Menstruation is a topic that people hesitate to talk about. Due to this reason, a majority of women are not aware of what is normal and what is abnormal in their menstrual cycle. In this article we will discuss about the fundamental and common Menstrual Problems that a woman should know.
What is Menstrual Cycle?
A Menstrual cycle brings about various types of discomforting signs that results in the menstrual period. From mild cramps and mood swings, to headache and fatigue, a woman experiences several signs before the beginning of her periods. This is referred to as premenstrual syndrome.
Once the period starts, all these symptoms disappear on its own. However, in some cases, menstruation can be very heavy, very light, or does not happen at all. This is considered to be an abnormal menstrual cycle.
Working of the Menstrual Cycle
Before we move on to the actual menstrual problems, let us first get an idea about menstrual issues.
A normal menstrual cycle is of twenty-eight days. This implies that the time gap between two menstrual periods is of the duration of twenty-eight days. It is calculated from the first day of the menstrual period. A normal menstrual period lasts for around four to five days in a woman. During this time, a women experiences series of changes in her ovaries, vagina, breasts, and uterus.
As the age increases, the duration of menstrual period reduces. A teenage girl may have a period of six days, but when she reaches the age of thirty and more, this period normally reduces to four days. The first day of your menstrual period is day one of your menstrual cycle.
For some women, their monthly periods happen without any hassle. Their periods are on time and do not cause them any major inconvenience. However, in other women, they may find a series of emotional, or and physical symptoms before and at the time of menstruation. They may come across missed periods, uncontrollable mood fluctuations, and heavy bleeding that can disturb their work efficiency.
For most of the issues experienced in menstrual cycle, there are a wide range of treatment options available to treat them. If you feel overwhelming, then you should seek assistance of a gynecologist. After the precise detection of symptoms, your doctor will help you select the most appropriate treatment that will make your periods tolerable.
What are normal discomforting symptoms in menstruation?
A woman will start to experience discomfort from seven to ten days before the actual start of the period. This is called as “Premenstrual Syndrome”. These symptoms can be felt on physical and emotional levels.
- soreness in breast
- cravings for sweet and oily foods
- excessive tiredness
- mild cramps in stomach
- mood fluctuations
- not able to focus
Some women experience all of these symptoms, while others experience a few of them or not at all. Also, the severity of these symptoms can vary from one woman to another. It is normal that these symptoms bring discomfort, but if it becomes unbearable, then you need to seek medical assistance of the doctor.
Different Types of Menstrual Problems
Let us see what types of menstrual problems can a woman experience.
1. Heavy Periods
Heavy Period, or heavy flow of blood is one of the common problems that women face in their menstrual cycle. This condition is called as menorrhagia. The length of the duration of menstrual periods can be as long as eight days. This situation is considered to be dangerous because it results in excessive loss of blood from the body.
The major reason for this disorder is the imbalance in the levels of female hormones, as estrogen, and progesterone in the body, structural irregularities in the uterus, existing medical conditions that includes such as thyroid issues, liver, kidney ailment, leukemia, miscarriage, puberty, cervix inflammation, ectopic pregnancy, fibroids, vaginal infections, underactive thyroid gland, noncancerous uterus tumors, over physical exertion in exercise, or changes in food intake, and blood clotting disorders.
Mostly girls who are in their teens experience heavy bleeding. This condition causes tiredness, and extreme fatigue in a person. Due to facing difficulties in managing blood flow, it may even interfere with her normal activities.
2. Absent Periods
This is opposite to the above menstrual problems. In this condition, a woman does not get periods. This condition is called as amenorrhea. It is categorized into two parts, primary amenorrhea, and secondary amenorrhea.
In case of primary amenorrhea, a woman does not get her first period by the age of sixteen. The main reason for occurrence of this problem is delayed maturing of the pituitary gland, delayed onset of puberty, malfunctioning of endocrine system that regulates production of hormones, low body weight, and inherited defect of the reproductive system.
