Conditions and Management

No two women will have the same experience when it comes to their period, but there is a range of what is considered normal in terms of cycle length, regularity, and flow.

Anything that falls outside of this range, along with any sudden or dramatic changes in your typical menstrual cycle, may signify a menstrual disorder.

Causes of Menstrual Disorders Irregularities

Tracking your period can be incredibly helpful, especially if you suspect something is amiss. A period log with dates and flow levels also can assist medical professionals to determine what may be causing your issues. However, it is important to seek help right away if you are experiencing excessive bleeding or severe pain.

The causes of menstrual irregularities and disorders vary and many of them are treatable. Here is a look at some of the most common issues behind these problems.

Perimenopause

Many women in their 40s experience perimenopause, which is the transitional phase that occurs before you go into full menopause. However, it also may affect younger women.

The signs of perimenopause can last for several years and often begin with changes to your menstrual cycle. This is because your estrogen levels tend to fluctuate during perimenopause, causing your cycles to get shorter or longer. If your menstrual disorder is accompanied by symptoms such as hot flashes, night sweats, difficulty sleeping, and mood changes, it could indicate perimenopause.

Polycystic Ovary Syndrome (PCOS)

Polycystic ovary syndrome, or PCOS, is a condition that impacts a woman’s hormone levels. This imbalance can cause you to skip periods and experience heavy bleeding when you do get your period.

It is important to report these issues to your healthcare provider as PCOS also may lead to infertility, obesity, male pattern baldness, and excess body or facial hair. Additionally, itcan contribute to serious problems like heart disease and diabetes. However, a doctor can help you to correct this hormone imbalance and improve your symptoms.

Endometriosis

When the tissue that normally lines your uterus begins to grow outside of the uterus instead, it leads to a condition known as endometriosis. This can cause very painful menstrual cramps that may be debilitating, in addition to prolonged periods with heavy bleeding and bleeding in between periods. Although endometriosis does not have a cure, it is possible to manage symptoms with medication or hormone therapy.

Thyroid Issues

Thyroid disorders are a common cause of menstrual irregularities. For example, hypothyroidism, or an underactive thyroid, may cause women to experience increased cramping and heavier, longer periods. Fatigue, weight gain, and sensitivity to cold are other symptoms of thyroid issues.

Having high levels of thyroid hormones in the form of hyperthyroidism can lead to lighter and shorter periods. This also might be accompanied by heart palpitations, anxiety, and sudden weight loss.

Hormonal Birth Control

If you are experiencing changes in menstruation, it is important to take a look at your birth control method to see if it could be causing the issue. Some hormonal birth control pills may cause irregular bleeding, spotting between periods, and later periods. Intrauterine devices, the Paragard non-hormonal IUD, may cause heavier bleeding.

Uterine Fibroids

In some women, muscular tumors known as fibroids develop within the wall of the uterus. Although this may sound scary, most fibroids are not cancerous. Nevertheless, they can lead to painful periods that are heavy enough to cause anemia. Iron supplements are often recommended for women with menstrual disorders that lead to anemia.

Weight Loss And Eating Disorders

Women who are underweight, have recently lost a significant amount of weight without trying, or have an eating disorder may find that their period stops entirely despite not being pregnant. This is because consuming insufficient calories interferes with the production of hormones your body needs to ovulate. Addressing eating disorders and reaching a healthier weight can alleviate these problems.

Too Much Exercise

There is no question that exercise is good for your health, but exercising excessively and too intensely can interfere with the hormones that are responsible for menstruation. Many female athletes and those who are taking part in intensive physical training develop amenorrhea, which is a condition that occurs when your periods stop or are missed frequently. In these cases, reducing training or increasing calorie intake can help periods return to normal.

Medications

There’s a broad range of medications that can interfere with a woman’s menstrual cycle and cause menstrual disorders. These include blood thinners, epilepsy drugs, chemotherapy drugs, aspirin and ibuprofen, antidepressants, thyroid medications, and hormone replacement therapy.

If you are experiencing a menstrual disorder, it is important to let your doctor know all of the medications you are taking so they can explore any potential connections. It is not a good idea to suddenly stop taking these medications, but a healthcare professional can help you to find alternatives that are less likely to cause menstrual disorders.

Talk To Your Doctor About Menstrual Disorders

Menstrual disorders can be caused by a range of issues, many of which can be corrected with medical treatment. If you are experiencing a sudden change in your cycle, spotting between periods, excessive bleeding, or your period stops for more than three months and you are not pregnant, it is important to contact your doctor right away.

