I explain in what cases unplanned bleeding and changes in the menstrual cycle are a reason to see a doctor.
Uncontrolled bleeding, heavy bleeding, cramps, and mood swings – I see women in my practice suffering with these symptoms as well as I remember myself not so long ago being so sick that I was not able to function right before my menstrual cycle would start. There are deeper causes hidden underneath the superficial and unpleasant symptoms we may experience. Definitely, every person is different and the approach is based on the baseline blood lab work, DUTCH (Dry Urine Test of Comprehensive Hormones), and symptoms. The most important point of this article: Do NOT settle for a mere prescription for Birth Control to “regulate” your hormones. There is NO hormone regulation there! Your ovaries and your brain stop communicating and you get synthetic (and subpar) equivalents of progesterone – PROGESTIN (not to be confused with bioidentical PROGESTERONE) and ESTROGEN (synthetic form). Your thyroid gland may suffer, your magnesium and B vitamins may get drained and need thorough supplementation.
#1. Your Menses are Suddenly More Profuse.
Is the bleeding so bad that you had to double the number of tampons and pads? One abnormal menstruation is not yet a reason to sound the alarm, but if profuse bleeding bothers you for several months in a row, consult your gynecologist. Possible causes are polyps or uterine fibroids. Do not panic: these are benign neoplasms, they are not particularly dangerous, but in any case, they require observation. Unfortunately, conventional medicine does not have much to offer to manage fibroids apart from birth control pills and observation. Why would Oral Contraceptives be NOT a good idea? Oral Contraceptives to Regulate Hormones, Heavy Bleeding or Painful periods have been used for a long time, but they only act as a bandaid covering up the symptoms and leading to the bigger issues later. HERE is more information about that.
Another probable diagnosis is an imbalance in thyroid or pituitary hormones. If such bleeding is accompanied by severe pain, the cause may be endometriosis.
That’s where Functional medicine approach may help greatly! Looking at the whole body as a complex system instead of treating one body part as a separate entity. Getting to the CAUSE of the symptoms, not just treating the symptoms with the “bandaids”.
#2. Irregular Menstruation
The cycle length for a woman varies from 21 to 35 days (for adolescent girls – up to 45 days). But if the cycle length begins to fluctuate abruptly, be sure to address it. Possible causes include infections, hormonal imbalance, polycystic ovary disease (a cluster of symptoms), as well as stress, depression, and harsh diets. Again, if you are taking oral contraceptives, you are not having a real cycle and a real bleeding – you are having a “withdrawal bleeding” when you take a placebo OCP (no hormone tablet) for a week.
#3. Bleeding after Sex
If this happens relatively rarely, there is no cause for concern. If often, the cause may be a bacterial infection, a cervical polyp, or a sexually transmitted disease.
#4. Persistent Bleeding
Contraceptives are often to blame for this. The unpleasant side effect usually goes away on its own: two to three months after the start of birth control pills and three to six months after the insertion of the intrauterine device. If the bleeding has not stopped during this time, talk to your gynecologist about changing the method of contraception. If you have been using your contraceptive method for a long time and you suddenly have spotting, make an appointment with your doctor: the cause may be an infection or a benign neoplasm.
#5. Disappearence of Menstruation
If you have not had your period for three months or longer and you are not pregnant and do not use hormonal contraceptives (oral or intrauterine device), you should get in touch with your healthcare provider. The most common cause is polycystic ovarian disease in women in their 20s and 30s, and the condition can be put into a remission with the proper diet and addressing insulin resistance and metabolic syndrome. (At the age of 40+, such disruptions in the cycle may indicate the onset of perimenopause.)
#6. Premenstrual Syndrome
So many symptoms but at the root, most likely, estrogen dominance (as well as in the case of fibroids, endometriosis, and other not so pleasant diagnosis women get). Mood swings are not pleasant – are there any risks? I dive in deeply into the estrogen dominance as the root cause of unpleasant symptoms HERE!
Zhanna Tarjeft, FNP is a certified Functional Medicine Practitioner and a founder of Sprouts Health Functional Medicine Practice in Gilbert, Arizona. Her articles are a matter of personal opinion and do not constitute direct medical advice. All conditions are unique and require the direct review and care of your own physician. To book an appointment with Zhanna Tarjeft contact her at (480) 550-9551