Common Causes of Severe Period Pain

The menstrual cycle is a familiar part of many women’s health journeys, but for some, it brings more than just a monthly inconvenience. Period pain may be common, yet it shouldn’t be dismissed—especially when it disrupts your daily life. If your cramps are causing you to miss school, work, or important activities, it’s time to check in with a healthcare provider. In the meantime, here are some of the most common underlying causes of severe period pain:

Endometriosis: This condition gets its name from the endometrium, the tissue that naturally lines the inside of the uterus. In this condition, similar tissue grows outside the uterus—often on the ovaries, fallopian tubes, or other pelvic organs. Unlike the uterine lining, this displaced tissue has no way to shed, leading to inflammation, scarring, and sometimes cysts.

Fibroids: Fibroids are the most common benign tumors in reproductive-age women. They’re made of muscle and tissue and grow within the uterine wall. While the exact cause is unknown, risk factors include being overweight and having African ancestry. Many women with fibroids have no symptoms. But for those that do, common symptoms include heavy bleeding and pelvic pressure.

Pelvic Inflammatory Disease (PID): PID is an infection of the reproductive organs, often caused by untreated sexually transmitted infections like chlamydia or gonorrhea. However, it can also result from other non-sexually transmitted bacteria. This infection can involve the uterus, fallopian tubes, and ovaries, and may lead to serious complications if left untreated.

Over-the-counter pain relievers can offer temporary relief, but understanding the root cause of your pain is just as important. Severe or worsening cramps are not something to ignore. At Trust Women’s Healthcare, our providers specialize in menstrual disorders and reproductive health. If painful periods are impacting your life, we’re here to help you find answers and relief.

The Other Hormones: What Thyroid Hormone, Prolactin, and Cortisol Mean for Women’s Health

When we talk about women’s health, most of us immediately think of the big-name sex hormones like estrogen and progesterone. Maybe even testosterone gets a little spotlight. But the body runs on many more chemical messengers than the usual trio, and they all have a say in how you feel day to day. Hormones travel throughout the body influencing everything from metabolism to mood, so let’s take a closer look at a few:

  1. Thyroid hormone This hormone is made and released by the thyroid gland, and it plays an important role in keeping the body in balance, including temperature regulation and metabolism. When thyroid hormones run high, like in Grave’s disease, people often notice weight loss, heat intolerance, fatigue, anxiety, and absent or irregular periods. When levels dip too low, the pendulum swings the other way: weight gain, cold intolerance, brain fog, and heavy menstrual cycles. These shifts can be picked up through lab testing, including TSH, T3, and T4.
  2. Prolactin. Prolactin is a chemical released to help mothers produce milk by acting on the mammary glands. During pregnancy, it works with oxytocin to get milk production and milk released respectively. Sometimes,  prolactin rises when it shouldn’t, leading to hyperprolactinemia. That can show up as unexpected milk production especially in the absence of pregnancy, irregular or absent periods, low libido, or infertility.
  3. Cortisol. Cortisol is often labeled the “stress hormone” as it rises in the presence of stress. But even on a normal day it helps regulate blood pressure, blood sugar, and inflammation. When cortisol stays too high for too long, such as in Cushing’s Disease, common signs include abdominal weight gain, stretch marks, insulin resistance, and menstrual irregularities or infertility. If cortisol levels are decreased, some may experience low blood pressure and salt cravings.

These are just a few of the many hormones working behind the scenes to keep your body functioning smoothly. When they’re out of balance, the symptoms can be surprisingly wide ranging. At Trust Women’s Healthcare, we’re here to help you make sense of those changes and address any underlying concerns, schedule an appointment with us!

Pink Ribbon Chronicles: What You Need to Know About Screening

Many of us know at least one person affected by breast cancer. Breast cancer is the second most common cancer among women in the United States, following certain skin cancers. The good news is breast cancer screening allows early detection, increasing the likelihood of successful treatment. Here are three things you should know when it comes to breast cancer screening:

  1. Breast cancer screening is generally recommended for women between the ages of 40 and 75, but earlier screening may be recommended based on personal risk factors. The US Preventive Services Task Force expanded the age recommendation from 45 to 40 in recent years due to the increasing incidence of breast cancer among younger women. Furthermore, those  at greater risk  may require personalization of the screening schedule. Some people have a strong history of breast cancer with genes (portions of their DNA) that increase their risk. For example, people with BRCA 1 and 2 genes are at ~50% higher risk of developing breast cancer.  Thus, it is important to discuss with your provider if earlier screening would be best for you based on your individual risk.
  2. Mammograms are the gold standard for breast cancer screening. Mammograms are designed to take several  small x-rays of the breast that can detect early changes in tissue. Additional imaging may be recommended for women with dense breast tissue. Dense tissue may be harder to analyze with mammograms alone, thus ultrasound or MRI may be offered to take another thorough look at the tissue.
  3. In some cases, you may be called back for additional imaging after your initial mammogram. Sometimes the radiologist would like a closer look at the tissue, like in the case of dense breasts as previously mentioned. Furthermore, there are other breast abnormalities besides cancer that can be picked up through mammography. Common benign (non-cancerous) lumps include the following cysts, fibroadenomas, and galactoceles. Try your best not to panic, and speak with your radiologists to further explain your findings.