Get In Touch With Raleigh Gynecology & Wellness

Although menstrual disorders can be frustrating, many of them are highly treatable. The friendly team of healthcare professionals at Raleigh Gynecology & Wellness can help you understand what is causing your menstrual disorder and recommend treatments that can provide much-needed relief.

Menstruation is a cycle that involves the monthly shedding of the lining of the uterus, known as the endometrium, in the absence of pregnancy. Although this definition implies that menstruation comes with a certain sense of regularity and may be quite predictable for some women, it is a highly individual experience that not only varies widely from woman to woman, but also can be experienced differently from month-to-month. Here are some of the most common menstrual disorders.

Common Menstrual Disorders

Discomfort before and during your period is not unusual, and cycles that vary in length by a few days are not a cause for concern. However, some women develop menstrual disorders that may require treatment to alleviate symptoms. Here is a look at some of the most common types of menstrual disorders.

Premenstrual Syndrome (PMS)

Premenstrual syndrome, or PMS, is an extremely common disorder with the American College of Obstetricians and Gynecologists estimating that almost 85 percent of women experience at least one of its symptoms during their reproductive years. However, around 5 percent of women will experience symptoms that are so severe that it is disabling.

The Symptoms of PMS

Each woman experiences PMS differently, but some of the most common complaints include:

• Fluid retention (such as swelling of the feet, ankles, and fingers)
• Psychological symptoms (especially anxiety, irritability, and depression)
• Skin problems, such as acne
• Bloating
• Gastrointestinal symptoms
• Appetite changes
• Breast tenderness
• Decreased libido
• Headache
• Reduced coordination
• Infections
• Fainting

Alleviating PMS

For many women, lifestyle modifications can help alleviate PMS symptoms. Exercising regularly and getting adequate sleep are great approaches that also can improve your overall health. In addition, consuming a balanced diet rich in vegetables, fruits, and whole grains while limiting salt, sugar, alcohol, and caffeine can help eliminate or reduce the severity of your PMS symptoms.

Amenorrhea

Amenorrhea is the absence of a menstrual period for longer than three monthly menstrual cycles.

It may be primary amenorrhea, which means that a woman never begins menstruating during puberty, or secondary amenorrhea, which occurs when what were once regular menstrual periods become increasingly abnormal or absent.

Causes Of Amenorrhea

It is important to note that amenorrhea may occur as part of the normal course of a woman’s life. Pregnancy is one of the most common reasons regular menstruation suddenly stops, but breastfeeding also may cause a woman’s period to be absent for an extended period. Menopause is another common cause of amenorrhea that is considered a normal part of aging.

However, it also could be caused by certain medications, behaviors, or medical problems, including obesity, eating disorders, excessive exercise, thyroid issues, ovulation irregularities , or an anatomical abnormality.

If you have missed three consecutive menstrual periods, you should visit a doctor for advice as early diagnosis and treatment are essential. Women who have not had their first period by age 16 also are advised to see a healthcare professional to ensure there are no issues preventing menstruation from occurring.

Menorrhagia

A common type of abnormal uterine bleeding is menorrhagia, which is characterized by prolonged, heavy menstrual bleeding that may be severe enough to disrupt your daily activities.

It is considered menorrhagia when a woman soaks through sanitary napkins or tampons to the point that they must be changed every hour or more often and/or a period lasts longer than seven days.

Menorrhagia may be caused by a hormonal imbalance, uterine fibroids, an abnormal pregnancy, pelvic infections or growths, bleeding disorders, pelvic inflammatory disease, some types of birth control devices, high levels of prostaglandins or endothelins, or other medical issues.

Other types of abnormal uterine bleeding include:

• Postmenopausal bleeding (bleeding that occurs more than a year after the last normal period at menopause)
• Oligomenorrhea (light or infrequent menstrual cycles)
• Metrorrhagia (nonmenstrual bleeding, such as bleeding that occurs between periods)
• Polymenorrhea (menstruating too frequently)

Dysmenorrhea

Dysmenorrhea is a condition marked by severe and frequent menstrual cramps and pain. Primary dysmenorrhea occurs when a chemical imbalance in a woman’s body causes abnormal uterine contractions. Other medical conditions could cause secondary dysmenorrhea, such as an infection, uterine fibroids, pelvic cavity growths, or pelvic inflammatory disease. In addition, an abnormal pregnancy, such as an ectopic pregnancy or a miscarriage, could cause dysmenorrhea.

