Treating Menstrual Problems

To determine whether a problem requires treatment, the doctor will ask several questions and do a thorough physical exam. The doctor may do a pelvic exam, blood tests, or urine tests. If there might be a structural problem, an ultrasound or CAT scan may be performed. Together, these tests can help the doctor determine how a condition should be handled.

Growths such as polyps or fibroids can often be removed and endometriosis can often be treated with medications or surgery. If a hormone imbalance is to blame, the doctor may suggest hormone therapy with birth control pills or other hormone-containing medications. Conditions like clotting disorders or thyroid problems may require treatment as well. And for menstrual pain with no underlying medical cause, anti-inflammatory medicines are the most effective treatment.

When to Call the Doctor

Although most period problems aren't cause for alarm, certain symptoms do call for a trip to the doctor. This is particularly true if a girl's normal cycle changes.

So take your daughter to her doctor if she:

• hasn't started her period by the time she's 15 or her period hasn't become regular after 3 years of menstruating. The most likely cause is a hormone imbalance (which may need treatment), but this also might point to another medical problem.
  
• stops getting her period or it becomes irregular after it has been regular. Also let your daughter's doctor know if her cycle is less than 21 days or more than 45 days, or if she doesn't get a period for 3 months at any time after first beginning to menstruate.
  
• has heavy or long periods, especially if she gets her period frequently. In some cases, significant blood loss can cause iron-deficiency anemia. Also, heavy bleeding could be a sign of a growth in the uterus, a thyroid condition, an infection, or a blood clotting problem.
  
• has very painful periods. Having cramps for a couple of days is normal, but if your daughter isn't able to participate in her normal activities, or has cramps for more than 3 days, let the doctor know. She might have a medical problem, such as endometriosis, causing the pain.

Helping Your Daughter

When your daughter's experiencing a particularly bad bout of PMS or cramps, you can help make her more comfortable. Suggest that she:

• eat a balanced diet with lots of fresh fruit and vegetables
• reduce her intake of salt (which can cause water retention) and caffeine (which can make her jumpy and anxious)
• include foods with calcium, which may reduce the severity of her PMS symptoms
• try over-the-counter pain relievers like acetaminophen or ibuprofen for cramps, headaches, or back pain
• take a brisk walk or bike ride to relieve stress and aches
• soak in a warm bath or put a hot water bottle on her abdomen, which may help her relax

If you notice that your daughter's periods are causing her great discomfort or interfering with her life, talk to her doctor to make sure nothing else is causing the problem and to see if anything can help. Sometimes hormone treatment, often in the form of birth control pills, can help ease many symptoms associated with uncomfortable periods.

But the most important way you can help your daughter feel more at ease about her period is to talk to her and explain that most annoying or uncomfortable conditions that accompany menstruation are normal and may improve over time. And be understanding when she's cranky and unhappy. After all, no one's at her best all the time.

Source: kidshealth

Read More

Endometriosis

Endometriosis

In this condition, tissue normally found only in the uterus starts to grow outside the uterus — in the ovaries, fallopian tubes, or other parts of the pelvic cavity. It can cause abnormal bleeding, dysmenorrhea, general pelvic pain, and lower back pain.

Endometriosis is a gynecological medical condition in which cells from the lining of the uterus (endometrium) appear and flourish outside the uterine cavity, most commonly on the peritoneum which lines the abdominal cavity. The uterine cavity is lined with endometrial cells, which are under the influence of female hormones. Endometrial-like cells in areas outside the uterus (endometriosis) are influenced by hormonal changes and respond in a way that is similar to the cells found inside the uterus. Symptoms often worsen with the menstrual cycle.

Endometriosis is typically seen during the reproductive years; it has been estimated that endometriosis occurs in roughly 6–10% of women. Symptoms may depend on the site of active endometriosis. Its main but not universal symptom is pelvic pain in various manifestations. Endometriosis is a common finding in women with infertility.

