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"  Count on this: Between puberty and menopause, you&amp;#039;ll spend almost seven solid years of your life dealing with your period. Whether you deem it &amp;quot;the curse&amp;quot; probably depends on how much the monthly bleeding interferes with your life. That perception may well shift as you get older. Each decade&amp;#039;s reshuffling of your hormones can bring about new firsts, such as your first cramp-free period, your first pimples since prom night and your very first PMS experience. &amp;quot;These are all normal changes,&amp;quot; says ob/gyn Gerson Weiss of New Jersey Medical School in Newark. Whether welcome or unwelcome, they demand new coping techniques. Here&amp;#039;s what you need to know: In Your 20s What to expect now: At this age you&amp;#039;ve gotten past the hormonal inconsistencies of adolescence and have established a rhythm -- one reason this is the easiest time of your life to get pregnant.  Your cycle statistics: Your period comes every 23 to 35 days, with 28 being the average. Bleeding lasts from two to seven days, and the flow is moderately heavy. Now&amp;#039;s the time to pay attention to what&amp;#039;s normal for you -- when, how long, how much -- so you have a baseline against which to gauge future changes.  What&amp;#039;s happening hormonally: To pull off a regular menstrual cycle, your body must do an intricate dance involving hormones, glands and the brain -- and at this moment in time, the odds are that it&amp;#039;s performing flawlessly. On the first day of your period, which is technically the beginning of a new cycle, the hormones estrogen and progesterone are at their lowest levels. As your cycle moves toward ovulation, estrogen increases gradually and then spikes, setting off processes that stimulate the release of an egg. During the second half of your cycle, progesterone increases and causes the lining of the uterus (a.k.a. the endometrium) to change so it can nurture a fertilized egg. If you do not become pregnant, production of estrogen and progesterone drops, and part of the endometrium is shed as your period.  Your biggest pain: cramps You&amp;#039;re not likely to experience PMS in your 20s, but chances are good that you&amp;#039;ll suffer from cramps, technically known as primary dysmenorrhea. &amp;quot;Most cramps are caused by prostaglandins, fatty acids that cause the uterus to constrict, sparking muscle spasms,&amp;quot; says family practitioner Susan M. Lark, author of the Menstrual Cramps Self-Help Book.Prostaglandins are a by-product of the fats you eat, especially those that are found in dairy products and red meat, says Lark, who recommends a low-fat diet. Related: How Often Do You Think About Sex?       Some anticramp moves:  Take a nonsteroidal anti-inflammatory drug: You&amp;#039;ll need to get a prescription for Motrin, but there are also over-the-counter versions of ibuprofen. These drugs suppress prostaglandins and are usually quite effective at relieving pain, especially if you start taking them a day or two before your period, says ob/gyn Weiss.  Go on the Pill. Oral contraceptives prevent ovulation and keep the uterine lining from thickening, so there&amp;#039;s less to shed and fewer cramps.  Try alternative methods. According to a study in the journal Obstetrics &amp;amp;amp; Gynecology, weekly acupuncture treatments can dramatically reduce pain caused by menstrual cramps. Cramps do lessen after you have a child as well as when you get older, because the cervical canal enlarges and the uterus doesn&amp;#039;t have to contract as much to eject the menstrual fluid. When to call your doctor: If you&amp;#039;re not pregnant and your formerly regular periods suddenly stop for three months; or if your cycle changes drastically (with your periods becoming infrequent -- more than 35 days apart, for example). The potential culprits: stress, a thyroid disorder and weight loss that is due to heavy exercise or a very low calorie intake. Not getting your period puts you at high risk for developing the dangerous bone-thinning disease osteoporosis, which may result in bone fractures. You should also tell your gynecologist about any cramps that don&amp;#039;t respond to nonsteroidal anti-inflammatories or birth control pills, as well as any unfamiliar pain during your period. You may have a growth in or around your uterus or an infection, either of which can be treated by your doctor.   In Your 30s  What to expect now: Your once-predictable cycle is starting to lose its clockwork regularity, thanks to hormonal changes.  Your cycle statistics: Your period may come more frequently. Bleeding may be heavier and last longer, for six or even seven days.  What&amp;#039;s happening hormonally: Your hormone system is beginning to misfire at times. Production of both estrogen and progesterone begins to be less predictable, affecting your body&amp;#039;s messages to your brain. Your biggest pains: PMS and heavy menstrual bleeding For many women, premenstrual syndrome begins in their 30s. Symptoms, which crop up as early as two weeks before your period and generally stop when it starts, are wide-ranging: bloating, weight gain, breast tenderness, headache, backache, acne, irritability, depression, anxiety and fatigue. The causes are complex: &amp;quot;It&amp;#039;s not just your hormones,&amp;quot; says family practitioner Lark. &amp;quot;Changes in mood-altering brain chemicals, such as serotonin and dopamine, can also be involved.