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Menstrual health

Endometriosis: One of the leading causes of period pain and infertility that you NEED to know about!

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Endometriosis affects an estimated 176 million women worldwide, and some women don’t even know they have it! That’s why March is worldwide endometriosis awareness month! Endometriosis is a gynecological condition that causes uterine tissue to grow outside of the uterus. The most common symptoms are significant period pain and infertility. It’s a condition I’m really passionate about treating because I don’t like anything standing in the way of your fertility AND I have it and it kind of sucks!

 

How do you know if you have endometriosis?

 

The trouble with endometriosis is that the diagnostic method is the same as the treatment method: laparoscopic surgery. Surgery is the standard way to visualize the uterine tissue growths, aka “endometriomas”, and to remove these growths. However, surgery is the last resort. If you do not respond to hormones or painkillers surgery may be an option for you. Surgery is invasive and comes with risks, I prefer to diagnose and treat endometriosis based on symptoms alone. You may have endometriosis if you experience the following:

 

  • Chronic period pains in your back, pelvis, and/or legs
  • Pain before and after your period
  • Period pain that developed in your 20s
  • Pain during sex and/or going to the bathroom
  • Ovulatory pain
  • Heavy periods or mid-cycle bleeding
  • A family member with endometriosis (in fact you’re 7x more likely to have it if your mother or sister has it). My mom had it, so I always knew it was coming for me!

What’s the best way to treat endometriosis?

 

Sadly, there is no known cure for endometriosis besides menopause. The recommended western treatment is laparoscopic surgery and suppressive hormones, but the endometriomas will grow back eventually. It’s unfortunately not the best solution; it’s a race against the clock. Luckily, there are many other treatment options for endometriosis. Naturopathic medicine, acupuncture, pelvic health physiotherapy, and osteopathy have all proven to help manage endometriosis and improve your quality of life with the condition!

 

Here are some of the therapies that can change your life with endo:

 

  • Naturopathic medicine: herbs and supplements for the prevention and management of endometriosis
  • Acupuncture: pain relief, heavy bleeding reduction, cycle regulation
  • Pelvic health physiotherapy: decrease pelvic floor tension and muscle spasms
  • Osteopathy: reduce adhesions and scar formation

 

Diet and lifestyle changes also make all the difference. Many of my patients have experienced reduced pain on a gluten and dairy free diet, and all of my patients feel better with daily exercise. I love exercising, but I have to admit I do love some gluten every now and then! Foundations of health like adequate sleep and stress management also play a role in the severity of endometriosis. I notice my pain is much worse when I’m stressed and going to bed too late. You overall physical and mental health always matter.

 

Now let’s get to the good stuff. My favourite three recommendations for endometriosis!

 

My Top 3 EASY Endometriosis Tips: Tried and true by Dr. Caleigh

 

  1. N-Acetyl-Cysteine: It’s just an amino acid. Women with endometriosis treated with NAC showed a statistically significant reduction in the growth of endometriomas compared to placebo, leading to early cancellation of surgery!
  2. The “end-endo-pain” trail mix: All you need is dark chocolate, almonds, and walnuts. The combination is the ultimate anti-inflammatory and antioxidant snack (and it’s super tasty too!)
  3. Castor oil: When applied over the uterus, it can increase blood flow and activate your parasympathetic nervous system (your resting and relaxing nerves) to calm uterine and bowel spasms. Massage a tablespoon over your uterus before bedtime.

 

Endometriosis can be an isolating condition, but you are not alone. I am with you and so are 175 million other brave women all over the world! If the symptoms I’ve listed above resonate with you, book an appointment with me to start getting to the bottom of your pain. You are your biggest advocate; spread the word about endometriosis so that all women can receive better care and timely diagnosis! Book an appointment here to get started 

 

References

 

Porpora, M. G., Brunelli, R., Costa, G., Imperiale, L., Krasnowska, E. K., Lundeberg, T., … & Parasassi, T. (2013). A promise in the treatment of endometriosis: an observational cohort study on ovarian endometrioma reduction by N-acetylcysteine. Evidence-based Complementary and Alternative Medicine2013.

