If you’ve been diagnosed with endo you may feel a strange mix of worry about the condition and also a bit of relief - finally… all that pain and discomfort makes sense! But if you’ve heard the word ‘surgery’ floating around in your GP’s office and you’re wondering if it could be the solution for you, what it entails, and if it even works, then you’ve come to the right place. Let’s take a look at endometriosis surgery as a treatment, and if it’s right for you.  

Before you think about how surgery could help your endo, you’ll want to consider what’s actually going on in your body. With endometriosis, tissue similar to the lining of the uterus (called the endometrium) starts to grow outside the uterus where it’s not supposed to be. 

When this happens, the hormones that affect the lining of your uterus each month can also trigger any misplaced tissue, leading to mild discomfort at best, and debilitating pain at worst. This tissue can grow on the ovaries, the fallopian tubes, inside the pelvis, and sometimes elsewhere. 

Is surgery the only option for endometriosis treatment?

Definitely not. Before surgery is suggested you will likely be offered other treatments to see if they have a positive impact on your level of pain. This usually includes pain relief medication, anti-inflammatories, hormonal birth control, or hormone therapy. 

For those with severe pain from endometriosis, or other symptoms that are affecting their daily life, surgery may be offered if medication hasn’t improved their situation, or if they are trying to get pregnant. Endometriosis surgery involves finding the affected tissue in the body and removing some or all of it, to lessen their pain. 

What are the different types of endometriosis surgery? 

There are a few options when it comes to surgical treatments for endometriosis, so you’ll need to talk to your doctor about which is best for your specific situation. Endo surgery is often categorised in three ways; conservative, complex, or radical. 

Conservative surgery is usually done using a laparoscopy (sometimes known as keyhole surgery) and allows a surgeon to remove the endometriosis by either cutting it out or destroying it using heat or lasers 

Complex surgery may be used if your endo is more severe and has spread to other organs in the body, like the bowel. Complex surgery can still be done via laparoscopy

Radical surgery is usually a last resort if medication or conservative surgery has not helped the situation, and it involves the removal of the womb (a hysterectomy) and/or removal of one or both ovaries (oophorectomy). This is an irreversible operation that directly affects fertility, so it’s an important decision to make with your doctor’s help 

What’s the difference between laparoscopy and laparotomy?

Laparoscopy surgery is common in endometriosis cases. It’s is a minimally-invasive surgery where tiny incisions are made in the abdomen, the belly is filled with gas to improve visibility inside, and a small camera called a laparoscope is inserted, along with surgical instruments to remove the affected tissue. It is performed under general anaesthesia (you’ll be asleep and remember nothing!), and often patients can go home the same day. 

Laparotomy surgery is sometimes called open surgery and is rarer in endometriosis cases. A larger incision will be made if the surgeon needs access to certain areas inside the abdomen due to more extensive endometriosis tissue. This is also done under general anaesthesia and may require an overnight stay in the hospital as recovery time is slightly longer. 

How effective is endometriosis surgery? 

Most people who have surgery for endo experience less pain afterwards, but it’s important to know that the results don’t always last, so if the pain comes back later in life you may need to undergo the procedure again in future. Research shows endometriosis returns in up to 20% of patients within 5 years of laparoscopy or laparotomy surgery, while around 15% of patients who undergo a total hysterectomy will experience further endo pain later in life. 

How do I know if endometriosis surgery is right for me? 

Endometriosis normally takes a while to properly diagnose, and once you have a diagnosis it may take several months or years of trying out different medications and treatments to see what works for your condition. However, at any point you can speak to your doctor about surgery options to find out what may be right for you, depending on your level of pain and personal circumstances. 

For example, if you have severe pelvic pain, are having trouble getting pregnant, or you have a growth that needs to be removed, your doctor may suggest surgery sooner. In contrast, if you are close to menopause you may wish to avoid surgery as endo pain tends to disappear on its own after menopause. 

As with any surgery, there are always risks like infection, but complications are rare so if you have weighed up the pros and cons and feel that surgery is right for you, speak to your doctor to find out more. 

Have you had endometriosis surgery? You can share your experience in our Full Stop FB group, or if you have questions about the procedure feel free to reach out to us on Instagram at @itsyoppie. Don't forget that our personalised menstrual cycle subscription box can get organic tampons, PMS supplements and much more delivered easily and regularly through your letterbox, to give you just a bit more peace of mind each cycle.

Should You Get Endometriosis Surgery?

No matter your age, the ‘C’ word is scary. Cancer research has come a long way, but in the UK ovarian cancer will still affect as many as 7,500 people a year, so instead of burying our heads in the sand on this topic we thought we’d focus on sharing the signs and symptoms to improve everyone’s chances of early intervention. Ovarian cancer and periods are pretty closely related, so here’s everything you need to know…

Our bodies are made up of billions of cells, and these cells group together to make our tissues and organs… so they’re pretty essential! Cells typically divide in order to replace older cells, but when this process goes wrong the cell continues dividing until it forms a tumour. These can either be benign (non-cancerous = won’t spread) or malignant (cancerous = can spread). 

Ovarian cancer occurs when these abnormal cells develop in the ovary and eventually form a tumour. Like many other types of cancer, if this is not discovered early it can spread to other tissues nearby and other parts of the body, making it more difficult to treat. 

