My Period Never Started. This condition is called primary amenorrhea. It can be caused by:
- an under active pituitary
- a pituitary tumor
- unresponsive ovaries (very rare) or
- a problem with the uterine lining.
Evaluation starts with a history and physical followed by blood work to check:
- Prolactin, a pituitary hormone
- FSH, LH
If these are normal or low we then do a progesterone challenge test. Progesterone rises in the last two weeks of the cycle. Its decrease tells our pituitary that no pregnancy has occurred and it is time to stimulate another cycle. If you are not cycling, replacing your progesterone at the appropriate time in your cycle can trigger the pituitary to take over and function normally. If this is unsuccessful further workup is necessary to evaluate other more unusual causes.[CONTACT US]
My Periods Started and Now They Have Stopped. This is called secondary amenorhea . There are many reasons for this. The first evaluation looks at your Pituitary hormones. As in the paragraph on irregular periods, this is most often a pituitary response to stress. It can, rarely, be caused by a benign pituitary tumor. We test for Prolactin, FSH and LH. If these are normal than we want to check your ovarian function by doing a blood progesterone , progesterone challenge and possibly an evaluation of your uterine anatomy. I have found the vast majority of women respond well to ovulation support.
My Periods Are Irregular. Some women never have a “normal” cycle and unless you are attempting pregnancy, this doesn’t have to be a problem. However if you are bothered by it or concerned, we can evaluate you and often resolve this issue. The most common causes are stress. All mammals have the ability to shut down ovulation if stressed. In nature, when life is difficult pregnancies can be life threatening. If normal ovulation is not being stimulated by the pituitary, the treatment is the same as above with progesterone challenge. We can also support the pituitary with an herbal combination of Dong Quai and Vitex. If you have a need for contraception, hormonal contraception will regulate your cycle. However this is not a cure. Women with irregular periods who go on hormonal contraception are very likely to have irregular or no periods when they come off.
Stress Reduction is helped in the following ways:
- Vitamin support, especially with magnesium and B vitamins.
- Exercise helps relieve stress in everyone, especially if it is exercise you enjoy doing. Remember, dancing is great exercise.
- Meditation. Twenty minutes of meditation is comparable to a two hour nap. Quieting the mind changes the biochemistry of stress in our bodies.
- Tai Chi, Qi Chong and other Marshall Arts are a stress release in the nature of the mind focus within the body’s movement. Like meditation, this is called centering.
- Transcutaneous Voltometric Evoked Biofeedback is very effective in undoing the biochemical effects of stress in our bodies.
Heavy Menstrual Flow. “Normal “periods last for three to five days. Heavy periods can be either a heavy flow minute by minute( such as soaking a super tampon or a heavy pad) or a strong flow that lasts longer than seven days. Heavy flow is caused by an excessive buildup of endometrial lining and or strong contractions of uterine muscles during menses
If you are experiencing heavy flow STOP DAIRY!: milk, cheese, yogurt, ice cream, etc (This does not include mayonnaise which is eggs and oil). I have found stopping dairy key in reducing heavy flow.
If you have only one or two heavy flow days your problem may be the production of too much prostaglandin. You can simply take Ibuprofen or Naprosyn every six hours as soon as your cramps or flow begins( which either begins first) and continue until the flow normalizes. Ibuprofen and Naprosyn can cause intestinal inflammation if used continuously, which is unlikely if used only for cramps.
Menstrual Cramps also known as Dysmenorrhea, is usually caused by either excessive production of prostaglandins or by a structural problem in the cervical canal that makes passing menstrual blood difficult.
Our uterus is a marvelous organ. As you travel through your cycle, the uterus makes prostaglandins in the endometrial lining. As this begins to break down, the prostaglandins are released and cause the uterus to contract. This closes down the opening to your Fallopian tubes and gently squeezes the lining out through the cervical opening. However if you produce too much prostaglandins they will cause too strong a contraction, causing pain and heavy flow. This is often the situation in women who have a very short, very heavy, painful period( i.e. 2 to 3 days). Naprosyn and or Ibuprofen will block the prostaglandin, releasing the cramp and pain and lightening the flow.
You can decrease the inflammatory prostaglandin production by avoiding all fats that are solid at room temperature. These include animal fat, butter, margarine, cheese. Use fats that are liquid at room temperature such as vegetable oil, nuts, avocados and fish. Coconut oil is an exception to this as it is solid at room temperature and is safe.
Menstrual cramps not responsive to the above approaches require evaluation. They can be caused by conditions such as endometriosis, retrograde menstruation, abdominal adhesion and other causes. [contact us]
My Periods Stop and Start. Intermittent flow can be very annoying. It is usually a normal situation as long as it is not associated with severe cramps or other distressing symptoms. This can be helped with herbal support of the pituitary, or progesterone during the second half of the cycle.
PMS or Premenstrual Syndrome involves a series of symptoms that occur prior to menses and that are relieved when menses begins.
Molemina is the medical term for normal symptoms that your period is coming on. It includes breast tenderness and fullness, mild bloating and weight gain, mild irritability and mild cramps.
PMS can include and is not limited to headaches, depression, rages, breast pain, severe bloating and weight gain of four pounds or more, body ache, being unreasonably emotional and craving foods such as sugar and salt. PMS is a biochemical imbalance brought about by unresolved stress, poor diet and lack of exercise. I also believe there is a genetic component to women who have PMS. When I was working at Women to Women, we conducted a research project. We noted each woman who had a family history of alcoholism in a parent or grandparent. We also marked a number of the illnesses we were treating. The only condition that correlated 100% was PMS. Every woman we saw who had PMS also had a family history of alcoholism. We don’t know whether the connection was caused by the social/emotional issues associated with life in an alcoholic family, or a genetic predisposition to the biochemical changes stress produces.
The first treatment for PMS is to supplement with progesterone for two weeks before the period. If your symptoms last longer than two weeks before your flow, do not take the progesterone for more than two weeks. I know three weeks is suggested by over the counter progesterone providers, and I have had a large number of women using progesterone for three weeks that have developed irregularities in their cycle.
The next treatment is working with:
- Stress Reduction
- I have had excellent response in clearing PMS with the use of the Trans-cutaneous Evoked Voltometric Biofeedback-Indigo. [link]
- Supplements. Irritability is helped with vitamin B6. Metagenics makes a powder food called Estrim which is very effective in treating PMS for some women. There are many other herbal approaches and remedies that can help relieve this condition [contact us]
I Develop A Vaginal Irritation Before and After My Period. This is almost always caused by a mild yeast infection. It can be treated in three ways.
- A 7 day course of Clotrimazole Cream. This is an over the counter anti fungal.
- 3 days of Clotrimazole before your period and 4 days after.
- Use about 1 inch in the applicator of Clotrimazole vaginally every night for 28 days. This keeps a small amount of cream present as the yeast spores bloom so they are unable to reproduce.
- Herbal approaches for yeast include tea tree oil vaginal suppositories and yogurt applications in the vagina.
I have found the 3 days before and 4 days after choice to work very well. It may take about 3 cycles to completely clear up the infection.
Other Menstrual Problems. There are a large variety of menstrual problems too complex for these pages. If you have a problem not listed here, I invite you to come see me at Imana Medicine. You can contact us to see if we can help you with your issue.[contact us]