Your health doesn't need to be a mystery! We asked Christina Maiale—registered nurse and women's health and fertility case manager—to tackle some of your women's health questions.
Q:Is it normal during PMS to want to eat five chocolate bars or cry your eyes out? Or are these hormonal fluctuations and emotional instabilities abnormal warning signs that point to some larger problem?
A: It is completely normal to have 2-3 days of these lovely symptoms that remind us that our period is quickly approaching. A lucky few will never experience carb-cravings, weight gain, bloating, headaches, depression, insomnia, and fatigue. But due to the roller coaster of hormone changes that are taking place inside our bodies, most women's emotions will get to go along for the ride.
But many women experience an unhealthy level of these PMS symptoms—for as long as 10 to 14 days at a time—which could be an indication of a hormone imbalance. Typically progesterone will start to drop off 2 to 3 days before the period, but with a hormone imbalance, it gradually decreases over 1 or 2 weeks, prolonging PMS symptoms. Too many women are spending literally half of the month struggling with these symptoms and aren't aware that it is a legitimate medical condition. The good news is that a hormone imbalance can be corrected!
Q: What exactly is going on during PMS?
A: During PMS our progesterone levels—elevated after ovulation to provide an optimal environment for implantation in case conception has occurred—start to drop several days before your period. High progesterone levels help maintain the thick lining of the uterine wall. But once the progesterone level bottoms out, the lining is no longer being supported and your period begins. That drop in progesterone is manifested as PMS.
Q. I have a family history of ovarian cysts, and I'm afraid I may be getting them as well. What are the tell-tale signs and how serious is it? Is there a treatment I should seek?
A: Ovarian cysts, which are small fluid-filled sacs within or on the surface of the ovary, are extremely common and are usually benign. Most of the time ovarian cysts go unnoticed and will go away on their own. In some cases they can cause pelvic pain, pressure, fullness, or even nausea and vomiting.
Other less common complications include rupture of the cyst or cancerous cysts, so if you think you may be prone to getting cysts it is important to have regular visits with your OB/GYN. These can be detected and monitored with a physical exam and ultrasound if needed. While they typically are harmless, it is important to rule out the possibility of something more serious—not to mention the countless other reasons why you should annually visit your OB/GYN!
Q. Are there certain foods that can help regulate an irregular menstrual cycle?
A: This is a great question, but unfortunately one that there is not a whole lot of research on. The general recommendation is to follow a healthy, well-balanced diet to improve your gynecologic health: complex carbs, lean protein, fatty fish, etc. Basically everything that we should all be eating anyway!
But there are other theories out there as well. One doctor I work with often has her patients with irregular cycles do food intolerance testing. Once a food intolerance is identified, which is often gluten or dairy, and the patient cuts that out of her diet, we may start to see her cycles normalize. We are not exactly sure why this happens, but it seems as though it happens far too often to be a coincidence. Many doctors are beginning to recognize a correlation here, but there is still much research to be done.
(photo by Shannon Lee Miller)