Yes, there are several types of ovarian cancer, which include:

Epithelial ovarian cancer - The most common, affecting around 90% of ovarian cancer cases. This is similar to primary peritoneal cancer and fallopian tube cancer, and these are often treated in a similar way

Germ cell ovarian tumours - This type is rare, and typically affects young people with ovaries up to their early thirties

Sex cord stromal tumours (SCSTs) - These can be cancerous or non-cancerous

Borderline ovarian tumours - These are abnormal cells that develop in the tissue covering the ovary. They’re usually non-cancerous and treated with surgery

What are the chances of developing ovarian cancer? 

In the UK, around 7,500 people are diagnosed with ovarian cancer every year, which makes it the 6th most common type for people with ovaries. Often, cancer survival rates are calculated by looking at how many people survive for 5 years after diagnosis, and in the case of ovarian cancer this is 49.1%. 

While this may seem like a worrying number, it’s also important to know that if ovarian cancer is found and treated early (still in stage 1) then the 5-year survival rate is 94%, proving early diagnosis and treatment is key, and knowing the signs and symptoms to watch out for can give you extra peace of mind. 

Who is most likely to develop ovarian cancer? 

If you’re wondering what risk factors apply to you, there are two main ones. The first, like with many other types of cancer, is age. People over 50 have a higher risk of developing ovarian cancer; the majority of cases are found in those who have already gone through menopause, and more than half occur in people over 65. 

If you are younger, it’s not as common but it does still happen, mainly due to family history of a similar type of cancer. Around 15-20% of cases are believed to be caused by an inherited gene, often the BRCA1 or BRCA2 gene, so if a close relative has had breast or ovarian cancer, you may be at a higher risk. 

However! You shouldn’t consider this an inevitability, because 80-85% of ovarian cancer cases are not inherited, so just because your relative has had it doesn’t mean you definitely will. There are a few other risk factors, like diabetes, use of hormone replacement therapy, endometriosis and smoking, but the most common come from age and family history.

What symptoms do I need to watch out for? 

We never want to scaremonger with symptoms, but we believe recognising symptoms in advance means if anything seems different in your body, you can notice it straight away and get early treatment. In the case of ovarian cancer, noticeable early symptoms can be difficult to detect, but they usually include: 

Feeling full very quickly after eating, or an upset stomach 

Changes in bowel movements, and/or needing to urinate more frequently 

Changes to your period, such as heavier or irregular bleeding

I think I have symptoms - what should I do?

If you experience some of the symptoms above or you are at a higher risk of ovarian cancer, visit your GP to get checked. Better safe than sorry applies in this case, and although it’s most likely nothing to worry about, you should never feel embarrassed to see your doctor for whatever is worrying you. 

Treatment for ovarian cancer depends on a few different factors, such as where the cancer is located, what stage of growth it’s at, the specific type of cancer, and your personal health, medical history and fitness levels. 

If surgery is recommended, this can involve the removal of the ovaries, fallopian tubes, cervix and/or womb. Some or all of these organs can be removed, depending on how far advanced the cancer is. If it has spread elsewhere, further surgery may be required. Other things that may be recommended either on their own or alongside surgery are chemotherapy, radiotherapy, hormone treatments and more. 

Is there anything I can do to prevent it? 

Unfortunately, there are currently no guaranteed ways to prevent ovarian cancer, but birth control pills have been found to reduce the risk. Contraceptives don’t suit everyone, so you’ll need to weigh the benefits vs potential side effects with your GP, but if you are particularly worried about developing ovarian cancer (whether due to your age or family history) then it may be worth having this discussion with your doctor. 

Also, telling your doctor about any family history means they can make the best recommendation for your specific situation, such as going ahead with genetic testing to determine your risk and potentially consider preventative surgery. 

Cancer is a tricky subject! We hope we’ve answered any questions you have about ovarian cancer, but if you have any other queries or concerns, you can talk to us and others in our Full Stop FB group, or get in touch with us directly on Instagram at @itsyoppie. Don't forget that our personalised menstrual care subscription can get organic tampons, PMS supplements and much more delivered easily and regularly through your letterbox, so that's one less thing to worry about with everything that can be going on down there.

Ovarian Cancer & Periods: Symptoms To Watch For

If you’re a regular reader of the Full Stop blog for info on PCOS, then you’ll probably have seen insulin mentioned in the past, and how the condition is linked to type 2 diabetes. We thought we’d do a deep dive on this topic; is there a relationship between the two? What’s insulin got to do with it? Can one cause the other? Let’s get into it… 

The relationship between polycystic ovary syndrome (PCOS) and type 2 diabetes comes down to one common factor: insulin. PCOS affects the endocrine system, and as a result can cause insulin resistance. This means high levels of insulin are produced by the pancreas which can cause an adverse reaction - hello type 2 diabetes! Researchers are still unsure of how some types of PCOS can cause insulin resistance, but numerous studies have found there is a connection. 

According to Diabetes.co.uk, a 2012 UK study found the risk of developing type 2 diabetes was notably higher for those with PCOS, and data collected in Australia found subjects with PCOS were 4 to 8.8 times more likely to develop type 2 diabetes. Similarly, a 2017 study of Danish women found those with PCOS were 4 times as likely to get type 2 diabetes, and tended to be diagnosed on average 4 years earlier than those without PCOS… it’s clear there are more than a few signs suggesting a strong link between the two!

