Period, Cramps, PMS, Oh My! Most Common Questions

 

What’s typical with a menstrual period?

• Age of onset 11-12y ranging from 8 to 14y
• Average frequency 32 days but 21-45 days is considered normal
• Length 2-7 days
• Normal blood flow requires 3-6 pads or tampons per day

 

When should I see a doctor if I think my periods are abnormal?

Most girls will start their menstrual periods around 11 to 14years old.  In a perfect world, periods come every 28 days, last 2-3 days and cramps don’t exist, but this may not be your story.  A menstrual period or cycle is counted from the first day of bleeding in one month to the first day of bleeding in the next month or whenever you get that next period.  Irregular periods can be the norm for many lasting a couple years after your menstrual cycles officially begins.  It may take a few years for your period to become regular.

 

How do you know if you have abnormal periods? 

It can be confusing during your teen years when your periods are coming every 3 to 6 months or once a year.  If you notice that your periods are coming frequently, less than 21 days, or infrequently, greater than 45 days, you should contact your health care provider to discuss reasons why this might be happening.  When your periods come less often, they tend to be heavier, last longer and with more painful cramping.

What are some reasons to have irregular periods?

• Thyroid and other Hormonal disorders
• Peri-menopause and Menopause
• Polycystic Ovarian Syndrome (PCOS)
• Excessive Exercising
• Sudden Weight Changes
• Physical or Emotional stress
• Illnesses
• Pregnancy
• Sexually Transmitted Infections (STIs)

You can download a period tracker on your smart phone or use a calendar to keep track of your periods.

No matter what your mom or girlfriends tell you, having monthly periods tells us that you are hormonally balanced.  Whether you call it “Aunt Flo”, “Strings Attached” or “Sharks are Circling”, regular periods are best for you physically and emotionally.

What are some holistic and natural remedies to help create a regular period?

In general, a healthy and regular diet doesn’t necessarily affect or regulate your periods. There are dietary and lifestyle changes that will put you in charge of your period instead of your period taking charge of you.

• Eat healthy foods including fresh fruits and veggies, proteins-fish, chicken- and complex carbohydrates such as whole grains and brown rice prevent bloating.
• Eat foods that are natural diuretics to reduce bloating and swelling such as celery, cucumbers, watermelon, tomatoes, asparagus, lemon juice, garlic, melon & lettuce.
• Exercise is often helpful for many PMS symptoms and cramps experienced during the menstrual cycle.  The feel good and mood boosting endorphins and serotonin help ease the pain and stress experienced during certain times of the month.  Walking, jogging, Pilates, yoga and swimming are excellent choices.
• Green tea is a great natural diuretic and can serve as a comforting beverage.
• Calcium rich foods and supplements reduce muscles from cramping.  Ideally 1,000mg/day of calcium works best.  Dairy products (cheese, yogurt, and milk), sunflower seeds, spinach, soybeans, kale, figs, almonds, sesame seeds and tofu are excellent sources of calcium.
• Drinking water, warm or hot, helps relax the uterine muscles.
• Vitamins such as calcium, vitamin’s E, D, thiamine, magnesium and omega 3-fish oil may also be helpful in relieving the period bloat and swelling.

 

What are dietary foods and beverages to avoid 1 to 2 weeks before your period?

• Limit your alcohol consumption during this sensitive time during your menstrual cycle since it makes bloating symptoms worse.
• Avoid foods that are classic causes of bloating including beans, broccoli, Brussels sprouts, cabbage and cauliflower. Other dietary culprits include rich and fatty foods, whole grains, apples, peaches, pears, lettuce, onions, Dietary rituals including many “B” and C vegetables are classic causes of gas and bloating and include beans, broccoli, Brussels sprouts, cabbage and cauliflower.
• Avoid foods high in sodium that contribute to bloating and weight gain such as Chinese and other salty ethnic foods.

 

What is the best way to treat period cramps?

My mom used to give me a hot water bottle for my period cramps when I was younger and to this day, I still recommend it.  Cramps can be easily treated with ibuprofen such as Advil and Motrin.  The feeling of pain is caused by increased levels of prostaglandins which makes the uterus contract.  NSAID’s block the action of prostaglandins which decrease the pain brought on by period cramps.