Goodman, L. R., & Franasiak, J. M. (2018). Efforts to redefine endometriosis prevalence in low risk patients. BJOG: An International Journal of Obstetrics & Gynaecology.

Lund, I., & Lundeberg, T. (2016). Is acupuncture effective in the treatment of pain in endometriosis?. Journal of pain research9, 157.

Sillem, M., Juhasz-Böss, I., Klausmeier, I., Mechsner, S., Siedentopf, F., & Solomayer, E. (2016). Osteopathy for endometriosis and chronic pelvic pain–a pilot study. Geburtshilfe und Frauenheilkunde76(9), 960.

 

 

 

 

5 Really Simple Strategies to Reduce Period Pain

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If you experience debilitating menstrual cramps, just as I do, then I’m sure you remember the first time they started and the constant struggle you’ve battled in learning to cope with them. I’ve been trying to take my own pain away since age 12 and it hasn’t looked pretty. It’s been a lot of missed work, sleepless nights, tears of desperation, and a couple of memorable hospital trips.

I have tried so many things I’ve lost count of what I’ve tried. I even have a closet full of half empty supplement bottles to show for it. In my countless efforts to find relief, I’ve found that bringing it back to the basics has helped me cope the most. I’m not going to lie and say that I don’t have pain anymore, but I’ve found these really simple strategies helpful and I wish I had known about them sooner.

5 Simple Strategies that Make a Difference

  1. Go to sleep.

    I know that sounds crazy because the pain can make it impossible to sleep, but what I mean to say is get regular sleep before your period. You know you already want to nap all of the time before your period because of our trusty friend progesterone! Progesterone is the driving hormone in the second half of your cycle (after you ovulate) and it has been shown to promote and maintain sleep. But even better than sleeping before your period, get regular sleep all of the time. Regular sleep means going to sleep and waking up at the same time every day. When you have a predictable circadian rhythm, you produce optimal amounts of melatonin. Melatonin is an antioxidant, analgesic, and anti-inflammatory [1]. Those are all actions you want for your uterus when you have a scalding hot water bottle pressed against your pelvis and there’s no relief in sight.

  2. Say goodbye to caffeine.

    You’ve just spent the night awake in pain and now I’m taking away your coffee? It seems cruel but it helps. Caffeine can be found in pain relieving medications (like midol) but it’s not necessarily your friend when it comes to period cramps. It turns out, period pain may be more common in coffee drinkers than non-coffee drinkers [2]. Think about this, caffeine is a vasoconstrictor (it constricts your blood vessels), which means decreased blood flow to your uterus. Reduced blood flow means reduced oxygen, which means muscle spasms, which means pain. I too love a good cup of joe in the morning, but I’ve found I do better when I give it up a few days before my period and during. You can have it again afterwards of course!

  3. Eat nuts, seeds & chocolate.

    What do they all have in common besides being a delicious trail mix? They decrease prostaglandins, which are fatty acids and hormone copycats that cause uterine contractions, pain, and inflammation [3]. Chocolate wants to heal our pain soooo badly, so let’s just let it! Make it dark chocolate (rich in magnesium) and add some almonds, walnuts, sunflower seeds, sesame seeds, pumpkin seeds, and flax seeds for the ultimate anti-inflammatory snack.

  4. Try castor oil massage.

    Castor oil is a wonderful oil used topically to decrease pain and inflammation. I’m not recommending that you drink it as a laxative! When applied over the uterus, it can increase blood flow and activate your parasympathetic nervous system (your resting and relaxing nerves) to calm uterine spasms and bowel spasms [4]. Use 1-3 tablespoons and massage it over your uterus when you’re in pain. The oil can stain your clothes so wear old pj’s and don’t be shy about the amount you use, it will absorb overnight. You can also rub it on aching joints and tissues, like your breasts and low back.