Yes, it can. Insulin resistance is a major contributing factor to PCOS, and increased insulin levels can cause weight gain. As a result, type 2 diabetes can develop over time. People with insulin resistant PCOS have been found to be around 40% more likely to develop type 2 diabetes at some point in life, so dealing with PCOS symptoms and starting to implement healthy habits as early as possible is hugely important. 

There is no research to suggest this works the other way around. However, according to the CDC, if your mother or sister has type 2 diabetes you may be more likely to develop PCOS. If this is the case for you, you may want to monitor yourself for symptoms of PCOS more closely than most. These include missed, irregular or very light periods, excess body hair or thinning hair on the head, weight gain, acne or oily skin, or fertility issues. If you have symptoms, speak to your GP to check this out. 

At what age do I need to worry about PCOS and diabetes?

If you have been diagnosed with PCOS, it’s best to consider the connection to type 2 diabetes and implement healthy lifestyle habits as early as possible. People who have PCOS in young adulthood have an increased risk of diabetes in later life, so learn how your body works in order to recognise the early warning signs.

As you get older, type 2 diabetes becomes more of a possibility; one study found the risk of type 2 diabetes goes up for middle-aged people with periods who haveh PCOS, while the Office on Women’s Health say around half of those with PCOS tend to develop either diabetes or prediabetes before age 40. There is also research suggesting around 27% of premenopausal people with type 2 diabetes also have PCOS, so it’s clear at every stage in life there remains a link. 

Several lifestyle factors must be considered when talking about the possibility of type 2 diabetes, such as stress levels, the amount of sleep you get, the amount of exercise you do, your diet, and so on. Probably the most crucial area to look at is weight, as type 2 diabetes is known to occur more commonly in overweight or obese individuals. Studies have concluded people with PCOS are more likely to be overweight, but it’s not always the case; some are more insulin-resistant than others, no matter their BMI. 

If you’re overweight, speak to your doctor about getting support to lose weight in order to improve your symptoms and avoid prediabetic issues. If you are not overweight but you have PCOS, you should still be checked by a doctor semi-regularly to ensure the condition doesn’t develop into type 2 diabetes down the line. 

If you have PCOS, regular check-ups are important to make sure you are not inching into prediabetic territory. Prediabetes can still be reversed with lifestyle changes, but once you become fully type 2 diabetic it’s much more difficult. Watch out for symptoms of prediabetes, such as increased thirst, frequent urination, excess hunger, fatigue, and blurred vision. 

If you suspect you may be having issues with blood sugar or any of these symptoms, don’t delay visiting your doctor to make sure everything is as it should be. If it’s not, they can recommend lifestyle changes to keep you at optimum health and help you avoid developing type 2 diabetes later in life. 

Got a question about PCOS, type 2 diabetes, or both? Reach out to our Full Stop FB group, or come say hello to us directly on Instagram at @itsyoppie. Don't forget that our personalised menstrual care subscription can get organic tampons, PCOS supplements and much more delivered easily and regularly through your letterbox, to help keep at least some of that PCOS annoyance under control each month.

PCOS And Diabetes: What You Need To Know

Despite the pain and discomfort caused by endometriosis, one of the worst symptoms of all can be the fatigue that comes along with it. Constant fatigue affects every area of your life, so if you experience this and you’re wondering what to do about it, we’re diving into the physical and emotional tiredness that can occur when living with long-term endometriosis:

How many people experience endometriosis fatigue?

It appears to be common. One study of 1,120 people with endo and 560 without found 50.7% of those with endo reported frequent fatigue, compared to just 22.4% of those without. Results remained consistent when researchers considered factors like BMI, history of depression, insomnia and more. No matter how intense other endo symptoms may be, fatigue can be present and negatively affect many areas of life. 

What is endo fatigue and why does it happen?

In other words… what is it about this condition that makes people so bloody tired?! It’s thought endo-related fatigue happens as a result of the body trying to get rid of diseased tissue. The immune system tries to attack endometriosis, causing cytokines (inflammatory toxins) to be secreted by the tissue, and these chemicals are often the cause of fatigue. 

Similar to when you feel fatigued and run-down during a bout of flu, it happens when your immune system is busy fighting something off, which takes up all your energy. Heavy menstrual bleeding is another common symptom of endo, and losing a lot of blood can lead to low iron and possible anaemia, which is known to cause fatigue. 

Why do I keep hearing about chronic fatigue syndrome? 

Chronic fatigue syndrome (CFS) is pretty much what it says on the tin; a long-term, sometimes inexplicable symptom of tiredness - in many cases, symptoms of endo can lead to this. CFS has been found to be more common in people with periods, and one 2011 study suggested those who have experienced endometriosis, ovarian cysts, irregular periods, gynaecological surgery or pelvic pain are more likely to develop CFS. 

“When I was first diagnosed [with endometriosis] I became extremely tired, even having a shower would leave me in bed for the rest of the day. I was later diagnosed with Chronic Fatigue Syndrome (CFS).”  - Louise, speaking to Endo UK

Is my endo fatigue anything to worry about? 

You shouldn’t put up with endometriosis pain, and we would encourage anyone with symptoms to visit their GP and discuss what can be done. That said, it’s not life-threatening, just incredibly frustrating, as extreme tiredness can cause you to miss out on things in favour of sleep or rest, and affect how much energy you can give to certain areas of life, for example, career, relationships, time with your kids, social activities, and more. 

