Menstrual Disorders: a brief overview

The onset of menstruation is one of the changes that occur in a girl’s body during puberty. A menstrual cycle is usually 28 days long where the uterus prepares for pregnancy and develops a uterine lining made up of tissue and blood vessels called the endometrium. When pregnancy does not occur, the lining sheds and a mixture of blood and tissue exits through the vagina, this process is called menstruation or periods, as is more commonly known. 

Some women go through periods with little to no problems. However, several women experience problems during their menstrual cycle which are known as menstrual disorders. These problems include the painful cramps one experiences in the days leading up to or even during periods, abnormally heavy bleeding during periods or not having any bleeding at all.

Though variations in menstrual patterns can occur normally too, but one should be concerned if the cycle is less than 21 days or more than 3 months long. It is also a sign of a disorder if your periods last for more than 10 days. 

Some Common Menstrual Disorders –

• Dysmenorrhea – Many women experience some pain and cramps during their period. However, when one experiences severe and persistent cramping during periods it is called Dysmenorrhea. The pain usually occurs in lower region of the abdomen but at times spreads to the lower back and thighs. Dysmenorrhea may be classified as primary or secondary. This is the most common menstrual disorder. 
  • Primary dysmenorrhea is the pain caused by cramping during menstruation and is usually caused by natural chemicals called prostaglandins. The cramps may occur from contractions in the uterus and are severe when bleeding is heavy.
  • Secondary dysmenorrhea is caused due to a disorder in the reproductive system.
     
• Menorrhagia – a condition of unusually heavy bleeding or prolonged periods is called Menorrhagia and can be a result of a number of factors including hormonal imbalance, fibroids, miscarriages etc. Normally, one loses around 30 mL of blood during menstruation and change of pads or tampons is 3 – 6 times a day. However, you are advised to consult a doctor if you experience the following -
  • Soaking tampon or pads in every 1 – 2 hours 
  • Symptoms of anemia, such as tiredness, fatigue or shortness of breath
  • limiting daily activities due to heavy menstrual flow
  • Bleeding between menstrual cycles or irregular vaginal bleeding. Though spotting or light bleeding is common at just the start of periods and during ovulation, it is advised to consult a gynecologist for an opinion. 
  • Passing blood clots with menstrual flow for more than one day
  • Periods that are heavy and last for 10 or more days
     
• Amenorrhea – Amenorrhea is a condition where your periods are totally absent. There are two types of amenorrhea– primary and secondary. 
  • Primary amenorrhea occurs when a girl has reached 16 years of age and hasn’t menstruated. There may be several reasons for this including delayed maturity of your pituitary glands, problem with your ovaries or in some cases genetic abnormalities. It is advised to consult a doctor for proper diagnosis and advice.
  • Secondary Amenorrhea is a condition which occurs when a girl who gets regular periods, suddenly stops menstruating for 3 months or more. This can be a result of problems that affect estrogen levels, including stress, weight loss, exercise or illnesses.

• Premenstrual Dysphoric Disorder (PMDD) - is a condition in which a woman has severe depression symptoms, irritability, and tension before menstruation. The symptoms of PMDD are more severe than those seen with premenstrual syndrome (PMS). The exact cause of PMDD isn't clear. However, the hormonal changes that trigger menstruation could be a cause of PMDD.

• Polycystic ovary syndrome (PCOS) – This is caused due to hormonal imbalance that could sometimes be a result of stressful lifestyle. The symptoms include irregular periods with absence of period for longer than 35 days to 4 months, heavy or scant bleeding, formation of cysts around the ovaries, weight gain, acne, and feeling of depression. PCOS can cause infertility among women. However, PCOS can be diagnosed and treated easily. Regular exercise, healthy lifestyle and weight control can help treat PCOS.

• Oligomenorrhea – It is a condition in which one experiences irregular periods with a gap of at least 35 days for a long period. It can be a result of side effects of hormonal birth control, is common among premenopausal and adolescent women because the menstrual cycle is erratic at these times. The condition itself is not harmful as such but could be symptomatic of another underlying condition.

These menstrual disorders can cause discomfort and pain. It is important to have regular check-ups and consult your gynecologist if you experience any of the symptoms listed above for proper diagnosis and treatment.  

Some basic tips to reduce discomfort & pain during periods –

• Sleep for at least 8 hours every day. Getting enough rest is important so as to avoid feeling exhausted.
• Applying a heating pad to the abdomen to alleviate menstrual pain and cramps. 
• Exercise regularly. It not only helps reduce bloating but also helps reduce anxiety, irritability and insomnia.
• Do some relaxation and breathing exercises to relieve stress.