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Women’s Health

The Blood Test to Diagnose Endometriosis

By | Endometriosis Pain Relief, Women's Health | No Comments

Have we been waiting for an easy way to diagnose endometriosis (well, I know I have) and it already exists?!

Endometriosis is extremely difficult to diagnose, it takes an average of 10 years to be found effectively.  Most women go unnoticed, and even ignored, for their symptoms. Wondering what endometriosis is and if you have it? Learn more about endometriosis.

The Current Diagnosis

The gold standard for the diagnosis of endometriosis is laparoscopy. That’s surgery. Surgery is no longer the recommended treatment for endometriosis, so unfortunately it’s no longer recommended for diagnosis. Trans-vaginal ultrasound can only be used to diagnose severe ovarian endometriosis. That leaves us without a way to diagnose the condition, and on the search for a non-invasive diagnostic method – like a blood test!

My problem with endometriosis is that since there isn’t an “easy” diagnosis, the symptoms are not taken seriously, the treatment is not taken seriously, and the women who suffer from it are not taken seriously. Endometriosis has severe implications. It affects the quality of life of 1 in 10 women, and is one of the leading causes of infertility.  We NEED to know if women have the condition, so that they can be treated properly. There may not be a lot that can be offered by conventional medicine, but there are a whole lot of treatment options in the naturopathic world.

CA-125 Blood Test

This brings me to the blood test we can use for diagnosis, right now! It’s called CA-125. It’s a protein in the blood associated with ovarian cancer and pelvic inflammation, particularily endometriosis.

The test is best performed in the follicular phase of your cycle, between the time when your period stops and when ovulation begins.

How do we interpret the results of the CA-125 blood test?

A positive test is anything over 36. A positive tests rules IN endometriosis, because it is a detector of pelvic inflammation. However, a negative test does NOT rule out endometriosis. You might still have endo if it’s negative, this test just isn’t definitive. Less severe and less invasive endometriosis may not be detected by the blood test. A positive test = endometriosis (as long as ovarian cancer has been ruled out with an ultrasound).

The Bottom Line:

It’s a noninvasive test that costs about $40 and it could provide you with the answers that you deserve, and will inform better treatment!

Book an appointment with me to get tested, and properly treated. Check out my endometriosis support page or endometriosis program for more info on endo treatment.

References:

 Ruan, Y. Q., Liang, W. G., & Huang, S. H. (2015). Analysis of laparoscopy on endometriosis patients with high expression of CA125. Eur Rev Med Pharmacol Sci19(8), 1334-7.

Kurdoglu, Z., Gursoy, R., Kurdoglu, M., Erdem, M., Erdem, O., & Erdem, A. (2009). Comparison of the clinical value of CA 19-9 versus CA 125 for the diagnosis of endometriosis. Fertility and sterility92(5), 1761-1763.

de Sá Rosa, A. C. J., e Silva, J. C. R., Nogueira, A. A., Petta, C. A., Abrão, M. S., & Ferriani, R. A. (2006). The levonorgestrel-releasing intrauterine device reduces CA-125 serum levels in patients with endometriosis. Fertility and sterility86(3), 742-744.

Vitamin D Supplementation May be the Easiest Way to Prevent Miscarriage

By | Hormone Testing, Natural Fertility Support, Prevent Miscarriage, Women's Health | No Comments

Prior to 2018, two prospective studies had investigated a weak association between lower vitamin D concentration and pregnancy loss. This 2018 study found a fourfold risk of pregnancy loss with low vitamin D status.

In fact, every one-degree of vitamin D deficiency was found to be associated with a 1% increase in risk of miscarriage.

That’s insane right?

How does vitamin D help?

Miscarriage often results from inadequate development of the growing placenta, a process that requires vitamin D. Vitamin D is needed for angiogenesis, the formation of arteries. Learn about the other common causes of miscarriage.

Vitamin D also prevents preeclampsia later on in pregnancy; a condition causing elevated blood pressure and damage to organ systems like the liver and kidneys. It has also shown to prevent low birth weight and slow fetal growth.

Levels of vitamin D lower than 30 nmol/L (that’s 45 points lower than the minimum requirement) are associated with a fourfold increase in miscarriage rate.

If you live in Canada you most certainly are vitamin D deficient due to our brutal winters and lack of sunshine #wethenorth

But don’t guess. Get tested. We need to know how far below the threshold you are to predict your associated miscarriage risk.

A level of 100+ nmol/L has NO association with pregnancy loss.

Here’s an example of my lab work:

I have a modestly low vitamin D status (in the peak of summer I may add, so I can only imagine how low it was in the dead of winter.) My levels are 7 degrees lower than the minimum required level, which puts me at a 7% risk of miscarriage and a whole host of other symptoms like fatigue, depression, muscle pain, poor immune response, hair loss etc.

A note on supplementing with vitamin D

The brand matters. I have seen patients religiously take vitamin D purchased outside of a health food store or naturopathic clinic and the blood levels just don’t increase. Other naturopathic doctors will share the same experience. Don’t take any old vitamin D, use a reputable brand from your naturopath.  Vitamin D is a fat-soluble vitamin so it must come in an emulsified form (mixed with oil).

Want to learn more about lab tests for preventing miscarriage? Book an appointment with me.

Could your yeast infection actually be cytolytic vaginosis?

