Menstrual-Related Conditions

Ask Your Gynecologist

Monthly or longer-term hormonal changes and fluctuations have physical and emotional effects on women. The degree of significance of these effects runs a broad range among individuals and thus can vary significantly from one women to the next, as well as from one cycle or stage of life to the next. Some amount of hormonal-related change - from week to week, month to month, year to year, or decade to decade - is normal and natural for all women. But for some women, these changes can be severe enough to cause disruption in their lives.

PMS

The most common and best-known condition accounting for these types of
problematic physical and emotional changes is premenstrual syndrome (PMS). This condition corresponds to the menstrual cycle. Women with PMS experience especially noticeable changes in their bodies or in their psychological state, or both, in the days leading up to and surrounding menstruation, in each cycle. For some women, PMS can be such a challenging monthly set of altered feelings and manifestations of both mind and body that it becomes a life-compromising condition. Our staff is experienced in helping to determine if the changes a woman is experiencing each month constitute PMS.

PMS can be largely or partly treatable for many women, through both counseling and lifestyle adjustments as well as medical care. Our staff can help you track and evaluate your monthly experience and put you on a regimen of care, if you suffer from PMS. This may include referral to or consultation with other specialists, including those in endocrinology, behavioral medicine, and other areas. Care can also include intervention through natural or alternative (complimentary) medicine.

PMDD

A smaller percentage of women experience emotional changes so severe that their psychological affect is dramatically altered during the premenstrual period. These women may have a mood disorder called premenstrual dysphoric disorder (PMDD).

This condition is often considered a severe form of PMS. Like PMS, PMDD must be taken seriously, as brief cycles of significant depression typify this malady and, again, the condition can have a vast impact on the quality of life of a woman and those close to her.

Our staff can help women determine if they fall into this group of women with menstrual-related dysphoric disorder. As with PMS, we can deliver, manage, and refer for all of the most up-to-date approaches to treating PMDD.

PCOS

Polycystic ovarian syndrome (PCOS) derives its name from the multiple, small, benign, fluid-filled, sac-like structures present in the ovaries of some women with this condition. The hormonal imbalance that also defines this common syndrome causes physical and appearance changes in women, and can create problems with their periods. Overproduction of androgen by the ovaries in PCOS, for example, can cause women to stop ovulating. In addition to the physical changes and other symptoms that accompany this disrupted hormonal balance, women with PCOS may have fewer periods and heavy bleeding, or no periods.

If PCOS is not addressed, it can lead to more serious health problems, such as heart disease or diabetes. It is also a common cause of fertility problems in women.

If you have symptoms indicating possible PCOS, our staff will take your medical history, perform a physical examination, check your blood pressure, calculate your body mass index and order blood tests. They may also perform a pelvic ultrasound.

If lifestyle changes, and drug or hormonal therapy, at not effective in restoring ovulation in women with PCOS, specialists may - in a small number of patients - perform laparoscopic surgery to inspect the ovaries, remove part of the ovaries, or to puncture enlarged follicles on these organs, with the goal of stimulating ovulation. Ovarian surgery can be effective in some women and is thought to work through reducing levels of production of some hormones.

Abnormal menstruation

Almost all women in their lifetimes will have a period that is missed, comes too quickly after the previous one, is unusually light or heavy, or brings more severe symptoms. However, significant and chronic disturbance or irregularity in menstruation is also common and can take these forms:

Noninvasive approaches to caring for this condition include use of nonsteroidal anti-inflammatory medications or hormonal therapy. While drug treatment or other conservative care for this condition help some women, others do not improve with these treatments or may not be eligible for them because of other medical factors. In these cases, specialists have had increasing success with techniques that remove the lining of the uterus nonsurgically. Treatment by endometrial ablation is highly effective and can be performed using a variety of methods for removing the tissue.

For endometrial ablation our center uses the NovaSure procedure. For more, see the NovaSure website

Our center takes advantage of a newer approach to endometrial ablation in which our gynecologists to use hysteroscopy, and a heat-generating tool inserted through the hysteroscopic tube, to deliver precisely controlled amounts of electrical energy to the lining of the uterus in order to heat and destroy (ablate) this tissue, thereby removing the cause of bleeding. There are no incisions or pretreatments required. The procedure is brief and available on an outpatient basis. Endometrial ablation can dramatically decrease menstrual bleeding, with most women reporting at most light or moderate periods after treatment. Satisfaction with the procedure has been very high. (After this procedure, most women will no longer have periods or be able to get pregnant.)

Hysterectomy is an additional option that definitively treats the problem when other forms of care have not worked. Our gynecologic surgeons can offer this procedure via laparoscopy, for suitable candidates, to minimize the invasiveness of the operation and the length of time needed for recovery.

Hormone therapies directed at excessive menstrual bleeding may have side affects or risk factors. For these reasons, our specialists have given increasing emphasis to the endometrial ablation technique. Our staff members can evaluate your condition and review the options for treatment, if they confirm menorrhagia as the diagnosis.

• amenorrhea (absence of menstrual bleeding).
• dysmenorrhea (severe cramping and pain).
• polymenorrhea (too many periods, i.e., at intervals of two to three weeks, including with excessive bleeding or periods that start and stop).
• oligomenorrhea (less than nine periods per year or periods that are too light).

Each of these conditions can have a variety of causes, relating to physical or mental stress, uterine abnormalities, endocrine disorders, and other conditions. Our staff can help patients determine the pattern of any significant disturbances in menstruation and work to determine the cause. While changes in menstrual patterns are not usually, in themselves, serious, they may signal underlying conditions that require treatment. Causes of abnormal uterine bleeding are many, including harmless or benign conditions as well ones requiring more concerted medical attention. The list of possible causes includes cancer , fibroids , problems with birth control methods, physical or mental stress, infections , and chronic medical conditions such as thyroid disorders , diabetes, or blood clotting disorders. Early menopause or perimenopause can also cause unexpected menstrual changes.

Treatment for abnormal uterine bleeding can include anti-inflammatory drugs, hormone therapy, or surgery. Surgery can take the form of endometrial ablation or hysterectomy.

Our staff members are skilled at determining what, if any, hormonal-related syndrome or disorder a woman may be experiencing. Our gentle, understanding, knowledgeable approach can assist you and help resolve or address such conditions. Our staff can also refer to an endocrinologist, reproductive endocrinologist, fertility specialist, behavioral health specialist or therapist, or other medical professionals as needed for menstrual-related symptoms.

The radiology and other diagnostic services at Aria Health ths offer the highest quality studies. As a patient at our center, you will know that results of your screening studies or other tests, including those involving biopsy, will be sent directly to us. Our staff can provide certain diagnostic procedures that may be helpful in diagnosing menstrual disorders, such as dilation and curettage (D&C), hysteroscopy, colposcopy, laparoscopy, pelvic ultrasound, or endometrial biopsy.

 

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