Medical Questions & Answers

Question: When I get my periods, they go on too long. Sometimes I bleed for 15 days each month. I am 25 years old. I have seen different doctors, but they don’t seem to help. I’m going crazy. What do you suggest?
Prolonged irregular periods in a young woman require detailed investigation to exclude any cause for the obvious hormonal imbalance you are suffering. These investigations could include blood tests, a laparoscopy (looking into your pelvis with a microscope tube), and a curette (cleaning out of the uterus). If all these are negative, and the problem continues, a number of different hormones and medications can be used to regulate your cycle.
The most commonly used treatment is the oral contraceptive pill, but a relatively high dose may be necessary to totally suppress your own hormone production. After some experimentation with dosage, most women find that this will give them regular, light, pain-free periods. Other alternatives include other types of hormones taken for the ten to fourteen days before an expected period, and hormone-blocking drugs. You should continue to pester the doctor in whom you have the most confidence, for a successful form of control. Continued doctor shopping will only lead to confusion in your mind, and between the different doctors.

Question: I have terrible period pain, but every two weeks when I am both menstruating and ovulating! It seems to be more pronounced on the right side. What can I do?
You are extraordinarily unlucky to be suffering from both forms of regular gynecological pain—uterine cramps and mittelschmerz.
When your periods come every month, the thick muscle of the uterus contracts to squeeze out the old uterine lining as blood mixed with cells. In some women, the uterus contracts too much, goes into spasm and causes severe pain, in much the same way that a leg muscle can go into cramp and cause pain.
In the middle of each month, a small cyst that contains a microscopic egg reaches the surface of a woman’s ovary, ruptures, and releases the egg and a small amount of fluid. If the woman produces eggs in a large cyst instead of a small one, excessive amounts of fluid will be released at ovulation when the cyst ruptures. The fluid is irritant to the lining of the pelvis, and so pain (called mittelschmerz) results. Often one ovary is more active than the other, and in your case the right ovary is producing more eggs than the left. Most women experience uterine cramps with periods, or mittelschmerz with ovulation at some time of their life, but when it occurs regularly, the problem becomes distressing. If you are not trying to fall pregnant, the simple way to treat your two problems is to take the contraceptive pill, which has the double benefit of stopping ovulation (and thus mittelschmerz), and of significantly reducing the loss at period times, thus reducing uterine cramps.
Period cramps can also be reduced by taking medication such as Ponstan or ibuprofen, but there is no other easy way to stop ovulation pain.

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