Mother nature is a witch
November 30, 2015 7:48 AM Subscribe
My period knocked me out for the third time this year. I need help coping with this, help preventing it if possible, and help looking for possible causes. (And how do I explain this at work?) Possible TMI.
While my period could be painful at times, I had it under control pretty well the last few years. In 2013, just at the start of my master's programme in Japan, my cycles started getting shorter, and I also started getting pre-period bleeding and pain, something I didn't really have before. Incidentally, 2013 is also when I had a major depressive and anxious episode while living abroad, which one doctor actually wrote off as "just my period" and another to living alone abroad. I believed that the whole thing was completely psychological, but it does seem weird that it occured just after my period changed a lot, and now that I know a bit more about hormones, I have also noticed that on a blood test taken in 2014, my TSH is too high (4.something if I'm not mistaken.) It was taken again this fall and was almost 3, which searching around here tells me is treatment-worthy, but the two doctors told me was normal. At my last ob/gyn visit last summer, I was told they couldn't find anything or do much, but I am trying to get an appointment with an endocrinologist soon. My mental state is also pretty good these days, so maybe it was just life circumstances back then... In the meantime, I am taking evening primrose supplements, which seemed to help at first - I had an almost painless period after first starting them - and iron supplements, which seemed to make my blood smoother. (TMI warning: I had several periods of only bright red liquid blood instead of the blackish goopy stuff.)
This time, the pain and bleeding started a week before my actual period today, with some days of mild cramping, but no blood, so I wonder what exactly my uterus is cramping for. Today, on the first "proper" period day, the pain got so bad that after taking the maximum allowed dosis of my naproxen pills, it was still pretty unbearable, and I also started feeling dizzy and nauseous. Applying warmth just gives me hot flashes, although it's November. I guess the pills could have caused the nausea, but I have been feeling nauseous and dizzy on and off for a few weeks now. (Obviously not pregnant.) The last time I felt nauseous for no apparent reason was in 2013 during my bad mental health spell, and when starting anti-depressants. I never vomited, though, until two months ago, when I had the flu and vomited for the first time in ten years.
I went to the gym and did some light exercise as recommend to ease periods, but I did have more stress than usual at work last week. I also went on a two-week vacation to Japan and just came back three weeks ago, so one really strange theory I have is that if it is my thyroid, something in Japan, maybe the higher iodine content in the water, threw it off. It's just one really strange theory I have to explain to myself why this is happening to me around visiting Japan, but it's invalidated by the fact that I lived in Japan for a whole year when I was twenty and nothing really happened emotionally or with my period, although I was on the pill back then (and haven't been ever since.)
I know you're not doctors, but I also know from experience with doctors that sometimes, you have to look for your own diagnosis and bring it to them because they don't often consider every possible cause. Especially "female" problems like bad menstrual pain or thyroid issues seem to not get taken seriously, as evidenced by my TSH levels.
Does anyone have any idea or even just a hint in the right direction, so I can ask a doctor about it?
How do I live with this for now? It's pretty unpleasant, obviously, and if it happens any more frequently, I'm afraid I'll have trouble explaining it at work. Today, I just used the "I'm not feeling well" speech on my male boss, but the last time, my female boss got it out of me that it was my period, and I obviously don't want people thinking I'll be out every month. I'm usually reliable, I'd say, and have only missed three days this year for the flu, but if this becomes a pattern, I worry for any promotion or even the renewal of my contract.
So, how can I make this better, how can I prevent this, and how, if it doesn't get better soon, do I explain it at work?
Thanks in advance!
While my period could be painful at times, I had it under control pretty well the last few years. In 2013, just at the start of my master's programme in Japan, my cycles started getting shorter, and I also started getting pre-period bleeding and pain, something I didn't really have before. Incidentally, 2013 is also when I had a major depressive and anxious episode while living abroad, which one doctor actually wrote off as "just my period" and another to living alone abroad. I believed that the whole thing was completely psychological, but it does seem weird that it occured just after my period changed a lot, and now that I know a bit more about hormones, I have also noticed that on a blood test taken in 2014, my TSH is too high (4.something if I'm not mistaken.) It was taken again this fall and was almost 3, which searching around here tells me is treatment-worthy, but the two doctors told me was normal. At my last ob/gyn visit last summer, I was told they couldn't find anything or do much, but I am trying to get an appointment with an endocrinologist soon. My mental state is also pretty good these days, so maybe it was just life circumstances back then... In the meantime, I am taking evening primrose supplements, which seemed to help at first - I had an almost painless period after first starting them - and iron supplements, which seemed to make my blood smoother. (TMI warning: I had several periods of only bright red liquid blood instead of the blackish goopy stuff.)