In one study, 22 subjects reported feeling endo-related fatigue with varying intensity, and the majority said their tiredness was at least “somewhat bothersome”. If at the very least you experience mild fatigue every month, this is still something to discuss with your GP.

How do I handle the physical fatigue of endometriosis? 

Just like when we said it’s similar to having the flu; endometriosis fatigue can be due to a chemical reaction in the body, and therefore it’s unlikely you’ll be able to simply ‘sleep it off’.

Speak to your doctor to discuss treatment possibilities like medication, hormone therapy or surgery. They may also want to check your blood to ensure nothing in your iron levels, blood sugar or thyroid hormone could be contributing to your fatigue.

A healthy diet rich in protein can boost energy throughout the day. You could also try avoiding excess sugar, anything processed, and any ‘junk food’ for a while. 

Supplements can also improve your energy levels and have you feeling loads better in just a few weeks. Your doctor can recommend any nutritional gaps you may have. 

When you’re feeling lethargic, exercising is the furthest thing from your mind, but maintaining a gentle, low-impact exercise routine can actually improve fatigue. Try short workouts, yoga, swimming or walking to improve energy levels. 

Maintain a healthy bedtime routine to improve daytime fatigue. 7-9 hours is recommended, but try to get as much as possible by going to bed at the same time each night, having a bath beforehand, avoiding screens - all that good sleep hygiene!

How do I handle the emotional fatigue of endo? 

Endo-related fatigue is a symptom that can take a real toll on your mental health, so it’s important not to fight against tiredness, but rather, accept your need for more self-care and compassion than you may normally give yourself. Understand your body’s limitations and try restorative activities to maximise the times when you’re feeling more energised. 

Talking to others about your fatigue can also help. Covering up why you can’t make certain social plans may work as a short-term solution, but it’s much better to let friends and family know what you’re experiencing and the times when you are more likely to feel your best. If cocktail night tends to wipe you out, ask your friends to go for brunch instead - adjust your plans for a while to help manage your social life while still giving your body rest time.

Should I speak to my doctor about my fatigue?

Yes! Yes, a thousand times, yes. Please don’t ever feel that tiredness is something you can’t speak to your doctor about. If it’s negatively impacting your life, get advice on how to lessen its effects, and hopefully treat the root of the problem. 

Do you suffer from endometriosis-related fatigue? We’d love to find out how you manage it day-to-day so we can continue to share advice with others. You can ask questions on our Full Stop FB group, or reach out to us directly on Instagram at @itsyoppie. Don't forget that our personalised menstrual cycle subscription box can get organic tampons, PMS supplementsand much more delivered easily and regularly through your letterbox, which is one big load off your mind each cycle.

Daily Life With Endometriosis Fatigue

If you’ve spent any time on the Full Stop blog, you’ll have heard the word ‘progesterone’ before, so we’re breaking down everything there is to know about this hormone. Let’s take a look at what it is, its function in the body and menstrual cycle, and the signs that indicate your progesterone levels may be out of whack. Let’s go…

According to the Society for Endocrinology, progesterone is one of a group of steroid hormones called ‘progestogens’, and it’s secreted by something called the corpus luteum inside the ovary. This happens in the second half of your menstrual cycle, and it’s important for maintaining the early stages of pregnancy, among other things. 

Is progesterone different from progestin?

Ah, yes - good question! Progeste-rone is the hormone that occurs naturally in the body, while proge-stin refers to a synthetic version that’s created in a laboratory and used for a number of medical reasons, most commonly in oral contraceptives and hormone replacement therapy. It’s pretty much the same thing and has a similar function, but one already exists within the body, and the other is man-made. 

OK, let’s get into the nitty gritty of its function. When the level of luteinizing hormone rises in the middle of your menstrual cycle, ovulation occurs, which means an egg is released from one of the ovaries. When this happens, the corpus luteum (a regular cyst that forms on the ovary every month) appears and begins to produce progesterone. This happens in order to prepare the body for pregnancy by encouraging glandular development and new blood vessels - the ideal conditions for a fertilised egg to implant. 

If the egg doesn’t implant, the corpus luteum breaks down, causing progesterone levels to dip again, which triggers your period. If a pregnancy does occur, the corpus luteum sticks around and continues to produce progesterone, which keeps blood vessels stimulated to supply the endometrium and provide nutrients to the embryo. As the placenta forms, it produces more progesterone than the corpus luteum, and this level remains constant throughout pregnancy. Along with its many other functions in the body, progesterone also helps to encourage the lactation process. 

If your progesterone levels are too high, it’s mostly nothing to worry about, but it is sometimes associated with a condition called congenital adrenal hyperplasia. High levels of progesterone are thought to occur because of this condition, they do not cause it. 

If you’re wondering whether or not the progestin in your hormonal birth control could cause it to rise to a dangerous level, the answer is: probably not. High levels of progestin are thought to be associated with a slightly increased risk of developing breast cancer, but there’s still a lot of research to be done in this area, so if this is something you are worried about, speak to your doctor about your concerns.  

Progesterone is mainly important if you are trying for or having a baby, so if your progesterone levels are too low you may encounter fertility issues, or issues with your pregnancy, but your doctor will monitor this to make sure everything is as it should be. If you aren’t pregnant or trying, there are other (mostly harmless) symptoms you may want to get checked out. These include headaches or migraines, mood changes like anxiety and depression, an irregular menstrual cycle or abnormal bleeding. 