Mammogram screening is not the cure to breast cancer, but it does allow clinicians to detect cancer in its early stages while it is the most treatable. At Trust Women’s Healthcare, we provide comprehensive breast examinations and can help you navigate breast cancer screening. Do not hesitate, schedule an appointment with us!

Beyond The Ovaries: The Multisystem Impact of PCOS

Polycystic ovarian syndrome (PCOS) is one of the most common hormonal disorders among U.S. women of reproductive age. Yet, many women still remain undiagnosed due to the variation in symptoms and presentation. Contrary to what some believe, PCOS can present with symptoms beyond the expected reproductive signs. Let’s take a further dive into its impact spanning several organ systems of the body: 

Reproductive
The reproductive symptoms are often the most discussed. Hallmarks of this diagnosis include dysregulation of the menstrual cycle leading to irregular periods, and for some, ovarian cysts. Furthermore, irregular ovulation can make it more difficult to conceive leading to infertility. Long term, absent periods can lead to increased estrogen exposure, potentially increasing the risk of estrogen-driven endometrial cancer.1

Metabolic and Endocrine
The majority of patients with PCOS also have insulin resistance. As a result, there may be difficulty in regulating blood sugar levels, ultimately leading to Type 2 diabetes. In addition to insulin resistance, high blood pressure, high cholesterol, and obesity can be present. Overall, these conditions can increase risk of cardiovascular disease.

Dermatology
Some of the first signs of the disease may be dermatologic manifestations. A key feature of PCOS is high androgen hormone levels. Increased levels of such hormones can lead to excessive body hair, acne, and alopecia. Acanthosis nigricans, dark patches on the skin can also be present and may be a sign of insulin resistance. These signs are more than just cosmetic concern but may speak to underlying health conditions.


Psychiatry
Women with PCOS may be at higher risk for conditions such as depression, anxiety, bipolar disorder, and obsessive-compulsive disorder (OCD). Those with PCOS are more likely to have hormonal imbalance, body image distress, societal pressure with infertility, among many other factors that can increase mental health burden.

Framing PCOS as a reproductive disease is narrowing. With its consequences expanding multiple organ systems, an integrative and holistic approach is needed to improve the quality of life of patients. Schedule an appointment with us, we are ready to find a treatment plan best suited for your symptoms and personal goals!

1Zeina Haoula, Maisa Salman, William Atiomo, Evaluating the association between endometrial cancer and polycystic ovary syndrome, Human Reproduction, Volume 27, Issue 5, May 2012, Pages 1327–1331, https://doi.org/10.1093/humrep/des042

Testosterone: The Forgotten Sex Hormone of Women’s Health

Estrogen and progesterone often steal the spotlight in conversations about women’s health — but there’s another hormone working quietly behind the scenes with just as much impact: testosterone. When you hear the word testosterone, you might picture a hormone linked primarily to men. But, testosterone plays a critical role in women’s health, too — and overlooking it means overlooking an important piece of the wellness puzzle.

While testosterone levels are lower in women compared to men, it plays a key role in several aspects of health:

  • Libido and sexual function: Testosterone plays a key role in sexual desire, arousal, and satisfaction. When levels are low, many women experience a noticeable decline in libido, difficulty becoming aroused, or reduced sexual satisfaction which can impact self-esteem and relationships. This is particularly common during perimenopause and menopause, when hormonal shifts naturally lower testosterone production. In some cases,  providers may recommend testosterone therapy to help restore sexual desire and function, often alongside lifestyle changes and other supportive treatments.
  • Cognitive function: Some studies suggest that testosterone may play a role in brain health. A sufficient level of testosterone may minimize brain fog, improve mood, and allow for better concentration.
  • Musculoskeletal health: Many are aware that as estrogen levels decline during menopause, bone density can also decrease as a result leading to osteoporosis. Researchers believe that higher testosterone levels are associated with higher bone density and lean body mass. Furthermore, studies have shown that testosterone alongside other sex hormones may help improve chronic musculoskeletal pain.