This time, the pain and bleeding started a week before my actual period today, with some days of mild cramping, but no blood, so I wonder what exactly my uterus is cramping for. Today, on the first "proper" period day, the pain got so bad that after taking the maximum allowed dosis of my naproxen pills, it was still pretty unbearable, and I also started feeling dizzy and nauseous. Applying warmth just gives me hot flashes, although it's November. I guess the pills could have caused the nausea, but I have been feeling nauseous and dizzy on and off for a few weeks now. (Obviously not pregnant.) The last time I felt nauseous for no apparent reason was in 2013 during my bad mental health spell, and when starting anti-depressants. I never vomited, though, until two months ago, when I had the flu and vomited for the first time in ten years.
I went to the gym and did some light exercise as recommend to ease periods, but I did have more stress than usual at work last week. I also went on a two-week vacation to Japan and just came back three weeks ago, so one really strange theory I have is that if it is my thyroid, something in Japan, maybe the higher iodine content in the water, threw it off. It's just one really strange theory I have to explain to myself why this is happening to me around visiting Japan, but it's invalidated by the fact that I lived in Japan for a whole year when I was twenty and nothing really happened emotionally or with my period, although I was on the pill back then (and haven't been ever since.)
I know you're not doctors, but I also know from experience with doctors that sometimes, you have to look for your own diagnosis and bring it to them because they don't often consider every possible cause. Especially "female" problems like bad menstrual pain or thyroid issues seem to not get taken seriously, as evidenced by my TSH levels.
Does anyone have any idea or even just a hint in the right direction, so I can ask a doctor about it?
How do I live with this for now? It's pretty unpleasant, obviously, and if it happens any more frequently, I'm afraid I'll have trouble explaining it at work. Today, I just used the "I'm not feeling well" speech on my male boss, but the last time, my female boss got it out of me that it was my period, and I obviously don't want people thinking I'll be out every month. I'm usually reliable, I'd say, and have only missed three days this year for the flu, but if this becomes a pattern, I worry for any promotion or even the renewal of my contract.
So, how can I make this better, how can I prevent this, and how, if it doesn't get better soon, do I explain it at work?
Thanks in advance!
Best answer: Ask for an ultrasound to check for the possibility of ovarian cysts and a full panel on your reproductive hormones including estrogen, progesterone, and testosterone. During a particularly stressful time in my life where I was not sleeping/eating/etc. well I began to spot between periods and eventually I began bleeding perpetually for months on end without warning. I also had severe anxiety, no appetite, and depression. Turns out I wasn't ovulating regularly and had untreated yet atypical polycystic ovarian syndrome. I say atypical because usually it is diagnosed in women that are overweight, have excessive facial and bodily hair growth, thinning scalp hair, and who experience irregular or no periods due to excessive testosterone, all of which I wasn't/didn't have. But an ultrasound revealed 14 cysts on one ovary and god knows how many on the other, which was causing everything to go haywire rapidly. Eventually the elevated testosterone began to change my skin and hair in ways that I found distressing.
They may dismiss the idea of it but I'd push for it anyway.
posted by Young Kullervo at 8:04 AM on November 30, 2015 [7 favorites]
They may dismiss the idea of it but I'd push for it anyway.
posted by Young Kullervo at 8:04 AM on November 30, 2015 [7 favorites]
Ugh, sorry. I would keep going to doctors because if the pain is not treatable by OTC medication, that is serious.
If the thyroid theory doesn't pan out, you might want to ask about fibroids or endometriosis. Both of these conditions can lead to excessive pain and irregular bleeding.
I'd eat really nutritious but light for the time being; seems to help with discomfort. Can you work from home on an as-needed basis once in a while? That way you can check in on email but get the rest you need without having to go into detail. (You shouldn't have to go into detail anyway, that's really invasive!)
posted by kapers at 8:05 AM on November 30, 2015
If the thyroid theory doesn't pan out, you might want to ask about fibroids or endometriosis. Both of these conditions can lead to excessive pain and irregular bleeding.
