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Period Problems Fibroids, Endometriosis, and Other Issues Getting Your Period Is for at Least a Third of a Fact of Life for Most Infertility in Women,” Women

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Period Problems Fibroids, Endometriosis, and Other Issues Getting Your Period Is for at Least a Third of a Fact of Life for Most Infertility in Women,” Women August 2019 National Institutes of Health • Department of Health and Human Services • newsinhealth.nih.gov Inside News: 3 Varicose Veins 4 Steps and Health Benefits 4 Psoriatic Arthritis 4 Urinary Diseases Period Problems Fibroids, Endometriosis, and Other Issues Getting your period is for at least a third of a fact of life for most infertility in women,” women. But every wom- Halvorson explains. an’s period is different. So Fibroids, endometriosis, how do you know if yours and other menstrual is causing problems that issues can cause a range it shouldn’t? of symptoms (see the Many girls and women Wise Choices box). Your get cramps, low back pain, doctor can help you figure fatigue, or discomfort out what’s causing the with their periods. But symptoms. some have pain so bad Very heavy bleeding they miss days of work during a woman’s period or school every month. is the most common Others experience such symptom of fibroids. heavy bleeding that it Severe pain that gets exhausts them. worse around the time of These are things that a woman’s period is the may signal a bigger issue. most common symptom But some women find of endometriosis. talking about menstrual Both fibroids and issues embarrassing. These issues can be caused by endometriosis can run in families, “Women tend not to talk about many different things, including explains Dr. Ayman Al-Hendy, an pelvic pain or bleeding,” says Dr. Lisa scarring, hormonal imbalances, NIH-funded gynecologist at the Halvorson, a women’s health expert certain diseases or conditions, and University of Illinois. Because of at NIH. “But the menstrual cycle is a even some medications. this, women may not know that critical part of your health.” Two of the most common disor- severe pain or heavy bleeding aren’t You can’t know about your ders that cause period problems are normal. treatment options unless you talk uterine fibroids and endometriosis. “The culture in a family could be, with your doctor. Fibroids are tumors, or growths, ‘you just have to put up with it, it’s made of muscle cells and other types part of being a woman,’” he explains. Common Issues • Most women’s of cells that grow inside or outside of “But there are treatments available menstrual cycles range between 21 the wall of the uterus, or womb. that can improve your health and to 35 days, or up to 45 days for teens. Studies estimate that more than your quality of life.” Bleeding usually lasts between 70% of women in the U.S. have at continued on page 2 three to seven days. It’s important least one fibroid during their lives. for women to get to know their own But most women who have them pattern. What’s normal for one don’t have symptoms. woman may not be for another. Endometriosis is caused by The most common menstrual tissue normally found in the uterus irregularities are not getting growing outside it on other organs. @ your period at all or not getting it Many women with endometriosis Subscribe regularly, getting it for too many never have any symptoms. But some or too few days, or having severely have life-altering ones. newsinhealth.nih.gov painful cramps. “Endometriosis probably accounts 2 newsinhealth.nih.gov/2019/08 continued from page 1 Finding the Cause • It can be Such treatments may work well for Wise Choices hard for doctors to tell menstrual many women, Halvorson explains. Menstrual Issues problems apart. Blood tests can “But they can also prevent a woman help detect hormonal changes. An from getting pregnant,” she says. Symptoms of fibroids, endometrio- imaging test called an ultrasound is This can limit how long some women sis, or other menstrual problems can very good at picking up fibroids. want to use them. include: But diagnosing endometriosis “is Researchers have developed l Severe pain in the pelvis particularly tough,” says Dr. Stacey approaches to treat fibroids that l Very heavy bleeding during Missmer, an NIH-funded researcher don’t involve major surgery. These periods at Michigan State University. It’s often work well. But sometimes, hard to see on imaging tests. No fibroids can come back. l Pain during or after sex blood tests currently exist that can Some women with endometriosis l Feeling pressure in the pelvis pick it up. The only way to know get pain relief from surgery to re- l that a woman has it for sure is by move the tissue that’s stuck to other Frequent need to urinate a surgery in which a doctor looks organs. However, other women still l Bowel problems (diarrhea or through a small incision made in the