Testosterone is part of a hormonal symphony that includes estrogen, progesterone, and others. Addressing testosterone levels isn’t about “becoming more masculine” — it’s about giving your body the tools it needs to function at its best. For all of your hormonal health concerns, schedule an appointment!

Estrogen and Progesterone: The Yin and Yang of the Menstrual Cycle

Hormones are chemical messengers produced by the body to regulate the function of organs and tissues. Together, they form a complex and interconnected network known as the endocrine system. Among the most well-known are the sex hormones: estrogen, progesterone, and testosterone. When in balance, these hormones work together to support a healthy reproductive system. However, even slight imbalances can lead to significant effects on reproductive and overall health. Let’s take a closer look at estrogen and progesterone and the role they play.

Estrogen

Estrogen is primarily produced by the ovaries and is recognized as the main female sex hormone, responsible for the development of female secondary sex characteristics. It plays a vital role in:

  • Breast development
  • Regulation of the menstrual cycle
  • Fat distribution, particularly around the hips, thighs, and glutes

When estrogen levels are too high, it can increase the risk of conditions such as breast cancer due to overstimulation of breast tissue. However, low estrogen levels may lead to irregular or missed periods and trigger menopausal symptoms like hot flashes, vaginal dryness, and loss of bone density.

Progesterone

Progesterone is another essential hormone in the menstrual cycle, primarily responsible for:

  • Creating a supportive environment in the uterus for early pregnancy
  • Triggering menstrual bleeding after ovulation if pregnancy does not occur
  • Balancing the effects of estrogen, preventing overstimulation of tissues

When progesterone levels are too high, individuals may experience irregular or missed periods, fatigue, bloating, and brain fog. On the other hand, low progesterone may fail to properly counteract estrogen, increasing the risk of estrogen dominance — which, as noted, can overstimulate breast tissue and raise the risk of hormone-sensitive cancers.

Like yin and yang, both estrogen and progesterone are needed to stay in balance. Too much or too little of either can throw off your cycle — but understanding this dynamic duo isn’t just about periods — it’s about holistic health. At Trust Women’s Healthcare, our providers are experts in hormonal health and treatments. For any concerns, schedule an appointment!

The Culprit Behind Vaginal Dryness

Vaginal dryness is something many women go through at some point, and while it might feel uncomfortable to discuss, it’s completely normal. The most common reason it happens is a drop in estrogen—a hormone that helps keep things running smoothly for vaginal health. Estrogen keeps the vaginal tissue healthy by supporting natural moisture, flexibility, and the right pH balance. However, factors like certain medical conditions, medications, or even some hygiene habits can also play a role. 

Here are potential factors that may contribute to vaginal dryness:

Leading Causes

  1. Menopause and Perimenopause– Vaginal dryness becomes more common as women get older, especially during and after menopause due to decreased estrogen production. As estrogen levels drop, the vaginal tissue can become thinner, blood flow decreases, and the natural balance of healthy bacteria can shift. While these changes are noticed during sexual activity. Dryness, itching, burning, or general discomfort may be experienced during regular daily activities.
  2. Pregnancy and childbirth– During pregnancy estrogen levels rise. After childbirth, once the placenta is delivered, levels of estrogen and progesterone drop quickly. These hormonal changes are completely normal but can have noticeable effects on the body similar to those experiencing menopause.
  3. Medications– Vaginal dryness may be a side effect for medications such as antidepressants and antihistamines. Anti-estrogen medications used to treat conditions such as fibroids can also have vaginal dryness as a side effect 
  4. Diabetes– Vaginal dryness can also be linked to nerve damage—and this is more common in women with diabetes. In fact, women with diabetes are twice as likely to experience vaginal dryness compared to those without the condition. Diabetes can cause damage to the nerves and blood vessels that help supply the vaginal area. Reduced vaginal blood flow can make it harder for the body to stay naturally lubricated.

Vaginal dryness can be frustrating. The good news? It is manageable and you can get relief! At Trust Women’s Healthcare, our providers can counsel on practical self-care tips alongside prescription medications to support your vaginal health! Do not delay your relief, schedule an appointment with us!

    More on Maternal Mortality: The Leading Causes

    The United States holds the unfortunate distinction of having the highest maternal mortality rates among high-income countries.¹ As per the CDC’s criteria, maternal mortality is characterized by a fatality occurring during pregnancy or within one year after the conclusion of pregnancy due to the physiological effects of childbirth.² In fact, 80% of maternal deaths in recent years were deemed as preventable.³ Keep reading to learn more about the leading causes of maternal mortality.