I'd eat really nutritious but light for the time being; seems to help with discomfort. Can you work from home on an as-needed basis once in a while? That way you can check in on email but get the rest you need without having to go into detail. (You shouldn't have to go into detail anyway, that's really invasive!)
posted by kapers at 8:05 AM on November 30, 2015
Best answer: Something I noticed - regular weight-lifting helped me. I do as-heavy-as-I-can-manage dumbell workouts with a bit of weight machine and barbell about three times a week for about 30 minutes a time, and this has made everything so much less painful and more predictable after having gotten used to several years of really awful discomfort and mess. Apparently, per the internet, this is not an uncommon result.
I just do curls/basic arm work, chest press, overhead press, lat raises - the basic stuff, nothing fancy.
posted by Frowner at 8:06 AM on November 30, 2015 [3 favorites]
I just do curls/basic arm work, chest press, overhead press, lat raises - the basic stuff, nothing fancy.
posted by Frowner at 8:06 AM on November 30, 2015 [3 favorites]
Response by poster: Forgot to add I'm a vegetarian who also consumes almost no soy because I somehow had the suspicion that Japan = soy = this mess. Obviously no sea food, and also no sea weed or other iodine-heavy foods for now. Trying to cut back on dairy because of hormones, too, so no cheese for a while.
Not on any medication anymore, just suppliments. (I need to take iron and vitamin D.) Only "herb" I take is evening primrose oil.
Normal weight, slightly chubby, no irregular hair growth. Hair may break/fall out slightly more than before, but maybe I'm imagining that or it's my shampoo/whatever.
I want to see an endocrinologist, as I said, but it's hard getting an appointment. (If anyone knows a great one in Switzerland, please let me know!)
Cannot work from home, unfortunately...
posted by LoonyLovegood at 8:09 AM on November 30, 2015
Not on any medication anymore, just suppliments. (I need to take iron and vitamin D.) Only "herb" I take is evening primrose oil.
Normal weight, slightly chubby, no irregular hair growth. Hair may break/fall out slightly more than before, but maybe I'm imagining that or it's my shampoo/whatever.
I want to see an endocrinologist, as I said, but it's hard getting an appointment. (If anyone knows a great one in Switzerland, please let me know!)
Cannot work from home, unfortunately...
posted by LoonyLovegood at 8:09 AM on November 30, 2015
I agree you should keep looking for solutions because this doesn't sound normal. Is it also possible for you to go on some form of birth control to regulate your periods? My method is to get a pill prescription and skip the skip week, so that I never have a period. I know some IUDs and similar devices can reduce or eliminate period pain as well. Those might well have other side effects, but for me it was worth it not to have my period!
posted by chaiminda at 8:09 AM on November 30, 2015
posted by chaiminda at 8:09 AM on November 30, 2015
Response by poster: I promise I won't be threadsitting, but before more people suggest birth control to help with this: I am absolutely against taking any hormonal birth control. I cannot take months to find the right one and be an emotional mess in between, and the last one I took (which made me super cranky) turned out to be unsafe years later, so no thanks. The same goes the IUD and anything similar.
posted by LoonyLovegood at 8:12 AM on November 30, 2015 [1 favorite]
posted by LoonyLovegood at 8:12 AM on November 30, 2015 [1 favorite]
although I was on the pill back then (and haven't been ever since.)
I have really heavy periods and I used to always have to miss a day+ of school for cramps because I literally could not get out of bed. (There were days where I'd just pull a blanket into the bathroom and camp out between tampon changes because getting up to go into another room was too hard.) I've been checked for ovarian cysts and fibroids a few times (I agree you should get an ultrasound to rule those out). A couple gynecologists have suggested I probably have endometriosis.
What helped me--the only thing that helped me--was going on hormonal birth control. It made my periods manageable. I was on a HBC pill for about 7 years, then switched to a Mirena which is what I'm using currently.
I've just kind of accepted that I have a bum uterus. I need the hormone regulating help of modern science in order to live a normal life. You may be the same.
posted by phunniemee at 8:12 AM on November 30, 2015 [2 favorites]
I have really heavy periods and I used to always have to miss a day+ of school for cramps because I literally could not get out of bed. (There were days where I'd just pull a blanket into the bathroom and camp out between tampon changes because getting up to go into another room was too hard.) I've been checked for ovarian cysts and fibroids a few times (I agree you should get an ultrasound to rule those out). A couple gynecologists have suggested I probably have endometriosis.
