How to Talk to your Doctor about Period Problems

So, you’ve begun to wonder if your period is actually normal. Maybe your moods are all over the place, you are in extreme pain, or you’re bleeding like Niagara Falls. You’ve decided it’s time to contact your doctor.

First of all, congrats to you for tuning in and deciding you matter enough to seek support for whatever it is that is altering the quality of your life. YOU ROCK!!

Going to the doctor as a utero-human can be intimidating. It often feels like a coin toss on how your concerns will be treated. Some of us have amazing relationships with our primary care practitioners, lucking out with fierce reproductive health advocates who listen, validate, and collaborate. Some of us have experienced a darker side of healthcare (doctors who click their tongues at us, tell us we’re overthinking it, are anxious, or my personal “favourite” just too fat).

The first step to figuring out your problem, is acknowledging there is a problem. So many of us have been told by well meaning relatives and friends “that’s totally normal” on totally not normal things, an intergenerational code for “I coped, we all coped, now you can cope too.” But, period misery isn’t the norm. You deserve more than just getting by.

So, here is a non-exhaustive list of things that are not the norm, that deserve attention if they are impeding your function:

Excessive bleeding and clots

If you are soaking a pad or tampon in 2 hours or less, your period is dragging on for more than a week, or your blood clots are larger than a grape, it may be time for a check up.

You are in pain

Everybody is different, and there is no objective amount of pain that is “go to your doctor territory” but a good rule of thumb is, if its bad enough to interfere with your life, ibuprofen isn’t cutting it, or it is making you miserable, it may be time for a check up

Your cycle is irregular

Is your cycle coming on a fairly consistent basis? Not everyone is a 28 day bleeder, but you should be bleeding every 28-35 days, without missing periods if you are not using hormonal birth control. If it’s not, it may be time for a check up.

You are having trouble conceiving

School made conceiving seem easier than it is, considering that the fertile window on average is approximately 6 days, and ovulation period is only 24 hours. That being said, practitioners usually start investigating fertility concerns after 12 months of active trying. If that’s you, it may be time for a check up.

Your PMS is headed toward mental illness territory

75% to 80% of cycling individuals experience PMS or premenstrual syndrome, which causes some physical symptoms (breast tenderness, bloating, etc.) and mild mood swings. If you’re becoming increasingly depressed or anxious before your period, or are experiencing suicidal thoughts, it may be more than PMS and time for a check up.

You have identified the problem, now what?

PREPARING FOR THE DOCTOR VISIT

Educate yourself about menstruation and reproductive health

Book a coaching call with Heather, attend the Red Tent at the Peterborough Farmer’s Market, or do some online research.

Begin tracking your cycle and symptoms

Practitioners want concrete data, and a lot of cycle related issues require tracking trends. You can use paper and pen or download a cycle tracking app like Clue, or a chronic illness app like Juno or Bearable. Some of these apps can even export your data for your doctor! You may want to track things like cycle length, bleeding volume, premenstrual symptoms, cervical fluid consistency, and pain level. Remember: tracking always begins on the first day of your bleed, and most doctors will want 3 months of data.

Select a practitioner and book an appointment.

Perhaps you have a GP or family doctor already, or you may want to explore your options. Many cities and hospitals have women’s health clinics as well. Some advocacy groups have lists of supportive doctors on their websites like the registry on Nancy’s Nook (for endometriosis) or IAPMD (for PMDD). Naturopathic Doctors or Nurse Practitioners who specialize in reproductive care are also excellent alternatives if you don’t feel supported or have access to a family doctor.

AT THE DOCTOR - now what?

Take a deep breath and approach the appointment as a collaboration. Your doctor should be on your team, not the captain. Tell them your concerns, show them the data, and brainstorm what happens next. You should emphasize the impact the symptoms have on your daily function and what activities it prevents you from doing, and what support you are interested in and not interested in. It is a good idea to have these concerns and any approaches that you’re curious about written down so you don’t forget.

If you are nervous about your appointment, you are allowed to bring a friend, family member or other advocate to help ensure you get the support you need.

Not going as planned? Here are some questions and boundary phrases for an appointment going off the rails.

If you do not think it’s X, what is your differential diagnosis?

A doctor should have evidence for their claims. If they are dismissing your symptoms as nothing, or unrelated to what you are asking, they should have a list of other potential reasons and inform you of them.

I’m not comfortable with that intervention (as a first step), can you provide me alternative options?

Maybe you aren’t comfortable with a diet, or hormonal birth control, or SSRIs, or an IUD. You’re allowed to say no and ask for different methods.

What tests would you recommend?

Some diagnoses are tracking related, where some require blood work, scans, or even exploratory surgery.

Can you document your refusal?

If a doctor refuses a test, referral, or intervention, they should have a professional and evidence based reason to refuse it. Asking them to document their refusal allows future doctors to know, and also holds your doctor liable for their clinical decision making.

Can I have a referral?

Maybe you like your doctor, but you’ve reached the end of their expertise, or perhaps the clinical relationship is feeling volatile. Either way, you can ask for a referral or a second opinion to another doctor or a specialist.

How Can Moon & Bloom Help?

Moon & Bloom can assist with menstrual education, cycle coaching, reflexology, and reiki that can increase personal capacity, lower stress, and assist with self-care and pain management. Book an appointment with Heather here to explore practices that feel right to you.