  5. Take ginger capsules. 

    They can be as effective as Advil. It’s just too simple. I avoided trying it for so long because I just figured I needed something fancy, expensive, and complicated to help my pain. Well, I didn’t. Now the dosing is important, you want to start taking ginger three days before the first day of expected pain. Pain reliving medications always work better before the pain starts; if you wait until it starts then you’re playing catch up. It’s also recommended that you take the ginger during the painful days of your period. The recommended dose in the study I refer to here is 250mg 4x a day [5]. Unlike ibuprofen, it has no liver or gastrointestinal toxicity.

    Super simple tips for preventing, reducing, and coping with period pain. If you’re like me and have spent years miserably trying to alleviate your pain, I hope you’re able to try out these techniques and see how you feel.

    Book an appointment with Dr. Sumner HERE. Learn about her program for endometriosis HERE

    References:

[1] Schwertner, A., Dos Santos, C. C. C., Costa, G. D., Deitos, A., de Souza, A., de Souza, I. C. C., … & Caumo, W. (2013). Efficacy of melatonin in the treatment of endometriosis: a phase II, randomized, double-blind, placebo-controlled trial. PAIN®154(6), 874-881.

[2] Unsal, A., Ayranci, U., Tozun, M., Arslan, G., & Calik, E. (2010). Prevalence of dysmenorrhea and its effect on quality of life among a group of female university students. Upsala journal of medical sciences115(2), 138-145.

[3] Awad, A. B., Toczek, J., & Fink, C. S. (2004). Phytosterols decrease prostaglandin release in cultured P388D 1/MAB macrophages. Prostaglandins, leukotrienes and essential fatty acids70(6), 511-520.

[4] Ozgoli, G., Goli, M., & Moattar, F. (2009). Comparison of effects of ginger, mefenamic acid, and ibuprofen on pain in women with primary dysmenorrhea. The journal of alternative and complementary medicine15(2), 129-132.

[5] Arslan, G. G., & Eşer, İ. (2011). An examination of the effect of castor oil packs on constipation in the elderly. Complementary therapies in clinical practice17(1), 58-62.

Pills & Periods: Everything You Want to Know in One Blog

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This blog is to help you navigate the world of periods and birth control, so instead of the debilitating fear we have associated with a little mishap, or a late period….you’ll know exactly what’s going on in your body. Be empowered, knowledgeable, and in control! Periods are annoying and complicated but I can help you navigate the physiology. Buckle in ladies!

In order to explain how birth control works, we first need to start with periods

How Periods Work: Intro to Hormones

All you need to know is that all of your reproductive hormones are under the control of gonadotropin releasing hormone (GnRH). GnRH is released by the hypothalamus in the brain. GnRH controls:

  • Follicle stimulating hormone (FSH) – makes those eggs mature
  • Luteinizing hormone (LH) – makes the ovary ovulate the egg
  • And indirectly: Estrogen and Progesterone – does everything else

The 3 Phases

 Follicular Phase & Estrogen (about 14 days)

The follicular phase occurs when your ovaries are working on maturing the “eggs” (aka oocytes or follicles). This happens under the influence of 3 main hormones: estrogen, FSH, and LH. It’s a competition of the fittest. Typically, only one follicle is released by one of your ovaries (you have two of course). When estrogen reaches it’s peak and then falls, you subsequently develop what’s called an “LH surge” this makes one of your ovaries release a follicle and you have officially ovulated! Some girls experience ovulatory pain called mittelschmerz and they can feel which side they ovulated from! Pretty cool eh! When you’re using ovulation strips to plan for pregnancy, it is LH that is detected in the urine. This follicle maturation process takes about 14 days.

While all of this is happening, under the power of the estrogen I mentioned earlier, your uterus is developing a thick lining called the endometrium. We’ll hear more about this later.

