Common Period Problems

I have painful periods. I have heard about endometriosis, but what is it really?

In brief, endometriosis is the presence of viable endometrial cells in places other than the uterine cavity. Every month when a woman has a period, the cells that line the uterus, known as the endometrium, are shed in the menstrual flow. Some small portion of this combination of blood and endometrial cells may also pass out through the fallopian tubes into the abdominal cavity. Most of the time, the body's natural defense systems attack and destroy these cells before they can begin to grow. However, this is not always the case. In some individuals, these endometrial cells actually implant on structures in the abdominal cavity and begin to grow. Then, each month when the normal hormonal changes bring on a menstrual period, much the same occurs in the endometriosis. A small amount of bleeding occurs from the endometriosis cells. This is very irritating to the body, and as a result of this, scarring occurs around the endometriosis. Most often this is a progressive process, with a small additional amount of bleeding and scarring occurring every month. It definitely has implications for future fertility, so check out the article Fertility and Endometriosis.

I'm only 39, but feel like my cycles—which have been regular all my life—are now going a little haywire. I seem to have PMS when I never did before, and huge variation in flow (sometimes nothing, sometimes I go through the "super" tampons in no time). I hope this isn't the start of menopause already! What do you think?

Not to be confused with menopause, a distinct stage in a woman's life where she has stopped producing estrogen and progesterone, and no longer menstruates, or even early menopause (defined by the cessation of a menstrual period for more than 12 consecutive months before age 45), perimenopause is a transitional phase—occurring up to a decade before menopause—defined by fluctuating hormone levels. With little or no progesterone (due to a non-ovulating cycle, or anovulation) to balance the effect, unopposed estrogen—up one day, down the next—causes many women to experience a myriad of symptoms from irregular menstrual cycles to changes in memory and mood. One big misconception about perimenopause is that what women are experiencing is all in their heads. It is not, and perimenopause may be one of today's most misdiagnosed conditions. Physicians have begun to realize that there is a definable entity prior to the onset of menopause. Read more about perimenopause.