By Theresa Giannetti

Have you been having trouble with your period? Maybe you’ve been bleeding more than usual, or not at all. If this is the case, speak with your doctor. Chances are there is an underlying cause.

According to information from the Mayo Clinic, menorrhagia, or bleeding too much, can be caused by anything from a hormonal imbalance or an IUD (intrauterine device) to dysfunction of the ovaries or uterine fibroids, even cancer. However, unlike many other illnesses or disorders, menorrhagia is generally easy to diagnose and, depending on the cause, treat. It is characterized by an extremely heavy flow that causes frequent pad or tampon changes (more frequently than every hour for several hours), needing to change protection during the night, and periods that last longer than seven days, among others.

In order to make a diagnosis, your doctor will ask questions related to your cycle, such as how long the bleeding lasts and how much sanitary protection you use during that time. Depending on what he or she thinks is causing the menorrhagia, your doctor may recommend a few different tests, including blood tests, Pap smear, endometrial biopsy, etc. There are many treatments available, but only your doctor can tell you what is right for you.

Amenorrhea, or the absence of a period, comes in two forms: primary and secondary. Primary amenorrhea occurs when a girl has not had her first period by the age of sixteen. The causes include chromosomal abnormalities, pituitary disease, or problems with the hypothalamus, the area of the brain that regulates your period. Problems with the hypothalamus are most commonly a result of extreme levels of physical or emotional stress, excessive exercise, and eating disorders, and less commonly a tumor. Blood and hormonal tests are needed to determine the cause.

Secondary amenorrhea occurs when you have no periods for at least three months; other symptoms can include milky nipple discharge, headaches, changes in vision, and sometimes, excessive hair growth. Some causes (there are more) are low body weight, thyroid malfunction, certain medications and birth controls, and stress. As with menorrhagia, several tests are available to check for certain causes. A pregnancy test and pelvic exam are usually the first tests administered, to rule out pregnancy and certain other causes. Blood tests may be given, as well as thyroid function tests or progestin challenge test, where your doctor administers hormones for seven to ten days to jumpstart your cycle. Again, as with menorrhagia, treatment varies widely and depends on the underlying cause.