There are a number of menstrual disorders. Problems can range from heavy, painful periods to no period at all. There are many variations in menstrual patterns.
Dysmenorrhea (Painful Cramps)
Dysmenorrhea is severe, frequent cramping during menstruation. Pain occurs in the lower abdomen and spreads to the lower back and thighs. In Primary dysmenorrhea, cramps occur from contractions in the uterus. It usually begins 2 - 3 years after a women begins to menstruate. In Secondary dysmenorrhea, menstrual pain accompanies another medical or physical condition, such as endometriosis or uterine fibroids.
During a normal menstrual cycle, the average woman loses about 30 mL of blood. Menorrhagia is the medical term used for heavier bleeding. Clot formation is common during heavy bleeding. Menorrhagia refers to long (greater than 7 days) or excessive (more than 80 mL) bleeding that occurs at regular intervals. Metrorrhagia refers to bleeding which occurs at frequent but irregular intervals, and with variable amounts. Menometrorrhagia refers to prolonged episodes of bleeding that occur at irregular intervals.
Amenorrhea (Absence of Menstruation)
Amenorrhea is the absence of menstruation. There are two types: primary amenorrhea and secondary amenorrhea. Primary amenorrhea occurs when a girl does not begin to menstruate by age 16. Secondary amenorrhea occurs when periods that were previously regular stop for at least three months.
Premenstrual Syndrome (PMS)
Premenstrual syndrome (PMS) is a set of physical, emotional, and behavioral symptoms that occur during the last week of the luteal phase i.e. a week before menstruation. Women begin to have premenstrual syndrome symptoms at any time during their reproductive years.
Complications from Menstrual disorders
Anemia: Menorrhagia is the most common cause of anemia in premenopausal women. A blood loss of more than 80mL (around three tablespoons) per menstrual cycle can eventually lead to anemia. Anemia can cause shortness of breath, rapid heart rate, lightheadedness, headaches, ringing in the ears (tinnitus), irritability, pale skin, restless legs syndrome, and mental confusion.
Osteoporosis: Amenorrhea increases the risk for osteopenia (loss of bone density) and osteoporosis. Conditions associated with low estrogen levels include eating disorders, pituitary tumors, and premature ovarian failure.
Infertility: Conditions associated with heavy bleeding, such as ovulation abnormalities, fibroids, or endometriosis, contribute to infertility. Many conditions that cause amenorrhea, such as ovulation abnormalities and polycystic ovary syndrome, also cause infertility. Quality of Life: Menstrual disorders, particularly pain and heavy bleeding, can affect school and work productivity and social activities.
Diagnosis of Menstrual Disorders
Sometimes a menstrual problem is caused by another medical condition such as appendicitis, urinary tract infections, ectopic pregnancy, and irritable bowel syndrome. Endometriosis and fibroids may cause heavy bleeding and pain.
Blood and Hormonal Tests: Blood tests help to rule out conditions that cause menstrual disorders such as low thyroid (hypothyroidism), follicle-stimulating hormone, estrogen, and prolactin levels, and anemia.
Ultrasound: Imaging techniques are used to detect certain conditions that may be causing menstrual disorders such as fibroids, endometriosis, or structural abnormalities of the reproductive organs.
Sonohysterography Ultrasound is the standard imaging technique for evaluating the uterus and ovaries, detecting fibroids, ovarian cysts and tumors, and finding obstructions in the urinary tract.
Other diagnostic procedures include Hysteroscopy that detects the presence of fibroids, polyps, or other causes of bleeding, Laparoscopy for diagnosing endometriosis, a common cause of dysmenorrhea, Endometrial Biopsy that helps to identify abnormal cells, Dilation and Curettage (D&C).