Menstrual disorders are problems affecting your periods, including changes to how often you bleed, how long your periods last, how heavy they are and how much pain or discomfort you experience.
While periods naturally vary from person to person, significant or persistent changes to your usual menstrual pattern can sometimes indicate an underlying gynaecological or hormonal condition.
Menstrual problems can have a considerable impact on everyday life. Heavy bleeding, severe period pain or unpredictable periods can affect work, relationships, exercise, sleep and emotional wellbeing.
At Gynae Solution, we understand that every woman's menstrual cycle is different. Mr Jafaru Abu will take the time to understand your symptoms, investigate potential causes and discuss treatment options based on your individual circumstances and priorities.
What Are Menstrual Disorders?
A menstrual disorder is a problem affecting the normal pattern of your menstrual cycle.
A typical menstrual cycle is around 28 days, although a cycle between 21 and 35 days can be normal. Periods themselves commonly last between 2 and 7 days.
There are many different types of menstrual problems, including:
- Heavy periods
- Painful periods
- Irregular periods
- Bleeding between periods
- Bleeding after sexual intercourse
- Very long or prolonged periods
- Very frequent periods
- Infrequent or missed periods
- Periods that have suddenly changed
- Premenstrual syndrome (PMS)
- Menstrual migraines
A menstrual disorder does not necessarily mean that there is an underlying disease. However, if your periods have changed significantly or are affecting your quality of life, it is worth seeking medical advice.
Symptoms of Menstrual Disorders
The symptoms of a menstrual disorder will depend on the type of problem you are experiencing.
You may notice:
Heavy Periods
Your periods may be considered heavy if you need to change your period product every hour or two, bleed through clothing or bedding, pass large blood clots or have periods lasting more than seven days.
Heavy menstrual bleeding can also leave you feeling extremely tired or short of breath, particularly if it has caused iron-deficiency anaemia.
Painful Periods
Some discomfort during a period is common, but severe or worsening pain should not simply be accepted as something you have to live with.
Period pain may feel like:
- Cramping in the lower abdomen
- A dull ache
- Sharp or intense pelvic pain
- Pain spreading into the back or thighs
- Pain that begins before your period and continues during it
Severe period pain can sometimes be associated with conditions such as endometriosis, adenomyosis, fibroids or pelvic inflammatory disease.
Irregular Periods
Your periods may become irregular if the time between them changes considerably.
You may find that your periods:
- Arrive earlier or later than expected
- Occur less than 21 days apart
- Occur more than 35 days apart
- Last longer than usual
- Vary significantly from one month to another
- Become heavier or lighter
- Stop altogether
Irregular periods are particularly common during puberty and the years leading up to the menopause, but other causes may need to be investigated.
Bleeding Between Periods
Bleeding or spotting outside your normal period can have a number of causes, including hormonal contraception, cervical changes, infections, fibroids and polyps.
Persistent or unexplained bleeding should be assessed by a healthcare professional.
Missed or Absent Periods
Periods can stop or become infrequent for many reasons, including pregnancy, stress, significant weight changes, excessive exercise, hormonal contraception, PCOS and thyroid problems.
If you have missed three periods in a row, or your periods have suddenly stopped without an obvious explanation, you should seek medical advice.
Causes of Menstrual Disorders
There is no single cause of menstrual disorders. Your symptoms may be related to hormonal changes, a gynaecological condition, medication, contraception or changes in your general health.
Possible causes include:
- Fibroids
- Endometriosis
- Adenomyosis
- Polycystic ovary syndrome (PCOS)
- Pelvic inflammatory disease
- Ovarian cysts
- Uterine or cervical polyps
- Thyroid disorders
- Hormonal changes
- Perimenopause
- Pregnancy
- Hormonal contraception
- Significant weight loss or weight gain
- Excessive exercise
- Stress
- Certain medications
- Blood-clotting disorders
Heavy periods can also occur without an identifiable underlying condition.
Sometimes, more than one factor may contribute to your symptoms.
When Should I See a Doctor?
You do not need to wait until your symptoms become severe before seeking help.
You should consider speaking to your GP or a gynaecologist if:
- Your periods have suddenly changed
- Your periods are consistently very heavy
- Your periods last longer than seven days
- You experience severe period pain
- Your pain is affecting your normal activities
- You bleed between periods
- You bleed after sex
- Your periods have become very irregular
- You have missed several periods without an obvious reason
- You experience pain during sex
- You have pelvic pain outside your periods
- You are struggling to become pregnant
If menstrual problems are affecting your physical, social or emotional wellbeing, treatment may be available. NICE specifically recommends that the impact of heavy menstrual bleeding on a woman's quality of life should be considered when planning treatment.
How Are Menstrual Disorders Diagnosed?
The first step is understanding your individual menstrual pattern.
During your consultation, Mr Abu will discuss your symptoms and medical history, including:
- When your periods started changing
- How frequently you have periods
- How long they last
- How heavy the bleeding is
- Whether you pass blood clots
- The severity and location of any pain
- Whether you bleed between periods or after sex
- Any bowel or bladder symptoms
- Pain during sexual intercourse
- Your contraception
- Previous pregnancies and gynaecological procedures
- Any previous diagnoses or treatments
- Whether you are planning a pregnancy
Keeping a period and symptom diary can be extremely helpful. Recording when your period starts and ends, how heavy the bleeding is and any pain or other symptoms can help your specialist identify patterns.
Blood Tests
Blood tests may be recommended depending on your symptoms.
For example, if you experience heavy periods, a blood test may be used to check for iron-deficiency anaemia.
Other blood tests may be appropriate where a hormonal or thyroid-related problem is suspected.
Pelvic Examination
Depending on your symptoms, a pelvic examination may be recommended to assess the vagina, cervix and womb.
