Understanding Menstrual Problems

The menstrual cycle is a complex process regulated by hormones, primarily oestrogen and progesterone, which prepare the body for potential pregnancy each month. A typical menstrual cycle lasts between 21 to 35 days, with menstruation (period) lasting 2 to 7 days. However, many women experience deviations from this norm, leading to various menstrual problems. These issues can manifest in different ways, including irregular cycles, excessive bleeding, severe pain, or the absence of periods altogether.

Common Types of Menstrual Problems

1. Dysmenorrhea (Painful Periods):

• Primary Dysmenorrhea: This is the most common form of dysmenorrhea and is characterised by cramping pain in the lower abdomen that occurs just before or during menstruation. It is often caused by the production of prostaglandins, which trigger uterine contractions. While common in younger women, the severity can vary from month to month.

• Secondary Dysmenorrhea: This type of dysmenorrhea results from an underlying medical condition such as endometriosis, fibroids, or pelvic inflammatory disease (PID). It tends to occur later in life and often becomes more severe over time.

2. Menorrhagia (Heavy Menstrual Bleeding):

• Menorrhagia refers to abnormally heavy or prolonged menstrual bleeding. Women with menorrhagia may need to change their sanitary protection every hour, and their periods may last longer than seven days. This condition can lead to anaemia and significantly impact a woman's daily activities and quality of life. Causes can include hormonal imbalances, uterine fibroids, polyps, or bleeding disorders.

3. Oligomenorrhea (Infrequent Periods):

• Oligomenorrhea is characterised by infrequent menstrual periods, typically defined as fewer than six to eight periods per year. It is often associated with polycystic ovary syndrome (PCOS), thyroid disorders, or extreme exercise and weight loss. This irregularity can complicate conception and may be an indication of other underlying health issues.

4. Amenorrhea (Absence of Periods):

• Primary Amenorrhea: This occurs when a girl has not started menstruating by age 15 or 16. It can be due to genetic conditions, hormonal imbalances, or structural abnormalities in the reproductive system.

• Secondary Amenorrhea: This occurs when a woman who previously had regular periods stops menstruating for three months or more. Causes include pregnancy, extreme weight loss, excessive exercise, stress, or conditions such as PCOS or thyroid dysfunction.

5. Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Disorder (PMDD):

• PMS encompasses a wide range of physical and emotional symptoms that occur in the one to two weeks before menstruation, including bloating, breast tenderness, mood swings, irritability, and fatigue. PMDD is a more severe form of PMS, with debilitating symptoms that can interfere with daily life and relationships.

6. Irregular Periods:

• Irregular periods refer to fluctuations in the length of the menstrual cycle, making periods unpredictable. This can be caused by stress, significant weight changes, hormonal imbalances, or underlying medical conditions such as polycystic ovary syndrome (PCOS).

Causes of Menstrual Problems

Menstrual problems can arise from a variety of factors, including:

• Hormonal Imbalances: Fluctuations in oestrogen and progesterone levels can disrupt the menstrual cycle, leading to irregular periods, heavy bleeding, or painful cramps.

• Medical Conditions: Conditions like polycystic ovary syndrome (PCOS), endometriosis, uterine fibroids, and thyroid disorders are common culprits behind menstrual irregularities.

• Lifestyle Factors: Stress, poor diet, lack of exercise, and extreme weight changes can all impact menstrual health. Excessive exercise, particularly in athletes, can lead to amenorrhea.

• Medications: Certain medications, including hormonal contraceptives, anticoagulants, and chemotherapy drugs, can influence the menstrual cycle.

• Structural Abnormalities: Congenital anomalies or abnormalities in the reproductive organs can result in menstrual problems, including amenorrhea or irregular bleeding.

Diagnosis of Menstrual Problems

Diagnosing menstrual problems begins with a comprehensive medical history and physical examination. Diagnostic tests may include:

• Pelvic Exam: A physical examination to check for abnormalities in the reproductive organs.

• Blood Tests: To evaluate hormone levels, check for anaemia, and rule out thyroid or other systemic disorders.

• Ultrasound: Imaging to assess the uterus, ovaries, and other pelvic structures for conditions like fibroids, polyps, or cysts.

• Endometrial Biopsy: A procedure to collect a sample of the uterine lining for analysis, particularly if there is abnormal bleeding.

• Hysteroscopy: A minimally invasive procedure that allows the doctor to look inside the uterus with a small camera to detect abnormalities.

When to Seek Help for Menstrual Problems

While occasional menstrual discomfort is common, persistent or severe symptoms should not be ignored. If you experience any of the following, it's important to seek medical advice:

• Heavy bleeding that requires changing sanitary protection every hour

• Periods that last longer than seven days

• Severe or debilitating cramps that interfere with daily activities

• Irregular periods or periods that stop for three months or more without pregnancy

• Significant mood changes or symptoms of depression around the menstrual cycle

• Symptoms that worsen over time or are associated with other health changes

Menstrual problems can have a profound impact on a woman's life, affecting her physical health, emotional well-being, and overall quality of life.

At Elysian Women’s Health, we are committed to providing expert care and support to help women manage their menstrual health and live more comfortably. Whether you are experiencing painful periods, heavy bleeding, or irregular cycles, our experienced team is here to help.

Book an appointment with our team to discuss your symptoms and explore the treatment options that are best suited to your needs.