&amp;quot;  You don&amp;#039;t have to suffer:  The selective serotonin reuptake inhibitor antidepressants (Prozac, Paxil, Zoloft, Effexor) can manipulate these brain chemicals and relieve your symptoms. Used at half-strength and only in the last two weeks of your cycle, SSRIs work largely by making more serotonin available to the brain. Relief is quick to kick in: &amp;quot;It takes six weeks for SSRIs to treat [clinical] depression, but for PMS these help right away,&amp;quot; says ob/gyn Weiss. You take pills on the 14th day of your cycle and continue until your period begins. More low-tech solutions:  To relieve food cravings and blue moods, try 5-HTP (5-hydroxytryptophan), a chemical from which serotonin forms, which is available in many health-food stores. Lark recommends that you take it daily throughout the month, at a dose of 50 to 100 mg.  You can beat bloating by taking 200 mg of magnesium a day, according to research published in the Journal of Women&amp;#039;s Health.  For irritability, headaches and breast tenderness, the herbal remedy vitex agnus-castus (the berry of the chaste tree) recently got the go-ahead from a German study published in the British Medical Journal. &amp;quot;Vitex triggers the secretion of the hormone LH, which sparks progesterone production and also promotes ovulation,&amp;quot; says Lark. She recommends taking 40 to 225 mg of the standardized extract daily.  Chewable calcium-carbonate tablets (such as the antacid Tums) or calcium supplements (1,200 mg a day) may also provide generalized relief, according to a study in the American Journal of Obstetrics and Gynecology.Heavy bleeding can be a monthly bugaboo for some women. &amp;quot;A single unusually heavy period probably means you did not ovulate, so your body is not making the progesterone that signals the endometrium to stop growing. The endometrium continues to build up and is eventually released in a heavy flow,&amp;quot; says ob/gyn Gerald Joseph of Ochsner Medical Institutions in New Orleans. You don&amp;#039;t have to live with this, either:  Take replacement progesterone (the most common brand is Provera) for two weeks every month; or &amp;quot;override the whole system with low-dose birth control pills,&amp;quot; Joseph says.  Every day eat one to two tablespoons of flaxseed oil, which contains fatty acids that may help trigger ovulation in midcycle. &amp;quot;Sprinkle the oil on top of pasta, steamed vegetables and even popcorn. It has a mild, buttery taste,&amp;quot; says Lark. &amp;quot;My patients say it evens out their periods.&amp;quot; When to call your doctor: If you experience heavy bleeding (which can cause anemia) or any significant change in your menstrual pattern (which could be a symptom of fertility-threatening fibroids, which are growths on the uterine wall; or polyps, which are tumors in the cervix or uterus; or endometriosis, in which cells of the endometrium grow outside the uterus). These conditions become increasingly common in women after the age of 35. In Your 40s What to expect now:You are either at or near perimenopause, the two- to seven-year phase of irregular periods that precedes menopause. Menopause -- the end of ovarian function -- officially begins after you haven&amp;#039;t menstruated for a year, typically at age 51 for American women. Your cycle statistics: &amp;quot;You experience fewer cycles in which you ovulate,&amp;quot; Lark says. You may have more frequent or -- and this is likelier -- fewer periods. Blood flow may become lighter or heavier than it was before and may last a shorter or a longer time. &amp;quot;There isn&amp;#039;t a sharp linear trend,&amp;quot; Lark explains. &amp;quot;For a few months your period will be atypical for you; then it will snap back to normal.&amp;quot; What&amp;#039;s happening hormonally: The trend that began in your 30s goes on, with estrogen and progesterone levels continuing to vary. Many perimenopausal women, however, experience an estrogen-dominant stage, in which the body cranks up its production of estrogen. &amp;quot;Ironically, you can have more estrogen during this phase than you&amp;#039;ve had at any other time,&amp;quot; says ob/gyn Weiss. This phase can last a few months, alternate with other patterns or, in some women, go on for years and years. If you have fibroids, increased estrogen production is likely to make them grow. Your biggest pain: haywire hormones Your unpredictable physiology may give you PMS for the first time in your life or make it more intense. For women in an estrogen-dominant phase, such symptoms as bloating and breast fullness and tenderness may persist well beyond the weeks when they&amp;#039;re premenstrual. &amp;quot;If you cannot tolerate the symptoms, low-dose birth control pills may help,&amp;quot; Weiss says. And Lark suggests the alternative solutions vitex and flaxseed oil (see &amp;quot;In Your 30s&amp;quot;).Your roller-coaster hormones may also produce hot flashes -- surges in blood flow through your upper body that make you feel warm and sometimes cause you to flush noticeably. &amp;quot;The hypothalamus (located in the brain) regulates body temperature and sex hormones, and one theory is that the proximity of the two functions causes the flushing,&amp;quot; says Lark. Taking low-dose birth control pills, which are progesterone-dominant (as are all birth control pills), is one option, Weiss says. Some doctors suggest treating hot flashes during perimenopause with estrogen/progesterone hormone-replacement therapy, but be warned: &amp;quot;The drug might overload your system with estrogen if you