Menstrual Cycle (menses)

SYMPTOMS		DIAGNOSIS		SELF-CARE
Begin Here
1. Have your periods become painful?	No	Go to Question 5.*
Yes
2. Have you been more emotional, fatigued or irritable, or do you have more bloating or weight gain than usual, or do you have trouble concentrating or sleeping just prior to your periods?	Yes	This may be normalMENSTRUAL CRAMPS, or you may havePREMENSTRUAL SYNDROME (PMS).		Use over-the-counter medicine such as ibuprofen or naproxen for bloating and pain. Avoid caffeine and alcohol. Make changes to the way you eat and exercise. Eat smaller, more frequent meals that are high in complex carbohydrates such as fruits,vegetables and whole grains, and take a daily multivitamin and calcium. See your doctor if symptoms get worse.
No
3. Do you have a sexually transmitted disease, or do you have a fever or foul-smelling vaginal discharge?	Yes	You may have a serious infection around your ovaries, fallopian tubes, and uterus calledPELVIC INFLAMMATORY DISEASE (PID).		URGENT See your doctor right away. Any infection in the abdomen can be serious.
No
4. Do you have pain at other times such as during sex, ovulation or bowel movements?	Yes	You may haveENDOMETRIOSIS, a problem with the lining of the uterus, orOVARIAN CYSTS.		See your doctor.
*5. Are your periods heavier or are you bleeding longer than usual?	No	Go to Question 9.**
Yes
6. Do you use an IUD?	Yes	The IUD may have caused this change in the pattern of your bleeding.		See your doctor.
No
7. Do you have a constant feeling that you need to urinate, or do you have pelvic pressure, constipation or pain in your back or legs?	Yes	Your symptoms may be from FIBROIDS,noncancerous tumors of the uterus.		See your doctor.
No
8. Do you have muscle aches, swelling or stiffness in your joints, tightness or swelling in your throat, and/or weakness in your legs?	Yes	You may have a problem with your THYROID GLAND such as HASHIMOTO'S DISEASE.		See your doctor.
**9. Are your periods irregular, infrequent or have they stopped?	No	Go to Question 14.***
Yes
10. Do you have breast tenderness, abdominal fullness or nausea?	Yes	You may have anOVARIAN CYST, or you may bePREGNANT.		If you could be pregnant, do an at-home pregnancy test. If it's positive, see your doctor for confirmation. If you don't think you're pregnant and symptoms continue, see your doctor.
No
11. Are you on birth control pills?	Yes	Some women will miss a period while onBIRTH CONTROL PILLS. There is a small chance you could bePREGNANT.		Wait to see if you have a period at the end of your next pack of pills. See your doctor if you have signs of pregnancy or you don't have a period after the second month.
No
12. Are you 35 years old or older?	Yes	Periods that stop after years of regularity may be caused by normal or prematureMENOPAUSE. Irregular periods may be due to FIBROIDS, HORMONE PROBLEMS, or other medical conditions.		See your doctor.
No
13. Have you felt sluggish, or have you gained or lost weight without trying?	Yes	You may have a HORMONE PROBLEM, such as a THYROID GLAND problem. Periods may stop or become irregular if your weight falls dramatically, as can occur with ANOREXIA NERVOSA.		See your doctor.
No
***14. Are you bleeding at times other than your period, or again after having gone through menopause?	Yes	Your bleeding could be from FIBROIDS,ENDOMETRIOSIS, or from a serious condition such asENDOMETRIAL CANCER.		See your doctor right away. Early detection of endometrial cancer is important for successful treatment.
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