Guest post by Hollie Jones

As women, we’re used to the difficult side of menstruation: heavy flows, painful cramps, severe PMS. But do we know where to draw the line between what is ‘normal’ and what isn’t? And do our doctors?

Women are frequently met with dismissal upon visiting a doctor with troubling symptoms — 33% of women are told that symptoms are in their heads by medical specialists.

However, these more serious period symptoms are our body is giving us a warning that something isn’t right. They could be a sign of a more serious health condition or illness, which is why it is so important to trust your body.

In this post, we’ll be taking a look at the period symptoms your doctor shouldn’t ignore — including the more serious conditions they could be a sign of.

Spotting between periods

Spotting between periods can be perfectly normal if you’ve recently changed your method of contraception — different types of pill, implant or coil and the varying hormone levels in them can disrupt your cycle slightly. This tends to settle within six months of changing contraceptive methods as your body adjusts to the change.

It’s also fine to spot slightly when you are pregnant — although it may be worrying to start with, it can be completely normal and nothing to stress about. In some situations it may be more serious — check out this article for other signs to look out for. However, if you are noticing unexpected spotting between periods or after menopause, especially if you haven’t made any lifestyle changes, then don’t let your doctor dismiss your symptoms.

What could this be a sign of?

Spotting can be a sign of a few different things, so ask your doctor to run some tests. It may be that you have a cervical or uterine growth like a polyp or fibroids (benign tumours that grow in or on the uterine wall). These are normally harmless, but you should speak to your doctor about how to proceed.

It could also be a sign of endometriosis (a condition in which uterine tissue grows outside the uterus in other places) or pelvic inflammatory disease (PID — a condition caused by a bacterial infection).

In rare cases, spotting or irregular bleeding can be a sign of cervical or uterine cancer, so it’s definitely worth getting checked out.

Excessive or very heavy bleeding

It’s not unusual to have a heavy flow and to need to use the maximum absorption products possible during your period.

If you’re used to having a heavy flow, you may not necessary question your bleeding. However, if you need to change your pad or tampon every two hours or less, rely on both for protection, or wake up in the night to change through the night, then this could be a sign of something more serious.

The red flags you need to be looking for are:

  • Your period lasting longer than seven days
  • You’re soaking through pads or tampons and having to change every hour or through
    the night
  • You’re passing blood clots bigger than a 50p coin

In terms of colour, don’t worry if your blood is particularly dark — period blood comes in all sorts of colours, and dark brown or black is fine, as is dark red. If your blood is orange, however, it could be an indicator of an STI or another infection.

What could this be a sign of?

The clinical term for an abnormally heavy or long period is menorrhagia, and it can be down to a number of underlying causes. If you think you are suffering from menorrhagia, then ask your doctor to run some tests to establish what this cause is.

They may do a pelvic exam, ultrasound, hysteroscopy or biopsy can determine what’s going on. They might also want to
do a pregnancy test in case your bleeding is due to a miscarriage or ectopic pregnancy.

Like spotting, heavy bleeding can be caused by uterine fibroids or cervical polyps (these are some of the most common causes). Other causes may be hormone-related, such as hormonal imbalance, a thyroid condition or polycystic ovary syndrome (PCOS).

Excessive bleeding can also be down to uterine adenomyosis (where the tissue typically lining the uterus breaks through the wall of the uterus) or endometriosis.

In more extreme cases, it may be an early sign of endometrial cancer.

Painful cramps or other severe pains

We’re often told that feeling menstrual cramps and pain are perfectly normal and “just part of being a woman”. And yes, sometimes, painful cramps are just part of having periods; most of us have had awful cramps that have left us feeling sore and reaching for some painkillers and our hot water bottle.

This menstrual pain is known as primary dysmenorrhea and is caused by an increase in the uterus-produced hormone prostaglandin, which makes your uterus contract, causing cramps. This should go away as your period continues.

However, if you experience the below, then you — and your doctor — shouldn’t discard your feelings:

  • Excruciating pain that makes it difficult for you to leave your bed or carry on with your regular routine
  • Any sudden or extreme pain
  • Pain from your pelvis all the way up to your shoulders
  • Period pains before or after you menstruate
  • Pain when you go to the toilet
  • Pain when you have sex
  • Painkillers aren’t making any difference to your pain

What could this be a sign of?

Severe cramps and pain could be caused by a number of conditions such as endometriosis, uterine adenomyosis, fibroids, or may mean that you have pelvic inflammatory disease (PID). If you experience pain when you are going to the toilet while on your period or any rectal bleeding, it could be a type of endometriosis when tissues grow on the bowel or

It may also be a sign of ectopic pregnancy, which can be extremely dangerous and even life-threatening. That’s why it is crucial that your doctor doesn’t ignore these symptoms — you need to get checked out and receive medical attention immediately.

You feel dizzy, weak or have a fever

Often, we can feel low in energy or run down when we’re on our period. However, if you feel like you’re suffering from some kind of cold or flu, then it could be a sign of something more serious.

Any cold or flu-like symptoms such as feeling weak, sore or dizzy, having a fever or chills, or experiencing any stomach problems like nausea, vomiting or diarrhea then it’s vital your doctor takes you seriously.

What could this be a sign of?

You may also notice a smelly discharge along with the above symptoms: this could be a sign of pelvic inflammatory disease or another type of infection.

Although rare, it could also be a symptom of toxic shock syndrome (TSS). This can be life-threatening, so it’s vital to get checked out, especially if you notice a rash as well as the above symptoms. You can reduce your likelihood of TSS by switching to pads or menstrual cups, regularly changing your tampons, and using products with the right absorption level for you.

If you’re experiencing any of the above period symptoms — or your period is suddenly irregular, late, or any different from normal — then push for tests until you have established the cause. Trust your gut, and don’t let the opinion of one doctor dictate what happens to your body: you might need further expertise, and it’s important that you are taken seriously.

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