Luteal Phase & Progesterone (about another 14 days)

Once you have ovulated, you’re now in the luteal phase. This phase is mostly under the influence of progesterone. The little follicle that was released from the ovary travels into the fallopian tube and waits to be fertilized by a little, mighty sperm. If you’re actively avoiding pregnancy, the follicle is not fertilized and it dies. The follicle only lives for 12-24 hours after ovulation. That’s not very long at all! The mighty sperm however, can live up to 5 days in the uterus waiting for the perfect follicle to fertilize. This means, there’s a chance you can get pregnant 4 days before you ovulate and the day you ovulate. That’s a very narrow window ladies! That is not to say that accidents don’t happen and result in unplanned pregnancies, but I am saying that you DO NOT need to live in fear every day of the month waiting anxiously for your period. If you know your unique body and keep track of when you ovulate then you hold the power!

Now, where was I? When this follicle was released from the ovary it left its fashionable yellow coat behind. This outer coat layer is called the corpus luteum (aka yellow body) and it secretes progesterone! How amazing is that?! Remember that thick lining we were talking about earlier? It is progesterone’s job to make it grow nice and thick so the follicle you released has a comfy spot to live once it has been fertilized. It is also progesterone’s job to keep other sperm away from the uterus after you have ovulated. No tardy sperm allowed! Progesterone blocks late sperm by creating a really thick mucous plug that covers the cervix, which is the opening to the uterus from the vagina.

The corpus luteum, which secretes progesterone, only survives for about 14 days. If the follicle is fertilized, human chorionic gonadotropin (hCG) is created. This is the hormone detected by a pregnancy test. If hCG is present, it tells the corpus luteum to stick around and keep making progesterone to support the endometrial lining. If the follicle is not fertilized, there is no positive feedback to the corpus luteum and it dies. Now there is no more progesterone. It is this progesterone withdrawal that causes bleeding.

Menses (who knows how long this lasts!)

Phew, we made it, what a relief! Now that there’s no progesterone to support the endometrial lining, your body gets rid of the “functional layer” and you have what we loving call a “period”. The length and symptoms of your period depend on ALLLLLL of the hormonal influences in the follicular and luteal phase and vary significantly from girl to girl!

Okay finally the fun stuff: How does birth control work?

The Pill e.g. Alesse

  • These pills are called “combination pills” because they contain 2 hormones: synthetic estrogen and synthetic progestin
  • These synthetic hormones suppress your body’s natural production of FSH and LH so that you do not ovulate. They essentially trick your hypothalamus and GnRH into thinking that your body has already ovulated so that you don’t!
  • Remember how progesterone created a thick mucous preventing sperm from entering the uterus? If you have synthetic progestin in your body at all times you always have this mucus plug, the progestin also changes the endometrial lining so it’s not thick and comfy for a fertilized follicle

The “pill” is 97-99% effective when used correctly

Patches and Rings

  • The Nuva Ring, which is vaginally inserted, and Evra patch, which you put on your skin, both work exactly the same way as an oral contraceptive pill

Hormonal IUD e.g. Mirena

  • The hormonal IUD only contains synthetic progestin. It creates those same mucous changes as the pill and may prevent ovulation.
  • Since it is directly in the uterus, it interferes with the mobility of the follicle and sperm, it produces “hostile” inflammatory prostaglandins, and it affects the enzymes in the endometrium preventing the fertilized follicle from implanting.

The hormonal IUD is 99% effective when used correctly

Copper IUD e.g. Nova-T

  • It is also placed directly in the uterus but does not secrete any hormones at all. It owes its effects to the copper
  • Like the hormonal IUD, it prevents mobility of the follicle and sperm by creating “hostile” inflammatory prostaglandins. It also affects the enzymes in the endometrium preventing the fertilized follicle from implanting.

The copper IUD is 98% effective when used correctly

And there we have it!

Now you have all the knowledge you need to understand what’s going on in your body and I hope this info alleviates the anxiety associated with…..well, not knowing.

Book an appointment with Dr. Sumner HERE

The ONE Tool You Need To Figure Out Your Hormones

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It’s a thermometer! And it only costs $10.00!

