Menstrual Disorders

MENSTRUAL DISORDERS

Menstrual disorders are problems that affect, or are triggered by, a woman’s normal menstrual cycle, such as: premenstrual syndrome (PMS), abnormally heavy bleeding (menorrhagia), the absence of menstruation (amenorrhea), painful cramps during menstruation (dysmenorrhea), and polycystic ovarian syndrome (PCOS). At OBGYN on the Park, our highly regarded team of board certified Obstetricians/Gynecologists understand the debilitating effect a menstrual disorder can have on a woman’s life, and will work closely with you to diagnose your condition and create a customized treatment plan designed to ameliorate your symptoms as quickly as possible. We offer two convenient office locations (Manhattan and Brooklyn, NY) and uniquely flexible scheduling options to ensure that your gynecological needs are efficiently fulfilled in a warm, welcoming environment.

PREMENSTRUAL SYNDROME (PMS)/PREMENSTRUAL DYSPHORIC DISORDER (PMDD)

Approximately 75% of menstruating women experience some form of PMS (premenstrual syndrome); however, the set of emotional and physical symptoms associated with this condition can shift and change from month to month, and may present differently in each woman. These symptoms generally peak 7-10 days prior to the onset of a woman’s menstrual cycle, and subside when the menstrual period begins.

Typical emotional/behavioral signs and symptoms associated with PMS include: tension, anxiety, crying spells, irritability/anger, depressed mood, food cravings, insomnia, social withdrawal, inability to concentrate, appetite changes, and mood swings. Emotional symptoms of PMS are often accompanied by physical symptoms, such as: headache, fluid retention, breast swelling/tenderness, joint or muscle pain, acne, diarrhea, constipation, and abdominal bloating. When PMS symptoms are so severe that they have a debilitating effect on a woman’s daily life, this is referred to as premenstrual dysphoric disorder (PMDD), a condition which can include additional symptoms such as: hopelessness, rage, low self-esteem, severe depression, tendency to isolate, and suicidal ideations.

Your clinician will work with you to find a treatment plan designed to alleviate your PMS symptoms, which may include one or more of the following medications or lifestyle changes:

  • Antidepressants: specifically from the category of SSRIs (selective serotonin reuptake inhibitors) such as Prozac, Zoloft and Sarafem. These medicines may be taken daily throughout the month, or limited to the two weeks prior to the start of menstruation
  • Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen to ease breast tenderness, cramping, and muscle pain
  • Diuretics to reduce water retention
  • Oral contraceptives to regulate ovulation and stabilize hormonal swings
  • Eating a high fiber diet and small, frequent meals
  • Increasing B-6, Vitamin E, calcium and magnesium intake via natural dietary food sources or vitamin supplements to reach optimal levels necessary to ease PMS symptoms (1200mg calcium, 400mg magnesium, 50-100mg vitamin B-6, 400 international units vitamin E)
  • Limiting caffeine, alcohol, and salty foods
  • Increasing exercise, getting sufficient sleep

MENORRHAGIA (HEAVY PERIODS)

Menorrhagia is the condition of having consistently heavy and/or prolonged menstrual periods, and includes symptoms such as:

  • Having to wake up to change sanitary protection during the night
  • Menstruating for longer than one week each month
  • Soaking through one or more tampons or sanitary pads each hour for several consecutive hours
  • Passing large blood clots during your period
  • Having to restrict your daily activities, miss work, or avoid sex as a result of your heavy period
  • Experiencing symptoms of anemia (fatigue, shortness of breath, exhaustion)
  • Headaches, nausea, and/or severe cramping
  • Depression, moodiness, anxiety, or a lack of confidence during your period

Treatment options for menorrhagia include:

  • Oral contraceptives
  • Iron supplements
  • Oral progesterone
  • The hormonal IUD (Mirena)
  • Nonsteroidal anti-inflammatory drugs (NSAIDs)
  • NovaSureEndometrial Ablation (EA): reduces or stops your periods using a quick delivery of radiofrequency energy to remove the uterine lining (endometrium). During this 5-10 minute outpatient procedure, your doctor will insert a triangular mesh device into the uterus, and will deliver precisely measured radio frequency energy through the mesh for approximately 90 seconds. You may resume your daily activities immediately after the procedure, there are no hormonal side effects, and 90% of women experience a dramatic reduction or stoppage of menstrual bleeding after treatment with NovaSure EA.

POLYCYSTIC OVARIAN SYNDROM (PCOS)

Polycystic ovary syndrome (PCOS) is a common hormonal disorder that affects women of reproductive age. Although the exact cause of polycystic ovary syndrome is unknown, early diagnosis and treatment can help to reduce the risk of later complications, such as weight gain, heart disease and Type II diabetes. PCOS symptoms vary significantly among patients, but generally include at least two of the following conditions:

  • Elevated levels of male hormones (androgens): often presents with physical signs including excess body and facial hair (hirutism), acne, and hair loss (androgenic alopecia); however the physical signs of excess androgen production vary depending upon the patient’s, and women of Asian or Northern European heritage may not be affected by the same symptoms.
  • Menstrual irregularities: may present as failure to menstruate for more than four months; prolonged periods; menstrual intervals longer than 35 days; or fewer than eight menstrual cycles a year.
  • Polycystic ovaries: this condition can be detected by ultrasound, and refers to the enlargement of the patient’s ovaries, as well as the presence of numerous small cysts on the ovaries

PCOS Treatment Options:

  • Oral contraceptives: low dose combination birth control pills comprised of a combination of synthetic progesterone and estrogen, or pure progesterone pills for 10 to 14 days each month.
  • Metformin (Glucophage, Glucophage XR) to lower insulin levels, regulate menstrual cycle, and aid in weight loss
  • Clomiphene citrate (Clomid, Serophene) is an oral anti-estrogen medication that helps to stimulate ovulation for women who are trying to become pregnant (metformin may be taken with this mediation to increase its efficacy and to further help induce ovulation if necessary)
  • Spironolactone (Aldactone) to block the effects of androgens on the skin and reduce hair growth
  • Laparoscopic Ovarian Drilling: outpatient surgery that uses electrical or laser energy to burn holes in follicles on the surface of the ovaries, thereby inducing ovulation.

Contact OBGYN on the Park

At OBGYN on the Park, we take pride in providing a superior level of patient care and clinical expertise in a compassionate and comfortable environment. Our exceptional staff members are experts in the field of Obstetrics/Gynecology and all our physician are faculty members at the Icahn School of Medicine at Mount Sinai. As a patient at OBGYN on the Park, you will experience an unparalleled level of attentiveness and responsiveness—we will always make time to thoroughly address every question and concern you might have, and will work tirelessly to ensure that your experience is a positive one.

Our multidisciplinary approach involves cooperative collaboration with your primary care physician and a network of highly esteemed specialists (when necessary) in order to create a customized treatment plan that meets your unique obstetric/gynecological concerns. We look forward to speaking with you, and to scheduling your initial appointment with one of our board certified physicians.