Symptoms Of Dysmenorrhea

Excessive menstrual cramping and pain are the hallmarks of dysmenorrhea, but other symptoms include:

• Lower abdominal pain and cramping
• Lower back pain
• Pain that radiates down the legs
• Vomiting or nausea
• Diarrhea
• Weakness and fatigue
• Headaches
• Fainting

How Can Menstrual Disorders Be Treated?

The specific treatments for a menstrual disorder will depend on your health, medical history, age, condition, symptoms, and the causes of the disorder.

There are lots of options available, including dietary modifications, oral contraceptives, hormone supplements, antidepressants, regular exercise, prostaglandin inhibitors, and surgery. It is essential to visit a healthcare professional to diagnose the problem and devise a treatment plan.

Reach Out To Raleigh Gynecology & Wellness

If you are experiencing any symptoms of menstrual disorders or have questions or concerns about your cycle, get in touch with the friendly team of medical professionals at Raleigh Gynecology & Wellness to learn more about our services and schedule an appointment.

Most people instinctively want to see a doctor when they are experiencing unusual symptoms, such as bleeding between periods, pain in the pelvis region or abnormal vaginal discharge. While visiting an obstetrician-gynecologist (OB-GYN) is wise when experiencing complex or ongoing conditions, many common gynecologic problems can be diagnosed and treated by a nurse practitioner (NP).

What Is a Nurse Practitioner?

A nurse practitioner is a type of healthcare professional that offers a wide range of services, including primary care, acute care and specialty care services. The role of an NP can change based on his or her environment. In a hospital setting, a NP may help care for sick patients who have been admitted to the hospital, have suffered injuries or are undergoing surgical procedures.

NPs are also permitted to order diagnostic and lab tests to help in the diagnosis process. They may also debride wounds, put casts on injuries or assist in intubation. NPs have the knowledge and skill needed to diagnose and treat both short-term and long-term conditions. They may also specialize in specific practice areas, such as pediatrics, orthopedics, psychiatry, gerontology or oncology.

To become a NP, a person must complete a Bachelor’s of Science in Nursing (BSN) program, as well as a Master’s of Science in Nursing (MSN) degree or a Doctor of Nursing Practice (DNP) degree. Many states require nurse practitioners to obtain their license before they can practice in their state. Requirements can vary by location, but NPs are often required to renew their license on a regular basis.

What Is the Difference Between a NP and A Doctor?

There are many similarities between NPs and doctors, but these two professions also have distinct differences. The first difference is the education and training received by each group. Doctors generally go to school and train longer than NPs. According to the American Academy of Family Physicians, it takes an average of 11 post-secondary years of training and education to become a MD or a DO. In comparison, it takes about six to eight years to become a NP.

There are also some similarities and differences in the work environment of both professionals. Both doctors and NPs work in a range of healthcare facilities, such as clinics, community health centers, hospitals, college campuses and private practices.

One of the biggest differences in how each performs in their work environment is the physical component. NPs often spend a lot of their day on their feet, providing physical care to patients in need while doctors spend a lot of time listening to patients concerns bedside.

When Should I See a Nurse Practitioner?

Seeking care from a professional with the title “doctor” is not always necessary, especially when it comes to routine exams and procedures. Nurse practitioners are just as knowledgeable and skilled in their field and can often see patients sooner than doctors.

NPs are often known for their great bedside manner. They are commonly referred to as Advanced Practice Registered Nurses (APRN) due to their extensive healthcare background and ability to care for patients at their bedsides, whether it is at home, in a hospital or another healthcare setting.

Some of the most common services that NPs offer include:

• Annual checkups, including pap smears and breast exams
• Vaccinations
• Routine screenings
• Diagnosis and treatment of minor conditions or illnesses

When it comes to pressing gynecologic problems, many women want to see a healthcare professional as soon as possible. Nurse practitioners are often able to see patients quickly to prevent delays in treatment. Visiting a NP can be comfortable and convenient for women who have concerns about their health and would like to speak with a women’s health provider.

NPss that work in women’s health are equipped to provide many common services with or without supervision from a doctor. These services may include pelvic exams, sexual health counseling, contraception counseling, mammography referrals, issues relating to menopause and age-appropriate screening tests. They may also address issues related to infertility, gynecology care after cancer and LGBT reproductive health.