This simple and informative technique is called Basal Body Temperature Tracking

Basal Body Temperature  Tracking is the perfect tool for you if you:

  • experience PMS
  • have painful periods or cramping before your period
  • get hormonal acne or hormonal headaches
  • experience mid-cycle spotting or premenstrual spotting
  • you’re trying to conceive
  • you’re trying NOT to conceive
  • you have a really long cycle ( > 35 days)
  • you have a really short cycle (< 28 days)
  • you have an irregular cycle (who even knows when your period comes!)
  • you have just come off of birth control
  • you’re still on birth control
  • you’re curious about your body and want to be empowered!

If you haven’t read my blog titled “How Stuff Works: Pills & Periods” you should read it first to get a better understanding of hormone physiology and the menstrual cycle. In extremely simplistic terms, the first half of your cycle- the follicular phase– is dominated by estrogen. Once you have ovulated and are in the second half of your cycle- the luteal phase– it is dominated by progesterone.  What is unique about these 2 hormones is that they have different thermogenic effects, this means they change your body temperature. If you track your body temperature daily you can chart your hormone patterns and figure out what’s going on in your unique body. Not every girl’s cycle is a perfect 28 days with ovulation on day 14!

Here is an example of a BBT chart using an app called Fertility Friend:

  • The lower body temperatures for the first 14 days show that this gal is in the follicular phase of her cycle
  • The red cross denotes ovulation. You will see that ovulation is the last day of low temperature. Once the temperature peaks, she has officially ovulated
  • As you learned in my other blog post, progesterone is secreted from the corpus luteum which is a byproduct of the egg. Progesterone is thermogenic, as you can see from the elevated temperatures. She is in the luteal phase starting day 15
  • On day 26 you can see that her temperatures are falling, this shows that progesterone is also decreasing and the endometrial lining will be shed
  • You may have noticed that the BBT tracking method is a hindsight method. You will not know that you have ovulated until after you have ovulated and you see a temperature peak
  • After tracking a couple of months of your cycle you will see that you always ovulate at the same time in your cycle so you can plan accordingly for future months

Sweet! Now how do I do this?

I highly recommend you download the fertility friend app so that you can easily record your temperature and the app will make you a beautiful chart and show you when you ovulate with a giant red cross.

Here are the rules:

  • Take your temperature as soon as you wake up in the morning, before doing anything else. The goal is to hardly move
  • Take your temperature at the same time every morning, or as close to the same time as possible (within a 30 minute window)
  • Take your temperature after a solid few hours of sleep (minimum 3 hours)
  • If you want to get really fancy you can take your temperature using a special BBT thermometer that has more than 1 decimal place
  • Enter your data on your chart in your Fertility Friend app
  • The rise in temperature is usually about 0.4 degrees Fahrenheit or 0.2 degrees Celsius, but the rise may be as slight as 0.2 degrees Fahrenheit or 0.1 degrees Celsius or even less in some cases. Great variability is possible.
  • More important than the value of the rise, is the overall pattern of the chart. Fertility Friend helps you determine ovulation based on the pattern of the chart and all fertility signs. It’s an awesome app

Are Your Periods Far From Normal? 10 Causes of Abnormal Cycles

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How do you know what’s normal and what’s abnormal when it comes to periods? Even after a decade or two of menstruating it can still feel like you don’t have a handle on when it’s coming, how many tampons you’ll need, and if you’ll be cringing with pain! Maybe you’re one of those people that wear a pad daily just in case, or have a heating pack with you at all times just to be sure you’re ready. If you’ve asked your friends about their periods, you probably get all kinds of answers because each of our cycles are pretty unique. Sometimes our cycles can change from month to month and then confuse us even more! Do you ever wish you could save your blood in a menstrual cup and show your friends, and hopefully a doctor, to get a better understanding of what on earth is going on? No one else wishes that? Okay, I guess I’m the only one! Consider this blog a discussion with a friend about the way you bleed and why that might be. The answers you’ve been waiting for could be on this page!

What’s normal when it comes to menstrual bleeding?

 

Cycle Length

 

Cycle length should be around 21-35 days (from the first day of bleeding one month, to the first day of bleeding the next month). However, the ideal cycle length is 27-30 days. In my naturopathic opinion, a 21-day cycle is too short and anything longer that 35 days is too long. With a 21-day cycle your body is going through estrogen and progesterone too quickly, with a 35-day cycle your body is likely producing either too much estrogen or too much progesterone.

