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What helps against heavy bleeding and PMS?

Johanna Janku, Lea Schumpf, Marcel Steinmann, and Sabrina Vollrath answered your questions in the 'Puls' chat

What can be done against a strongly pronounced negative mood due to PMS?

Johanna L. Janku: Premenstrual syndrome consists of various physical and psychological symptoms. Among the most common psychological symptoms are tension, fatigue, irritability, and mood swings. Concentration and memory difficulties can also occur. After a clinical investigation of possible causes and documentation of symptoms over several months (menstrual calendar), I would first recommend lifestyle changes: Regular exercise, a healthy diet, and good sleep hygiene can reduce mood swings. Mindfulness and meditation exercises can help reduce stress. Support from your social environment can also help you during this time. If you continue to be burdened by PMS symptoms, alternative therapies can be initiated. For example, treatment with Vitex agnus-castus (chasteberry) and calcium can be mentioned. Hormonal contraception or antidepressants could also be considered.

I experience very heavy bleeding, which is draining my energy. However, the bleeding is usually painless. Is there anything that can help with this?

Johanna L. Janku: For your situation, I would strongly recommend a gynecological examination, including an ultrasound, by your gynecologist. Heavy bleeding can be burdensome. It may also be necessary to have a blood test to rule out possible iron deficiency. Heavy bleeding can cause anemia, leading to a feeling of weakness. Iron supplementation can help counteract iron deficiency.

How can I achieve a regular cycle despite having PCOS and endometriosis?

Sabrina Vollrath: For PCOS, a comprehensive gynecological-endocrinological diagnosis should be conducted to address the various factors accordingly. At the forefront are lifestyle modifications (more exercise, a healthy balanced diet, plenty of sleep), followed by correcting any disrupted sugar metabolism, and possibly taking a birth control pill, which can regulate the menstrual cycle pattern through pill intake.

What is the best way to deal with severe abdominal cramps? What tablets could one take that would help?

Marcel Steinmann: There are many different approaches: 1. Heat (hot water bottle), tea, diet (cheese/quark > alleviate cramps through calcium intake; spinach/leafy greens > reduce bleeding intensity) 2. Herbal remedies: magnesium, calcium, Premens (chaste tree) 3. Painkillers: NSAIDs (ibuprofen, for example), Novalgin (pain-relieving and antispasmodic) 4. Antispasmodic medications: Buscopan, for example 5. Hormonal preparations such as the pill or a progestogen-based preparation (including the hormonal coil) can also be a good option.

I have three children. With each child, my PMS symptoms have gotten worse. What can be done about that? Are there natural methods that can help?

Sabrina Vollrath: Yes, there are many natural methods for PMS symptoms that can be tried initially. These include: 1) Micronutrient supplementation with vitamin E, vitamin C, magnesium, and vitamin B6 2) Herbal therapy with chaste tree, St. John's wort, saffron, or ginkgo preparations. If natural methods don't help, in a second step, pharmacological methods (ovulation suppression, antidepressants) may be considered.

Good day. Since the birth of my second child 7 years ago, I (47) have had very heavy menstrual bleeding and therefore almost constantly low ferritin levels (4-7 ng/ml). Iron infusions help for a few months, then the iron stores are empty again. With Cyclokapron, I more or less have the bleeding under control, but sometimes this medication doesn't work. A fibroid has been ruled out. My gynecologist recommends a hormonal coil to reduce the bleeding. Are there any other options? Thank you in advance for your advice!

Marcel Steinmann: This is a common phenomenon. The hormonal coil (preferably Mirena) actually works very well in this case. An alternative would be a progestin-only pill (without estrogen), either cyclically or continuously; a good new option here is Slinda. If you also have menopausal symptoms, hormone replacement therapy, especially in a continuous regimen (to avoid bleeding), would be an option.

Hello, does a woman experience heavier or lighter bleeding with the copper intrauterine device? Thank you.

Johanna L. Janku: Copper intrauterine devices can increase blood flow in the uterus and lead to heavier menstrual bleeding. Unfortunately, both the duration and the amount of menstrual bleeding can be affected. The effects of the intrauterine device are very individual, so a medical assessment is advisable.

Ich bin interessiert zyklusbasiert zu trainieren, Ausdauer wie auch Krafttraining, gibt es einen Literaturtipp von Ihrer Seite?

Lea Schumpf: Guten Abend. Swissolympic engagiert sich sehr zu diesem Thema. Hier gibt es viel spannendes zum Lesen:

Hello! I had two pregnancies close together and now I've been having my period again for about 4 months. Each time, the bleeding gets heavier, and I'm struggling with the usual products. For example, I combine a menstrual cup with a pad, but that doesn't last long either. What products can you recommend? Does the intensity decrease over time?

Johanna L. Janku: Good evening. In the situation you described, a gynecological examination including imaging with ultrasound by your gynecologist is advisable. Hormonal changes (pregnancy, breastfeeding) can affect your menstruation. Your current contraception, mode of delivery, breastfeeding status, and your age are also important pieces of information for assessing the situation. Additionally, infections should be ruled out. Imaging can reveal abnormal changes in the uterus. After completing the diagnostics, more can be said about the cause of irregular bleeding. It's important to note that for heavy bleeding, absorbent, large pads or large tampons may be more advisable than menstrual cups.

Read all questions and answers on the original SRF article.

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