Menstrual disorders and gynecological endocrinology

When your period is different from what you’re used to

Your cycle won’t necessarily follow the calendar every month. A one-time delay or a change in bleeding does not necessarily mean an illness. But if the changes keep coming back, your period significantly limits you, or you also start having pain, it is good to find out why.

You don’t have to be sure whether your problems are “big enough.” If they make you cancel plans, sleep poorly or feel unwell, it is worth talking about them.

What you can come to us with

• Your period is irregular, significantly late or not coming at all.
• Bleeding is heavier or longer than before.
• You have spotting between periods or bleeding after intercourse.
• Menstrual pain is severe, new or getting worse.

The changes may be caused by hormonal fluctuations, stress, significant weight change or the years leading up to menopause. Sometimes they are related to fibroids, polyps, endometriosis, a thyroid disorder or another condition. If you miss a period, we also consider pregnancy.

What we will ask about during your visit

We will ask how your cycle usually goes and what has changed. It helps if you note the start dates of your periods, how long the bleeding lasts, how heavy it is and any accompanying symptoms. If you don’t have a record, that’s fine — we will go through everything as we talk.

Depending on the situation, we will recommend a gynecological examination, ultrasound or blood tests. With heavy periods, it may be important to check your complete blood count. Extensive hormone testing is not necessary for every woman; we choose tests based on your specific symptoms.

Treatment can take different forms

Treatment depends on the cause of your symptoms and on whether you are planning a pregnancy. Sometimes pain medication or medication to reduce bleeding helps; at other times, hormonal treatment or an IUD. If we find a polyp, a fibroid or another condition, we treat that finding. If you have anemia, we replenish your iron.

You don’t have to accept severe pain as a normal part of your period. Nor do you have to put up with bleeding that exhausts you over the long term.

When to come in sooner

Make an appointment if you haven’t had a period for several months without a clear reason, you repeatedly bleed between cycles or after intercourse, or you have significant pain. Any bleeding after menopause needs to be examined.

If you have very heavy bleeding with weakness, shortness of breath, dizziness or fainting, or sudden severe pain, seek urgent medical care.