Days of Flow

 

The bleeding should last a maximum of 7 consecutive days, and it should not be heavy for the full 7 days. Bleeding for less than 7 days is okay though; if you’re on birth control you may bleed for only 3 days. Bleeding in between periods (aka metrorrhagia) is also not normal.

Colour of Blood

 

Typically the blood is bright red at the beginning of your period and as your period gets lighter in flow the blood becomes a darker brown. Essentially, your body is saving that stagnated, tough to expel blood until the end. You may refer to this as “spotting”. Some women start their period with a dark brown spotting blood; this may or may not be normal. Read on to find out.

Amount of Blood

 

How much blood is normal? Supposedly, the average woman menstruates about 35ml of blood over a whole period (that’s a little bit over 2 tablespoons) seems like nothing, right! Bleeding in excess of 80ml in one cycle (1/3 of a cup) is considered heavy bleeding or “menorrhagia”. It is typical for the first three days of menses to be heaviest, but not that heavy. The best way to know how much blood you are losing is to use a menstrual cup, like a Diva Cup, because the measurements are written right on the cup.

Amount of Pain

 

No amount of pain is normal! The ideal period has no pain before, during, or after your period. This includes back, uterus, and bowel pain. It’s normal to experience an occasional spasm as the blood passes but it should not interfere with your day or require pain medications.

What if your period doesn’t sound like it’s normal?

 

If your cycle length, days of flow, colour of blood, amount of blood, and amount of pain are usually pretty consistent but sometimes you have an “off” period there’s typically nothing to worry about. One abnormal period should not cause alarm, however, three consecutive abnormal periods warrants further investigation.

What could be the cause of abnormal cycles?

 

Abnormal periods can be caused by a vast number of things, but these are the most common reasons:

  1. Anovulation

    When you do not ovulate, your body produces a lot of estrogen and very little progesterone. When there is no progesterone to oppose estrogen, you build up your endometrial lining nice and thick but there’s no hormone withdrawal to bring on menses. If you do not ovulate, you will not have regular 21-35 day cycles. The bleeding you do get is extremely sporadic because there’s just too much lining and your body wants to get rid of a little bit of it at inconvenient times. What does this look like? Unpredictable bleeding and blood that’s sometimes bright red and sometimes dark brown because different areas of the endometrium are getting sloughed off at different times during the month.

  2. Short luteal phase

    After you ovulate, you are in the luteal phase of your cycle. The luteal phase is dominated by progesterone, which is needed to have a period. If you have a very short luteal phase then you likely have a very short cycle- closer to 21 days. Without progesterone you are in a so-called “estrogen dominant” pattern, as your body produces more estrogen than progesterone. This can translate into heavy and painful periods.

  3. Oral contraceptive induced bleeding

    Just because you are on birth control, does not mean you will have regular cycles. When starting a new form of birth control it can take your body up to 3 cycles to regulate, so it’s normal during this time to experience irregular bleeding. If you experience bleeding while you are taking the pill (not on the sugar days) or if you don’t experience bleeding while on the sugar pills, you should meet with your doctor to alter the dose of your medication. It’s also common for bleeding abnormalities to occur if you don’t take your pill regularly or miss pills!

  4. Endometriosis

    This is a pathology where endometrial tissue ends up outside of the uterus, like on the ovaries, bowel, and surrounding ligaments. Endometriosis can cause irregularities in all of the criteria I mentioned. The key feature is extreme pain: pain around menses, back pain, abdominal pain, pain during sex, and pain going to the bathroom. You may also have extremely heavy and clotted periods and experience spotting often.

  5. Fibroids/Cysts

    Fibroids are large masses of tissue in the uterus. They can grow in various places in the endometrial tissue, but cysts can appear in and around the ovaries too. Fibroids and cysts grow under the influence of estrogen ad cause heavy bleeding (menorrhagia). Think of it this way, when you have fibroids you have more endometrial tissue and more blood vessels to slough off when it comes to your menses. Your flow is likely greater than 80ml and is extremely clotted and stringy.