If progesterone is too low, estrogen can sometimes become the primary hormone, which can lead to symptoms like weight gain, mood swings, low libido, depression, an irregular cycle or heavy bleeding, breast tenderness, fibroids, and gallbladder issues, so keep track of any symptoms your doctor may need to know of so they can decipher what the issue may be. 

Why does my doctor want to test my progesterone levels?

There are a few reasons your doctor may want to test your progesterone levels. This could be to find out why you are experiencing fertility issues, why you may have abnormal bleeding, to diagnose an adrenal disorder, or something else. Overall, testing your hormones just makes sure they’re doing what they’re supposed to do each month.

What are the signs that progestin is causing a problem?

If you’re taking birth control or another medication that contains progestin, you can keep an eye out for side effects that include headaches, breast tenderness, tummy issues, appetite changes, weight gain, fatigue, muscle pain, mood swings, anxiety, discharge, and more. 

It’s also important to check for more serious symptoms that need attention, such as any changes in the breasts, migraines or dizziness, changes in speech, coordination or ability to swallow, weak limbs or leg swelling, shaky hands or seizures, breathlessness, a racing heartbeat or chest pain, coughing up blood, blurred vision or eye changes, unexpected vaginal bleeding, stomach pain, skin rashes, and any unidentifiable swelling. 

This list may seem exhaustive, but many of these symptoms can indicate a problem that needs medical attention sooner rather than later, so speak to your GP or call 111 if in doubt. 

Got a question about progesterone? We’re all ears! Ask away over in our Full Stop FB group, or reach out to us directly on Instagram at @itsyoppie. Don't forget that our personalised menstrual cycle subscription box can get organic tampons, PMS supplements and much more delivered easily and regularly through your letterbox, so that's one less thing you'll need to keep an eye on.

Menstrual Cycle Progesterone: What's It For & What It Does

If you suffer from anxiety attacks, you’ll know how scary, inconvenient and downright annoying they can be… but what triggers them? There are lots of reasons an anxiety attack might rear its ugly head, and turns out your PMS could be to blame. We’re looking at what anxiety attacks actually are, why hormones could be responsible, and how to manage them.

You’ll likely have heard the terms ‘anxiety attack’ and ‘panic attack’ used interchangeably as the symptoms are often the same, but there are some differences between the two. Symptoms of anxiety and panic attacks include a sudden, intense feeling of anxiety or fear, racing heartbeat, feeling faint or dizzy, feelings of losing control, sweating, shaking, rapid breathing, a tingling feeling, nausea, and more. 

These can last anywhere from 5 to 30 minutes, and although they’re scary, they aren’t physically dangerous. Sometimes it can be hard to distinguish the difference between a panic attack and anxiety attack, but it’s thought that anxiety attacks are mostly triggered by something seemingly stressful or threatening, and can have different levels of intensity, while panic attacks are immediately very intense and seem to appear out of nowhere.  

Looking at general anxiety, there are many reasons why this occurs. Common causes are anything that induces stress, like work pressure, financial issues, family or relationship issues, big life changes like moving house, divorce or death, and more. Other conditions that can trigger more severe anxiety attacks include social phobias, (PTSD) post-traumatic stress disorder, certain medications, or having a history of substance abuse.

Unfortunately, when it comes to anxiety and panic attacks, there’s often a vicious cycle at play; the person experiencing them becomes fearful of having another attack in public or a specific situation, and avoids this situation, leading to stress, leading to further attacks. 

Dan Harris, an American television host and author of the book 10% Happier, famously experienced a panic attack live on television, and realised his hectic lifestyle was to blame: 

“... what I had experienced on air was an overwhelming jolt of mankind’s ancient fight-or-flight response, which evolved to help us react to attacks by sabre-toothed tigers or whatever.” - Dan Harris, author of 10% Happier

For people with periods, the cause of anxiety and panic attacks could be a little different. Anxiety in general is a common symptom of PMS, due to changing levels of the hormones estrogen and progesterone. When levels rise and fall frequently during your cycle it can affect the neurotransmitters in your brain, like serotonin and dopamine, which control your mood. This is what leads to emotional symptoms of PMS such as depression, mood swings, and our old friend anxiety. 

Research suggests if you already suffer from anxiety attacks or panic attacks, then your PMS could intensify these. Also, if you suffer from a more severe form of PMS, called PMDD (premenstrual dysphoric disorder), this can cause panic attacks. One study suggests people with periods may be more susceptible to panic attacks due to hormones making them more reactive to external stressors. Another study confirms this, finding 41% of the sample reported “premenstrual worsening of panic symptoms”.

Panic attacks are a recognised symptom of PMDD (premenstrual dysphoric disorder) so if you suffer from these attacks around the same time each month, look out for other symptoms of PMDD, which include an intense irritability or anger that can affect your relationships, extreme feelings of sadness or despair, or even thoughts of suicide, intense anxiety, brain fog, fatigue, trouble sleeping, and more. If you suffer from several of these symptoms then PMDD is a possibility, and you should discuss this with your doctor. 

Managing anxiety attacks or panic attacks is easier said than done, as they can be very scary in the moment. If you are worried about anxiety attacks in day-to-day life, there are some things you can do to help prepare and ease them quicker. When an attack comes on, counting slow, deep breaths can help, but it’s mostly about remembering some key information until it passes. If possible, keep in mind:

You’re not trying to fight the attack - just let it pass

It’s not life-threatening, even if it feels like it in the moment 

It will pass, sometimes in a matter of minutes

No one around you is judging you, they only want to make sure you are OK

After an attack, pay attention to what your body needs, rest up, and if you feel up to it, tell someone you trust what happened. If you spend a lot of time with this person, let them know the signs to watch out for so they know if you’re having another one, and what to say to help you get through it. 