What helped me--the only thing that helped me--was going on hormonal birth control. It made my periods manageable. I was on a HBC pill for about 7 years, then switched to a Mirena which is what I'm using currently.
I've just kind of accepted that I have a bum uterus. I need the hormone regulating help of modern science in order to live a normal life. You may be the same.
posted by phunniemee at 8:12 AM on November 30, 2015 [2 favorites]
Best answer: You have symptoms very close to a friend of mine who had Endometriosis and needed surgery. She was misdiagnosed for years because doctors told her that she was just having heavy periods. Add this to your list of demands of things to be tested for. They didn't want to test her because they insisted she was displaying enough symptoms but she argued for it and was right. If you don't have a lot of experience arguing with doctors speaking in a firm voice and saying "I understand what you are saying, but I need to be tested for this." works well.
posted by lepus at 8:19 AM on November 30, 2015 [2 favorites]
posted by lepus at 8:19 AM on November 30, 2015 [2 favorites]
I cannot take months to find the right one and be an emotional mess in between, and the last one I took (which made me super cranky) turned out to be unsafe years later, so no thanks. The same goes the IUD and anything similar.
Just FYI, lots of women (like myself) have horrid times with pills and hormonal birth control but do very well on the hormonal IUD. I have a Mirena, and haven't had my period in several years. And I could not tolerate pills.
posted by roomthreeseventeen at 8:25 AM on November 30, 2015 [1 favorite]
Just FYI, lots of women (like myself) have horrid times with pills and hormonal birth control but do very well on the hormonal IUD. I have a Mirena, and haven't had my period in several years. And I could not tolerate pills.
posted by roomthreeseventeen at 8:25 AM on November 30, 2015 [1 favorite]
"Normal weight, slightly chubby, no irregular hair growth. Hair may break/fall out slightly more than before, but maybe I'm imagining that or it's my shampoo/whatever."
Yeah it was slow and weird for me. The way my PCOS worked was: I felt okay and normal until about 7 days before my period, where my skin would change (break out, become course) and my hair would change in texture and shed. Eventually I'd have a period and everything would go back to normal. It was goddamn bizarre, but then all imbalances tend to not be created equal.
I also hate birth control, but since this disorder is genetic and incurable, my primary care physician prescribed me a pill that is actually very well suited to this disorder (Tri-Sprintec) and there are formulas available outside of the U.S. that have been developed to address this disorder specifically. Although it was FREAKING ROUGH at first, it has balanced out and my mood/appetite/periods have improved dramatically. Obviously its a risk, but it beats feeling and looking like a 13 year old boy 14 days out of every month.
That being said you may not have this at all but it doesn't hurt to check.
Edit: Forgot to mention I also have a uterine fibroid as a result of the imbalance and was causing the heavy bleeding. It has since been removed.
posted by Young Kullervo at 8:29 AM on November 30, 2015
Yeah it was slow and weird for me. The way my PCOS worked was: I felt okay and normal until about 7 days before my period, where my skin would change (break out, become course) and my hair would change in texture and shed. Eventually I'd have a period and everything would go back to normal. It was goddamn bizarre, but then all imbalances tend to not be created equal.
I also hate birth control, but since this disorder is genetic and incurable, my primary care physician prescribed me a pill that is actually very well suited to this disorder (Tri-Sprintec) and there are formulas available outside of the U.S. that have been developed to address this disorder specifically. Although it was FREAKING ROUGH at first, it has balanced out and my mood/appetite/periods have improved dramatically. Obviously its a risk, but it beats feeling and looking like a 13 year old boy 14 days out of every month.
That being said you may not have this at all but it doesn't hurt to check.
Edit: Forgot to mention I also have a uterine fibroid as a result of the imbalance and was causing the heavy bleeding. It has since been removed.
posted by Young Kullervo at 8:29 AM on November 30, 2015
Please find another OB/GYN who shows an understanding of the huge variability in symptoms and will examine all possible options and run more tests. Some OB/GYNs have less exposure to medical conditions such as fibroids, Endometriosis, cysts, etc, while others are much more familiar with them. It seems like there is something physical going on that your current doctor(s) has not identified. (I had to do that when I was 27 and needed an ob/gyn who would *not* do a hysterectomy just because I had a large fibroid that was causing problems...best decision ever.)
posted by apennington at 8:30 AM on November 30, 2015 [1 favorite]
posted by apennington at 8:30 AM on November 30, 2015 [1 favorite]
You have symptoms very close to a friend of mine who had Endometriosis and needed surgery. She was misdiagnosed for years because doctors told her that she was just having heavy periods. Add this to your list of demands of things to be tested for. They didn't want to test her because they insisted she was displaying enough symptoms but she argued for it and was right...
