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Period Symptoms You Should Know About

Written by Elizabeth Buescher, Gynecologist

As anyone who has had a menstrual period knows, they are not without symptoms. Some people have very few symptoms of their menstrual period, while others have severe symptoms, such as flu-like symptoms, nausea, PMS symptoms, period cramps, and abnormal bleeding that makes those period days difficult to tolerate. Some women have such severe symptoms during the period that after the period, they feel exhausted and have a hard time getting back to their normal life.

Every woman is different and, in many cases, every period is different. For women who have irregular periods, they don’t know when to expect the bleeding, and they often go up to a month without a period. Women who consistently have an early period will often have heavy bleeding unassociated with period cramps. These early periods are often unassociated with ovulation. When they have an ovulation period, the period stretches out so that there are a full 28 days between periods. This is more typical of an ovulation period than one that happens without ovulation.

Symptoms of Periods to be Concerned About

If your period is very heavy or if you have a missed period, you may need to visit a doctor see why this has happened. Many women miss periods for no reason but sometimes, it can indicate a pregnancy—the most common reason why a woman misses a period. The same is true of a late period. This can mean pregnancy, or it can mean that your ovulation is not cyclical, and you ovulate later than a normal woman. It sounds like a weird thing to have periods so far apart, but this is not dangerous and means that you might have a trickier time getting pregnant when the time comes.

Heavy periods can mean you didn’t ovulate and that you might be suffering from some iron deficiency. Your doctor will be able to help sort that out for you so that you can get on some kind of iron supplementation to bring your iron stores up.

What are some pre-period symptoms?

Many women know when they are about to get a period. While not all period symptoms are the same, many women feel bloated, have pelvic cramps, feel nauseous or have period signs like spotting before a period. With some women, pre-period symptoms cause mental and physical changes that are so debilitating that it is called premenstrual dysphoric disorder or PMDD. Women with PMDD can’t wait until after hysterectomy when they will no longer suffer these symptoms. Selective serotonin reuptake inhibitors or SSRIs are often used to control the mood changes that go along with having PMDD. Women with PMDD don’t necessarily have worsened period pain than other women. It’s the pre-period time that is so distressful. They can go days having to cramp without bleeding that can require pain medications to control.

When do you get Period Symptoms?

Most women have a relatively easy time in the first two weeks of their menstrual cycle. It’s only after they ovulate that they begin to suffer the typical premenstrual symptoms and begin to suffer. This period of time can last up to two additional weeks before the period comes, and then the post period symptoms occur. There aren’t very many post period symptoms. Most women have resolution of their bloating, feel mentally well and have an excess of energy. These two weeks give the woman a chance to recover before they ovulate again, and the PMS symptoms begin to take hold.

Symptoms of a Period that is Anovulatory

Anovulatory menstrual cycles tend to be shorter than normal periods. They can be as short as 21 days. Usually, there aren’t many PMS symptoms in anovulatory cycles and cramping is less before the period starts. When the period does actually happen, there is often little cramping but a lot of bleedings. The bleeding can include clots that cause a great deal of blood loss. The period tends to last a little bit longer than with an ovulatory period. Women can have these kinds of periods indefinitely and have a few ovulatory periods in between. It is difficult to get pregnant when most of your periods are anovulatory. Fortunately, your doctor has ways to stimulate ovulation in women who are trying to get pregnant but have anovulatory cycles.

What are period symptoms like before menopause?

As one approaches menopause, the period symptoms can intensify with more cramping and more anovulatory cycles. Bleeding can be heavier as women approaching menopause have things like internal fibroids and estrogen overload that causes heavier vaginal bleeding during the peri-menopausal period of time.

Just before menopause, the periods begin to space out and eventually stop. Cramps and bloating are replaced by hot flashes and night sweats that can last for several years. When the periods end for a total of 12 consecutive months, then the woman is said to be in “menopause” and the hot flashes tend to diminish. This starts the postmenopausal years that are free of bleeding, but that put a woman at risk for heart disease and stroke.

What are Symptoms of Period Bleeding?

Some women have light spotting as part of their period and only have this for a couple of days. This is commonly the case of women who are on birth control. Taking birth control pills for more than a few months will make the period lighter so that only a few days of spotting constitute the period. The periods are regular because of the birth control pills and most women have very little in the way of premenstrual symptoms. Birth control pills can be used to lessen bleeding and to reduce acne. Besides their effectiveness at avoiding pregnancy, birth control pills will help women with PMS feel better throughout the menstrual cycle. If that doesn’t work or if the woman desires pregnancy, then SSRIs are the best way to go.

