Menstrual Disorders

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Abnormal Uterine Bleeding

There are several menstrual disorders seen in menstruating individuals. Abnormal uterine bleeding, be it too much or too little or no bleeding at all, is one of them.

Normally, individuals lose between 15mL and 80 mL of blood during menstruation.

There are three types of abnormal uterine bleeding. These include:

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The menstrual period or menstruation is a part of the menstrual cycle that takes 28 days, on average, to complete. It starts at puberty at around 12-16 years of age and lasts until menopause at around 45-55. The first day of menstruation is counted as day one of the menstrual cycles. Average menstruation lasts from 3-5 days.

All of these vary for different individuals and a normal menstrual period looks different for different individuals.

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Menstruation is the bleeding phase of the menstrual cycle. The first day of menstruation is counted as day one of the menstrual cycle that usually lasts for 28 days. Normal menstruation differs for different individuals. While some individuals have fairly easy menstrual periods, others have severely debilitating ones that require them to take time off from school or work.

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General Things to Keep in Mind about Menstrual Disorders

Menstrual cycle is a natural phenomenon and part of regular life for women of reproductive age. A little pain or discomfort is expected. It is not considered a menstrual disorder as long as it is tolerable and does not interfere with an individual’s daily lifestyle.

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Watch the videos to know about various aspects of Menstrual Disorders

Videos from Divakars Hospital Youtube Channel

Q & As on Menstrual Disorders

What causes menstrual disorders?

Menstrual disorders are characterized by any deviation from the normal menstrual cycle. They are usually defined as primary and secondary, based on the cause of the particular disorder.

Various causes of menstrual disorders are as follows-

– Hormonal imbalance – Most common and primary cause of menstrual disorders is hormonal imbalance. The menstrual cycle is characterized by fluctuating female hormones, i.e., estrogen and progesterone. Hormonal imbalance causes physical problems like bloating, menstrual cramps, acne, etc., and psychological symptoms like irritability, confusion, anxiety, tearfulness, etc.

– Infections – Any uterus or pelvis infection can lead to menstrual disorders.

– Medication – Medications that interfere with hormones can cause menstrual symptoms. Other medications, like oral contraceptives, blood thinners, etc., also lead to menstrual disorders.

– Structural abnormality – Any structural abnormality of the uterus can lead to menstrual disorder, most commonly endometriosis.

– Disease – Most systemic diseases in women of reproductive age affect their menstrual cycle.

What are the symptoms of menstrual disorders?

Menstrual disorders have a lot of symptoms, both physical and psychological. Some of the most common physical symptoms experienced by most individuals are listed below:

– Pain and menstrual cramps in the lower abdominal area

– Lower back pain

– Pain radiating to legs

– Nausea, Vomiting

– Faint spells

– Diarrhea or constipation

– Fatigue, weakness

– Headaches

– Bloating

– Swollen, tender breasts

– Acne

– Muscle spasms

– Diminished libido

– Changes in appetite

Psychological symptoms include-

– Anger

– Anxiety/confusion

– Mood swings, tension

– Crying and depression

– Inability to concentrate

– Irritability

What does PMDD do to the brain?

While most women experience some unpleasant symptoms in the days before their period, PMDD is more serious. PMDD is thought to be caused by disturbances that alter the brain’s neurochemistry and communication circuits. Characterized by severe mood changes that occur a week or two before menstruation, symptoms generally resolve shortly after the period arrives. Some women are more prone to PMDD due to factors like genetics and stress.

Estrogen and progesterone can alter the production or effectiveness of neurotransmitters in the brain, including serotonin and dopamine, so-called “feel good” chemicals. Individuals with PMDD experience an exaggerated drop in serotonin levels. Low serotonin levels are associated with the depressed mood, food cravings, and impaired cognitive functioning of PMDD. This is why selective serotonin receptor inhibitors (SSRIs) are the top treatment for PMDD.

Can dysmenorrhea cause infertility?

While dysmenorrhea does not cause infertility but it may be symptomatic of a fertility issue. Most individuals with dysmenorrhea have primary dysmenorrhea, which is caused by natural pelvic pain during menstruation. This type of dysmenorrhea is not associated with fertility. Some individuals with dysmenorrhea, however, have secondary dysmenorrhea, which means the pain and cramping are due to an underlying gynecological cause.

Some of these causes may lead to infertility, such as pelvic inflammatory disease and ovarian cysts. If a few months have passed and over-the-counter medications and relaxation techniques have not resolved the symptoms, one should consult with their doctor to see if an underlying condition is responsible.

What is the main cause of dysmenorrhea?

Painful periods are called Dysmenorrhea. This pain is caused by natural chemicals called prostaglandins that are made in the lining of the uterus. It is classified as primary dysmenorrhea. Prostaglandins cause the muscles and blood vessels of the uterus to contract. On the first day of a period, the level of prostaglandins is high. As bleeding continues and the lining of the uterus is shed, the level goes down. This is why pain tends to lessen after the first few days of a period. There are other conditions that cause secondary dysmenorrhea like endometriosis, uterine fibroids, adenomyosis, problems with the uterus, fallopian tubes, or other reproductive organs, and some urinary disorders can also cause dysmenorrhea.

What happens during amenorrhea?

Amenorrhea is the absence of menstruation. It can be either primary or secondary. Primary amenorrhea is when a female has reached the age of 16 years has not started menstruating. It can be due to hormonal imbalance, eating disorders like anorexia, bulimia, obesity, etc.

Secondary amenorrhea is when an individual who has had regular periods stops menstruating for 3 months or longer. It is mostly due to an underlying cause leading to the absence of menstruation. It can be due to various factors that affect the levels of estrogen in the blood, such as stress, diet, exercise, weight loss, or illness. Other hormonal imbalances like thyroid or elevated levels of prolactin, ovarian cysts, and oophorectomy (removal of the ovaries) also cause amenorrhea.

How is amenorrhea treated?

Amenorrhea, when caused due to hormone imbalance or an underlying disease, can be treated by various methods. It involves following measures –

  • Losing weight through diet and exercise
  • Gaining weight through a customized diet plan
  • Regular, correct, and customized exercise plan.
  • Stress management can include therapy, anti-anxiety or

anti-depression medication, meditation, etc.

  • Medication to treat the underlying cause.
Can menorrhagia be life-threatening?

It is not life-threatening, but it is a grave medical concern. Excessive loss of blood, prolonged bleeding, and irregular periods can greatly impact an individual’s life. It is disruptive to the daily routine, and they need to take time off from work or school to manage it. Menorrhagia is, fortunately, a treatable disorder.

The most important aspect of the treatment is to identify the underlying cause and treat that. One should consult a trained physician for their symptoms of menorrhagia and follow the prescribed treatment.

Can amenorrhea make you gain weight?

Individuals with amenorrhea generally suffer from an eating disorder or are under-eating. Menstruation stops when the body experiences famine-like conditions (i.e., restrictive dieting) due to inadequate fuel to support the menstrual process. So, no amenorrhea does not cause a gain in weight.

Individuals who suffer from amenorrhea are advised to start eating healthy.

What tests are done for irregular periods?

There are various diagnostic methods employed to detect the cause of irregular periods. These are:

  • Blood tests for hormone studies, complete blood counts, etc.
  • Pap smear
  • Pelvic exam
  • Biopsy of uterine tissue
  • Laparoscopy/hysteroscopy
  • Ultrasonography of the abdomen or any other concerned area
  • MRI

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