have pain after this type of surgery. constipation) abdomen. For women who don’t get relief This can lead to a long delay in from drugs or less invasive diagnosis, “in part because no one procedures, a hysterectomy may be treatments are badly needed, she ex- wants to be quick to do surgery,” an option. This is surgery to remove plains, because “some women can’t Missmer says. Sometimes, if the uterus and sometimes the tolerate the side effects of hormonal endometriosis is suspected, doctors ovaries. Women who undergo this treatments.” And hormonal treat- will prescribe medications first to surgery can no longer get pregnant. ments don’t work for women who see if they provide some relief. Hysterectomy used to be much want to get pregnant. more widely used than it is now, says Al-Hendy is studying potential Current Treatments • Many drugs Al-Hendy. “But we have alternatives new fibroid treatments. His lab has used for fibroids, endometriosis, for hysterectomy now. So we tend found evidence that lack of vitamin and other disorders that affect the to use it only when other options D may play a role in fibroid growth. menstrual cycle work by altering haven’t worked,” he explains. How- His team is now developing new certain hormones. Birth control ever, it doesn’t cure chronic pelvic drugs based on vitamin D and plans pills and other drugs can block these pain for everyone. to test them to see if they can shrink hormones. fibroids. Looking for Better Options • Researchers also hope that by NIH-funded researchers continue to understanding the processes in the NIH News in Health look into new ways to detect, treat, body that drive period problems, “we ISSN 2375-6993 (Print) ISSN 1556-3898 (Online) and prevent period problems. can eventually intervene early and Editor Harrison Wein, Ph.D. “We need better, noninvasive prevent them,” Al-Hendy explains. Managing Editor Tianna Hicklin, Ph.D. ways to diagnose endometriosis,” For now, he adds, there’s a lot to Graphics Alan Defibaugh (illustrations), Halvorson says. gain from women being aware of Bryan Ewsichek (design) Missmer is researching ways how common these disorders are, Contributors Tianna Hicklin, Geri Piazza, Sharon to create a test for endometriosis. and of the options already available Reynolds, and Claire Rutkowski “Many scientists are now exploring to treat them. Use our articles and illustrations in your own using blood, urine, and saliva,” Missmer stresses the importance publication. Our material is not copyrighted. Please acknowledge NIH News in Health as the she explains. “We’re looking for a of speaking up. “If you were having source and send us a copy. signal that can determine whether a pain every time you moved your woman has endometriosis without elbow, you wouldn’t hesitate to go to newsinhealth.nih.gov having to do surgery.” the doctor and discuss it. So, there’s For both fibroids and endome- no reason why, if you’re having pain triosis, “we need nonhormonal every time you have your period, that NIH…Turning Discovery Into Health® treatments,” Halvorson says. These shouldn’t be discussed,” she says. n Office of Communications & Public Liaison Building 31, Room 5B52 Bethesda, MD 20892-2094 For more about mentrual issues and an extended Q&A, email: [email protected] Web see “Links” in the online article: phone: 301-451-8224 Links newsinhealth.nih.gov/2019/08/period-problems 3 newsinhealth.nih.gov/2019/08 Bulging Veins What to Do About Varicose Veins Are there bluish-purple or red lines your heart—and work against popping out on your legs? Those gravity to do it. could be varicose veins. Varicose Your heart pumps oxygenated veins are swollen, twisted veins blood out through arteries to that lie just underneath the skin’s your organs and other tissues. surface. They aren’t just a cosmetic Once your body uses the oxygen, issue. If they aren’t treated, they can the blood makes its way back to also cause health problems. the heart through your veins. “By the age of 50, nearly 40% of Then it’s pumped to your lungs woman and 20% of men will have to pick up oxygen before being some significant leg vein problem,” sent around your body again. says Dr. Cheryl McDonald, a Veins have one-way valves physician at NIH. that let blood flow forward. The Varicose veins are caused by blood valves then close to keep blood pooling in the veins. This makes from leaking backward. When a them bulge out. Varicose veins most valve doesn’t function properly, often occur in the legs, but they can blood can flow back down the appear other places too. vein. This can cause the blood to The veins farthest from your heart pool in the vein and keep it from have the toughest job. They must going back to the heart. Blood move blood a long distance back to pooling in the veins stretches them out—creating the swollen, twisted veins that can be seen Wise Choices and felt through the skin.
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