Menstrual Disorders

Menstrual disruptions can take different forms:

• Heavy periods also called menorrhagia, involve bleeding that is unusually heavy or lasts longer than normal.
• Painful periods, known as dysmenorrhea, cause cramps that are more severe than usual.
• Irregular periods can occur in two ways:
  • Oligomenorrhea occurs when cycles are too long (more than 35 days)
  • Polymenorrhea occurs when the cycles are too short (less than 21 days).
• Missed periods, known as amenorrhea, happen when you do not have a period for three or more consecutive months, without being pregnant.
• Premenstrual syndrome (PMS) causes a group of emotional and physical symptoms before your period starts.
• Premenstrual dysphoric disorder (PMDD) is a more severe form of PMS that leads to significant mood changes and disrupts daily life.

The symptoms of menstrual disorders depend on the specific condition, but common signs to watch out for include:

• Experiencing unusually heavy bleeding, such as needing to change a tampon or sanitary pad every hour for several hours.
• Having prolonged periods that last more than seven days.
• Bleeding between periods or after menopause.
• Missing periods for three or more months.
• Experiencing severe menstrual cramps that do not improve with over-the-counter pain relievers.
• Experiencing fatigue, dizziness, or shortness of breath due to heavy blood loss.
• Mood swings, irritability, or depression around the time of your period, especially if it significantly affects your daily life.

The causes of menstrual disorders vary depending on the type of problem, and often more than one factor may be involved:

• Hormonal imbalance can cause fluctuations in the levels of hormones such as oestrogen and progesterone, leading to irregularities in the menstrual cycle. Hormonal imbalances are especially common during puberty, after childbirth, and close to menopause.
• Pelvic inflammatory disease (PID) can lead to irregular periods and result from infections in the female reproductive organs.
• Polycystic ovary syndrome (PCOS) can cause irregular periods and is often linked to higher levels of androgens (male hormones), which can affect menstrual regularity.
• Thyroid disorders, whether an overactive thyroid (hyperthyroidism) or underactive thyroid ( hypothyroidism) can affect menstrual regularity.
• Uterine fibroids, which are non-cancerous growths, may cause heavy or prolonged periods.
• Endometriosis occurs when tissue similar to the uterine lining grows outside the uterus, causing painful periods.
• Certain medications, such as birth control pills, blood thinners, and some other drugs, can affect your cycle.
• Stress and lifestyle factors, including extreme stress, rapid weight changes, or extreme exercise can disrupt the menstrual cycle.

Depending on your symptoms, we may use the following diagnostic tools:

• A pelvic exam helps identify any abnormalities in the reproductive organs.
• Blood tests check for hormonal imbalances, thyroid issues, or underlying health conditions.
• An ultrasound provides images of the uterus, ovaries, and pelvic organs to detect fibroids, polyps, or cysts.
• An endometrial biopsy involves taking a small sample of the uterine lining to rule out other conditions.
• Hysteroscopic surgery uses a thin, lighted instrument inserted into the uterus to detect abnormalities, such as fibroids or polyps.

The treatment for menstrual disorders depends on the cause, but here are the most common options:

• Taking medication, such as ibuprofen, can reduce cramps, and heavy bleeding. Hormone-based treatments (HRT), including birth control pills, can regulate or lighten periods.
• Hormone replacement therapy (HRT), including progestin therapy or hormonal IUDs can reduce heavy bleeding and regulate the menstrual cycle.
• Surgery may be recommended to remove uterine fibroids, polyps, or endometrial tissue causing pain and heavy bleeding.
• Lifestyle adjustments, including stress management, exercise, and maintaining a healthy weight can make a noticeable difference.
• Treatment for underlying conditions such as thyroid disease, PCOS is often the first step in restoring a normal menstrual cycle.

It is important to see a doctor if your menstrual cycle significantly affects your life, causes severe pain, or involves heavy or irregular bleeding.

While it is not always possible to prevent menstrual disorders, maintaining a healthy lifestyle can help keep your cycle regular and your symptoms manageable:

• Maintaining a healthy weight helps support regular periods.
• Engaging in regular exercise promotes overall hormonal balance
• Managing stress appropriately can prevent menstrual irregularities 

Eating a balanced, nutritious diet supports healthy hormone levels and menstrual cycles

If you experience symptoms of menstrual disorders, you should consult a gynaecologist, who specialises in women’s reproductive health. Depending on the underlying cause, your doctor may also refer you to:

• An endocrinologist for hormonal or thyroid-related problems.
• A reproductive endocrinologist if fertility issues are involved.
• A psychologist or psychiatrist if mood-related symptoms such as PMS or PMDD significantly affect daily life.