Menstrual Disorders - Causes & Treatment for Irregular Menstruation
Due to its regularity and sensitivity to internal and external factors, the menstrual cycle is a good indicator of your hormonal balance, reproductive health, and overall health. A regular menstrual cycle reflects the proper functioning of the endocrine system and the entire body.
On the other hand, an irregular cycle with abnormal characteristics gives you valuable signals and information about possible health problems that require medical attention. If you notice that your periods are not coming regularly, find out in this article what types of menstrual disorders exist, what causes them, and how you can treat them.
Menstruation and the menstrual cycle
A normal menstrual cycle lasts, on average, 28 days. But because every body is different and every woman's experience with her period is unique, a menstrual cycle that is slightly longer or shorter is considered healthy.
Thus, for most women, the normal length of a menstrual cycle is between 21 and 35 days, with menstruation lasting between 4-7 days. If there are no significant changes from one month to the next in terms of menstrual and cycle length, flow, or symptoms, then the menstrual cycle is considered regular.
Irregular menstrual cycle
If the interval between two consecutive menstruations is less than 21 days or exceeds 35 days, then it is considered an irregular menstrual cycle . An irregular menstrual cycle can also look like this:
- Menstruation is absent for 3 months or more.
- Menstrual bleeding continues for more than 7 days.
- Menstrual flow is much lighter or heavier than usual.
- Menstruation is accompanied by worrying symptoms, such as very severe pain, migraines, or nausea.
- The length of the intervals between two menstruations is always changing, and the difference exceeds 9 days (e.g.: one menstrual cycle lasts 29 days, the next lasts 38 days, and the next lasts 27 days).
- Bleeding between periods or after sexual intercourse.
There are many factors that can cause these irregularities, including hormonal changes, stress, changes in diet and lifestyle, certain medications, or health problems.
What are menstrual disorders?
Menstrual irregularities refer to any deviation from what is considered a normal menstrual cycle. These deviations can be both physical and emotional changes in symptoms during or before the menstrual period.
For example, symptoms of menstrual disorders can include severe cramps, absence of menstruation for long periods of time, mood swings that are difficult to manage, or very heavy menstrual bleeding that requires changing pads hourly or even more frequently. If you are experiencing these symptoms, use 100% organic cotton pads to provide protection and comfort with only safe and natural ingredients.
Causes of menstrual disorders
The causes of menstrual disorders are very varied, ranging from lifestyle factors to more serious health problems.
Dietary changes, intense physical activity, chronic stress, colds and flu, weight gain or loss, and birth control pills or other treatments can cause menstrual delays or changes in menstrual symptoms. Puberty, perimenopause, and pregnancy are also causes of menstrual cycle disorders.
But there are also conditions associated with menstrual irregularities that can cause abnormal bleeding, severe pain, absence of menstruation, and other changes. The most common causes include endometriosis, pelvic inflammatory disease, polycystic ovary syndrome, primary ovarian insufficiency, and thyroid disorders.
Types of menstrual disorders
Depending on how they manifest, there are several types of menstrual disorders.
When menstruation is absent or less frequent, it falls into the category of deficiency menstrual disorders. This category includes hypomenorrhea, amenorrhea, and oligomenorrhea or spaniomenorrhea.
When the frequency of menstruation increases or the flow becomes heavy, they fall into the category of excessive menstrual disorders. This includes polymenorrhea, hypermenorrhea, and menorrhagia.
There are other menstrual disorders, such as metrorrhagia (bleeding outside of menstruation) and syndromes associated with the menstrual cycle (premenstrual syndrome, intermenstrual syndrome, and dysmenorrhea).
Menstrual disorders due to deficiency
Menstrual deficiency disorders are those menstrual cycle disorders that involve the absence of menstrual bleeding or a decrease in its frequency.
hypomenorea
Hypomenorrhea refers to menstruation that comes regularly, at approximately equal intervals, but is unusually short in duration and has a considerably reduced flow.
People with hypomenorrhea have periods that last less than 2 days, and bleeding is very light (no more than 1-2 menstrual products are needed per day).
