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Okay, girls (and everyone else who has a menstrual cycle — we’re not discriminating here). It’s time to stop sucking things up, grinning and bearing it and taking one for the team. It’s time to talk those awful bloody things that happen to us every month that can make us feel anything from just a little off to excruciating physical and emotional pain. Yes, it’s time to talk periods.

If you’re like most women, you might experience discomfort when Aunt Flow comes a-calling. That’s normal, right? Maybe not. As women, we’re often told that when periods give us pain or limit the things we feel we can do, that’s just part of the ~female experience~. That might be true to a certain extent – our non-vagina-having counterparts will never know the panic of hunting around in their purse for a tampon only to find dead air – but there are a lot of symptoms and side-effects that women muscle through that are totally treatable. Who knew, right?

To let us in on the secret (and encourage us not to keep it to ourselves) OBGYN Dr. Yolanda Kirkham spoke to us from Women’s College Hospital and St. Joseph’s Health Care Centre in Toronto. She offered some great insight into heavy periods and treatments, when you should see a doctor for your period symptoms and the importance of honesty and openness with your doctor.

What’s normal?

A “normal” menstrual cycle (calculated from the first day of your period) is typically 25 to 40 days with period bleeding lasting approximately four to seven days over which time a woman loses an average of 20 to 60 millilitres (four to 12 teaspoons) of blood.

During a period, women can experience a whole array of additional symptoms like abdominal cramping, muscle aches, headaches, bloating, bladder pressure, constipation, nausea, heightened anxiety or moodiness. You might know exactly what you’re in for every month, but these symptoms might also change depending on a number of factors like stress, diet and weight.

What’s not normal?

While period flow, duration and symptoms vary wildly between women and even from month to month, Dr. Kirkham says that anything that negatively affects your quality of life is not “normal” and can be treated. If you experience anxiety, depression or lack of confidence to the point that you feel the need to cancel events, miss work or otherwise change how you live your life during your period, that’s not normal and it’s not something you have to suck up.

Premenstrual Dysmorphic Disorder (PMDD) is a more extreme version of PMS that affects about eight per cent of women who report PMS symptoms. It is characterized by getting severe psychological symptoms that present about 10 days before a period and dissipate completely within a few days of its onset. As with any mental concern, you should talk to your doctor about your experience and explore treatment options with him or her. Treatment can include lifestyle changes, psychological treatments or medications.

What’s a heavy period?

According to Dr. Kirkham and Heavy Period Talk, period heaviness is most easily measured in the number of sanitary products you use in a day and how frequently you need to change them. If you’re switching out every one or two hours, girl, you got a heavy period. There are a number of other factors too, listed on HeavyPeriodTalk.ca.

Don’t worry though, there are also a number of treatments for that.

What? There’s treatment for that?!

Yes! There are a whole host of treatments out there for anyone who suffers from heavy periods. No more sucking it up. There are both hormonal and non-hormonal options that you can ask your doctor about for more information.

Hormonal treatments include birth control in the form of the pill or a hormonal IUD. In both cases, the treatment is known to reduce menstrual flow.

Non-hormonal treatments include non-hormonal medications such as Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (yes, your pain meds can sometimes lighten flow) and a minimally invasive surgery like endometrial ablation which removes the lining of the uterus. In extreme cases and when women are unresponsive to other treatments, a hysterectomy is another effective (albeit permanent) option.

Here is a comprehensive graphic comparing the different types of treatment.

Remember: while the internet has a wealth of information, you need to consult your doctor, be open and honest with them and trust their advice.

But that’s not ~natural~

Dr. Kirkham admits that a common criticism of treatment for periods is that it’s not natural to play around with hormones, pump yourself full of drugs or undergo invasive surgeries. To that she says, “Yes, but it’s also not natural to feel that way.” Your period shouldn’t cripple you or take you out of your own life for a week at a time every month. She encourages anyone who has problems with their period to see a doctor and find out about treatment options.

When should you see a doctor?

If it’s chronic pain or heavy periods that are plaguing you, see your doctor ASAP and explain the situation.

If it’s a variation in your normal cycle (duration, flow, cramps, skipping) that you’re worried about, Dr. Kirkham says three months is an appropriate length of time to wait before seeing a professional. There are a bunch of reasons like stress or changes in diet that could change your period for a month or two so one skipped period or particularly crampy week probably isn’t anything to panic over (although, of course do a pregnancy test if you’ve skipped a period and it’s applicable).

NOTE: there are obviously times – like in the case of extreme bleeding or pain — that you shouldn’t hesitate to see a doctor right away. If your flow becomes dangerously heavy, you may require a blood transfusion or other medical treatment. Remember: again, the internet is not the be-all and end-all of medical knowledge!

What to know before you go

Before you go to the doctor about your period, you should be ready to talk specifics such as the number of days in a typical cycle, how long you usually get your period for, any symptoms you experience, what’s changed and for how long. Also be prepared with answers to lifestyle questions such as key points about your diet (are you vegan? Dairy-free? Low on protein? Vegetable averse?), your level of activity and what kind of stress you’re under (not just at work or school, but with family, relationships and financially too).

One more thing

Your doctor is there to help you. Dr. Kirkham wants to make sure women understand that they don’t need to look good down there for their appointment or even be off their period. You don’t need to shave, wax or be blood-free to go in for your OBGYN exam. Sometimes, it’s even possible for the doctor to make assessments based just on what you tell them about your period, body and life or with the information gathered in a pelvic ultrasound.

The bottom line: take control of your health and use doctors for what they are there for – to help you be as healthy as possible.

What it feels like when your period is over
Giphy