I suggest keeping track of your period using a “period tracker” app so that you can take ibuprofen prophylactically or before you know your cramps and period are coming.  Oral contraception or “the pill” is not only a great birth control but makes your menstrual blood less heavy which minimizes your cramps

each month.  Other easy remedies include a warm bath, heating pad or a hot water bottle that your grandma might have suggested.

Massage is associated with relaxation. Massaging muscles and pressure points may help reduce pain, tension and stress associated with cramping. It doesn’t have a direct effect on uterine muscles, but it is certainly relaxing and pleasurable.

Biofeedback is also helpful in treating period cramps.

Lifestyle choices that will help ease cramps and other symptoms related to PMS include exercising regularly, eating a healthy diet and avoiding salt, sugar, caffeine and alcohol.

Does acupuncture help with period cramping and irregular periods? 16

Acupuncture has long been used for painful medical problems including menstrual cramping and irregular periods. Even though scientific research is limited, it’s thought to work by activating your body’s own self-healing mechanism.

Does CBD help with period cramping?

CBD is the active ingredient in marijuana that helps make your body feel good, relaxes muscles in the pelvis and distracts your brain from feeling the pain associated with menstrual cramps.  There are many ways to use CBD products including bath salts, tampons, suppositories, infused chocolates, body balms and tinctures and they all seem to be effective for mild and moderate cramps. They are safe and harmless products.

When are cramps a sign of a bigger health issue?

Your uterus is basically one big muscle (the shape of a pear) which starts to contract, causes cramping, that helps the lining of the uterus shed.   This shedding will be your 4 to 6 days of uterine bleeding and is called your menstrual cycle or “period”.  Period cramping can be felt in the lower back or belly.  Cramps tend to be more intense during the first day or two of a period.

Every woman experienced cramps differently.  If you are having heavy periods with large blood clots you will probably experience more intense cramping.  Some women may have light bleeding but still have severe cramps.  Blood flow and volume doesn’t always correlate how significant the cramping will be.

For many of us cramps can be completely debilitating and stop us from doing our daily routine.  For others cramps are noticeable but not disruptive.  Cramps can be a normal part of the period cycle.

A constant, low-grade pain that is bearable could represent mild cramping that doesn’t respond to typical treatment include a ruptured cyst, a bladder infection, sexually transmitted infections, pregnancy, or endometriosis. All reasons to be worked up by a healthcare provider.

If period cramps don’t respond to typical treatment remedies including ibuprofen, nonsteroidal anti-inflammatory medications, acupuncture, biofeedback or the birth control pill.

I would be concerned endometriosis was the cause of the pain which doesn’t always respond to traditional treatments.

When should you be worried about a change in color/what period colors are “worrisome”?

Blood is a form of liquid but can turn solid and appear as a clot in certain conditions. If your blood flow is heavy and leaves the uterus quickly blood clots are not usually created.  But if you have a heavy flow and blood leaves the uterus slowly, blood clots develop. Blood clots are not uncommon during a period.  They tend to be dark or bright red in color and come in irregular shapes and sizes. Small clots the size of raisins are usually nothing to worry about and can happen during a heavy blood flow.  Larger and thicker blood clots, greater than the size of a quarter, are reasons to be concerned. Blood clots can develop during a period but are not considered normal if persistent.  Causes of blood clots can be due to a hormonal imbalance, uterine fibroids, uterine polyps or an abnormal pregnancy. Seeing your healthcare provider who can check your blood for medical conditions and getting a pelvic Ultrasound will be helpful in determining a potential explanation.

Is spotting between periods normal?

Spotting between periods is a common problem for many women.  Once in a while it can be normal to have some spotting as a result of physical or emotional stress.  If you are having 3 or more months of erratic and heavy spotting it is an important time talk to your health care provider to see if it’s due to a hormonal disorder, sexually transmitted infection, or other organic reason. 

If a woman’s period stops, how can I regulate it and get it back?

There are many reasons a period can just stop on its own if you are not taking the birth control pill or using a progesterone IUD for contraception as a known side effect.  The most common hormonal issues associated with irregular periods where it may stop completely include pregnancy, polycystic ovary syndrome and thyroid dysfunction—too much or too little.  Other hormonal causes include Cushing’s disease, poor control of diabetes mellitus, premature ovarian failure and congenital adrenal hyperplasia.

When a women’s period stops the first step is to try and figure out the cause by checking blood tests. Once this is done, it’s often easy to jump start a period by inducing it with the hormone progesterone.

Working with a health care provider is important when new period changes occur.

What is PMS?

