Image: 123rf

Don’t just sweep it under the rug if you’re victim of heavy periods – it’s best to seek professional opinion because you could have endometriosis. According to research by National University Hospital (NUH), seven in 10 Singaporean women who suffered heavy menstruation also had late stage endometriosis.

More disturbingly, 80 per cent of those studied waited for as long as two years before seeking treatment. “These findings point to a general lack of awareness of the condition and the prevalent misconception that even severe menstrual cramps are part of ‘growing up’,” says Dr Fong Yoke Fai, head and senior consultant, Benign Gynaecology Division in the Department of Obstetrics and Gynaecology at NUH.

So when does “normal” PMS go from benign to malignant? The experts answer.


Period pains vs Endometriosis

Image: 123rf

Normal:  Tolerable abdominal discomfort.

Abnormal: Heavy periods accompanied by intense pain that interferes with your work or social activities.

The next time you call in sick because of those dastardly cramps, do yourself a favour and see a gynae. Endometriosis could be the cause for that excruciating pelvic pain before and during your period. This happens when cells lining the womb implant and grow outside of it. Known as endometrial implants, these growths can occur on the ovaries, bowel, rectum, bladder, on the lining of the pelvic area, as well as other parts of the body.

Endometriosis is a progressive condition that tends to deteriorate with time, so it can lead to ovulation problems and even infertility. And don’t even think of trying to will the pain away. Such unbearable cramps will only worsen with time as the implanted cells will continue to grow and release pain-inducing chemicals with each menstrual cycle, explains Dr Fong.

There is no cure for endometriosis, but there is an effective, safe treatment with medication and/or surgery that can help to relieve pain and prevent progression of the disease. 


Low mood vs Depression

Image: 123rf

Normal: Slight irritability and mood swings just before menstruation.

Abnormal: Low mood for two weeks or more.

It’s all about the timing, says Dr Lim Yun Chin, consultant psychiatrist at Raffles Counselling Centre, Raffles Hospital. He elaborates: “What distinguishes PMS-related depression from other forms of depression is the timing of the symptoms. Specifically, they occur two weeks prior to the onset of menses, around the time of ovulation. And they subside once the period begins.”

On the other hand, clinical depression, lasts for more than two weeks, and is often associated with feelings of helplessness and hopelessness. One might also feel incapable of performing daily tasks and interacting socially. Plus, one might lose interest in activities that were previously enjoyable, he adds.

Keep a mood chart, suggests Dr Lim. It’ll help you determine if PMS is at the root of your blues. But if you feel constantly down or feel the strain in your work life or relationships, get professional help. Psychological intervention, such as cognitive behaviour therapy – a form of mental health counselling that helps you develop the skills needed to cope with negativity – can be useful.