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Your response to our last story on period conditions was, well, overwhelming. So, we asked a doctor to share some more conditions which women often struggle with...in silence.
Check out Dr Bella Todd MBBS FRACGP’s info and advice below on dysmenorrhoea, amenorrhoea and fibroids...
As always, remember to get your regular check-ups, and always speak up if something doesn’t feel right.
Struggling with painful periods? Don’t know why? It could be dysmenorrhea.
But what is the difference between dysmenorrhea and ‘normal’ period cramps or pains?
There are 2 different types of dysmenorrhoea:
Primary: the cramps/pains are caused by really strong contractions in the uterus, which cause areas of the uterus to not get enough blood flow for a short period of time.
Secondary: this pain is caused by another disease, not just really intense contractions, like endometriosis, adenomyosis or fibroids (but there are lots more!).
Period pain is considered normal if it there only for the first few days of your period (and should gradually get better over that time), if it goes away if you take pain medications or use the contraceptive pill, and if it doesn’t affect your ability to do doing normal things.
When should you seek medical help for period pain?
If your periods are really painful, last longer than a few days, don’t go away with pain medications, are bothersome, or are affecting work, school, or other aspects of your life, then you should speak to your doctor so we can look into “secondary” causes for the pain, and also discuss your treatment options.
What treatment is available for dysmenorrhoea – and can it be cured?
Usually, primary dysmenorrhea gets better as you get older. There isn’t really a cure, until you stop having periods altogether.
If there is an underlying cause (“secondary”), usually the painful periods start later in life and get worse over time, but if we treat the underlying cause then the pain usually gets better.
For primary dysmenorrhoea, easy treatments to start with are regular exercise and things like heat packs and warm baths. Everyone should try these (and I’m sure we all have!)
Next, our options are anti-inflammatory medications (like ibuprofen, naproxen, mefenamic acid), or hormonal contraception, like the combined oral contraceptive pill. In some people, the hormonal intrauterine device (Mirena) is also a good option.
If these treatments don’t work, it is important to again make sure that there’s not another cause for the pain.
How can Modibodi help?
Some of our customers report reduced period pain when they switch from tampons to period underwear...we can’t promise it will work for you, but if you haven’t tried it yet, it might!
Our Classic Full Brief is soft, comfy and comforting with a high waistband that doesn’t dig into your lower belly – where you might be experiencing cramps.
‘Favourite period ever!! Love using my new Modibodi undies. Super comfy, stretchy for those bloated days, absorbent for the extra heavy flow and even better, they look super cute. I have expreienced a HUGE decrease in cramps. I was diagnosed with dysnemorrhoea at a young age and have even had to go to the ER due to pain, but ONE cycle in these undies and no foreign objects inside me and dang...near no cramps. I love these undies and have already raved about them to my friends and family!” - Bry
Our Maternity Brief is a Modibodi staff favourite for periods as well as pregnancy because of its super soft fabrication and low, wide waistband which sits gently on your lower belly.
What are the most common causes of amenorrhea?
Primary amenorrhea is when someone has NEVER had a period by the age of 15, or hasn’t had a period nor shown any signs of physical sexual development (such as breast development or public hair growth) by the age of 13. If this occurs, it’s worth seeing your GP for an initial investigation. They may well suggest you just wait a bit longer, or, if there’s no evidence of other sexual development, tests might be recommended.
Secondary amenorrhoea is when someone has had a period at some point - but it has since stopped.
If you’ve previously had regular periods, but haven’t had one for three months, or if you’ve previously had irregular periods and haven’t had a period for six months, then see your doctor to find out why.
The first obvious cause that we need to rule out (or in) is pregnancy, and this is actually the cause MUCH more often than people realise. Other common causes are weight loss or gain, over-exercising, being extremely stressed, polycystic ovarian syndrome (PCOS), other hormonal problems, such as thyroid issues.
When should you seek help for absent periods?
While the evidence suggests women who have previously had normal periods should seek medical advice if they haven’t had a period for six months, it’s perfectly reasonable to see your doctor early if you’re concerned, if you’ve lost or gained a lot of weight, if you’re struggling with disordered eating, or if you’re worried about worsening acne or hair growth which could be related to PCOS.
If you are sexually active, doing a home pregnancy test is a really good first step, because although contraception can be very effective, it is not 100%, and it is still possible to get pregnant.
Is it common for periods not to return after childbirth – and if so, for how long?
Amenorrhea is common after childbirth, especially if you are breastfeeding, because breastfeeding inhibits ovulation. This may persist for many months.
In women who are not breastfeeding, most will ovulate for the first time 6-13 weeks after birth (with a period occurring two weeks later). Many of these ovulations will be “sub-fertile”, meaning it is difficult to become pregnant from them, but it is still possible, which is why it is really important to talk about contraception after you have a baby, and this should be done is hospital before you go home, and again at your 6-week check-up.