Having anxiety attacks at certain times during your cycle should put your mind somewhat at ease, as this confirms it’s a hormone issue and there’s nothing physical to worry about. That said, it doesn’t make them more fun or easier to manage! 

If you experience attacks throughout the month, or severe panic attacks, it’s best to speak to your doctor so they can ensure any other symptoms (such as a racing heart, nausea, etc.) are nothing serious, and start treatment that may include psychotherapy or medication. 

Do you suffer from PMS-related anxiety or panic attacks? We’d love to know your tips for managing them in daily life. Chat to others about this over in our Full Stop FB group, or reach out to us on Instagram at @itsyoppie. Don't forget that our personalised menstrual cycle subscription box can get organic tampons, PMS supplements and much more delivered easily and regularly through your letterbox, which is one less thing to worry about through the month.

What's Up With PMS & Anxiety Attacks?

Jeez, make up your mind already! If your period keeps starting… then stopping… then starting again, and you can’t seem to find a pattern, you may have irregular periods, also known as oligomenorrhea. If you’re wondering what the heck is going on, here’s a deep dive on all things irregular periods. Let’s see what could be happening to your body.

What does it mean to have irregular periods? 

Having irregular periods means the length of your menstrual cycle and your bleed keeps changing, with periods arriving early or late every time and not lasting the length you expect. The average is 28 days, but not everyone will experience a cycle that’s exactly 28 - most will be shorter or longer. When puberty is over, most people end up with a cycle with a similar length of time between periods, but it’s normal for this to fluctuate by a few days each time. 

Irregular periods are normal during puberty, and if this has always been the norm for you then it’s likely fine. If not, the most common reasons for experiencing irregular periods after puberty include the use of hormonal contraception, extreme weight loss, stress, pregnancy, the beginning of menopause, or an underlying medical condition (we’ll cover these later). 

Is it normal for periods to stop and start?

For some, yes. Periods that are start/stop are pretty common, with around 14-25% of people with periods experiencing irregular menstrual cycles, according to the National Institutes of Health. It is thought that the average person loses around 2-3 tablespoons of blood in one period, consisting of some blood and some tissue from the lining of the uterus.

Sometimes this lining doesn’t shed at regular intervals, so you may have lighter and heavier days. And sometimes tissue can block the flow of blood through the cervix, resulting in a lighter flow, and potentially a start-stop pattern. If your period still lasts 3-7 days, a little fluctuation in blood flow is considered normal and probably nothing to worry about. 

What if the stop-starting happens throughout the month? 

Having a period that stops and starts frequently is often the result of hormone fluctuations. While bleeding, your estrogen and progesterone levels are low, and in the first 4 or 5 days of your cycle the pituitary gland produces more follicle-stimulating hormone (FSH) while your ovaries produce more estrogen. Then around days 5 to 7 estrogen levels reach their peak, the pituitary gland releases luteinizing hormone (LH), and progesterone levels go up. 

So there’s quite a lot happening hormone-wise! And all that activity can result in - for some people - periods that start, then stop, then start again. Hormones are typically the culprit, but outside factors that also affect this include being overly stressed, losing a lot of weight very quickly, over-exercising, pregnancy, breastfeeding, and some underlying health conditions. 

Usually irregular periods are nothing to worry about, but if you used to have a regular flow and it’s changed recently, it’s probably best to get it checked out. In some cases, a change in period flow or regularity could be an indication of an underlying health condition, such as:

Fibroids - abnormal benign growths that grow in or on the uterus

Endometriosis - when tissue grows outside the uterus, where it’s not supposed to be 

Polycystic ovary syndrome (PCOS) - when the ovaries produce excess androgen hormones and sometimes small cysts form in the ovaries

Can irregular periods themselves cause any issues?

Usually, no… but sometimes yes. Irregular periods that last a long time could cause you to be more susceptible to other issues:

Iron deficiency, or anaemia: If you lose a lot of blood due to more frequent periods, you could develop an iron deficiency 

Fertility issues: Irregular periods could mean you’re not ovulating, and therefore could struggle to get pregnant if you are trying to have a baby 

Osteoporosis: The ovulation part of your cycle produces more of the estrogen hormone, which - fun fact - helps keep bones strong! If you don’t ovulate, you may have less estrogen and have a higher risk of osteoporosis

Cardiovascular disease: As above, a lack of estrogen can also increase your risk of cardiovascular disease

Endometrial hyperplasia: Without regular periods to shed the uterine lining, you could be at higher risk of developing this condition in which the uterus lining becomes abnormally thick. This can increase the risk of endometrial cancer, so it’s important to have it checked out 

Irregular periods may not seem like something to go to a doctor about, but if you have just started experiencing a random pattern of periods and you don’t know why, it’s probably a good idea to get it checked out to make sure everything is A-OK. Similarly, if you are in any pain, you should always see your doctor to rule out anything serious. 