There's actually no test for endometriosis beyond exploratory surgery, which is how the diagnosis is made. But given the intensity of your pain, I would definitely consider that it could be endo. And if so, surgery and hormonal treatment is pretty much it besides pain management.
I hope you find some answers!
posted by fiercecupcake at 8:42 AM on November 30, 2015 [1 favorite]
There's actually no test for endometriosis beyond exploratory surgery, which is how the diagnosis is made. But given the intensity of your pain, I would definitely consider that it could be endo. And if so, surgery and hormonal treatment is pretty much it besides pain management.
I hope you find some answers!
posted by fiercecupcake at 8:42 AM on November 30, 2015 [1 favorite]
http://www.mayoclinic.org/drugs-supplements/evening-primrose/safety/hrb-20059889
This is what the Mayo says about Evening Primrose Oil. Cervix ripening, anxiety and some other things.
posted by Oyéah at 8:53 AM on November 30, 2015
This is what the Mayo says about Evening Primrose Oil. Cervix ripening, anxiety and some other things.
posted by Oyéah at 8:53 AM on November 30, 2015
Endometriosis. You need to get to a doctor who specializes in gynecology and ask them about it. Unfortunately, the treatment options aren't great - basically in the short term hormonal birth control helps a lot in reducing symptoms, but in the long term you have to get surgery to have the errant endometrial tissue removed.
Also, it seems like periods just seem to get worse as we get older (especially in terms of the emotional symptoms), based on the group of women I know who range from 30-50 years old. Figuring out how to cope now will make it a lot less annoying over time.
posted by joan_holloway at 8:54 AM on November 30, 2015
Also, it seems like periods just seem to get worse as we get older (especially in terms of the emotional symptoms), based on the group of women I know who range from 30-50 years old. Figuring out how to cope now will make it a lot less annoying over time.
posted by joan_holloway at 8:54 AM on November 30, 2015
With that kind of pain, you should definitely try to find another GYN doctor who will actually listen. It may help to do a chronology of the symptoms, as your description here is kinda ping-ponging around from symptom to symptom.* The more orderly your description, the more likely the Dr. will make something of it and not dismiss it as "heavy periods, whatcha gonna do?" If the situation is not resolved with this period, I suggest taking a notebook, calendar, or whatever and marking on it when you have pain, bleeding, bloating, or any other symptom you are tracking. Any patterns you discover may help with diagnosis.
My own symptoms in this area were somewhat different, but I did have three fibroids, including one growing inside my uterus, that caused quite a bit of bleeding and pain. For sure they should do an ultrasound to check for that and for ovarian cysts, as well as blood work to look at your hormonal and endocrine levels.
posted by tuesdayschild at 8:59 AM on November 30, 2015
My own symptoms in this area were somewhat different, but I did have three fibroids, including one growing inside my uterus, that caused quite a bit of bleeding and pain. For sure they should do an ultrasound to check for that and for ovarian cysts, as well as blood work to look at your hormonal and endocrine levels.
posted by tuesdayschild at 8:59 AM on November 30, 2015
My periods got much worse when I had a very large (11.5cm) fibroid. My main symptom was copious bleeding. I would try to find an endocrinologist to look into PCOS and endometriosis as well. When my fibroid was removed, my period got much better immediately. I also was mildly hypothyroid, and went on very mild meds for it. My OB/GYN only really investigated/treated the thyroid because I wanted to get pregnant and was having trouble.
posted by vunder at 9:38 AM on November 30, 2015
posted by vunder at 9:38 AM on November 30, 2015
I'm another person who had periods heavy enough to make my job difficult, had had a bad time on the Pill, and had great results with Mirena. OTOH my mother and aunt had endometriosis, a lot like what you describe, and they needed specific treatment for that.
posted by clew at 3:20 PM on November 30, 2015
posted by clew at 3:20 PM on November 30, 2015
Please don't completely discount hormonal birth control if the more serious diagnoses prove unfounded. I had all the typical indicators of ovarian cysts (woo facial hair!) but I don't actually have them. What has helped immensely is a very low dose of hormonal bc. I can take it without a placebo period for three months and then I take the placebo pills for a "withdrawal bleed". The adjustment phase was about one week of wonky uterus fluttering and crying at commercials and that was it, followed by a slow and steady upward improvement of pain, cramps, thinning out and eventual disappearance of bleeding, and now even a thinning of the facial hair. (My weight is the same but I am not trying to do anything about it and I am on an SSRI that typically causes weight gain, so I suspect they are balancing each other out.)