Many women say, “oh I’m not even thinking about having sex yet!”, but trust me, it can happen, and it is better to be prepared. It is also important to remember that you will usually (but not always) ovulate BEFORE your first period after birth, so you can’t rely on waiting to have a period before thinking about contraception.
There is a rare condition called Sheehan syndrome which can occur after a woman has lost a lot of blood during childbirth and the pituitary gland becomes damaged. One of the symptoms is amenorrhoea, however there are many other symptoms and you should see your doctor if you are concerned.
Even if you’re not having periods, you can still enjoy the comfort and protection of Modibodi’s everyday undies to absorb sweat and discharge.
How common are fibroids?
Fibroids are non-cancerous growths of muscle that develop inside the wall of the uterus. They can grow in different layers of the uterus wall, and some might be very small (like a pea), while others can grow very large, even as large as a rockmelon. By the age of 50 (around the time of menopause), 70% of women will have had fibroids.
Are fibroids more common as you get older?
Since female hormones stimulate fibroids to grow, they are common during reproductive years when these hormones are higher, especially in your later reproductive years before menopause. After menopause, when these hormone levels drop, fibroids tend to shrink or even go away completely.
Things that put you at higher risk of developing fibroids are having a family history of them, being obese, having PCOS, having your first period at a younger age, and never having given birth.
Although the combined oral contraceptive pill contains hormones, this has actually been shown to reduce your chances of developing fibroids because it is regulating your hormones levels.
What are the common symptoms of fibroids?
Many women will have fibroids and not even know about it.
Of those that do experience symptoms, these might include heavy, long or particularly painful periods, a sensation of pressure in your pelvis or the feeling of not being able to fully empty your bowels or bladder when you go to the toilet, lower back pain, abdominal swelling or pain when you are having sex (dyspareunia). This is a deep pelvic pain, not pain on entry. Symptoms that people experience will depend on where the fibroid is, and how big it has grown.
What is the treatment for fibroids?
If fibroids are not causing problems, we don’t need to do anything about them. Sometimes we find them by accident when looking for something else (we call that an incidental finding).
If you are experiencing symptoms, treatment will take into consideration your plans (or not) for future pregnancies.
The treatment for painful periods caused by fibroids is the same as the treatment for dysmenorrhoea above.
Heavy periods can be treated with anti-inflammatory medications, or tranexamic acid which slows down clots being broken up, and contraceptive options like the combined pill, or the Mirena IUD.
Other hormonal therapy using a GnRH agonist can be used to shrink fibroids, this is something to be discussed with your gynaecologist.
There are a few different surgical options available, including procedures to reduce blood flow to the fibroid, resection (cutting out) of the fibroid, ultrasound waves to overheat the cells (not Medicare covered), or removal the whole uterus (hysterectomy). The most suitable therapy will also depend on where your fibroids are located.
Do fibroids impact fertility, menstruation or menopause?
Most fibroids do not affect fertility (becoming pregnant). In rare cases, if the fibroid is really big and distorts the lining of the uterus, or if it sits within the cavity of the uterus itself, surgery might be used to remove it.
Sometimes fibroids can grow during pregnancy, usually in the first trimester.
It is important to note that usually, fibroids do NOT cause complications in pregnancy. Depending on the location, some large fibroids (>3cm) MAY increase the risk of miscarriage, restrict the growth of baby, or cause preterm labor. Sometimes, women may need to have a planned caesarean due to the location of a fibroid. If a procedure has previously been done to remove a fibroid, this might cause the placenta to attach more deeply into the wall of the uterus, which does present some risks to mum and bub, but is usually identified during pregnancy ultrasounds.
As above, fibroids may cause menorrhagia (heavy periods) or dysmenorrhoea.
Women with fibroids may experience worsening symptoms as they approach menopause, particularly in terms of heavy periods, but after menopause, fibroids tend to shrink and may disappear completely.
How can Modibodi help?
Fibroids causing heavy periods? Try our Maxi-24hrs styles for secure protection and comfort. Absorbing the equivalent of 10 tampons’ worth of fluid, they’ll help you feel safe and dry as you go about your day (or overnight!)
‘I’ve struggled with the symptoms of fibroids (leaky bladder, bleeding outside your period) so I bought these to try them out. This pair worked great for my leaky badder. I usually wear 1-2 pads every day. I wore these all day and didn’t have any odour issues or discomfort down below. Very soft, Great job Modibodi – Chelsea
‘I’ve had very heavy periods due to fibroids and these pants meant for the first time in ages I didn’t have to spend the first two nights of my period getting up in the middle of the night to change, or waking up uncomfortable. Thank you 😊’ - Nat K
A final word
The above is for information purposes only and does not constitute professional medical advice. For any menstrual conditions or queries, always consult your doctor for advice and treatment.