are in a heavy estrogen phase,&amp;quot; says Weiss. It&amp;#039;s also not clear that HRT actually relieves hot flashes in premenopausal women, since they are transient and resolve by themselves. Other means of cooling down hot flashes: vitamin E (at least 800 IU daily) and the herb black cohosh, which contains the plant form of estrogen (80 to 160 mg a day). You can also get some estrogen by drinking three 8-ounce glasses of soy milk or taking 50 to 100 mg of soy isoflavones a day, Lark says. When to call your doctor: If you cramp or experience heavy bleeding. Either symptom may indicate the presence of fibroids, polyps or endometriosis.Your Most Private Period Questions Answered1. Can having sex during your period give you endometriosis? There is a theory, never proven, that endometriosis is caused by a backflow of menstrual fluid. Largely made up of sloughed-off endometrial tissue, the fluid is thought to flow backward through the fallopian tubes and into the pelvic cavity, where the tissue implants itself and starts to grow. &amp;quot;But it&amp;#039;s not at all clear that the thrusting from sex pushes blood back into the tubes,&amp;quot; says New Orleans ob/gyn Gerald Joseph. &amp;quot;Even if that does happen, lots of women have small amounts of a retrograde flow and don&amp;#039;t develop endometriosis.&amp;quot; Bottom line: Have sex whenever you feel like it. 2. Why does my period always stop when I am changing jobs? It&amp;#039;s probably stress. &amp;quot;An excess of cortisol, a hormone your body produces when you are under stress, can throw your sex hormones out of balance,&amp;quot; says Cynthia M. Watson, who practices family medicine in Santa Monica, California. &amp;quot;In some women, the glands that produce sex hormones are much more sensitive to the effects of stress than others,&amp;quot; Joseph adds. 3. Can you get pregnant when you&amp;#039;re having your period? If you have very short cycles, it&amp;#039;s possible, says Joseph. The math goes like this: No matter how long your cycle is, you usually ovulate 14 days before your period begins. But the time between menstruation and ovulation varies a lot. For example, if you have a 28-day cycle, you ovulate on day 14 (28 - 14 = 14). But if your cycle lasts 21 days, you ovulate on day 7 (21 - 14 = 7). Thus if you have sex on the last day of a six-day period, you will have sperm inside you on the seventh day, when you ovulate, and you could conceive.4. I&amp;#039;m in my 20s, and I have been bleeding after my period ends. Most of the time there is no pain. Sometimes I get cramps, however. What could be the cause of this?  &amp;quot;The first question I would ask is whether you are taking birth control pills,&amp;quot; Joseph says. &amp;quot;Lots of women, especially those who&amp;#039;ve been taking pills for several years, experience breakthrough bleeding, in which small amounts of staining and sometimes cramps occur at various points in the cycle.&amp;quot; While this isn&amp;#039;t dangerous, you may wish to change Pill formulations. If you&amp;#039;re not on the Pill, see your doctor: You may have a vaginal infection, a hormonal imbalance or a polyp or a growth in or on the cervix (this last is especially likely if the bleeding only occurs after intercourse). 5. Can I masturbate during my period? Absolutely, says Watson. And as a bonus, an orgasm may help relieve cramps. 6. If you have sex while you have a tampon in, could the tampon be pushed up to the point where you would not be able to feel it or remove it?  Your vagina is a closed pouch, but a tampon could get pushed up too high for you to retrieve it easily. You&amp;#039;d probably be able to feel it if you squatted and inserted a finger in your vagina. If you want to prevent blood from flowing out during intercourse, put a diaphragm in. Since there&amp;#039;s little chance you&amp;#039;ll get pregnant, you can remove (and clean) it shortly after sex.Rare today, toxic shock syndrome made for scary headlines in 1980, when 813 women came down with the blood-poisoning disease and 38 died -- all because of tampon use. &amp;quot;Toxic shock syndrome can happen when tampons, especially really absorbent ones, are left in the vagina, providing the staphylococcus [staph] bacteria already there with an ideal environment in which to multiply,&amp;quot; explains Suzanne Merrill-Nach, a San Diego ob/gyn. Toxins released by the staph bacteria can get into the bloodstream through tiny tears in the vagina and cause a sudden high fever, a rash that looks like a sunburn and flulike symptoms. Women under 30 are most susceptible, presumably because they have not yet produced antibodies to the toxin. Only a handful of cases now occur each year, because tampons have been reformulated to be less absorbent. But physicians insist the danger is still real. &amp;quot;The longer you leave tampons in, the greater your risk of toxic shock syndrome,&amp;quot; says Merrill-Nach, who believes that women should change their tampons at least every six hours. (For sleeping, she suggests wearing pads rather than tampons.) She adds, &amp;quot;If you are using one tampon all day long, you are using too large a size for your flow.&amp;quot; A light flow may also make putting a tampon in uncomfortable, says Santa Monica family practitioner Cynthia M. Watson. &amp;quot;Some women are dry because of the low estrogen during menstruation,&amp;quot; she adds. A minipad may be a better bet.  "^^<http://www.w3.org/2001/XMLSchema#string>
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