Schedule An Appointment Today With A Nurse Practitioner

NPs play a key role in promoting better health and wellness for women of all ages. These essential healthcare workers screen women for sexually transmitted infections (STIs), depression, cancer and domestic abuse. They also provide care for lesbian and transgender women, as well as for menopausal women. NPs are also dedicated to educating women about a wide range of nutrition and wellness topics.

At Raleigh Gynecology & Wellness, our nurse practitioners are an important part of our healthcare team. Contact us today to schedule an appointment for routine care or to speak to us about any health concerns that you may have. Our highly trained physicians and NPs provide services to women of all ages and assist in the management of many GYN conditions and disorders.

A nurse practitioner (NPs) is trained to assess symptoms, diagnose conditions, prescribe medications, order and interpret medical tests, and collaborate in patient care plans. These diverse medical professionals may provide primary care, acute care and urgent care services to children and adults of all ages.

A NP is a registered nurse (RN) with advanced clinical training and education. In some cases, a NP will go on to receive a master’s degree or a doctoral degree. Many NPs specialize in specific areas of care or focus on certain populations, such as pediatrics, adult medicine, geriatrics or mental health.

It takes an average of six to eight years of education and training to become a NP, according to Health eCareers. Here is a more in-depth look at education and training requirements.

Scope Of Practice

Nurse practitioners undergo extensive education and training to provide patients with comprehensive care. In 20 states throughout the U.S., NPs have full practice authority, meaning they do not have to work under the supervision of a doctor. In other states, NPs have more authority than RNs, but may require a doctor to sign off on more advanced patient care decisions.

Each state has its own laws and regulations regarding what services a nurse practitioner can deliver. Some of the most common tasks performed by NPs include basic checkups, requesting lab tests, refilling prescriptions and making treatment decisions for conditions like viruses, infections and hypertension. NPs can also refer patients to specialists.

Education & Training

Patients may encounter NPs in a wide range of settings. These medical professionals often work in hospitals, managed care organizations, office practices, clinics, community health centers, college campuses and many other locations. Before accepting a job position, NPs must provide proof of their education and training.

RN Credentials

The first step in becoming a NP is becoming a RN. There are several educational paths that can be followed to become a RN, such as enrolling in an Associate Degree in Nursing (ADN) or entering a Bachelor’s Degree in Nursing (BSN) program. Nurse practitioners may also choose to become a licensed practical nurse (LPN) before becoming a RN and eventually a NP.

Bachelor’s Degree

Enrolling in a Bachelor’s in Nursing Science degree is often the next step in a NP’s educational journey. If a nurse already has an ADN, he or she can choose to enroll in an accelerated RN-BSN program which can often be completed online. Bachelor programs in nursing typically include a clinical component where students are taught essential skills like communication, management, supervision, research and quantitative skills.

Experience

Nurses are expected to gain some level of experience after completing a bachelor’s degree program. Although this step can sometimes be skipped, it is best to have some on-the-job experience as a nurse before continuing with education.

Graduate Program

Earning a master’s degree is often the best path for nurses that already have a bachelor’s degree. A Master of Science in Nursing (MSN) is the minimum degree requirement for becoming a NP. However, some NPs may choose to enroll in a Doctor of Nursing Practice (DNP) program which is the highest level of nursing education.

Graduate nursing studies typically include both clinical training and classroom education. Master’s degrees involve 18 to 24 months of full-time study while DNP programs are a two-to-three-year educational commitment.

Licensure

Each state sets its own rules for nurse practitioner licensure; however, most facilities require proof of a national nursing certification and an advanced nursing degree. Some nurses may choose to obtain certification from a specialty nursing board, such as from the National Certification Corporation (NCC), American Nurses Credentialing Center (ANCC), the American Association of Critical-Care Nurses (AACN) or the American Academy of Nurse Practitioners Certification Board (AANPCB).

Additional Specialization

While not a requirement for becoming a NP, some health providers may pursue further education or training to specialize in a specific area or to cater to a certain population. These educational and training requirements are based on the type of specialization the person is seeking.

Receiving Care From A Nurse Practitioner

Some patients may have concerns about seeing a NP over a doctor. Although NPs typically receive less training than a doctor, they are highly qualified to handle, diagnose and treat a wide range of ailments, physical issues and diseases. Patients can count on their NP to take on many of their medical needs, such as annual checkups, vaccinations, routine screenings, and the treatment of common conditions like allergies, sore throat and the flu.

