Hi, my name is Leila, and I am one of URJA’s interns. Working with URJA has given me the exciting opportunity to speak with Dr. Sherry Ross, a Co-Founder and the namesake of URJA Intimates by Dr. Sherry!
Dr. Sherry is a renowned OBGYN, known as “doctor to the stars” and is also the author of two best-selling books, She-ology and The She-quel. She has been a passionate advocate for women’s health for over 25 years. The questions I’ve compiled have been shared across several blog posts with the series title Women’s Health Q+A with Dr. Sherry… this is Part 3 (last, but not least)!
I myself am 19 years old and am just a tad bit embarrassed to admit that I have never been to the gynecologist. With that being said, I am very excited to interview someone who can answer my most pressing questions about womanhood… those questions that I’ve never thought (or have been too scared) to ask. I walked into this interview seeking clarity about women’s health + taboos and was blown away by what Dr. Sherry had to say… I hope you feel the same way.
Q: My sister struggles with PCOS (Polycystic Ovary Syndrome) - I know there are many issues that women may struggle with - what are some abnormalities that women should look for in order to better take control of their health and understand their bodies? Are there any standout symptoms or red flags we should be aware of?
A: In order to know what is abnormal, you first need to know what is your normal.
Here’s what’s normal with a menstrual cycle...
- Age of onset is typically 11-12 years, but ranges from 8 to 14 years
- Average frequency is 32 days, but 21-45 days is considered normal
- Length 2-7 days
- Normal blood flow requires 3-6 pads or tampons per day
- Normal amount of blood is 4-12 teaspoons each cycle
Normal symptoms of a period include cramps with lower abdominal or back pain, bloating, tender breasts, mood swings, food cravings and headaches. Gas and diarrheas are also normal symptoms a couple days before and during your period.
Period red flags will include issues related to how long or frequent are your periods, the quality and amount of blood flow and the severity of PMS symptoms/cramps experienced.
If you notice your periods are coming frequently, less than 21 days or lasting longer than 7 days, for more than 3 months, this would be considered abnormal. Heavy bleeding with big blood clots, like the size of grapes or apricot’s, would be an abnormal amount of blood flow. In general, an abnormal period or menstrual bleeding is when you are changing a pad or tampon every 30 to 60 minutes for 3 to 4 hours. You may also have irregular bleeding that looks like a few spots of reddish-brown blood at unexpected times of the cycle. Some women can have spotting that lasts a couple of days then stops and restarts again during the middle of the month. Brown spotting can also happen mid-cycle or during ovulation. If irregular bleeding or brown spotting continues for more than 2 to 3 months this is a reason to contact your health care provider to discuss reasons why this might be happening. You can download a period tracker on your smart phone or use a calendar to keep track of your periods.
Other signs to contact your health care provider include debilitating cramps, migraine headaches, disruptive emotional changes such as mood swings, depression and crying spells that prevent you from doing your normal daily activities. Vaginal dryness, itching, discharge, sores and odors should be a sign to follow-up with your health care provider. Pain with sex is just not talked about enough! Let’s face it, everyone has experienced pain with sex in one form or another. If you have persistent pain with intimacy, it’s important to follow-up with your health care provider. Other symptoms that need a doctor’s appointment include persistent pelvic and abdominal pain, pain with urination and breast pain or nipple discharge.
Q: I always dread my period (the mood swings, back pains, cramps, heavy bleeding, and bloating) – Do you have any unique solutions for any of these symptoms?
A: It’s true, period cramps can be debilitating. There are many dietary suggestions that will help reduce the pain associated with cramps and get you through that time of the month.
Drinking water, warm or hot, helps to relax the uterine muscles. Additionally, water-based foods can help with hydration, including: berries, celery, cucumber, lettuce and watermelon. Adding ginger to hot water is another useful remedy.
Calcium rich foods and supplements reduce muscles from cramping. Ideally 1,000mg/day of calcium works best. Sunflower seeds, spinach, soybeans, kale, figs, almonds, sesame seeds and tofu are excellent sources of calcium. Other helpful foods include dark chocolate, flaxseed, cinnamon, fiber and parsley.
Foods which make cramps and other PMS symptoms worse may include dairy products (cheese, yogurt, milk and butter), foods high in sodium, red meat and other fatty proteins, caffeinated drinks, alcohol and processed foods. So stay away!
