4 things that could happen on your period that are worrisome

Although our periods occur once every month, they sometimes still feel shrouded in mystery. And when something changes with your period, your instinct may be to jump to the worst possible conclusion. Yet, while there are some worrisome things that can occur during your period, Mary Jane Minkin, MD, spoke to HelloGiggles about signs to look out for during your period and her advice overall was to, “Don’t panic.” So, yes, just as it is the top rule in The Hitchhiker’s Guide to the Galaxy, it also is when it comes to your menstrual health.

Along with being a practicing OB/GYN, Dr. Minkin is a clinical professor of obstetrics, gynecology, and reproductive sciences at the Yale University School of Medicine. (She also runs the cleverly-named website Madame Ovary, which mostly focuses on menopause.) And her main message is one of reassurance. While there could be something happening during your period that could indicate uterine fibroids or endometriosis, where the lining of your uterus grows outside of your uterus, most the time, that’s not the case — especially if changes in your period are few and far between.

"If you get one funky cycle and then you're back to normal, ignore it — by definition basically," Dr. Minkin says. "Because if you've got something like a fibroid, your periods aren't going to get better and worse and better — they're going to keep on getting nastier."

Dr. Minkin says the same goes for endometriosis. “If you have one bad period and then you’re fine, don’t worry about it being endometriosis ’cause that’s going to keep giving you problems,” she says. And even though fibroids and endometriosis sound scary, they are relatively easy to deal with medically once you’re diagnosed with them, Minkin noted.

But, if your extreme period is not a one-off, then you should be doing something about it.

"If you have persistence of things — like heavier flow, crampier flow — pay attention. Don't panic. Check in with your health care provider — be it your doctor, your nurse practitioner, nurse, midwife, whatever — and see what they have to say about what's going on," Dr. Minkin says.

That’s where monitoring your menstrual cycle becomes so important. So, while Dr. Minkin says there isn’t often “evil type stuff” that happens during your period, here are some things to look out for.

1Your flow has gotten heavier.

As Minkin told Redbook in a previous interview, “Heavy bleeding could signal a number of problems, including a blood-clotting disorder or hypothyroidism.” She suggested using apps like a note pad or iPeriod to keep track of your flow. Because if you don’t know what’s normal, then you won’t know when you need to see your doctor about a change in your period. However, if you JUST changed your method of birth control (or went off of it recently), check with your OBGYN — sometimes your flow will change.

2Your PMS has become more intense.

If you’re noticing more mood swings or new (or increased) signs of depression happening before your period, your PMS could becoming premenstrual dysphoric disorder (PMDD), which is pretty much “really bad PMS,” Minkin says. You should see your doctor if your mood changes are impacting your life. Minkin recommends lifestyle changes, like regular, good aerobic exercise and vitamins. Her “vitamin cocktail” that she recommends to her patients is B6 (100-200 mg), E (200 units), and evening primrose oil  (a couple of capsules a day). You can do this just a week before your period or take these vitamins on a regular, daily basis — Minkin says whatever works for you.  She thinks these vitamins not only help your mood before your period, but it also helps with fibrocystic breast changes, which can can also be impacted by your period.

If these non-medical suggestions don’t help, then she says selective serotonin reuptake inhibitors (SSRIs) — aka antidepressants — can help. She has some patients who take them on a regular basis and others who increase their dosage right before their period. (Of course, consult with your doctor before changing how you take your prescription.) And there are certain birth control pills that are known for helping PMS and PMDD — most notably, YAZ (or similar generics), which use the progestin drospirenone.

3Your period has gotten crampier.

If your cramps have started to cause immense pain, you should see a doctor since — as previously mentioned — it could be a sign of fibroids or endometriosis. There are treatments for both of these, but they should not be ignored. If your cramps aren’t an indication of a bigger problem, but are still affecting your life, Dr. Minkin encourages people to take simple medications since suffering through your period is “not your lot in life.” (Amen to that!) Physicians believe that the cause of cramps is the release of the chemical prostaglandins, so along with birth control, medications like ibuprofen, naproxen, Motrin, and Aleve can help with cramps. These are best taken before symptoms occur since they’ll block the making of more prostaglandins. And because diarrhea and nausea during your period may also caused by prostaglandins, just taking a Motrin may help with that too.

If you start having bad cramps after you’ve been successfully managing your cramps though — with or without medication — then is the time to see your doctor.

4You think you might have toxic shock syndrome

While we normally associate toxic shock syndrome (TSS) with tampons, Dr. Minkin notes there is some dispute about that. Yet, TSS does classically occur when a woman has her period. TSS is extremely rare and there will normally not be any ambiguity if you do have TSS. “In general, it’s more than just, ‘I don’t feel well with my period’ or something like that,” Dr. Minkin saays. “People with toxic shock have a fever of 102 or 103 degrees, they’re turning bright red, and their skin is falling off.”

She says if you have TSS, your skin would look like it was scalded with boiling hot water. If you ever have those symptoms, see a doctor immediately since it is life-threatening.

Overall, Dr. Minkin’s advice to don’t panic is sound since, in most cases, what’s occurring to you isn’t life or death like TSS. And another comforting fact is that if you do have persistent problems with your period that are a symptom of a bigger problem, most the time your health care provider will be able to treat it. In the words of Dr. Minkin, if you do ever have something happening during your period that is worrying you, “Don’t panic, but pay attention to it.” Those are certainly some words to live by in all situations — not just your period.