    Leading Causes

    1. Hemorrhage Hemorrhage can be defined as severe bleeding which can occur after birth. In some cases, excessive blood loss may call for a blood transfusion. Risk factors may include multiple pregnancies (twins/triplets/etc.) and delivery beyond the expected due date. However, this can happen among women without risk factors. Your provider may prescribe medications prior to delivery if they believe a patient is high risk. 
    2. Hypertensive disorders Hypertensive conditions or abnormal blood pressure levels can increase a patient’s risk of maternal mortality. Two common hypertensive conditions include  preeclampsia and eclampsia. Hallmarks of preeclampsia may include swelling of the face and hands, persistent headache, and changes in vision. More severe symptoms may develop which may include high blood pressure and changes in kidney or liver function. When preeclampsia progresses and leads to seizures, it is referred to as eclampsia. These conditions must be managed closely under a provider alongside lifestyle changes such as monitoring diet and incorporating exercise.
    3. Infections Infections are one of the leading causes of maternal death worldwide. Infection is a complication that may arise in different scenarios, from cesarean sections (C-section) to abortion procedures. Infections can lead to sepsis, which is an immune system response to the infection that can lead to organ failure and ultimately death. 
    4. Mental Health Disorders Mood disorders, specifically postpartum depression (PPD), accounts for at least 20% of maternal deaths.⁴ Like other common depressive disorders, symptoms of PPD may include sadness, anxiety, difficulty sleeping, and thoughts of self-harm.  Those with mood disorders prior to pregnancy may be at higher risk for PPD. Research suggests having a healthy sleep schedule may help to alleviate depressive symptoms.
    1. Munira Z. Gunja, Evan D. Gumas, and Reginald D. Williams II, “The U.S. Maternal Mortality Crisis Continues to Worsen: An International Comparison,” To the Point (blog), Commonwealth Fund, Dec. 1, 2022. https://doi.org/10.26099/8vem-fc65
    2. Centers for Disease Control and Prevention. Preventing Pregnancy-Related Deaths. Published September 26, 2023. https://www.cdc.gov/reproductivehealth/maternal-mortality/preventing-pregnancy-related-deaths.html
    3. Pregnancy-Related Deaths: Data from Maternal Mortality Review Committees in 36 US States, 2017–2019 | CDC. Published September 26, 2022. https://www.cdc.gov/reproductivehealth/maternal-mortality/erase-mm/data-mmrc.html
    4. Baby Blues and Postpartum Depression: Mood Disorders and Pregnancy. Published July 25, 2023. https://www.hopkinsmedicine.org/health/wellness-and-prevention/postpartum-mood-disorders-what-new-moms-need-to-know

    Pregnancy is not a disease, but is one of life’s most unique and natural processes. At Trust Women’s Healthcare we specialize in counseling high risk pregnancies. Do not delay your support, schedule an appointment today.

    Alopecia Awareness: Types and Treatment

    ome say the hair is a woman’s crown. Others say “it’s just hair.” Alopecia is more than just a cosmetic concern – it’s a medical condition that affects millions of people worldwide. Regardless, of your perspective, alopecia can be a reflection of your physical health and have profound impacts on self perception and mental health.  This condition is characterized by hair loss anywhere on the body but most commonly the scalp. Keep reading to learn more about the different types of alopecia and solutions offered at our practice.

    What is cholesterol?

    Androgenic Alopecia
    Androgenetic alopecia is the most common type of hair loss, affecting both men and women¹. It’s caused by genetics and can start as early in your teens, though noticeable hair loss typically happens later in middle-aged adults. In men, hair loss usually starts at the hairline or crown. In women, hair thins evenly across the scalp without the hairline receding. This type of hair loss is a natural part of aging for many.

    Traction alopecia 
    Traction alopecia happens from wearing tight hairstyles like braids, buns, or ponytails. It can also be caused by wearing tight hats or scarves that rub against your hair causing friction. The constant tension on the scalp can lead to follicle damage and hair loss.

    Alopecia Areota
    Alopecia areata is a condition where the body’s immune system attacks hair follicles, causing patchy hair loss. It can start as small, round patches of hair loss and sometimes progress to larger areas or even complete hair loss on the scalp. The hair follicles don’t scar, so it is possible that the hair may grow back over time.

    At Trust Women’s Healthcare, we offer solutions for women experiencing hair loss. Platelet Rich Plasma is a non-surgical option designed to revitalize hair growth using the body’s natural promoting hair growth factors. There is minimal down time with this procedure. Schedule an appointment with us if you would like to learn more!

    1. NYU Langone. Types of Hair Loss. Accessed March 2, 2025. https://nyulangone.org/conditions/hair-loss/types

    Submission received, thank you!

    Close Window