Anyway, I was very dubious about birth control because the last time I took it, I started getting feelings of disassociation and spiraled down into a bad suicidal episode. And I never cared about the actual birth control aspect because sex wasn't on the table for ages and my bisexuality means that at least half the time it isn't an issue, so I never had that motivation either. But! We're just really starting to understand hormones and dosing and many productive health issues, and it turns out the mental health problems didn't ever let up and were just caused by my becoming an adult, rather than any pills I was taking. A very low dose might be enough to set things in motion. It's working for me, at least.
posted by Mizu at 4:00 PM on November 30, 2015 [1 favorite]
Anyway, I was very dubious about birth control because the last time I took it, I started getting feelings of disassociation and spiraled down into a bad suicidal episode. And I never cared about the actual birth control aspect because sex wasn't on the table for ages and my bisexuality means that at least half the time it isn't an issue, so I never had that motivation either. But! We're just really starting to understand hormones and dosing and many productive health issues, and it turns out the mental health problems didn't ever let up and were just caused by my becoming an adult, rather than any pills I was taking. A very low dose might be enough to set things in motion. It's working for me, at least.
posted by Mizu at 4:00 PM on November 30, 2015 [1 favorite]
I'm going to nth finding a Dr that will do more testing.
In the meantime, I can offer a data point: acupuncture worked miracles on my PMS and painful periods. Yeah. I didn't actually know that was possible, but it regulated my period, wiped out all my symptoms including mood swings, cramps, etc. After several sessions of acupuncture over the course of a few months, my periods normalized and now all I do is try to avoid caffeine and sugar the week prior (if my consumption of either/both is high, I tend to get cramps).
Speaking of which, using a heating pad for cramps is like throwing fuel on a raging fire for me. I use ice packs and it helps.
posted by jenquat at 5:40 PM on November 30, 2015
In the meantime, I can offer a data point: acupuncture worked miracles on my PMS and painful periods. Yeah. I didn't actually know that was possible, but it regulated my period, wiped out all my symptoms including mood swings, cramps, etc. After several sessions of acupuncture over the course of a few months, my periods normalized and now all I do is try to avoid caffeine and sugar the week prior (if my consumption of either/both is high, I tend to get cramps).
Speaking of which, using a heating pad for cramps is like throwing fuel on a raging fire for me. I use ice packs and it helps.
posted by jenquat at 5:40 PM on November 30, 2015
Best answer: Nth putting the time in to find a doctor familiar with all this. I know from when I had suss thyroid nodules that the ranges for TSH aren't necessarily consistent (from doc to doc or lab to lab), so it is really going to depend on the doc (and lab). I think it comes down to talking to women in your area who've dealt with these issues and getting recs. Or doing online research, being mindful that reviews tend to be biased, though asking around in forums for people with endo/PCOS/thyroid might be fruitful. Then, it's down to making calls, and meeting docs and seeing if it's a fit. (I need to do it myself, it's just… it's a real project, isn't it. Necessary, though.)
FWIW, I have ovarian cysts but not the other PCOS symptoms (diagnosed by GP, just with the ultrasound). Also not doing BCP because there's stroke risk (but even if not, I'd have to be dragged into that forcibly). With BCP off the table, the treatment options I was given (for this, obviously) are pain management and monitoring with occasional ultrasounds (and I guess one or another surgery in the worst case, if that ever happens). Naproxen when it's bad; to prevent predictable period pain, ibuprofen every 4 hours 2 days before period is expected, because that modulates prostaglandins (and therefore pain). Yours are unpredictable, of course, though :/
I have no idea if this is the best non-BCP care possible, but that might be the sort of thing you'd get, with maybe-normallish TSH and without specialists or further investigations.
It doesn't sound to me (a non-expert) like it is (or is just) PCOS, though.
