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Compliments of American Academy Of Family Physicians

Menstrual Cycle Problems

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From missed periods to painful periods, menstrual cycle problems are common and often benign. Follow this chart for information regarding a change in your cycle.

SYMPTOMS	DIAGNOSIS	SELF-CARE

1. Have your periods become more painful?	Go to Question 8.**

2. Have you been more emotional than usual, do you have more swelling than usual, or symptoms or irritability, trouble concentrating, fatigue, or sleep disturbance just prior to periods?	You may have PREMENSTRUAL SYNDROME (PMS).	Use simple, over-the-counter medicine for bloating or pain, and avoid caffeine. Try vitamin B₆for the PMS or ibuprofen or naproxen for the painful periods. See your doctor if they continue to get worse.

3. Is there more pain just prior to and during your period?	Go to Question 5.*

4. Do you have a fever or foul-smelling vaginal discharge?	You may have a serious infection around your ovaries, fallopian tubes, and uterus, called PELVIC INFLAMMATORY DISEASE (PID).	URGENT See your doctor as soon as possible. Any infection in the abdomen can be serious.

You may have a painful condition called ENDOMETRIOSIS.		See your doctor.

*5. Are your periods heavier or are you bleeding longer than usual?	Go to Question 8.**

6. Do you use an IUD?	The IUD may have caused this change in the pattern of your bleeding.	Discuss this with your doctor.

7. Have you had a number of pregnancies or are you over age 35?	Your symptoms may be from FIBROIDS, noncancerous muscular tumors of the uterus, or from changes from MULTIPLE PREGNANCIES.	See your doctor.


**8. Did your periods stop?	Go to Question 11.***

9. Do you have breast tenderness or abdominal fullness?	With these symptoms, PREGNANCY is possible.	Do an at-home pregnancy test. If it's positive, see your doctor for confirmation.

10. Have you ever had regular periods?	You may have a problem with your HORMONES.	See your doctor.

Go to Question 12.****

***11. Are your periods infrequent?	Go to Question 14.******

Go to Question 13.*****

****12. Are you on birth control pills?	Some women will miss a period while on BIRTH CONTROL PILLS. There is a small chance you could be PREGNANT.	Wait to see if you have a period at the end of your next pack of pills. See your doctor if you have signs of pregnancy or you don't have a period after the second month.

*****13. Are you 35 years old or older?	Periods that stop after years of regularity may be caused by normal or premature MENOPAUSE. Irregular periods may be due to FIBROIDS, HORMONE PROBLEMS, or other medical conditions.	See your doctor.

******14. Have you been sluggish, or have you gained or lost weight without trying?	These are symptoms of a HORMONE problem, such as a THYROID problem. Periods will also stop if your weight falls dramatically, as sometimes occurs with ANOREXIA NERVOSA.	Consult your doctor.

15. Are you bleeding again after having gone through menopause, or do you have unexplained lower-abdominal swelling?	Your bleeding could be from a simple VAGINAL INFECTION or from a serious condition such as ENDOMETRIAL CANCER.	See your doctor.

For more information, please consult your doctor. If you think the problem is serious, call right away.

This tool has been reviewed by doctors and is for general educational purposes only. It is not a substitute for medical advice. The information in this tool should not be relied upon to make decisions about your health. Always consult your family doctor with questions about your individual condition(s) and/or circumstances. Source: American Academy of Family Physicians. Family Health & Medical Guide. Dallas: Word Publishing; 1996.