9 health issues that could be making your periods play up

Endometriosis and polycystic ovaries aren't the only conditions that can wreak havoc with your menstruation.

Woman with hot water bottle on stomach period pain
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Your periods are a monthly insight into how well things are ticking over inside your reproductive organs. Having particularly heavy, light, long, short, early, late, or even non-existent periods can be an indicator of a whole host of health issues, and Dr Anita Mitra, guest gynaecologist at Pink Parcel and author of Gynae Geek, takes us through some of the possibilities...

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1. Polycystic Ovary Syndrome (PCOS)

'This is a complex hormonal syndrome that is incredibly common, affecting around one in ten women. Changes in the female hormones oestrogen and progesterone, as well as other hormones such as testosterone and insulin all underlie the symptoms associated with PCOS, although the cause is often difficult to pin down.

'Most commonly, PCOS causes irregular, infrequent periods. Many people don't realise that you don't necessarily ovulate every time that you have a period, as is frequently the case in PCOS. If you don't ovulate, your uterine lining is able to build up more than usual so your period tends to be heavier as a result.'

2. Endometriosis

'This is a condition that affects one in 10 women and is defined as the growth of endometrial-type tissue (lining of the womb/uterus) outside of the uterus, on areas such as the ovaries, bowel, bladder, pelvic side wall and even liver and lungs, known as "endometriotic deposits". This tissue responds to female hormones, so grows and sheds with your cycle in the same way as the lining of the womb. However, the blood cannot escape and causes irritation and inflammation of the inside of your abdomen. Therefore, it can cause very painful periods which tend to be quite heavy, as well as pain during sex, on urination and on opening your bowels.'

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3. Fibroids

'These are benign overgrowths of the smooth muscle that makes up the wall of the uterus that can be detected on ultrasound scan. And they can be completely contained in the wall, pressing out towards the other pelvic organs, or pressing into the uterus. It's the latter that tend to cause problems with periods making them heavier and more painful due to the increased surface area of the uterine lining. They grow in response to oestrogen, so they shrink after the menopause and don't tend to cause any more trouble after that.'

4. Thyroid disease

'Thyroid hormone levels have an impact on the production of oestrogen and progesterone. If your thyroid is under-active you may have infrequent, heavy periods, and if it's overactive it's usually the opposite; they're lighter or non-existent. It's one of the basic tests for period-related complaints and is usually pretty simple to fix with medication.'

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5. Stress

'Quite simply your menstrual cycle is designed to prepare your body for a pregnancy. Cortisol is the stress hormone and is released in situations where you don't eat well, don't sleep enough, over-exercise, or go through a tough time at work or home for example, and signal to your body that it's not the right time to have a baby, and so higher stress levels often result in missing a period, or your periods becoming irregular. As with PCOS, it's common not to ovulate as a result of excess cortisol, and therefore your period may be irregular, and also heavier.'

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6. Being overweight

'Oestrogen is the hormone that acts to build up the uterine lining to make it nice and cosy for that fertilised egg that your body so desperately wants you to implant there. Fat tissue is a major source of oestrogen, so higher levels will lead to a thicker uterine lining which results in a heavier period quite simply because there is more to come away.'

7. Being underweight

'Conversely, underweight women make less oestrogen, both due to lack of fat-based production, but also because the body senses it doesn't have the resources to waste to have a period, or to potentially sustain a pregnancy.'

8. Breastfeeding

'Breastfeeding prevents your brain from releasing the hormones that activate your ovaries and causes your menstrual cycle to stop, preventing you from getting pregnant (which would ultimately stop you from producing milk for the baby you're currently feeding).

'It's difficult to predict when your periods will start again based on how much you're feeding. For some women it happens when they're still feeding a couple of times a day, and for others it's when they've stopped completely. I've seen a lot of people who have got pregnant whilst breastfeeding though, so do remember that absence of your period at this time is not always a fail-safe contraceptive.'

9. Cancer

'This is incredibly rare, but deserves a mention because it can affect your periods and it's the thing that everyone worries about, even if it's just subconsciously. However, a recent published study of almost 9,000 women with heavy periods showed that the rate of endometrial cancer (cancer of the uterine lining) was only 0.11%, so it's highly unlikely when we compare it to how common some of the earlier mentioned conditions are.'

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