By | Hormonal Imbalance, Women's Health | No Comments

We all know those tell tale signs, the itchiness, the redness, the agony; the instant you notice them you run to the nearest pharmacy and grab an over the counter pill and cream and go about your day waiting for the discomfit to pass. Then the next infection hits and you’re going through the same thing all over again. We just assume it truly was a yeast infection because the anti-fungal medication sort of works, and well, we really hope it’s not anything else! But, what about when it doesn’t work? What about when you keep getting them over again and no amount of Canesten or Monistat is doing the trick? In these cases the yeast infection you think you have may actually be cytolytic vaginosis.

It sounds scary, cytolytic vaginosis, but it really isn’t! It’s just an overgrowth of the normally occurring, protective bacteria in the vagina called lactobacilli. What’s the difference between this and a yeast infection? A yeast infection (candidiasis) is fungal overgrowth, but cytolytic vaginosis is bacterial overgrowth. Confusingly, the symptoms are exactly the same! When you have too many lactobacilli in the vagina they produce extra lactic acid and hydrogen peroxide, which cause the itchiness, redness, and white curdy discharge that look and feel exactly like a yeast infection! It can be caused by a hormonal imbalance, or a more local concern.

Yeast Infection vs. Cytolytic Vaginosis

  • BOTH present with irritated and itchy vulva and vagina
  • BOTH present with profuse white and thick discharge that has no smell
  • BOTH present with a vulva that is red and swollen
  • BOTH present with a vaginal pH that is less than 4.5 (optimal vaginal pH is 3.8-4.5)
  • ONLY a yeast infection will present with a positive swab for candida, if you have cytolytic vaginosis the candida swab will be negative

Neither a yeast infection nor cytolytic vaginosis are sexually transmitted, meaning you don’t typically “catch” them from your partner, however sex can lead to imbalance in the vaginal and penile flora so both partners (same sex or opposite sex) can develop similar symptoms. Both the penis and vagina depend on steadily controlled, protective flora in order to stay healthy.

Here is a list of some of the factors that affect our flora and predispose us to developing vaginal infections:

  • Oral antibiotics – These can wipe out the healthy bacteria in the vagina
  • Unprotected sex (with a male partner) – Semen is acidic and can irritate the vaginal mucosa.
  • Protected sex (with a male partner) – But on the other hand, latex condoms and condoms with spermicides may irritate the vagina and eradicate good bacteria.
  • Oral sex – Saliva is not the most hygienic of lubricants, but it can also interfere with the pH of the vagina (which should be 3.8-4.5). I wouldn’t ever suggest taking this away from you; just take a little break if you’re prone to infections!
  • Low vitamin D – Vaginas need sunshine too!
  • Vaginal creams – The vagina is self-cleaning, that’s why you have daily discharge, so there’s no need to use any store bought cleaning products.
  • Scented toilet paper and tampons (and wearing daily pads for that matter) – Even though Tampax makes a pumpkin spice tampon it is not our friend!
  • Food sensitivities and too much sugar – Food intolerances affect the gut flora, which often translate to the vaginal flora. Sugar is also a motivating fuel source for pathogens.
  • Not letting the vagina breathe- G-strings and skinny jeans aren’t doing as any favours, but going commando at every opportunity will!

If you’re suffering from the symptoms of a yeast infection but the vaginal swab comes back negative, you should suspect cytolytic vaginosis.

Here’s what to do to get rid of it:

Twice daily baking soda sitz baths. Fill your bathtub (or a large bucket) with a small amount of warm water and add two tablespoons of baking soda per litre of water in the tub. Sit in the bath and read a book for at least 30 minutes. The purpose of this treatment is to decrease the acidity of your vagina and reduce the lactobacilli. You should be feeling better in no time!
Book an appointment with Dr. Sumner

References

Sobel, J. D. (2016). Recurrent vulvovaginal candidiasis. American journal of obstetrics and gynecology214(1), 15-21.

Yang, S., Zhang, Y., Liu, Y., Wang, J., Chen, S., & Li, S. (2016). Clinical Significance and Characteristic Clinical Differences of Cytolytic Vaginosis in Recurrent Vulvovaginitis. Gynecologic and obstetric investigation.

Ahmad, A., & Khan, A. U. (2009). Prevalence of Candida species and potential risk factors for vulvovaginal candidiasis in Aligarh, India. European journal of obstetrics & gynecology and reproductive biology144(1), 68-71.

Suresh, A., Rajesh, A., Bhat, R. M., & Rai, Y. (2009). Cytolytic vaginosis: A review. Indian journal of sexually transmitted diseases30(1), 48.

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

By | Hormonal Imbalance, Hormone Testing, Women's Health | No Comments

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, hormonal imbalance sucks, 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. You may also want to do some hormone testing if you have any concerns about what is happening in your body.

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

The ONE Tool You Need To Figure Out Your Hormones

By | Hormonal Imbalance, Natural Fertility Support, Women's Health | No Comments

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 headaches or other hormonal imbalance
  • experience mid-cycle spotting or premenstrual spotting
  • you’re trying to conceive and want natural fertility support
  • 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

If you have questions about BBT tracking book an appointment

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

By | Hormonal Imbalance, Women's Health | No Comments

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! This is a definite sign of a hormonal imbalance. 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. Learn more about natural fertility support.

  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. You can do hormone testing to figure this out

  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! Learn more about birth control and your body 

  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. Learn more about endometriosis pain relief

  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

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.