Nausea for weeks is concerning.
posted by cotton dress sock at 5:49 PM on November 30, 2015
FWIW, I have ovarian cysts but not the other PCOS symptoms (diagnosed by GP, just with the ultrasound). Also not doing BCP because there's stroke risk (but even if not, I'd have to be dragged into that forcibly). With BCP off the table, the treatment options I was given (for this, obviously) are pain management and monitoring with occasional ultrasounds (and I guess one or another surgery in the worst case, if that ever happens). Naproxen when it's bad; to prevent predictable period pain, ibuprofen every 4 hours 2 days before period is expected, because that modulates prostaglandins (and therefore pain). Yours are unpredictable, of course, though :/
I have no idea if this is the best non-BCP care possible, but that might be the sort of thing you'd get, with maybe-normallish TSH and without specialists or further investigations.
It doesn't sound to me (a non-expert) like it is (or is just) PCOS, though.
Nausea for weeks is concerning.
posted by cotton dress sock at 5:49 PM on November 30, 2015
Just nthing doctor. I'm yet another example of atypical PCOS with likely endo, who's terrified of HBC. I got answers from a young female GP who specialises in womens's health.
posted by jrobin276 at 7:40 PM on November 30, 2015
posted by jrobin276 at 7:40 PM on November 30, 2015
Best answer: So, obviously going to a doctor is a good idea, particularly as things have changed over time, but I have some suggestions for managing the pain.
First, try taking two types of painkillers - an NSAID like Naproxen, or Ponstan/Ponstel (which I found way more effective), and some sort of paracetemol (acetominophen) mixed with codeine. In Australia, you can buy 500mg paracetemol with 15 mg codeine over the counter, but if this is not the case where you live, get a prescription when you see the doctor.
Second, even if you feel you don't need the second pain killer, the effect of the NSAID builds up over time, so my doctor suggested starting to take it a day before your period starts, if you know when that is.
Third, accept that you are going to miss a day, or half a day of work. People take time off all the time, it's no big deal. I'm not sure why you have to say anything beyond "I'm not feeling well" - it's none of their business.
I always had very severe period pain from the start. No real reason, that is just how my body works. With the combination of two types of pain killers and a hot water bottle, I could reduce the pain to a manageable level, as long as I didn't have to leave my bed.
Honestly, though, getting a hormonal IUD (Mirena) made a huge difference for me. They're not for everyone, but it is worthwhile to keep an open mind.
posted by neatsocks at 9:59 PM on November 30, 2015
First, try taking two types of painkillers - an NSAID like Naproxen, or Ponstan/Ponstel (which I found way more effective), and some sort of paracetemol (acetominophen) mixed with codeine. In Australia, you can buy 500mg paracetemol with 15 mg codeine over the counter, but if this is not the case where you live, get a prescription when you see the doctor.
Second, even if you feel you don't need the second pain killer, the effect of the NSAID builds up over time, so my doctor suggested starting to take it a day before your period starts, if you know when that is.
Third, accept that you are going to miss a day, or half a day of work. People take time off all the time, it's no big deal. I'm not sure why you have to say anything beyond "I'm not feeling well" - it's none of their business.
I always had very severe period pain from the start. No real reason, that is just how my body works. With the combination of two types of pain killers and a hot water bottle, I could reduce the pain to a manageable level, as long as I didn't have to leave my bed.
Honestly, though, getting a hormonal IUD (Mirena) made a huge difference for me. They're not for everyone, but it is worthwhile to keep an open mind.
posted by neatsocks at 9:59 PM on November 30, 2015
Best answer: If you were in Zürich (or didn't mind coming here to see a doctor), I could recommend you my gynaecologist. Memail me if you'd like her name. She's the second one I've seen about my own horrible periods, and way better than the first. I'm having a fibroid removed soon, which the first doc also spotted but was completely blasé about, and I hope that will help. (It needed an internal ultrasound to pick it up; my regular doctor had given me an external one and not seen anything.)
I have thyroid issues but all the exciting stuff happened while I was still living in the UK, so I've just had maintenance check-ups from my regular doctor and don't really know any endocrinologists here, sorry. You should definitely keep pushing to see one.
I'm glad you're taking the iron and vitamin D supplements! It took me a while to accept that I should just keep taking an iron supplement and not go on and off them, at least till the fibroid is sorted out.
See if your doctor will prescribe you mefenamic acid, on top of whatever you're already taking for the pain. I've not been taking it for long this go round so I can't say if it's helping for sure, but when I had painful periods as a teenager it was like magic. And take everyone's advice about needing to take days off when you feel really bad. It's your right and people won't mind.
