Sexuality and U

Sexual Health

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Cramps Pimples and PMS


Your hormones control your menstrual cycle. In addition to bleeding, your body goes through other changes during the different phases of your cycle. Some of these changes are completely invisible to you. Others show up as physical or emotional symptoms. While you can blame it on hormones, understanding what is happening, what is normal for you and what you can do to make life a bit smoother can make all the difference.

While each woman is different, there are certain common symptoms that go along with the different phases of the menstrual cycle. Not all women will experience these symptoms during each of their monthly cycles, and many find that the symptoms vary depending on age and stage of life. However, you should not have to suffer through any symptoms that interfere with your daily life. If you find that managing is difficult, talk to your doctor or health-care professional.

Just before you get your period (during the premenstrual phase)
Physical symptoms may include:
  • Weight gain or bloating
  • Acne
  • Tender breasts
  • Pain in the abdomen, back or legs (a day or two before menstruation starts)
  • Less energy
Emotional symptoms may include:
  • Feelings of anxiety, irritability or depression
Some women experience symptoms during this phase of the menstrual cycle that are:
  • severe enough to get in the way of their daily lives, and
  • happen at the same time with every menstrual cycle.

These might be signs of PMS (premenstrual syndrome). If you think that you might have PMS talk to your doctor.

During your period (menstruation or bleeding)
Physical symptoms may include:
  • Cramps (also called dysmenorrhea)
  • Nausea
  • Tiredness
  • Diarrhea or constipation
Emotional symptoms may include:
  • Irritability
  • Feeling tired

Almost every woman experiences painful menstruation (called dysmenorrhea) to some degree. However, how strong the cramps are or how often they are felt varies greatly from woman to woman and can change over her lifetime. There are different ways of coping with the pain, but if painful periods are interfering with your daily life and the usual measures don’t help, it would be a good idea to consult your doctor or health-care professional.

What causes cramps?

You get cramps during menstruation because your uterus is contracting to help shed the lining that is not longer needed. Prostoglandins (which are hormone-like substances) make the smooth muscle tissue contract. Women who experience more severe pain have higher levels of prostoglandins. These high levels create strong uterine contractions and make the nerve endings more sensitive.

What can I do about cramps?
  • Exercise and move around. This helps improve the blood flow and produces pain-fighting endorphins.
  • Eat a healthy diet and avoid caffeine.
  • Apply heat to your abdomen with a heating pad or a hot water bottle. You can also take a hot bath.
  • Give yourself a gentle massage. It’s your muscles that are working and massage helps relax tense muscles.
  • Lie on your side and bring your knees up to your chest. This helps any back pain or pressure you may be feeling.
  • If you have vaginal pain with cramps, try using a pad instead of a tampon.
  • Try having sex. This may relieve pelvic cramping and backache. But remember to use contraception if you don’t want to get pregnant. Just because you are having your period doesn’t mean you can’t get pregnant! Having sex during your period is not dangerous and won’t cause infection.
  • Use over-the-counter pain relief like those containing ibuprofen. These NSAIDs (nonsteroidal anti-inflammatory drugs) lower the level of prostaglandin. If you are younger than 20 years old, do not take aspirin, because of the risk of Reye’s syndrome (a rare but serious illness that can affect the blood, liver and brain of children and teenagers recovering from an infection).

If none of these approaches seem to work or only provide a little bit or relief, you should talk to your doctor. He or she might suggest these approaches:

  • Using stronger prescription medications, such as Naprosyn®, Anaprox®, Ponstan®, Motrin® or Vioxx®.
  • Hormonal birth control (which, when used properly, prevents pregnancy by controlling and regulating the hormones that control your menstrual cycle) can also make your periods more regular, less heavy, and less painful. Some women choose a form of birth control that makes their periods less frequent (Seasonale ™) or that may stop their periods completely (Depo-Provera®, Mirena®) while they are on the medication.
Premenstrual Syndrome (PMS)

Lots of people talk about PMS (premenstrual syndrome) and blame it for many of the symptoms that women have just before and during their period. Moody? Blame it on PMS. Tired? Blame it on PMS. While many women have premenstrual symptoms, not all have PMS.

What is PMS?

PMS is a specific, reoccurring and relatively severe set of symptoms that occur during the premenstrual phase of a woman’s cycle. It is quite common and affects approximately four out of every 10 women. There are no tests that can diagnose PMS and there is no one symptom that is unique to PMS. All women have probably experienced, at one time or another, some of the symptoms that go along with PMS.

However, in order to be diagnosed with PMS a woman must experience certain symptoms during the premenstrual phase of her cycle. These symptoms must be severe enough to interfere with her daily life and must be felt for at least 3 consecutive cycles.

What are the symptoms?

Some of the symptoms of PMS are experienced by almost every woman at some point in her life. They include:

  • Depression
  • Angry outbursts
  • Irritability
  • Anxiety
  • Confusion
  • Withdrawal from people
  • Breast tenderness
  • Bloating
  • Headache
  • Swelling of extremities (fingers, hands, feet)

If you think you have PMS you should keep a log of your symptoms, their severity and their pattern of occurrence. Make an appointment with your doctor or health-care professional and you can work together to rule out any possible underlying condition (other than PMS) and manage your symptoms in order find some relief.

What are some of the treatments for PMS?

If you have been diagnosed with PMS, you and your doctor can work together to find treatment options that work for you. If your symptoms are relatively mild or moderate, changes in your lifestyle might help:

  • A healthy diet rich in complex carbohydrates like whole gain bread, rice, pasta and cereals, may help to relieve symptoms.
  • Regular aerobic exercise for twenty minutes at least three times a week may also be helpful and has other health benefits as well.
  • Stress makes PMS worse. Reducing stress and doing things that you find relaxing may ease your symptoms.

It may take a few months before you notice any improvement.

Other treatment options might include:
  • Drugs (such as birth control pills) to stop ovulation from occurring. Women on the pill report fewer PMS symptoms, such as cramps and headaches, as well as lighter periods.
  • Selective serotonin reuptake inhibitors (SSRIs) that change serotonin levels in the brain have also been shown to help some women with PMS.
  • Vitamins and natural treatments such as:
  • Calcium (1200 mg/day) has been shown to reduce PMS symptoms and is also good for bone health.  
  • Magnesium (360 mg/day) may also help reduce the swelling of PMS.
  • Vitamin B6 (50 mg/day) and evening primrose oil (500 mg three times a day) helps some women (although the research on this is not clear). It is important that if you take any over-the-counter vitamins or other supplements, not to take more than the recommended amount as they may be dangerous in large amounts.
  • Dandelion, borage seed oil and black cohosh may also be helpful.

It is very important to check with your doctor before taking any medication (including vitamins, minerals and herbal treatments). Your doctor knows your history and medical condition and some of these treatments should be avoided by women on certain medications and with certain health conditions.

Take care of yourself

Staying healthy, eating a healthy diet, reducing stress and getting enough exercise will make it easier for you to handle the changes that go along with your menstrual cycle. But if any of your symptoms get worse or begin to interfere with your daily life, talk to your doctor. If you are not sure whether your own personal pattern has changed, keep a menstrual calendar [link to the tracking calendar created for the site]. This might help you prepare for changes that come with the different phases of your cycle or give you enough information to talk to your doctor.