1. Killer cramps
Virtually all women in their childbearing years have period pain (or dysmenorrhea). In fact, its a leading reason for calling in sick to work or school. “Your uterus is a muscle, and it squeezes really hard,” says Susan Haas, MD, an associate professor of obstetrics and gynecology at Boston University. “Sometimes it can squeeze so hard it blocks the arteries coming into it. Just like in a heart attack, when the arteries are blocked, it causes pain.”
Naproxen, aspirin, and ibuprofen help by short-circuiting the production of pain-causing chemicals called prostaglandins that are involved in muscle contractions. They work best if you start an hour before your cramps hit. “Load up with a double dose and keep the blood level up,” Dr. Haas says. (The maximum safe daily dose of ibuprofen is 2,400 milligrams, or 12 200-mg pills. Take the minimum dosage that works for you.) As soon as you get your period, start with 800 mg and then go to 600 mg every six hours. But talk to your doctor if you have elevated heart disease risks; the Food and Drug Administration (FDA) recently reported that all NSAIDs, except aspirin, may heighten cardiovascular risks. And remember that extended use of high dosages of aspirin or NSAIDs may cause gastrointestinal troubles.
2. Severe bleeding
Ten million American women have heavy bleeding, also called menorrhagia. (The average woman loses about three to four tablespoons per cycle; more than five tablespoons is considered heavy.)
NovaSure, in which a wand is inserted into the uterus through the cervix, emits energy that, in most cases, permanently removes the uterine lining. Its best for women who, like Katherine Sutherland, no longer want to have children. (Getting pregnant after having the uterine lining removed could be risky.) The five-minute procedure is done in a gynecologists office. Many women report lighter bleeding right away. And a recent study found that after seven years, more than 95% stopped having periods.
3. Punishing PMS
About two-thirds of regularly menstruating women have premenstrual symptoms, says Jean Endicott, PhD, director of the Premenstrual Evaluation Unit at Columbia Universitys College of Physicians and Surgeons. It could be headaches, breast tenderness, or big, unpleasant mood swings. Up to 8% of women who have PMS suffer mood changes severe enough to cause problems in their personal lives and daily routines; this more serious version of PMS is called premenstrual dysphoric disorder (PMDD).
Calcium supplements are a good first thing to try, Endicott says, because research shows they ease symptoms. (Calcium may help even out hormone levels, although no one knows for sure why it works.) Besides, most women dont get enough calcium in their diets anyway. She suggests 1,200 mg daily, and not just on the day youre PMS-ing. “It should help take the edge off” over time, Endicott says.
4. Gastro upsets
Many women have diarrhea, gas, or constipation during their periods. Prostaglandins, the chemicals that cause cramping in your uterus, do the same in your bowels. “For lots of women, its common to have a loose stool or diarrhea on the day they have a lot of bleeding,” says Leslie Miller, MD, University of Washington–Seattle clinical associate professor of obstetrics and gynecology.
Fiber can help keep GI issues under control. Aim for 30 grams a day from cereal, fruit with the skin, and vegetables. But dont add fiber to your diet too fast when you get your period; that could worsen diarrhea. For constipation, check your habits. Dr. Miller says women often hold in bowel movements because theyre in public places. Before you know it, you are bloated and constipated. “When you get the urge, go,” Dr. Miller advises.
Some women experience a combo of excessive bleeding, cramping, breast tenderness, headaches, PMS, and other troubles. What to do?
Stop treating the individual symptoms. Dr. Miller recommends continuous birth control pillsyou just skip the placebo week and move on to your next pack. If your insurer wont pay for that, ask about Lybrel and the other Pill options. Also, consider NovaSure if childbearing isnt in your future.
It looks as if the answer is yes. Studies on long-term use of the new 365-day birth control pill are still ongoing, but women have been taking the traditional Pill without interruption (skipping the seven placebo pills and starting a new package) for some time. And there is no sign of increased health risks, says University of Washington–Seattle's Dr. Miller. The bigger risk may be typical Pill use: Women who are supposed to take a week of placebos often dont take any and then forget to restart a fresh pack, boosting their odds of pregnancy. Still, ditching the monthly cycle isnt right for everyone, so ask your doc.