It seems like my girlfriend has been on her period forever! Every time we try to fool around or whatnot that seems to get in the way. I know her well enough and through her behavior that she isn't lying to me (it didn't always used to be this way). What could be wrong with her? Is this normal?
Periods are quite common. Complaints about menses (the fancy word for periods) are almost as common. A successful menstrual cycle requires a complex dance between the hypothalamus, pituitary, ovaries and uterus. To further complicate matters, the source of bleeding may not even be her "period" -- it could be coming from any of the female genital structures (vulva, vagina, cervix, uterus etc.). Plus the urinary tract and gastrointestinal tract occupy tight quarters.
What is abnormal uterine bleeding? Simply too much or too little; too frequent or too rare. The Association of Professors of Gynecology and Obstetrics officially define abnormal uterine bleeding as:
1.Bleeding shorter than two or longer than seven days
2.Cycles (start of period to start of next period) shorter than 24 or longer than 35 days
3.Bleeding between periods or after sex.
4.Flow greater than 80 mL.
This could be caused by anovulation (or no ovulation). Remember the complex dance? Careful releases of hormones lead to the ovary producing a mature egg (ovum). Bleeding occurs as the cycle begins, the body sloughs off the endometrium because the last cycle failed to produce a fertilized embryo. Ah, maybe next month...
Anovulation occurs every month for women who are on birth control. Higher estrogen and/or progesterone levels trick the ovaries into thinking women are pregnant and the ovum is not released. The last week of the cycle, estrogen is withdrawn and endometrium is sloughed off.
Some other causes of anovulation: sudden weight change, stress or eating disorders. Chronic anovulation could be caused by a disorder called polycystic ovarian syndrome (PCOS) and can be diagnosed by a clinician.
The most likely cause of abnormal uterine bleeding in the college population is breakthrough bleeding from birth control pills. Breakthrough bleeding is the response of uterine lining to the levels of hormones contained in birth control. These hormone levels are often lower than what the uterus is used to seeing. It is quite easy to fix.
There are other causes of abnormal bleeding to consider. Pregnancy or miscarriage, trauma to any of the reproductive structures, recent abortion, infection, cancer, uterine abnormalities, inherited bleeding disorder. A trained physician can deal with all of these issues.
Back to your question. You have a girlfriend you obviously care for, enough to write into the newspaper to ask about her health. This isn't about fooling around; you sound genuinely concerned. Support her in going to Student Health. Talk to her about her fears and reassure her with your support. Remind her that menstrual concerns are common -- usually the answer is less scary than the problem. This is why we have the Student Health Gynecology Clinic. The physicians and nurses are trained to deal with these issues and more. If your girlfriend isn't a student, she could see her own health care provider or Planned Parenthood.
Special thanks to Dr. Christine Peterson of Student Health for information used in this column.
Lisa Hermann is a Cavalier Daily Health & Sexuality Columnist. She can be reached at lisa@cavalierdaily.com or through the Sex & Balances submission page at cavalierdaily.com/sex.asp. This column is used for educational purposes only and is not meant to substitute advice from your doctor.
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