In General Practice, we see large numbers of women with heavy and/or painful periods. Some cases will be successfully managed with simple pain relief or various methods of contraception including the pill, the depo injection, the implant or the coil. A number of women are referred to Gynaecology for further interventions including endometrial ablations and hysterectomies.

This is a very common presentation. The main concern for women presenting with extreme symptoms is whether or not they may have a condition called Endometriosis. Debilitating period pain is not normal. Endometriosis is a condition where the cells lining the uterus (endometrial cells) are found outside the lining of the uterus on your ovaries, fallopian tubes, bowel and bladder. This causes inflammation and often extreme pain. If there is a possibility that you may have endometriosis, it is important that your doctor refer you to a Gynaecologist for further investigations.

If you are looking for more natural ways to manage period pain, we would recommend looking up Dr Lara Briden who is an experienced women’s health naturopathic doctor who writes extensively on blogs and author of the Period Repair Manual. See the link below – Is it normal period pain or endometriosis? https://www.larabriden.com/when-period-pain-is-not-normal/

If you want to understand more about root cause for endometriosis, we would recommend looking up Dr Sara Gottfried, Harvard trained Gynaecologist and Functional Medicine doctor who also writes extensively on women’s health issues and author of the Hormone Cure. See the link below – Endometriosis: Diet and lifestyle changes that help

https://www.saragottfriedmd.com/endometriosis-diet-and-lifestyle-changes-that-help/

PCOS 

The majority of women with PCOS have a problem with high levels of insulin and insulin resistance which contributes to their symptoms. These women do well on real foods lifestyle which is lower in carbohydrate - basically denormalise sugar and minimise refined processed carbohydrates (bread, pasta, rice and cereal). These lifestyle changes (not forgetting movement, sleep and stress management) can help rebalance hormones and improve fertility.

 Dr Lara Briden writes about the 4 types of PCOS. Whilst the majority of women with PCOS have the above Insulin-resistant PCOS, she describes 3 other types of PCOS:

• Post-pill PCOS
• Inflammatory PCOS
• Adrenal PCOS (genetic and an abnormal response to stress)

Check out her blog for more information https://www.larabriden.com/4-types-of-pcos-a-flowchart/

 Dr Sara Gottfried has also written extensively on PCOS so please consider looking at this comprehensive article that she has written – PCOS: Natural solutions for a common hormone imbalance - https://www.saragottfriedmd.com/pcos-natural-solutions-for-a-common-hormone-imbalance/

Some women can actually lose their periods due to undereating. This condition is called hypothalamic amenorrhoea and is not uncommon in women under the age of 30 especially if also doing a lot of exercise and training. Hypothalamic amenorrhoea can sometimes be mistaken for PCOS.

https://www.larabriden.com/are-you-eating-enough-get-period-amenorrhea/

PMS can be a difficult condition to effectively treat even with using the pill (which does not often work) and antidepressants (like Citalopram and Sertraline). PMS is one of those conditions that can range from milder symptoms of feeling bloated and slightly irritable before a period to extreme depression and rage for some women (PMDD which stands for Premenstrual Dysphoric Disorder). If everything you have tried so far has not worked for you, consider looking at the following links:

How to overcome PMS and painful periods - https://www.saragottfriedmd.com/how-to-overcome-pms-and-painful-periods/

Why progesterone is both good and bad for mood (and how to treat PMDD) - https://www.larabriden.com/progesterone-mood-treat-pmdd/