This comment is rather disjointed because I ought to be at work and don't have my glasses on yet, sorry. *hugs* for having to deal with this crap. It sucks!
posted by daisyk at 12:30 AM on December 1, 2015
I have thyroid issues but all the exciting stuff happened while I was still living in the UK, so I've just had maintenance check-ups from my regular doctor and don't really know any endocrinologists here, sorry. You should definitely keep pushing to see one.
I'm glad you're taking the iron and vitamin D supplements! It took me a while to accept that I should just keep taking an iron supplement and not go on and off them, at least till the fibroid is sorted out.
See if your doctor will prescribe you mefenamic acid, on top of whatever you're already taking for the pain. I've not been taking it for long this go round so I can't say if it's helping for sure, but when I had painful periods as a teenager it was like magic. And take everyone's advice about needing to take days off when you feel really bad. It's your right and people won't mind.
This comment is rather disjointed because I ought to be at work and don't have my glasses on yet, sorry. *hugs* for having to deal with this crap. It sucks!
posted by daisyk at 12:30 AM on December 1, 2015
Best answer: Oh, I meant to add -- I totally get you on wanting to stay away from hormonal birth control. I've had enough of it too (for various reasons). Once they accept that you have a real problem, doctors might try to push the Mirena on you, but stick to your guns if you don't want it. They probably won't suggest the copper (non-hormonal) IUD; it doesn't seem to be so popular here as in the UK. But just in case, you should be aware that it can lead to heavier bleeding and that's probably not a good fit for you.
posted by daisyk at 12:36 AM on December 1, 2015
posted by daisyk at 12:36 AM on December 1, 2015
Best answer: I have autoimmune hypothyroidism and "lean" PCOS, both of which took ages to properly diagnose; in these last couple of years I've also had reproductive tract polyps, fibroids, and non-ovarian cysts, all of which contributed to the most miserable menstrual periods of my life. Post-surgeries (which showed no sign of endometriosis), my periods were still heavy, clot-filled, and painful, and I requested a prescription for tranexamic acid (brand name Lysteda in the US, Cyklokapron in the UK).
This non-hormonal drug for menorrhagia is prescription-only in the US but OTC in other parts of the world, and you would take it up to 3x/day for a maximum of five days a month. Of course, you'd discuss its suitability for your situation with your doctor, and weigh the possible side effects (two months in and mine are the commonly-reported mild headaches and fatigue).
My life has really changed for the better, and for the first time in 30+ years I have a "normal" menstrual cycle. I wish more doctors were familiar with tranexamic acid for heavy periods.
posted by Iris Gambol at 9:25 PM on December 1, 2015
This non-hormonal drug for menorrhagia is prescription-only in the US but OTC in other parts of the world, and you would take it up to 3x/day for a maximum of five days a month. Of course, you'd discuss its suitability for your situation with your doctor, and weigh the possible side effects (two months in and mine are the commonly-reported mild headaches and fatigue).
My life has really changed for the better, and for the first time in 30+ years I have a "normal" menstrual cycle. I wish more doctors were familiar with tranexamic acid for heavy periods.
posted by Iris Gambol at 9:25 PM on December 1, 2015
Best answer: Yes, yes, yes, you should get this properly figured out.
To help you maybe feel a little bit less bad in the short term while you work on it, how is your gastointestinal function during your period? Taking things for some specific symptoms can ease some pains (for example, anti-gas pills or a fiber dose for constipation). I have normal mild-ish period pain, and a lot of that stuff turns out to be your nearby organs reacting to all the hormones.
Also seconding start the pain killers before the pain starts (but be careful with the acidic side effects on your stomach).
posted by anaelith at 4:55 AM on December 4, 2015
To help you maybe feel a little bit less bad in the short term while you work on it, how is your gastointestinal function during your period? Taking things for some specific symptoms can ease some pains (for example, anti-gas pills or a fiber dose for constipation). I have normal mild-ish period pain, and a lot of that stuff turns out to be your nearby organs reacting to all the hormones.
Also seconding start the pain killers before the pain starts (but be careful with the acidic side effects on your stomach).
posted by anaelith at 4:55 AM on December 4, 2015
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posted by Oyéah at 8:00 AM on November 30, 2015 [1 favorite]