You will be given the opportunity to discuss the examination beforehand and ask any questions.
Ultrasound Scan
An ultrasound scan can provide detailed images of the womb, ovaries and surrounding pelvic structures.
It may help identify conditions such as:
- Fibroids
- Adenomyosis
- Ovarian cysts
- Endometrial or uterine abnormalities
- Other structural causes of abnormal bleeding
Hysteroscopy
If there is a concern about the inside of the womb, a hysteroscopy may be recommended.
This involves passing a small camera through the vagina and cervix to examine the inside of the womb.
A hysteroscopy can be particularly useful where conditions such as polyps or fibroids affecting the uterine cavity are suspected.
Further Investigations
Depending on your symptoms and initial findings, you may require additional investigations such as an MRI scan, specialist ultrasound, cervical assessment or biopsy.
You will not necessarily require every test. Your investigations will be tailored to your symptoms and individual circumstances.
Treatment Options
There is no single treatment for menstrual disorders because treatment depends on the underlying cause and the symptoms you are experiencing.
Your treatment options may include medication, hormonal treatment, minimally invasive procedures or surgery.
Importantly, your own priorities should be part of the decision-making process. For example, treatment may be different if you are hoping to become pregnant, want to preserve your fertility or simply want to improve your quality of life.
Medication
Medication can be used to manage a number of menstrual symptoms.
For heavy periods, treatments can include medicines such as tranexamic acid, which reduces menstrual bleeding, or anti-inflammatory medicines that can help with both bleeding and pain.
Hormonal Treatment
Hormonal treatments can sometimes regulate the menstrual cycle, reduce bleeding and improve period pain.
Depending on your circumstances, options may include:
- Combined hormonal contraception
- Progestogen-only treatments
- Hormonal intrauterine systems (IUS)
- Other hormone-based medication
Some types of contraception can make periods lighter or less painful and may be recommended specifically to manage menstrual symptoms, even when contraception is not the primary reason for treatment.
Treating the Underlying Condition
If your menstrual disorder is caused by another gynaecological condition, treating that condition may improve your symptoms.
For example:
- Fibroids may be treated with medication, procedures or surgery.
- Endometriosis may be managed with hormonal treatment, pain relief or surgery.
- Polyps may be removed.
- Adenomyosis may be treated with medication or, in selected circumstances, surgery.
- Hormonal conditions such as PCOS or thyroid disorders can be treated according to their underlying cause.
Surgical Treatment
If medication or less invasive approaches are unsuccessful, surgery may sometimes be considered.
Depending on the cause, this could include:
- Hysteroscopic removal of polyps or fibroids
- Myomectomy to remove fibroids while preserving the womb
- Endometrial ablation for selected women with heavy menstrual bleeding
- Other minimally invasive procedures
- Hysterectomy in selected circumstances
The appropriate procedure will depend on the underlying condition, your symptoms and your future fertility plans.
Menstrual Disorders and Fertility
Changes to your periods can sometimes affect fertility.
For example, irregular or absent periods may indicate that you are not ovulating regularly. Conditions such as PCOS, endometriosis and fibroids can also sometimes affect fertility.
If you are trying to conceive or may want children in the future, this should be discussed before starting treatment.
Some treatments are suitable for women who want to preserve their fertility, while others are not appropriate if you are hoping to become pregnant.
Your fertility wishes should therefore be an important part of any treatment decision.
Recovery and Aftercare
Your recovery will depend on the cause of your menstrual symptoms and the treatment you receive.
If your symptoms are being managed with medication, you may need follow-up appointments to assess whether the treatment is working and whether any adjustments are required.
Following a procedure or surgery, you will receive advice about recovery, managing discomfort and returning to normal activities.
Your symptoms may improve significantly once the underlying cause has been treated, although some menstrual disorders require longer-term management.
Ongoing review can be particularly important for conditions such as endometriosis, fibroids or adenomyosis, where symptoms may change over time.
Risks and Benefits of Treatment
Every treatment has potential benefits and risks.
The potential benefits may include:
- Reducing heavy menstrual bleeding
- Improving period pain
- Making periods more predictable
- Reducing pelvic discomfort
- Improving energy levels where anaemia has been caused by heavy bleeding
- Improving day-to-day quality of life
- Treating an underlying gynaecological condition
- Supporting fertility where appropriate
The risks depend on the treatment chosen.
Medication can cause side effects and may not be suitable for everyone. Procedures and surgery carry risks such as bleeding, infection and complications associated with anaesthesia. Some treatments may also affect future fertility.
NICE recommends discussing the benefits, risks and implications of different treatment options with each patient, taking their individual circumstances, preferences and fertility priorities into account.
Mr Abu will explain the options available to you so that you can make an informed decision about your care.
Living With Menstrual Problems
Periods should not regularly prevent you from living your normal life.
If you are missing work or social activities because of heavy bleeding, planning your life around pain, struggling with fatigue or feeling anxious because you cannot predict when your next period will come, it is worth seeking help.
Menstrual disorders are common, but that does not mean you simply have to put up with symptoms that are affecting your quality of life.
A specialist assessment can help identify whether there is an underlying cause and what treatment options may be available.
Specialist Care for Menstrual Disorders
At Gynae Solution, we understand that menstrual symptoms can be difficult to discuss, particularly when you have been experiencing them for a long time or have been told that heavy or painful periods are simply something you have to live with.
Mr Jafaru Abu will take the time to understand your individual symptoms and investigate potential causes before recommending a treatment plan.
Whether you are experiencing heavy periods, painful periods, irregular bleeding, missed periods or another change to your menstrual cycle, our aim is to provide clear answers, specialist expertise and personalised care.
If your periods are affecting your everyday life, contact Gynae Solution to arrange a consultation with Mr Jafaru Abu.
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