic ovarian syndrome (PCOS), a hormone imbalance that affects about ten percent of women aged 15-44.

What to do: If you do have PCOS it’s important that you get a diagnosis right away, since it’s been linked to other serious health issues—more than half of women with the condition will develop diabetes or pre-diabetes before the age of 40, for example. It also increases chances of developing high blood pressure or cholesterol. One way to treat PCOS, especially if you don’t want to get pregnant, is to go on a hormonal birth control method such as the pill. Not only will it make your menstrual cycle more regular, but birth control can also improve other symptoms of PCOS such as acne and facial fuzz.

Uber-painful periods

More than half of women report experiencing pain around their period, but it usually improves with an over-the-counter anti-inflammatory like ibuprofen. If yours doesn’t, and it’s so debilitating that you’re lying curled up in bed with a heating pad or missing work or school, it could be endometriosis. About eleven percent of women between the ages of 15 and 44 experience this painful condition in which the lining of your uterus grows outside of it and attaches to the pelvic cavity or onto surrounding organs.

What to do: your gyno can often diagnose endometriosis through a pelvic exam and ultrasound. The first line treatment is often hormonal birth control. One good option may be the progestin-only pill—a 2017 study published in the journal Fertility & Sterility found it was more effective than combination pills when it came to reducing pain. If hormonal treatments don’t help, you may need surgery.

Menstrual migraines

Ever notice you get a head splitter right before or at the start of your period? Welcome to menstrual migraines. These types of headaches are due to the sharp drop in hormones, primarily estrogen, right before your monthly visitor arrives. More than seven percent of all menstruating women get them, according to a 2014 study.

What to do: if your migraines are really bad your doctor can prescribe a triptan, a type of migraine drug that relieves pain by reducing inflammation and relaxing blood vessels. If your menstrual cycles are regular, you can even take a triptan preventatively a few days before the start of your period. Another good option: Certain types of hormonal contraception like pills, rings, or patches, which stabilize estrogen levels. You’ll still experience a drop in hormones when you reach your placebo week and get your period, but the change in hormone levels won’t be quite as dramatic so the headaches shouldn’t be as bad. You can also use birth control pills continuously, to prevent that headache-inducing hormone drop entirely.

Mood swings around your period

Sure, it’s normal to feel irritable at that time of the month, but if you’re a seething ball of rage or can’t stop crying you may have premenstrual dysphoric disorder (PMDD), an extreme form of PMS which affects about five percent of all women. You can thank low levels of serotonin, a feel-good brain chemical that naturally dips a week or so before your period. While the serotonin dip happens to all women, some—especially those who already struggle with anxiety and/or depression—may be more susceptible to PMDD as a result. 

What to do: your doctor can prescribe a type of antidepressant called a selective serotonin reuptake inhibitors (SSRIs) such as sertraline (Zoloft and generic) or fluoxetine (Prozac, Sarafem or generic) that you take just for the second half of your cycle.  Certain birth control pills, like Yaz, Beyaz, and Nikki, can help because they contain a type of progesterone called drospirenone, which has been shown to help with PMDD.

The bottom line

If your period causes you significant discomfort and inconvenience, don’t just suffer — seek help. Hormonal birth control can alleviate or even solve your menstrual misery, especially if you use it to skip periods entirely. Beyond that, ask your healthcare provider for tests to help understand the cause of your period problems, so you can get precise treatment and relief. Because it’s normal for periods to be a pain, but they shouldn’t be a health problem. 

About the Author

Hallie Levine is an award-winning journalist who has covered health and wellness for more than twenty years for publications including Consumer Reports, The New York Times, Health, Prevention, Time, Reader’s Digest, Parents, Good Housekeeping, and Redbook.

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