What are Menstrual Disorders?

Menstrual disorders are a disruptive physical and/or emotional symptoms just before and during menstruation, including heavy bleeding, missed periods and unmanageable mood swings.

Some women get through their monthly periods easily with few or no concerns. Their periods come like clockwork, starting and stopping at nearly the same time every month, causing little more than a minor inconvenience.

However, other women experience a host of physical and/or emotional symptoms just before and during menstruation. From heavy bleeding and missed periods to unmanageable mood swings, these symptoms may disrupt a woman’s life in major ways.

Most menstrual cycle problems have straightforward explanations, and a range of treatment options exist to relieve your symptoms. If your periods feel overwhelming, discuss your symptoms with your health care professional. Once your symptoms are accurately diagnosed, he or she can help you choose the best treatment to make your menstrual cycle tolerable.

How does the Menstrual Cycle work?

Your menstrual period is part of your menstrual cycle—a series of changes that occur to parts of your body (your ovaries, uterus, vagina and breasts) every 28 days, on average. Some normal menstrual cycles are a bit longer; some are shorter. The first day of your menstrual period is day one of your menstrual cycle. The average menstrual period lasts about five to seven days. A “normal” menstrual period for you may be different from what’s “normal” for someone else.

Types of Menstrual Disorders

There are many types of menstrual disorders, including:

  • Abnormal uterine bleeding. Excessive or prolonged menstrual bleeding
  • Amenorrhea. The absence of menstrual bleeding
  • Oligomenorrhea. Light or infrequent menstruation
  • Fibroids. Noncancerous uterine tumors
  • Premenstrual syndrome (PMS). Physical and emotional discomfort prior to menstruation
  • Premenstrual dysphonic disorder (PMDD). Severe physical and emotional discomfort prior to menstruation

What causes Menstrual Disorders?

Menstrual disorders can be caused by a variety of factors, including:

  • Uterine fibroids
  • Hormonal imbalances
  • Clotting disorders
  • Cancer
  • Sexually transmitted infections (STIs)
  • Polycystic ovary syndrome (PCOS) – cysts on the ovaries
  • Genetics

What are the symptoms of Menstrual Disorders?

Symptoms may include:

  • Abnormal menstrual bleeding
  • Pain or cramping
  • Depression
  • Headaches
  • Emotional distress
  • Bloating or fullness in the abdomen

If your periods come too frequently (fewer than 21 days apart), not often enough (more than three months apart), or last longer than 10 days, talk with your doctor.

How are Menstrual Disorders diagnosed?

Diagnosis starts with a detailed medical history and physical exam, including pelvic exam and Pap smear. You may be asked to keep a diary of your menstrual cycles, including dates, amount of flow, pain and any other symptoms.

Additional testing may include:

  • Blood tests
  • Hormonal tests
  • Ultrasound. To detect conditions that may be causing menstrual disorders.
  • Hysterosonography. An ultrasound using sterile saline to expand the uterine cavity for better imaging.
  • Magnetic resonance imaging (MRI). For intricate pictures of the uterus and surrounding organs.
  • Hysteroscopy. A procedure that uses a small, lighted telescope (hysteroscope) inserted through the vagina and cervix to examine the uterus for fibroids, polyps, or other areas of concerns.
  • Laparoscopy. Looks for abnormalities of the reproductive organs using a tiny lighted instrument with a camera on the end (laparoscope) inserted through a small incision in the abdomen.
  • Endometrial biopsy. An office procedure in which a small sample of the lining of the uterus is removed to examine for abnormal cells.
  • Dilation and Curettage (D&C). Involves scraping the inside lining of the uterus and cervix to take tissue samples or relieve heavy bleeding.

How are menstrual disorders treated?

Treatment for menstrual disorders will depend on the underlying cause, the woman’s desire to have children, and other factors. Treatment options range from lifestyle changes to medical options to surgery, including:

Dietary changes. Such as reducing salt, caffeine, sugar, and alcohol intake before a woman’s period to reduce cramping and other symptoms.

Medical treatment. Using pain relievers for cramps and hormonal contraceptives to help reduce heavy bleeding and regulate, reduce or even eliminate menstrual periods.

Surgical treatment. Surgery can be performed:

  • Using hysteroscopy, a minimally invasive approach to examine and treat areas of concern inside the uterus
  • Through laparoscopy, using a scope inserted in small incisions in the abdomen
  • Through traditional abdominal techniques
  • Procedures include endometrial ablation, which destroys the lining of the uterus to stop periods, and hysterectomy, the surgical removal of the uterus.

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