Causes of decreased menstrual flow can be stress, weight loss, or excessive exercise, but also diseases of the reproductive organs, especially the uterus. In general, hypomenorrhea is just a stage that precedes other deficiency menstrual disorders, such as oligomenorrhea and amenorrhea.
oligomenorrhoea
Oligomenorrhea involves irregular menstruation, which occurs with a low frequency, at intervals longer than 35 days. Because of these long delays, women with oligomenorrhea have only 4 to 9 periods in a year.
According to current research, oligomenorrhea is the most common menstrual disorder among all hormonal disorders, and it can be improved with the help of an endocrinologist. Any change or condition that causes hormonal imbalances in the body can be a cause of oligomenorrhea.
amenorrhea
Amenorrhea is characterized by the total absence of menstruation for at least 90 consecutive days (3 months).
This disorder is classified into primary amenorrhea (when the first menstruation has not occurred by the age of 15) and secondary amenorrhea (after the menstrual cycle begins, when menstruation is suddenly delayed for 3 months or more).
The causes vary depending on the type of disorder. In the case of primary amenorrhea, they can be hormonal, genetic, or anatomical (problems with the uterus, vagina, or hymen). Secondary amenorrhea can be caused by pregnancy, but also by other factors: stress, sudden weight loss, hormonal changes, or conditions such as primary ovarian insufficiency and polycystic ovary syndrome.
Menstrual disorders due to excess
Excessive menstrual disorders are changes in the menstrual cycle that cause a considerable increase in menstrual flow or the frequency of menstrual bleeding.
Polymenorrhea
Polymenorrhea is a form of abnormal and frequent menstrual bleeding, at very short intervals, less than 21 days. Menstrual flow can also be very heavy in people with oligomenorrhea, who have to change at least 5 menstrual products per day.
Some people have a naturally shorter menstrual cycle, but ovarian problems and hormonal changes or conditions that cause hormonal imbalances are most often the main cause of this disorder.
Hipermenorrea
Hypermenorrhea is a disorder of the menstrual cycle in which menstruation occurs regularly, at approximately equal intervals, but involves extremely heavy bleeding, with a volume exceeding 90 ml.
Among the causes of this quantitative increase in menstrual flow can be found fibroids, uterine polyps and other problems in the uterus, but also certain health problems or treatments that affect the blood clotting process.
metrorrhages
Metrorrhagia is any uterine bleeding outside of the menstrual period . The most common causes of this abnormal and irregular bleeding, which is not associated with the menstrual cycle, include uterine fibroids, hormonal disorders, infections, and menopause.
Syndromes associated with the menstrual cycle
When the symptoms of menstrual disorders are related only to physical discomfort and emotional states, not to changes in the duration or flow of menstruation, we are talking about menstrual cycle-associated syndromes:
- Premenstrual syndrome : the totality of physical and emotional disorders that occur in the period between ovulation (mid-cycle) and the first day of menstruation; affects over 85% of women and can include symptoms such as breast tenderness, bloating, abdominal cramps, anxiety and irritability, insomnia, melancholy, etc.
- Intermenstrual syndrome: also known as ovulatory syndrome, is a short-term pelvic pain (generally 2-4 hours) specific to ovulation, which may be accompanied by light bleeding.
- Dysmenorrhea : mainly manifested by pelvic and lumbar pain during menstruation, the intensity of which differs from woman to woman; affects between 30% and 50% of women.
Premenopausal menstrual disorders
Perimenopause usually begins around age 40 or even earlier, after age 35. Changes in your menstrual cycle are normal during this time.
As the ovaries become less sensitive to hormonal stimulation, more anovulatory cycles may set in, with irregular periods occurring at intervals of less than 28 days or longer. Mood swings, vaginal dryness, and hot flashes are also common symptoms of perimenopause.
