A woman's menstrual cycle involves normal physical and hormonal changes in her body that prepare her for a pregnancy. The changing hormone levels signal the thickening of the lining of her womb, and the release of an egg cell from the ovaries. When a woman does not become pregnant, then her body must shed the thick lining of the uterus -- causing the bleeding known as the menstrual period. The process takes place over the course of about 28 days (though some women may have shorter or longer cycles).
Pre-Menstrual Syndrome, or PMS, occurs when a woman's body has a severe reaction to the normal cycling of hormones and chemical messengers—especially in the week or two just before the menstrual period starts, when there is a dip in estrogen and serotonin levels. More than half of menstruating women experience pain from cramps during their period.
Sometimes, simple measures are all that is needed to help you feel better. Some practical measures for overcoming PMS:
If your symptoms are continuing and disruptive, you may find that medications will help. There are materials available in our office to help educate and guide you. If you have any concerns about your symptoms, please call the office to speak with a nurse or to schedule an appointment.
Many young women have very irregular periods during the first few years of menstruating - even skipping some months, until the system adjusts to this new stage in life.
Other concerns may be:
Hot Flashes in Premenopause
Hot flashes can make you want to move to Alaska and find an igloo, right? Or spend your day in front of a fan turned on high... Don't worry. The answer is "Yes" — you can minimize the symptoms and they will, eventually, go away. Hot flashes (and night sweats) are sudden feelings of being extremely over-heated—you may even break out in a sweat. But there's nothing "wrong" that needs to be fixed. For some women, they are a normal part of menopause. You can, however, lessen the symptoms. The Art of Natural Family Planning, Premenopause, Student Guide, (Couple to Couple League 2009) recommends:
During a hot flash, FCN [Fertility, Cycles & Nutrition] suggests the following:
If these suggestions don’t alleviate your discomfort, do talk to your doctor about other possible treatments such as hormone, anti-depressants, or over-the-counter remedies such as Estroven or Promersil.
Endometriosis is a painful female medical condition that can lead to infertility and a decrease in the joys of life.
This serious medical condition occurs when cells that normally grow on the inside of the uterine (womb) lining end up inside the abdominal cavity (rather than in the vagina, on a tampon, or on a pad), either by flowing backwards through the fallopian tube, or flowing through blood vessels or lymph channels, or by transforming from normal peritoneal cells in a process called metaplasia. All women are vulnerable to this condition, but some women with lowered immune function, outflow obstruction like a narrow cervix, early age of starting menses, endometriosis in the family, repeated miscarriage, or heavy cycles are at an increased risk. Endometriosis is a disease dependent on the fluctuation of the hormones estrogen and progesterone in an ovulatory cycle which causes the implants to grow and then break down like the endometrium does.
Painful periods, chronic pelvic pain (especially low back pain), painful intercourse, and irregular cycles are all symptoms of this variable and unpredictable condition. Endometriosis may be associated with infertility by distorting the anatomy, or creating a chemical, immunological barrier to the health of the egg and sperm.
We diagnose endometriosis by listening to our patient’s complaints and by examining her abdomen with an endoscope. We can see the disease and see the adhesions and scars or the spots of endometriosis. If a first-degree relative has endometriosis, the patient has a ten-fold increased risk of having this condition. Endometriosis also increases the CA-125 blood level and is the main reason why we do not routinely use that blood test for the screening of ovarian cancer.
Conventional medical wisdom is to suppress ovulation, and thereby prevent the hormonal fluctuation which results in the growth of the endometrial lesions. Over the last four decades, the medical profession has used estrogens, testosterones, progestins, oral contraceptives, danazol, nonsteroidal anti-inflammatory drugs, and gonadotropin-releasing hormone agonists. However, all of these medications have side effects: weight gain, headaches, hot flashes, irritated vagina, and irregular bleeding. They act by trying to prevent ovulation or turn off portions of the immune system, both difficult challenges complicated with serious consequences. Natural progesterone, used during the luteal phase, may be helpful with less-significant side effects. For married women, pregnancy (if appropriate) followed by breastfeeding is also an excellent way to quiet the ovaries, allowing the body to heal naturally.
We also use surgery to help us diagnose and treat endometriosis. Inserting the endoscope/telescope through the belly button, we can see the disease and remove it with electricity or laser therapy. Since endometriosis is an "organic" condition, one that changes the structure of the pelvis, we think that meticulous destruction of the endometrial implants and reconstruction of the normal anatomy and the prevention of adhesion formation is crucial to helping restore bodily health from this condition.
At the Tepeyac Family Center, we treat each patient as an individual human person with dignity and integrity, and therefore tailor the therapy and treatment to each patient.
With this in mind, we might suggest other less invasive options:
These options could include the following:
Some or all of the above may be beneficial and help decrease the pain and suffering of endometriosis. It is a difficult condition, but with perseverance, hope, and openness to an "out of the box" approach to treatment, most patients can be helped significantly.
Marital Sexual Intimacy During Premenopause and Beyond!
by Dr. Marie Anderson, F.A.C.O.G.
Many women are hesitant to discuss their lack of desire for sexual relations.The natural order of life is for sexual desire to decline beginning in the premenopausal years. One can't argue with biology, but we can optimize it. Since the Women's Health Initiative in 2002, the literature has supported limiting exposure of menopausal women to hormone replacement for a variety of reasons, not the least of which is an increase in the risk of breast cancer, heart attacks, strokes, and DVT's. The good news is that hormone replacement was never a panacea to correct lack of sexual desire anyway. The two most important influences on sexual relations are the strength of the relationship and the physical condition of each spouse. Have a physical to identify any underlying problems such as thyroid or adrenal issues.
One of the chief reasons sexual desire decreases is that women experience painful relations due to thinned vaginal tissues. This condition is known as vaginal atrophy. Avoidance of pain is natural, and this example is no exception. Over the counter lubricants are sufficient to help some women. Others benefit from prescription vaginal estriol or other estrogen formulations which have been designed solely for local absorption, thus limiting the health risks associated with systemic estrogen exposure. So if pain is the issue, consider one of these treatments.
Once pain has been addressed, concentrate on the relationship itself. This is a time to grow and discover new dimensions. With the decrease in childbearing and childrearing responsibilities comes a whole new set of opportunities. Explore together and individually what this new phase of life has to offer: spiritually, emotionally, and professionally. This change in focus also provides great opportunities to grow in sexual intimacy and enjoyment. Try new things. Share the enthusiasm. The most important sexual organ is the brain. Remember, there is a huge incentive to come to a mutually agreeable solution regarding any sexual dilemma. Ultimately, whatever frequency and duration a couple decides is right for them…is right for them. There is no standard answer. You are laying the groundwork for the direction your relationship will take for the rest of your life. Act accordingly.
Viagra and the enormous publicity surrounding it speak volumes about the values of our culture. It is about performance rather than love. Sometimes, it is good to be counter-cultural. Viagra is an external force that changes the equilibrium of a particular sexual relationship. The effects are only good if both spouses feel they are. There is no question that this drug can be a boon to quality of life for many couples in which the man suffers from erectile dysfunction due to health conditions or the medications used to treat them. But enhanced sexual performance through medical manipulation cannot heal a broken relationship. Adding Viagra can mean that the woman becomes an object to be used rather than a spouse to be loved and cherished. Expressing love rather than selfish gratification should be the objective for having relations. Many women prefer cuddling, back rubs, and having their spouse to be truly present, rather than the sexual act itself. Women want to feel connected. If Viagra helps that to happen, then it is good. Otherwise it is not. A pill cannot replace a loving relationship.