You get abnormally heavy bleeding (as in, need more than one tampon or pad every hour for a few hours)

Your periods last longer than 7 days (yikes!), or they’re less than 21 days apart, or more than 35 days apart 

Your periods have disappeared for longer than 3 months (and you’re not pregnant)

You have bleeding or spotting between periods, or experiencing unusual discharge 

You experience any severe or new pain during your period, or nausea and vomiting

You have any of the symptoms of TSS (toxic shock syndrome) like fever, diarrhoea or dizziness

Still wondering why your period might be irregular? You can chat with others over on our Full Stop FB group, or reach out to us directly on Instagram at @itsyoppie - we’re always happy to help you find the answers you need! Don't forget that our personalised menstrual care subscription can get organic tampons, PMS supplements and much more delivered easily and regularly through your letterbox, whatever your flow.

Periods Stopping & Starting: What's Happening?

PCOS has a lot to answer for, but whether its symptoms include worse period pain is up for debate. We’re taking a closer look at how PCOS affects menstruation, and answering the big questions; is this what’s making your period pain worse? What’s with the heavy bleeding and irregular menstruation? When is it time to see a doctor? Let’s dive in. 

PCOS stands for polycystic ovary syndrome and it’s thought to affect around 1 in 10 people who menstruate in the UK. It’s when the ovaries contain harmless follicles that can grow up to 8mm in size. These are underdeveloped sacs where eggs grow, but in those with PCOS the eggs don’t always release, which means ovulation doesn’t always occur. The main feature of PCOS is irregular periods due to lack of ovulation, but could it be the cause of painful periods too? 

One of the main symptoms of PCOS is having irregular periods or in some cases no periods at all. Some people with PCOS may also experience heavy bleeding during menstruation - the technical name for this is menorrhagia. It’s caused by low levels of progesterone associated with PCOS. But how much blood is too much, you ask? 

Good question. Menorrhagia is often characterised by heavy bleeding that lasts more than 7 days, and while the average blood loss in a normal period is around 40ml, those with menorrhagia might pass more than 80ml of blood, and experience clots too. 

How does irregular or heavy bleeding occur? 

There are different intensities of PCOS, but if you have the condition, your cycle most likely works a little differently to others; each month, a follicle matures and is released by an ovary to be fertilised, but if you have PCOS you may have high levels of androgen hormones (like testosterone) which interfere with ovulation. This hormone imbalance causes the follicle not to develop or release, and instead it just stays put in the ovaries. 

But what’s with the heavy bleeding? When ovulation doesn’t occur, the uterus doesn’t know it’s time to shed its lining, and so your period may not arrive on cue like it should. This looks different for everyone with PCOS, as some people experience a regular cycle with no issues and will bleed every 28 days, while others may only have a period every 30-40 days, making it much heavier. Or they may not get a period at all. 

If you’re of the mindset that fewer periods is a good thing (who needs ‘em, right?!) you should still see a doctor if you are getting fewer than 8 or 9 periods a year, as this can negatively affect your long-term health. 

So could PCOS be what’s causing my painful periods? 

PCOS is known to make periods heavier, irregular, or disappear entirely, and produce what’s considered a ‘normal’ level of period pain from cramps, but there’s little research on whether or not it’s the cause of severe period pain. Although PCOS can lead to heavy periods, and enlarged ovaries with cysts which could be the cause of severe menstrual pain, it’s less likely this is the case and more likely there’s another condition at play. 

The more likely scenario is a secondary condition, such as endometriosis, which is known to make periods severely painful. If you have already been diagnosed with PCOS and you’re experiencing intense pains, it may be a good idea to get this checked out to make sure nothing else is going on. Don’t assume it’s PCOS and put up with it; if in doubt, go see your doctor. It’s rare to have both PCOS and endo, but it’s not impossible. 

What can I do about intense period pain? 

The first step is always to see your GP so they can rule out any major issues and find the root of the problem. Your doctor can recommend treatments for PCOS or any other condition they find to be causing the pain. Alternatively, they may simply treat the pain itself by recommending a change in diet and exercise to improve your overall health. If you have PCOS, a healthy diet is often recommended as this can help your body to utilise insulin more efficiently, lower blood glucose levels, and increase ovulation activity.

Your doctor may also treat period pain by recommending hormonal birth control to help regulate the menstrual cycle and lower androgen levels. In rare cases, some other medications are recommended (like diabetes medication) which can be used to lower insulin resistance in people with PCOS and reduce androgen levels to help with regular ovulation.

How can I speed up the process of diagnosis? 

Although doctors are much more aware of period-related conditions than in years gone by, it’s still helpful to provide as much information as possible about the symptoms you are experiencing in order to get to the root of the problem faster. 

Keep a diary of your symptoms and any other helpful information that can offer insight into your day-to-day. Doctors can use this to spot patterns and figure out what might be going on with your hormones. Write down symptoms like period pain and heavy bleeding, how long they last, when they occur. If you take painkillers for period pain, it’s also a good idea to write down what kind you take and how often you need them. The more information you can provide, the easier diagnosis will be, and the quicker you’ll be treated. 

Got a question about PCOS or period pain? Our Full Stop FB group is a great place to discuss symptoms with others who may have similar conditions. You can also reach out to us directly on Instagram at @itsyoppie, and our team will do our very best to help. Don't forget that our personalised menstrual care subscription can get organic tampons, PMS supplements and much more delivered easily and regularly through your letterbox, to help keep at least some of that PCOS pain under control each month.

PCOS Period Pain: Is It Really Worse?

