One of the most common things that patients consult their gynecologist about is menstrual disorders. Menstrual disorders refer to any problems with a woman’s normal menstrual cycle, resulting in symptoms that can affect her daily life.
It’s important to be aware of your menstrual cycle irregularities and talk to your gynecologist about any concerns, because menstrual irregularities are often symptoms of deeper underlying problems that may require early correction.
If you suffer from these period disorders, know that you are not alone – the more we talk about period physiology and menstrual disorders, the more people can connect and normalize their periods. This article looks at different types of menstrual disorders and some possible conditions they are associated with.
How are they diagnosed?
When you go to your OB/GYN for a menstrual disorder, they will first take your complete medical history and then do a physical exam, which includes a Pap smear and pelvic exam. Sometimes you will be asked to keep a record of your menstrual cycles and note the amount of flow, the dates and other symptoms such as pain or nausea that occur. Some other tests they may perform include:
- Hormonal tests
- blood tests
- Ultrasound
- Ultrasound (a type of ultrasound of the uterus)
- MRI
- Laparoscopy
- Hysteroscopy
- Obtaining tissue samples by dilatation and scraping
- Endometrial biopsy
Types of Period Disorders
Dysmenorrhea
Is your period accompanied by significant pain and cramping? This condition is known as dysmenorrhoea and depending on the cause it can be primary or secondary. Primary dysmenorrhea is when a chemical imbalance causes abnormal uterine contractions, and secondary dysmenorrhea is usually caused by medical conditions such as uterine fibroids, tumors, pelvic infections, and pelvic inflammatory disease. Symptoms include:
- Dizziness
- Fatigue
- Motion sickness
- Pain or cramping in the lower abdomen
- Vomiting
- Pain in lower back and legs
- Headaches
Some risk factors for dysmenorrhea include excessive alcohol consumption, smoking, obesity, and early menstruation.
Amenorrhea
When menstrual periods disappear completely or never start, it is known as amenorrhea. If a woman turns 16 and still hasn’t gotten her period, the cause is usually related to the endocrine system, which is what controls the hormones that regulate periods. Low body weight can also delay the maturation of the pituitary gland. Estrogen levels play a role when a woman who has had regular periods suddenly experiences amenorrhea for three months or more. Other causes of amenorrhea include:
- Eating disorders
- Breastfeeding
- Pregnancy
- Menopause
- Abnormal ovulation
- Birth defects
- Excessive amounts of exercise
- Thyroid disorder
Premenstrual Dysphoric Disorder (PMDD)
Premenstrual dysphoric disorder, or PMDD, it’s basically the old premenstrual syndrome (PMS) times one hundred. PMDD is more serious and chronic than PMS that may require attention and treatment and affects many women of childbearing age. Symptoms can be treated with medication and lifestyle changes.
Unfortunately, PMDD is still somewhat of a mystery to doctors, so there are no specific known causes, but it is likely an abnormal reaction to the hormonal changes that occur during each menstrual cycle. Sufferers can have significantly low levels of serotonin during their period, which results in mood swings and physical symptoms.
Although we still know very little about the condition, the following groups have a higher incidence of PMDD:
- Women who have a personal or family history of mood disorders, depression or postpartum depression
- Women who have a family history of PMDD or severe PMS
- Lower education and smoking are also associated with PMDD, although this may be related to mental health in general
Although there are no acute treatments for the condition, it is important to seek help from your OB/GYN, who may refer you to a therapist or endocrinologist, as the condition can have a significant impact on your life and work.
Menorrhoea & Polymenorrhoea
One of the most common types of menstrual bleeding is menorrhoea, or prolonged, heavy bleeding—sometimes to the point of interfering with normal daily activities. The opposite of menorrhagia is hypomenorrhea, or unusually light periods, which can be the result of certain contraceptives as well as low body fat, stress or hormonal imbalances. Some conditions that fall under menorrhagia include:
- Polymenorrhoea – periods that are too frequent
- Postmenopause – periods that continue after menopause
- Uterine bleeding – bleeding between periods
The most common causes of menorrhagia include, but are not limited to:
- Uterine fibroids
- Hormonal imbalance
- Pelvic Inflammatory Disease (PID)
- Miscarriage and other forms of abnormal pregnancy
- Platelet or bleeding disorder
- Infections or tumors of the pelvic cavity
- High concentration of endothelin
If you bleed so much that you are afraid to miss the bathroom for a long time because you have to constantly change pads or tampons, or your period is regularly delayed for more than a week, you should consult your doctor. Other things to look out for include spotting or bleeding between periods or during pregnancy.
When diagnosing menorrhagia, your doctor will first rule out other possible menstrual disorders, medication, or medical conditions that may be causing the heavy periods before performing diagnostic tests such as those listed above.
