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Many women suffer some sort of discomfort before and during their period, but some symptoms can border on extreme to severe. Really painful cramping, debilitating headaches, heavy bleeding, light or even missed periods, and changes in cervical mucus can indicate an underlying health problem or an underlying hormonal imbalance that your doctor should evaluate. Unfortunately, many doctors don’t recognize these symptoms as indicative of a larger issue. But, neither we nor our doctors should simply dismiss them as "normal". 

This was a lesson I learned the hard way.

When I was 17, I began to experiences extreme symptoms during my period. Intense cramps and fatigue, and bleeding that seemed abnormal. My mother told me of her own similar experiences, explaining that I’d been “cursed” as the rest of the women in our family had been.

I was young and nervous about my symptoms, but I was terrified of seeing a doctor about it. It was embarrassing enough to discuss with my mom—bringing it up with a complete stranger seemed like an awful experience.

My mom found a D.O. (doctor of osteopathic medicine) for me, hoping it might be a helpful introduction to this new world of symptoms. A D.O. is a fully trained and licensed medical doctor who has attended and graduated from a U.S. osteopathic medical school. An M.D. has attended and graduated from a conventional (allopathic) medical school. The main difference between osteopathic and allopathic doctors is that some osteopathic doctors provide manual medicine therapies, like spinal manipulation or massage therapy, as part of their treatment.

The D.O. listened to my complaints and said, “I think you may have endometriosis.” Endometriosis—a condition in which tissue normally meant to line the uterus begins to grow outside it, leading to scarring. Endometriosis is very difficult to diagnose and there is no cure. But I later discovered that there was a way to treat my symptoms that didn't simply mask the underlying problem.

The Problem With Hormonal Birth Control

I left for college and suffered through my symptoms for many, many years, while also suffering from the side-effects of hormonal birth control, which I was prescribed to treat the symptoms. These symptoms continued into my twenties. Cramping became more intense, bleeding and fatigue only got worse. I turned to my current doctor for help, but to no avail. She immediately dismissed me, saying heavy periods are common and cramping is simply "part of the process." She recommended hormonal birth control, despite knowing I was trying to conceive a child at the time. It seemed counterproductive to the outcome, but she told me it was my only option to control the symptoms. There was never a discussion about treating the underlying “cause.”

Hormonal birth control can be an effective way to suppress—but not cure—the symptoms of endometriosis and PCOS— a disorder that causes multiple cysts to grow on the ovaries, resulting in hormonal imbalances. A 2011 report by the Guttmacher Institute showed that a study based on U.S government data from the National Survey of Family Growth (NSFG) revealed that “after pregnancy prevention (86%), the most common reasons women use the pill include reducing cramps or menstrual pain (31%)..." followed by, "menstrual regulation, which for some women may help prevent migraines and other painful 'side effects' of menstruation (28%)."

For many women who have journeyed down this path only to find birth control as their sole option, it can be extremely frustrating. It feels like a mask for a problem, not a real solution, which is scary considering both endometriosis and PCOS can lead to hormonal issues, infertility, and pregnancy loss, as well as other issues regarding weight, overall health, and mood.

How Sex Hormones Play a Role

When I sought to learn more about what was going on with me, all signs pointed to sex hormones. A 2008 study on the correlation between female sex hormones and fluid regulation in the body showed a connection between the main female hormones estradiol and progesterone and other complex neural and hormonal systems within the body. 

More comprehensive health initiatives can help women understand how hormones relate to the body as a whole. It can also aid in finding treatments that don’t simply mask problematic symptoms, like birth control, but lead to treating the issues that cause these imbalances. For example, we now know that treating postmenopausal women with estrogen can help combat cardiovascular disease, which supports the idea that hormone structures affect our overall health. 

A New Way to Manage

Fertility Awareness-Based Methods (FABM) is a relatively new way of looking at reproductive health that works to understand the body’s systems cooperatively. By learning the ways our cervical mucus, temperature, mood, and other monthly behavior can fluctuate, we not only arm ourselves with a deeper understanding of sex hormone disorders, but we can use that information to actually treat the imbalances that are causing us discomfort. 

The practice of charting is gaining traction as more and more women choose to forgo outdated methods of treating difficult symptoms. There is an abundance of cycle charting apps like Clue, MonthLog, YONO, My Cycles; all give women tools at their fingertips to monitor their cycles and spot changes that could identify hormonal problems.

A Swedish company has developed a new app called “Natural Cycles” which calls itself “the only certified contraceptive app” and uses algorithms based on input a woman gives while monitoring reproductive symptoms. While the Natural Cycles app is meant to prevent pregnancy, it demonstrates a growing trend toward a natural, holistic approach to women’s reproductive care that includes alternatives for women frustrated with limited answers.

We know our bodies are not “one size fits all,” so it is up to us to demand research and solutions that challenges the current standards of treatment. Accepting that extreme symptoms aren’t the norm may be the first step in better, more comprehensive reproductive healthcare for all of us.