Menstrual Problems

Menstrual problems, also known as menstrual disorders, encompass a range of conditions that affect the normal menstrual cycle. These issues can involve changes in the frequency, regularity, duration, or volume of menstrual bleeding, as well as associated symptoms like pain or emotional disturbances.

Common Types of Menstrual Problems

Dysmenorrhea - Painful periods with cramps in the lower abdomen or pelvis, sometimes radiating to the back and thighs. Can be primary (not linked to other diseases) or secondary (caused by conditions like endometriosis or fibroids).

Menorrhagia - Abnormally heavy or prolonged menstrual bleeding, often requiring frequent changes of sanitary products or lasting more than 7 days.

Oligomenorrhea - Infrequent menstrual periods, typically cycles longer than 35 days or fewer than 8 periods a year.

Amenorrhea - Absence of menstruation, either primary (no periods by age 16) or secondary (periods stop for 3 months or more after starting).

Metrorrhagia - Irregular bleeding between periods or at unpredictable times.

Menometrorrhagia - Heavy, prolonged, and irregular bleeding.

Hypomenorrhea - Abnormally light periods.

Premenstrual Syndrome (PMS) - Physical and emotional symptoms before menstruation, such as irritability, bloating, and mood swings.

Abnormal Uterine Bleeding (AUB) - Any disruption in the volume, duration, or regularity of menstrual bleeding.

Causes

Hormonal imbalances - Thyroid disorders, PCOS

Stress and lifestyle changes

Weight changes - Gain or loss, excessive exercise

Medications - Anticoagulants, hormonal therapies

Medical conditions - Fibroids, endometriosis, clotting disorders, infections, chronic illnesses

Structural abnormalities - Polyps, uterine septum

Genetic factors

Pregnancy complications - Miscarriage, ectopic pregnancy

Diagnosis

Detailed menstrual history - Record cycle length, flow, pain, and associated symptoms

Physical and pelvic examination

Laboratory tests - Hormone levels, thyroid function, blood count

Imaging - Pelvic ultrasound to detect structural abnormalities

Other tests - Endometrial biopsy, hysteroscopy if indicated

Treatment Options

Lifestyle and Self-Care

Maintain a healthy weight, balanced diet, and regular exercise

Stress management techniques

Keep a menstrual diary to track patterns and symptoms

Medications

NSAIDs - Ibuprofen, naproxen for pain and to reduce heavy bleeding

Hormonal therapies - Birth control pills, hormone patches, IUDs with hormones, or progesterone therapy to regulate cycles and reduce bleeding

Medications for underlying conditions - Thyroid medications, metformin for PCOS, or treatments for infections

Tranexamic acid - To reduce heavy menstrual bleeding

Herbal remedies - Such as chasteberry, ginger, or turmeric (evidence is limited)

Surgical Treatments

For structural problems like fibroids or polyps - Myomectomy, polypectomy, endometrial ablation, or hysterectomy (in severe cases)

When to Seek Medical Attention

Very painful or irregular periods

Bleeding between periods or after sex

Very heavy bleeding - Soaking through pads or tampons hourly

Periods that last longer than 7–10 days

Absence of periods for 3 months (if not pregnant)

Severe PMS or mood changes interfering with daily life