Signs and symptoms

Pelvic pain

A major symptom of endometriosis is recurring pelvic pain. The pain can range from mild to severe cramping that occurs on both sides of the pelvis, in the lower back and rectal area, and even down the legs. The amount of pain a woman feels correlates poorly with the extent or stage (1 through 4) of endometriosis, with some women having little or no pain despite having extensive endometriosis or endometriosis with scarring, while other women may have severe pain even though they have only a few small areas of endometriosis 

Symptoms of endometriosis-related pain may include:

• dysmenorrhea – painful, sometimes disabling cramps during menses; pain may get worse over time (progressive pain), also lower back pains linked to the pelvis
• chronic pelvic pain – typically accompanied by lower back pain or abdominal pain
• dyspareunia – painful sex
• dysuria – urinary urgency, frequency, and sometimes painful voiding

Throbbing, gnawing, and dragging pain to the legs are reported more commonly by women with endometriosis. Compared with women with superficial endometriosis, those with deep disease appear to be more likely to report shooting rectal pain and a sense of their insides being pulled down. Individual pain areas and pain intensity appears to be unrelated to the surgical diagnosis, and the area of pain unrelated to area of endometriosis.

Endometriosis lesions react to hormonal stimulation and may "bleed" at the time of menstruation. The blood accumulates locally, causes swelling, and triggers inflammatory responses with the activation of cytokines. This process may cause pain. Pain can also occur from adhesions (internal scar tissue) binding internal organs to each other, causing organ dislocation. Fallopian tubes, ovaries, the uterus, the bowels, and the bladder can be bound together in ways that are painful on a daily basis, not just during menstrual periods.

Also, endometriotic lesions can develop their own nerve supply, thereby creating a direct and two-way interaction between lesions and the central nervous system, potentially producing a variety of individual differences in pain that can, in some women, become independent of the disease itself.

Read More

Dysmenorrhea

Dysmenorrhea (Painful Periods)

There are two types of dysmenorrhea, which is painful menstruation that can interfere with a girl's ability to attend school, study, or sleep:

1. Primary dysmenorrhea is very common in teens and is not caused by a disease or other condition. Instead, the culprit is prostaglandin, the chemical behind cramps. Some prostaglandin can lead to mild cramps. But large amounts of prostaglandin can lead to nausea, vomiting, headaches, backaches, diarrhea, and severe cramps. Fortunately, these symptoms usually only last for a day or two.
   
   
2. Secondary dysmenorrhea is pain caused by some physical condition like polyps or fibroids in the uterus, endometriosis, pelvic inflammatory disease (PID), or adenomyosis (tissue that usually lines the uterus growing into the muscular wall of the uterus).

Having cramps for a day or two each month is common, but if your daughter has symptoms severe enough to keep her from her normal activities, or cramps that last for more than 3 days, discuss it with her doctor.

Read More

Menorrhagia

Menorrhagia (Extremely Heavy, Prolonged Periods)

It's normal for a girl's period to be heavier on some days than others. But signs of menorrhagia (excessively heavy or long periods) can include soaking through at least one sanitary napkin (pad) an hour for several hours in a row or periods that last longer than 7 days. Girls with menorrhagia sometimes stay home from school or social functions because they're worried they won't be able to control the bleeding in public.

The most frequent cause of menorrhagia is an imbalance between the levels of estrogen and progesterone in the body, which allows the endometrium (the lining of the uterus) to keep building up. When the endometrium is finally shed during menstruation, the resulting bleeding is particularly heavy.

Because many adolescents have slight hormone imbalances during puberty, menorrhagia isn't uncommon in teens. But in some cases, heavy menstrual bleeding can be caused by problems such as:

• fibroids (benign growths) or polyps in the uterus
• thyroid conditions
• clotting disorders
• inflammation or infection in the vagina or cervix

If your daughter has heavy periods, or periods that last longer than 7 days, talk to her doctor.

Source: kidshealth

 

Read More