Five common questions with straightforward answers on the most common causes of menstrual changes.
Q: What causes heavy bleeding during menstruation?
Marla Ahlgrimm: Uterine fibroids are one of the most common causes of a heavy flow. These non-cancerous tumors attach to the wall of the uterus and can grow as large as a melon, but are typically pea sized or smaller. They occur frequently in women in their 30s and 40s and often disappear without treatment.
When to see a doctor: If bleeding is heavy enough to change pads/tampons more than once an hour for an entire day.
Q: Are periods that last for more than a week normal?
Marla Ahlgrimm: It’s common with age to have periods that last longer than usual. As the body makes less progesterone (the pregnancy hormone), it doesn’t always get the signal to stop menstruation. An underactive thyroid may also be a trigger.
When the ovaries fail, it becomes more difficult to conceive. Here, Marla Ahlgrimm answers questions about ovulation disorders and possible ways to counter infertility.
Q: What is ovulatory dysfunction?
Marla Ahlgrimm: Ovulatory dysfunction is a condition in which the ovaries do not release an egg regularly. Ovulation is a complex process dependent upon hormones being released at the precise time and in the right quantities during the menstrual cycle. Anything that interferes with hormone regulation can result in ovulatory dysfunction. Infertility is a major concern for women with irregular periods.
Q: What usually causes it?
Marla Ahlgrimm: For the most part, ovulatory dysfunction is caused by hormone imbalance. The pituitary gland and hypothalamus play a vital role in regulating Luteinizing Hormone (LH) and Follicle Stimulating Hormone (FSH). If these are out of balance, it can cause a disruption of the menstrual cycle.
In this brief but informative Q & A session, Marla Ahlgrimm answers questions about a painful but common condition that affects many women.
Q: What is endometriosis?
Marla Ahlgrimm: Endometriosis is a condition where uterine tissue doesn’t grow where it’s supposed to. It commonly involves the tissue lining of the pelvis, bowels, and ovaries. Rarely, endometrial tissue may be found outside the pelvic region.
Q: What are the symptoms?
Marla Ahlgrimm: Endometriosis can cause a number of uncomfortable, or downright painful, symptoms. Extreme cramping that may spread to the lower back is common. Painful bowel movements and urination are likely and they often worsen during menstruation. Menorrhagia (excessive bleeding) and breakthrough bleeding are not unheard of as well.
According to women’s health expert and pharmacist Marla Ahlgrimm, painful periods are the leading cause of absences at school or work among women in their teens and 20s.
Q: Is pain during menstruation normal?
Marla Ahlgrimm: Yes, most women have some discomfort during their periods, and more than half have some pain for one or two days each month.
Q: When is menstrual pain considered abnormal?
Marla Ahlgrimm: Menstrual pain is considered abnormal if the pain is so severe that it keeps a woman from her normal activities. Severe menstrual pain is known as “dysmenorrhea” and can be treated in most cases. Read more…
According to pharmacist Marla Ahlgrimm, hormone replacement therapy (HRT) can be prescribed in a number of different ways, depending on the individual needs of each woman. While some women require estrogen, many receive both estrogen and a progestogen.
Q: How does hormone replacement therapy work?
Marla Ahlgrimm: When estrogen and progesterone levels drop, some women may benefit from artificially boosting hormone levels to reduce certain menopausal symptoms. HRT increases the estrogen and progestin levels in the body.
Q: HRT can be prescribed in different ways. What are the main types of hormone replacement therapy?
Marla Ahlgrimm: There are three main types of HRT. Hormone replacement therapy with only estrogen is for women who have had a hysterectomy and their uterus and ovaries have been removed. They do not need progesterone, because there is no risk of endometrial cancer. Cyclical HRT is for patients who are still menstruating but have menopausal-like symptoms. These patients are given an estrogen daily and estrogen plus a progestogen for 14 days. Continuous HRT is used for post-menopausal patients. They take a combination of estrogen and a progestogen daily. Read more…
Marla Ahlgrimm recently answered some questions about one of the most popular prescribed treatment methods for menopause, HRT. Below is a summary of the Q&A session.
Q: Do all women need hormone replacement therapy?
Marla Ahlgrimm: No, hormone therapy helps women whose menopausal symptoms are severe and affecting their quality of life. Women need to discuss with their doctor whether their symptoms are serious enough to warrant taking hormones.
Q: Which factors determine whether hormone therapy is right for me?
Marla Ahlgrimm: There are several factors, including age, personal or family history of breast cancer or clotting disorders, and whether or not you’ve had a hysterectomy. Read more…
Perimenopause, or the menopause transition, begins several years before menopause, says pharmacist and women’s health expert, Marla Ahlgrimm. During this time the ovaries begin to make less estrogen and progesterone. For many women, perimenopause is also a time of risk for the onset of a mood or anxiety disorder. While perimenopausal anxiety is very common, in a minority of women, anxiety symptoms are severe enough to warrant treatment.
Q: Is it because women are feeling anxious about menopause? Or, the other way around, does menopause itself cause anxiety?
Marla Ahlgrimm: Both. There is a connection between hormonal changes and psychiatric symptoms in general, and women undergoing specific hormonal changes during perimenopause have increased risk for particular psychiatric disorders.
Q: How is perimenopause diagnosed?
Marla Ahlgrimm: Often a doctor can make the diagnosis based on a woman’s symptoms. A simple blood test to check hormone levels may also help. Read more…