Please Make it Stop!

Part of being a woman is experiencing the physical and emotional craziness that happens 1 to 2 weeks before your period. Also known as premenstrual syndrome, PMS symptoms start 1 to 2 weeks before your period and are much more disruptive.  The majority of PMS symptoms, caused by normal cyclic hormonal changes, include bloating, weight gain, menstrual cramps, headaches, crying spells, depression, mood swings, anxiety, irritability and fatigue, quickly go away once your period begins.

The cause of these physical, emotional and psychological symptoms are thought to be caused by the hormonal changes and fluctuations during the menstrual cycle.

Why do some women feel depressed and sad before a period?

Emotional changes such as mood swings, depression and crying spells is a completely common and normal symptom of PMS. As long as these emotional symptoms are manageable through lifestyle changes and not affecting your work or personal life, they are not a cause for concern.

 

Why do some women have food cravings and feel hungrier before a period?

Food cravings and feeling hungrier is thought that the production of sex hormones, estrogen and progesterone, and their cyclic nature has a strong effect on appetite. Researchers found that an increase in progesterone production happens before your period, and this is responsible for binge eating.  Estrogen, on the other hand, peaks before ovulation and drops before your period, and acts as an appetite suppressant.

 

Is there anything we can do to minimize PMS symptoms?

Emotional changes including depression, mood swings, irritability and anxiety are common and normal symptoms associated with PMS. When these emotional changes become disruptive with work or your personal life, the diagnosis of Premenstrual Dysphoric Disorder (PMD) is made.  Medications that treat depression and anxiety are often given to women suffering from this debilitating diagnosis.

It’s best to avoid foods that cause excessive bloating 1 to 2 weeks before your period.  During this time, hormonal changes cause bloating, diarrhea and constipation so it’s best to avoid foods and beverages that make these symptoms worse.

Dietary rituals including many “B” and C vegetables are classic causes of gas and bloating and include beans, broccoli, Brussels sprouts, cabbage and cauliflower. Other dietary culprits include rich and fatty foods, whole grains, apples, peaches, pears, lettuce, onions, sugar-free foods containing sorbitol, mannitol and xylitol are directly associated with this frustrating symptom.  Lactose intolerance commonly affects women and is a frequent cause of bloating. Other lifestyle behaviors include drinking carbonated beverages, overeating, eating too fast, lack of exercise and drinking alcohol all contributes to bloating.

Foods high in sodium contribute to water retention, weight gain and bloating.  These symptoms also increase your risk of depression during this vulnerable time of the month.

When you try without success of dietary other lifestyle changes, there are scientifically studied herbs that help you get your life back on track.  Herbs including Chasteberry, Passion Flower extract, Royal Jelly, Ashwagandha and Chromium have been found to combat the most disturbing symptoms including bloating, water retention, mood swings, anxiety, depression, night sweats and cramps.

How can a woman tell if she suffers from Premenstrual Dysphoric Disorder?

Emotional changes including depression, mood swings, irritability and anxiety are common and normal symptoms associated with PMS. When these emotional changes become disruptive with work or your personal life, the diagnosis of Premenstrual Dysphoric Disorder (PMD) is made.  Medications that treat depression and anxiety are often given to women suffering from this debilitating diagnosis.

 

Why do women experience changes in bowel movement during their period?

Gastrointestinal havoc is common during your menstrual cycle.  Bloating, nausea, diarrhea or constipation are the most frequent intestinal symptoms.  The most common bowel change is diarrhea.  It’s thought to be caused by the release of certain chemicals, primarily prostaglandins and progesterone.  Prostaglandins are also responsible for the cramps experienced during your period.  These disruptive prostaglandins make the intestines and uterus contract causing diarrhea and menstrual cramps the first 3 days of your period. An increase in the hormone progesterone causes bloating, diarrhea and constipation.

The best way to treat these disruptive symptoms include eating a healthy, fiber-rich and colorful diet, exercising regularly and avoid caffeine, sugar, salt, diary, spicy foods and alcohol.  Adding a probiotic made especially for women helps balance and control the healthy bacteria needed to improve annoying gastrointestinal symptoms. It’s also important to manage stress through relaxing techniques such as mindfulness, yoga and Tai Chi.

Everyone experiences that time of the month differently.  Hormonal changes can be more troublesome to some women and not others. Healthy lifestyle and dietary behaviors will definitely control some of these less common and unusual symptoms.