Other women have seriously heavy periods with clots and cramping. The periods are so heavy that the woman has to wear pads and tampons at the same time. Often medications need to be taken to control the cramping, and iron therapy is necessary to keep the iron stores from becoming depleted. These periods are often anovulatory, or the woman has internal fibroids or polyps that contribute to the heavy bleeding. The main treatment for this is a dilatation and curettage (a D and C) in which the lining of the uterus is scraped out so that it doesn’t bleed as much. Other treatments include birth control pills that gradually shrink the lining of the uterus, so it doesn’t bleed as much. Some women get Depo-Provera or progesterone shots that cause the periods to be much less in frequency and intensity.

How to Relieve Period Symptoms

There are many ways to relieve period symptoms. During the premenstrual state, women can take medications like Aleve or ibuprofen to control cramping pain. These are especially good medications to take during the first day or two of bleeding when cramping is so severe. Women who have premenstrual emotional problems do well on selective serotonin reuptake inhibitors (SSRIs), which control the mood and depressive symptoms of PMDD. Other women choose birth control pills or the Depo-Provera shot to control period symptoms. These can take a couple of months in order to take effect, but the can be very effective in controlling symptoms of heavy bleeding, cramping and even the emotional symptoms of the menstrual cycle.

If none of these things seem to work, seek the advice of your doctor or gynecologist in order to get some prescription medications to control the symptoms of PMS, PMDD, or heavy bleeding. There are surgical procedures that an lessen the bleeding of the menstrual period. Your gynecologist can help you figure out what way would be best to control these symptoms.

How early can you get period symptoms?

Women tend not to have many symptoms until the time of ovulation. Then the progesterone levels rise and the estrogen level is maintained at a high level, leading to mood swings, cramping, bloating, and other symptoms of premenstrual discomfort. These symptoms can last a full two weeks or can just be present for a few days before the menstrual period. Regardless of the length of the symptoms, those days can be debilitating, making a woman suffer much before the period finally comes.

When this kind of thing goes on through the woman’s reproductive years, it can be very difficult to live with, especially in teens who tend to suffer the most. Pregnancy can control some of the symptoms of heavy periods but often the woman has to make a choice between fertility and having lots of symptoms versus being on birth control pills, unable to conceive but feeling much better. This can be a difficult choice for some women to make. Women who have difficult menstrual cycles can only hope that the symptoms change over the years or get better after being pregnant once or twice.

Dealing with Premenstrual Dysphoric Disorder

Women who today have PMDD were once thought to be hysterical. They suffered greatly with many of their male doctors and husbands not really knowing what was happening. We now know that there are many different hormonal situations going on during the menstrual cycle that lead to emotional, mental, and physical changes in a woman. Now, there are actual treatments for women with difficult menstrual cycles that can make the days before getting the period much better and more tolerable. Things like birth control pills and SSRI therapy are now commonplace among women who would rather take these medications than suffer through their menstrual cycle naturally.

Menstrual Symptoms in Young Women

Most young women get their menstrual period between the ages of 11 and 14. During this time, the periods can start regularly or can start and stop over a few months before becoming regular. Some girls have mild periods in the beginning that intensify over time. Other young women have severe cramping and bleeding almost from the beginning. This can be uncomfortable and embarrassing for the young woman who is trying to get through puberty with as little hassle as possible. Even young woman who is virgins might have to go on birth control pills to regulate their cycles and to keep them from having terrible PMS symptoms. It doesn’t hurt to have a young women in puberty on birth control as well because this can eliminate the possibility of a teen pregnancy. Girls on birth control pills are challenged by a great many peer pressures so that they may be in a position to have sex very young in life. When they are protected against pregnancy, this can help them not to get pregnant while still allowing them to have normal periods with few symptoms.

The Role of Medication Management in Menstrual Symptoms

There are simple and complex things that can be done to control menstrual symptoms, no matter how severe they are. Simple things include taking ibuprofen or Aleve to take away the cramps that occur in the last days before the period finally comes. These can be used indefinitely to control menstrual symptoms and are available over the counter.

Birth control or Depo-Provera can be used in women who also desire some kind of contraceptive therapy along with control of symptoms. In both treatments, the woman will have lighter or absent periods that represent minor withdrawal bleeding and that help make the entire menstrual cycle more tolerable. These can also be used indefinitely or until the woman desires a pregnancy. Depo-Provera, once stopped, will gradually return the fertility to normal, but it may take several months to get pregnant. After birth control pills are stopped, normal fertility occurs within a month or so.

SSRIs are reserved for women who have a lot of emotional and mental symptoms around the premenstrual phase. This can make the difference for women who feel like they are going crazy during their premenstrual days. Rather than suffer, SSRIs are taken every day, even when there are no symptoms so that the premenstrual days are much more tolerable.