Cramps can be easily treated with ibuprofen such as Advil and Motrin. I suggest keeping track of your period so that you can take ibuprofen before you know your cramps and period are coming.
Oral contraception, aka “the pill”, is not only a great birth control, but makes your menstrual blood less heavy, which minimizes your cramps each month.
Other easy remedies include a warm bath, heating pad (or a hot water bottle that your grandma might have suggested!) and CBD (THC-free) is also a natural anti-inflammatory that may help with pain. CBD relaxes muscles in the pelvis and distracts your brain from feeling the pain associated with menstrual cramps. There are many ways to use CBD products including bath salts, suppositories, infused chocolates, body balms and tinctures. Check out URJA’s tincture and rollerball. All these options seem to be effective and safe for mild and moderate cramps.
Q: There are so many different birth control brands and methods… it’s overwhelming – and so many misconceptions about how it affects your health. What do you suggest to women trying to navigate the birth control landscape?
A: Luckily, we have many choices in selecting a birth control that works best for a woman and her specific concerns. If a woman has concerns about side effects from the hormonal forms of birth control such as the pill, I may talk to her about considering the IUD. If a woman doesn’t like taking a pill every day because she is forgetful, she may want to consider any of the long-acting birth control methods, or the NuvaRing. If the cost is a concern, the pill may be the least costly and most effective option depending on her insurance coverage. I find it useful to go through each of the methods to see if the woman might not have considered one of the forms, we have options!
I definitely love talking about the IUD for women with concerns of emotional and physical side effects from the pill. For those women who have all the disruptive side effects associated with the pill, the IUD is safe, effective and is a long-term contraception alternative. The IUD has been around a long time, but for many, it’s the “new kid” on the block since women of all ages are now considered eligible to use it.
The Copper IUD (Paragard) is the non-hormonal IUD that can be used up to 10 years. A woman will still have monthly periods and the menstrual flow may be heavier than usual. This is perfect for those sensitive to or cannot take any kind of hormones especially breast cancer patients. Women who have concerns about using a reliable contraception without any hormones, the Copper IUD is for you. The Copper IUD will not cause any emotional side effects including depression.
The progesterone containing IUD’s - Mirena, Kyleena and Skylar - were designed to give you a lighter or non-existent period. The Mirena IUD often gives a woman no period which is a welcomed side effect for many women. In fact, the Mirena IUD is also used to treat women with irregular and heavy periods. The progesterone containing IUD’s also can be used comfortably in women with depression or have concerns with emotional side effects.
For women with a personal or family history of depression, but aren’t actually suffering from depression themselves, they certainly could try the birth control pill if they are interested in using this form of contraception. The most common emotional side effects include depression, moodiness and feeling weepier. Other side effects include irregular bleeding, nausea, breast tenderness, bloating and headaches. It’s important to know these side effects are temporary, and if they don’t go away in 2 to 3 months you should change to another type of pill because there are many different types and combinations of estrogen and progesterone depending on your side effects and body type.
The cause of these side effects depends on how sensitive you are to these man-made or synthetic estrogen and progesterone hormones. There are many different brands of OCP’s, each varying in the types and doses of these 2 key hormones. Some women are more sensitive to one or both of these hormones exacerbating these side effects. If you try 2 or 3 different brands of birth control pills and still experience many disruptive side effects, it’s time to consider another type of contraception.
Barrier methods including the diaphragm and condoms are not as reliable in preventing pregnancy but are alternatives for those women who are sensitive to the hormonal effects of other birth control options.
The Rhythm Method relies on you tracking your menstrual cycle and avoiding sex during your most fertile days. It’s a non-hormonal option with a high chance of accidental pregnancy.
The Pull-Out method, also known as “Pull and Pray”, is where your male partner doesn’t ejaculate inside the vagina. Since there is a small amount of sperm released prior to a man ejaculating, this method also has a high failure rate and is not a reliable birth control option.
As long as there is an open communication of what to expect and for how long, women tend to be more willing to try a recommended form of contraception knowing there are alternatives.
I hope this final Q+A with Dr. Sherry was as insightful for you as it has been for me! Discover more information on women’s wellness and vaginal health throughout URJA’s website or check out Dr Sherry’s books here.