If you’re a woman, it’s easy to dismiss a bad case of cramps just like you may dismiss a stomach ache after eating too much candy. But how do you know if the premenstrual cycle symptoms you’ve been experiencing are just the “norm” or due to an underlying, more serious issue?

Dr. Melissa Helman of OB-GYN at Novant Health WomanCare in Winston-Salem said that on a weekly basis, she sees patients with heavy or prolonged periods, as well as more frequent than normal periods, or severe cramping. “It depends a lot on the patient’s age and stage in life,” Helman said. “What is offered to a teenager is not always the same as what I would offer to a woman in her 50s.”

“If cramping is mild and controlled with over the counter medications then nothing further is needed,” Helman said. “But, if the cramping is not tolerable and becomes bothersome, it’s certainly worth further evaluation,” she said.

It is not uncommon for women of any age to have a cycle that is “different,” Helman said.

Helman said that if your period is changing the way you live your life, then there’s no reason to delay seeing a gynecologist. “Some women might believe this is just how your period is supposed to be, or maybe her mother had similar issues. If menstruation is impacting your life, I encourage patients to get an evaluation by their gynecologist and see what options they have.”

Helman said that menstruation abnormalities are not difficult to diagnose and treatment is based mostly on controlling the patient’s symptoms. “In addition to an examination, sometimes blood work or a pelvic ultrasound is needed to diagnose a patient with an underlying menstrual symptom.” Helman said new ultrasound technology can evaluate patients for things like uterine polyps without requiring surgery.

Helman added that many patients of her patients respond to hormonal treatments to regulate or suppress their cycles. “If childbearing is completed there is also something called an endometrial ablation which is a procedure that permanently removes the uterine lining and will often make heavy prolonged periods much lighter or go away altogether,” she said.

Menstrual cramping can improve with over the counter medications, like ibuprofen, Helman said. “To be most effective, women need to take these medications before their cramping gets too severe.” Helman also suggested natural remedies such as warm baths, heating pads or heat packs.

Heavy, prolonged, or severe cramping can happen at any age, Helman said. “Certainly adolescents often experience irregular and unpredictable periods, but women should expect to notice changes in their cycles with age, particularly in their 40s as they approach menopause.”

It’s important for women of all ages to establish a relationship with a gynecologist, Helman said. “I have been in practice long enough to see my patients go through early menstrual problems, to pregnancy and even entering menopause,” she said.

Helman believes patients are likely to feel more comfortable voicing any concerns when they are familiar with their gynecologist. “If patients have this relationship and get their annual gynecologic exam, patients receiving counseling about possible issues they might experience based on their age and history and what is considered to be a ‘red flag.’”

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