Schedule An Appointment Today With Our Nurse Practitioner

At Raleigh Gynecology & Wellness in Raleigh, NC, our team includes licensed doctors, nurse practitioners and other health professionals dedicated to assisting women with the management and treatment of GYN conditions and disorders. Contact our office today to schedule an appointment.

Part of every woman’s health care regimen should include keeping up with breast health. Women have a 1 in 8 risk of getting breast cancer. It is the most common form of cancer in women, second only to lung cancer. That is why women need to perform regular self-examinations, have annual visits to their breast care specialist, and adhere to the recommended schedule for mammograms.

Where To Start

The process usually begins when a woman or her doctor finds a change in the breast. Finding a change can begin during a self-examination, an examination by a doctor, or in a mammogram.

Self-examinations are essential for every woman once she reaches puberty. Breast cancer is a leading cause of death among young women age 15-34.

Performing monthly self-examinations will help the young woman notice changes such as a lump, a change in the texture of the breast skin, a nipple pulling inward, or a bloody discharge from the nipple. If any of those conditions are noted, a visit to the doctor or gynecologist is warranted.

Sometimes, the abnormality is unnoticed by a woman during a self-examination, yet it is detected during a routine clinical examination by a woman’s primary care doctor or gynecologist. Once the abnormality is noted, the doctor usually will order a mammogram for further evaluation.

In many cases, the developing cancer is in its early stages and is too small to be detected during a physical examination. However, a mammogram can detect the existence and location of microscopic tissue abnormalities. That is why it is crucial for women to keep up with regular mammograms once they reach the age of 40.

Once a mammogram has identified a suspicious area in the breast, more testing will be necessary to form an accurate diagnosis. That is when the patient will be referred to a breast care specialist.

Know When To See Your Breast Care Specialist

Any changes in your breasts should be looked at by your doctor. Things to watch out for include:

• A lump in or near your breast or under your arm.
• Changes in the size or shape of your breast.
• Dimpling, puckering, swelling, or bulging of the skin of a breast.
• A nipple that has changed position or is pushed inward.
• Redness, soreness, or rash on the breast.
• Unexplainable nipple discharge, especially if bloody.

These symptoms do not always mean you have cancer, but they do need to be evaluated by your doctor.

Referral To A Breast Care Specialist

Once a primary care doctor or gynecologist detects an abnormality in a breast of one of their patients, the doctor will refer the patient to a breast care specialist for a diagnosis.

What A Breast Care Specialist Does

By the time a patient is referred to a breast care specialist, the patient likely will have already had a traditional mammogram. If the patient has not had one, the breast care specialist will order one. A mammogram is a low dose X-ray examination of the breasts usually performed yearly to help detect breast cancer in its earliest stages.

3-D Mammogram

A breast care specialist may perform a high resolution 3-D mammogram. This state-of-the-art mammogram allows the doctor to view the images on a remote computer and zoom in on the suspicious areas.

Digital Breast Ultrasound

A breast ultrasound is an important device used to examine the breast using high-frequency sound waves. The sound waves create images of the internal breast tissue. The ultrasound device can usually show the doctor whether a lump is a benign fluid-filled cyst or a solid mass.

Breast MRI

A breast MRI can be used to determine the extent of cancer conditions in the breast and detect other abnormalities in the breast once they are initially detected by a mammogram, ultrasound or manual breast examination.

Biopsy

A breast care specialist may need a biopsy of the breast tissue to determine whether cancer is present and how extensive it may be. These biopsies allow the doctor to analyze the abnormal breast tissue in detail.

Genetic Testing

Some breast care specialists are able to conduct genetic testing for their patients to get information about their predisposition for cancer.

Surgery

If the breast care specialist determines breast tissue removal is appropriate, the breast care specialist may perform that surgery. Depending on the extent of the cancer, all or part of the breast tissue may be removed.

Referral to Oncologist

If the diagnosis is cancer, the breast specialist may need to refer the patient to a medical oncologist and/or a radiation oncologist for further treatment.

Contact The Expert Breast Care Specialist For More Info About Breast Health

The women’s health experts at Raleigh Gynecology and Wellness can answer any of your questions about your breast health, diagnosis or treatment. They are happy to discuss any breast health care concerns no matter what the issue may be and schedule an appointment.