  6. PCOS

    Also known as Polycystic Ovarian Syndrome. PCOS is diagnosed based on 3 criteria: infrequent menses, cysts in the ovaries, and elevated androgens. Testosterone is an androgen, and elevated androgens in a female cause acne, male pattern hair growth, or male pattern hair loss. With PCOS, there are also often issues with insulin so you may experience difficulty losing weight and/or gain weight easily.

  7. Hyperthyroidism & Hypothyroidism

    The first is elevated thyroid hormones and the second is decreased thyroid hormones. Both an increase and decrease in thyroid hormone can impair ovulation, which will prevent you from having a regular period.

  8. Hypothalamic Amenorrhea

    This is a fancy term for not having a period because you don’t have enough stimulating hormone coming from the hypothalamus in the brain. The most common reasons for this are stress and low body weight. If you’ve skipped a couple of periods due to stress or you’re an Olympic athlete, you owe those missed periods to hypothalamic amenorrhea.

  9. Cancer

    Endometrial and ovarian cancer can cause pain and abnormal bleeding. Make sure you schedule regular check-ups with you doctor. Benign tumors in the pituitary gland of the brain can also cause abnormal hormone production and abnormal menses. Keeping communication open with your doctor is essential when it comes to cancer screening.

  10. Clotting Disorder

    Heavy bleeding may be due to a clotting disorder. Menses requires a fine balance between clotting the blood so that you don’t bleed too quickly, and decreasing clotting factors so that you can get the blood out of your system. If a clotting disorder runs in your family, speak with your doctor. Examples of clotting disorders are hemophilia and von Willebrand’s disease.If any of these causes of abnormal periods resonate with you, you may be on the path to figuring out what’s going on in your body. Always keep in mind that pregnancy and menopause will change your cycle and are worth mentioning too! Making sure you are not exposed to exogenous hormones; in meats, drinking water, and cosmetic products is also a great way to keep your period regular, light, and pain-free.

    Book an appointment with Dr. Sumner HERE

References

Jamil, A. S., Alalaf, S. K., Al-Tawil, N. G., & Al-Shawaf, T. (2016). Comparison of clinical and hormonal characteristics among four phenotypes of polycystic ovary syndrome based on the Rotterdam criteria. Archives of Gynecology and Obstetrics293(2), 447-456.

Vilos, G. A., Allaire, C., Laberge, P. Y., Leyland, N., Vilos, A. G., Murji, A., & Chen, I. (2015). The management of uterine leiomyomas. Journal of Obstetrics and Gynaecology Canada37(2), 157-178.

Ajmani, N. S., Sarbhai, V., Yadav, N., Paul, M., Ahmad, A., & Ajmani, A. K. (2016). Role of Thyroid Dysfunction in Patients with Menstrual Disorders in Tertiary Care Center of Walled City of Delhi. The Journal of Obstetrics and Gynecology of India66(2), 115-119.

Ray, S., Ray, A., & George, A. T. (2014). Non‐surgical interventions for treating heavy menstrual bleeding (menorrhagia) in women with bleeding disorders. The Cochrane Library.

Mahmood, T. A., Templeton, A. A., Thomson, L., & Fraser, C. (1991). Menstrual symptoms in women with pelvic endometriosis. BJOG: An International Journal of Obstetrics & Gynaecology98(6), 558-563.

Michopoulos, V., Mancini, F., Loucks, T. L., & Berga, S. L. (2013). Neuroendocrine recovery initiated by cognitive behavioral therapy in women with functional hypothalamic amenorrhea: a randomized, controlled trial. Fertility and sterility99(7), 2084-2091.

Scott, B. (2014). Estrogen Dominance in Endometriosis & Naturopathic Treatments (Doctoral dissertation).

Maybin, J. A., & Critchley, H. O. (2015). Menstrual physiology: implications for endometrial pathology and beyond. Human reproduction update21(6), 748-761.