Those with long-term endometriosis symptoms will know it can take over your whole life. From career to relationships to simply doing your weekly food shop; everything is affected when symptoms arise, and while sometimes they only show up during your period, this isn’t always the case, and the mental health symptoms of endo can appear any time. Let’s look at what’s causing them and how to cope…

What are the physical symptoms of endometriosis? 

Endometriosis is a condition where tissue that’s supposed to grow in the uterus grows elsewhere in the pelvis, like the ovaries and fallopian tubes. The main physical symptoms of endo typically happen in conjunction with your period - but not always.

These include pelvic pain, cramping, lower back and abdominal pain, pain during or after sex, pain when going to the toilet, excessive bleeding, bleeding between periods, fertility issues, fatigue, and more. Just a whole lot of pain and discomfort really! Everyone experiences different levels, but whether symptoms are mild for you, or severe and debilitating, you could still experience emotional symptoms alongside. 

These can include low mood, anxiety, depression, irritability, and more. One 2013 study found people with endo had a lower quality of life, with the reasons being primarily chronic pain and dyspareunia (pain during sex). The study found around 86% of 109 patients reported depression symptoms, while 87% reported anxiety symptoms.

What’s causing these emotional symptoms? 

According to a 2017 literature review, people with endometriosis reported high incidences of psychiatric conditions like depression and anxiety, and while research suggests there is a link between the two, it’s not clear whether or not endo directly causes depression. Here are some of the other potential causes:

A 2018 meta-analysis suggested endo sufferers who experienced pelvic pain as a primary symptom had significantly higher rates of depression. Researchers recommend further study in this area, as it’s unfortunately difficult to untangle this vicious cycle: your endometriosis causes chronic pelvic pain, which leads to psychological distress, which leads to increased pelvic pain, and the cycle continues. 

If fatigue is your primary endo-related concern, this could be what’s causing your emotional symptoms. Endo fatigue happens when the body tries to get rid of diseased tissue, causing cytokines (proteins that are inflammatory modulators) to be secreted, causing fatigue. Endo-specific fatigue can cause a change in attitude; a good example of this is if you have ever found yourself skipping day-to-day activities when you’re normally a social butterfly. 

Studies have also found those with endometriosis sometimes suffer from lower self-esteem and negative body image due to, for example, limitations the body experiences when in pain, or physical changes from endo surgery scars, weight gain from hormonal therapy, and more. 

Endometriosis is known to cause fertility issues for some people, so those who are trying for a baby and struggling to conceive may also experience emotional symptoms such as depression and anxiety. 

And then there’s the fact that as of 2017, getting an endo diagnosis in the UK took on average 7.5 years. Yes, years. One study titled ‘The social and psychological impact of endometriosis on women's lives’ stated “Several papers suggest that prior to diagnosis, women commonly experience repeated visits to doctors where symptoms are normalized, dismissed and/or trivialized, resulting in women feeling ignored and disbelieved.”

Very good question! If you are in a relationship and suffering from endometriosis, or you are in a relationship with someone who has the condition, it can affect the mental health of both partners. It’s difficult to see a partner in pain, and this can have a negative impact on the quality of your life together; work, social responsibilities, childcare, financial responsibilities, your sex life, everyday tasks around the house and more, it’s all at risk of disruption. 

Whichever side of the coin you find yourself on, communication is key. As the person in pain, sharing what you need will help your partner learn how to support you, and remember you can both attend a GP appointment together if you feel comfortable, to support each other, absorb information, and discuss the best possible treatment for you and your family. 

My endometriosis is taking over my life. What can I do about it? 

If you are experiencing any of the symptoms mentioned above, under no circumstances should you be ignoring the pain or downplaying it - whether you suspect endometriosis or not, go see your doctor without delay. 

Although historically many people have struggled to get a diagnosis for endo, there is now much more awareness around this condition, so speak to your doctor about possible treatments which may include pain medications, hormone therapy, fertility treatment, and in some cases surgical treatments. Treating the underlying endometriosis can have an immediate and significant positive impact on your mental health.

Dealing with chronic pain is a notoriously difficult thing to handle, and although your doctor can help you get a proper diagnosis and improve your symptoms, in the meantime maintaining a healthy lifestyle (such as exercising when possible and eating nutritious foods) can help you feel more in control of your symptoms. 

In addition, joining a community of others with similar issues could provide a place to talk it out. Endometriosis UK has a list of support groups focused on living with endo, and you can also join our Full Stop FB group to discuss it with others suffering from their own period-related conditions.

Got a question about endometriosis and mental health? You can always reach out to our friendly team on our Instagram at @itsyoppie. Don't forget that our personalised period box can get organic tampons, PMS supplements and much more delivered easily and regularly through your letterbox, which is one big load off your mind each cycle.

Endo Feels: Endometriosis & Mental Health

If the idea of having your cervix prodded makes you feel a bit ill, we’re here to break down everything you need to know about this rather uncomfortable but incredibly necessary test; what it is, why you need it, what happens during, what the results mean, and more. It’s time to take the scariness out of cervical screening because it’s really nothing to worry about… smear-ly a quick test to make sure everything’s healthy!

Cervical screening is often referred to as a “smear test”, which isn’t the nicest sounding name, we’ll admit! It’s basically a quick swab-style test that checks the health of your cervix - that’s the opening of your womb. It’s good to remember this isn’t a test for cancer, it simply checks for abnormal cells that could help prevent cancer further down the line. 

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