Symptoms of menstrual disorders
The symptoms of each menstrual disorder differ depending on the type and each woman's body. But in general, menstrual disorders manifest themselves through:
- Menstruation at intervals shorter than 21 days or longer than 35 days
- Absence of menstruation for 3 or more consecutive months
- Unusually light or heavy menstrual flow
- Menstruation lasting more than 8 days
- The need to change your tampon or pad every hour
- Severe cramps during or outside of menstruation
- Heavy bleeding with large clots
- Bleeding between periods or after menopause
- Nausea and vomiting during menstruation
Diagnosis and investigations
Collaboration between the gynecologist and the patient is essential for establishing a correct diagnosis. Therefore, the first step is to track your menstrual cycle. Note the first day of each period, what the flow is like, how strong the cramps are, whether there is bleeding between periods, and any other relevant symptoms.
All this information will be helpful to the doctor to correlate it with the observations obtained from the investigations and to establish a correct diagnosis. He may request:
- A gynecological examination, to check for the presence of any uterine abnormalities
- A pelvic ultrasound, to examine the uterus, ovaries, and fallopian tubes
- Analysis of vaginal secretions
- Pap smear
- An endometrial biopsy
- A hysteroscopy
Complications and risk factors for menstrual disorders
Some people have irregular periods their entire lives without any serious health problems. However, in the long term, menstrual irregularities can increase the risk of other conditions, such as:
- Iron deficiency anemia, due to heavy blood loss during very heavy and frequent menstruation, as blood contains iron.
- Infertility, in the case of anovulatory cycles, because pregnancy cannot be achieved without ovulation.
- Endometrial hyperplasia (thickening of the uterine lining), in the case of a long-term irregular menstrual cycle.
- Osteoporosis, due to decreased ovulation frequency, which leads to decreased estrogen levels and increased risk of osteoporosis.
Cardiovascular diseases, also due to decreased estrogen levels.
Treatment for menstrual disorders (cycle disorders)
Treatment for menstrual disorders depends on the symptoms and their causes. Initially, your doctor will recommend medication, which may include:
- Birth control pills, if menstrual disorders are caused by endometriosis, polycystic ovary syndrome, uterine fibroids, or certain hormonal imbalances
- Tranexamic acid, for treating heavy bleeding
- Analgesics, for pain relief
- Antibiotics, if menstrual irregularities are symptoms of an infection
- Hormone therapy, if hormonal imbalances are caused by perimenopause
If the body does not respond to drug treatment, the specialist may propose a surgical intervention such as endometrial ablation (to reduce bleeding), myomectomy (to remove uterine fibroids) or hysterectomy (in severe cases, when it is necessary to remove excess endometrial tissue from the abdomen and pelvis).
Frequently asked questions about menstrual disorders
Even when you know the type and symptoms of menstrual disorders, it's normal to still have questions. When should you see a doctor? Is it normal for your menstrual cycle to be irregular after giving birth? Find answers to the most frequently asked questions about menstrual disorders below.
When should we see a doctor?
It is a good idea to see a doctor as soon as you notice any unusual changes in your menstrual cycle. If your periods suddenly become irregular or last longer than 7 days, your flow decreases or increases significantly, you experience intermenstrual bleeding, or you notice other worrisome symptoms (fatigue, facial hair growth, etc.), schedule a gynecological consultation to detect and treat the cause as soon as possible.
Also, if you have an irregular menstrual cycle and are unable to get pregnant, discuss this with your doctor.
What complications can arise from menstrual disorders?
Menstrual irregularities usually do not cause any short-term health problems. In the long term, depending on the type of disorder, complications such as iron deficiency anemia, infertility, cardiovascular disease, osteoporosis, or endometrial hyperplasia may occur.
What is a short menstrual cycle?
The normal length of a menstrual cycle is between 21 and 35 days, with the average length being 28 days. When the menstrual cycle (i.e. the interval between two consecutive menstruations) lasts less than 21 days, it is considered a short menstrual cycle .
Is menstruation irregular after childbirth?
No matter how regular your period was before pregnancy, it's normal for it to become irregular after giving birth. There have been a lot of hormonal changes in your body to support the growth and development of your baby, so it can take up to a year for your body to get back to a regular period.
reference
To prepare this article, I took information from the following sources:
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