On the other hand, secondary amenorrhea happens when she fails to get regular periods for a period of more than three months, and more. It is due to inadequate production of female reproductive hormones in the body that are responsible for the regularity of menstrual cycle. Improper levels of these hormones can lead to this issue. Other reasons that can contribute to the development of this issue are stress, surgically removed ovaries, ovarian cyst, excessive exercise or physical activity, illness, or sudden weight loss.
Other reasons responsible for absence of periods in “adults” are –
- premature failure of ovaries
- pelvic inflammatory disease
- stopped consumption of birth control pills
One of the major signs of pregnancy is a missed period. It is advised to take a pregnancy test to determine if that is the reason behind your condition.
3. Premenstrual Syndrome (PMS)
There are over 150 symptoms of Premenstrual Syndrome. These symptoms can be mild and can disappear as soon as the period start. It can also become severe like depression, uncontrolled anger, and other acute psychological, and physical symptoms. Though mild symptoms are common and not an issue of worry but when they take a severe form, that is when you need to get yourself checked by the doctor.
This condition is caused due to drastic increase and decrease in the reproductive hormones in the female. It impacts the “Serotonin” chemical in the brain that powerfully affects the mood of the person.
It has been found that severity of PMS symptoms increases after each pregnancy. It can become worse with age when it finally ends at menopause. Women who suffer from PMS, often have one or more other family members with the same problem. She may even become more sensitive towards alcohol during specific times in the cycle.
4. Premenstrual Dysphoric Disorder (PMDD)
Premenstrual Dysphoric Disorder is the extreme form of Pre Menstrual Syndrome. It is a condition that causes significant intrusion with the life of a woman. The common symptoms of PMDD are anxiety, mood swings, and heightened irritability. It is found that women who has a history of postpartum depression, severe depression, or mood disorders were seen to be at a high risk of experiencing this disorder.
Emotional and physical signs of PMDD are recurring in nature. These symptoms subside on their own when the woman begins her period. As depression is not linked to the menstrual cycle, it can stay for a few weeks, to some months or years. If this condition persists, then it is required that you seek necessary assistance from a qualified therapist.
5. Painful Periods
This is another type of menstrual disorder wherein the woman will have heavier, or lighter flow accompanied by pain. This condition of painful menstruation is referred to as dysmenorrhea. Here, the woman experiences excruciating and persistent pain in the form of cramps that is caused due to contractions in the uterus. These contractions are initiated by “prostaglandin” substance released by the internal lining of uterus. This substance mixes with the bloodstream and gives you pain.
In addition to pain, you may even experience diarrhea, faintness, sweaty palms, lightheadedness, reduced blood pressure etc. It happens due to increase in the rate of intestinal contractions in the intestine caused by prostaglandins. Other reasons for experiencing painful menstruation are:
- pelvic inflammatory ailment
- endometriosis condition or abnormal growth of tissues outside the uterus
Diagnosis of Menstrual Problems
If you relate to any of these menstrual disorders, then the first thing you need to do is to get an appointment with your gynecologist. Make a record of the duration, and frequency of your periods. Note down symptoms, that includes cramping, and discuss your health history with her. Let us see how your doctor will assist you in diagnosis of menstrual disorders:
Your doctor will start off with a physical examination and will perform a pelvic exam. This test enables her to examine the condition of reproductive organs. It also helps her in determination of the inflammation in the cervix, or vagina. A Pap smear test is also a vital test to identify the reasons for menstrual disorder. By this test, she will come to know about the risks of cancer and other severe medical conditions in the body.
Blood tests is one of the best ways for the determination of hormonal imbalances in the body that is leading to menstrual issues. If you are doubtful that you are pregnant, then she may even perform a pregnancy test to find out whether it this disorder is due to pregnancy or not.
If the above tests are not sufficient to arrive at the final conclusion, then a few more tests can be performed such as:
- Endometrial biopsy. In this procedure your doctor will use scraping method to remove sample of the uterine lining for examination. This tissue is then examined under a microscope to figure out health risks like cancer.
- This procedure is done to find out any abnormalities in the body. A camera is inserted into the uterine cavity to identify any unusual conditions. This is done using a miniature telescope-like instrument known as hysteroscope.
- This procedure uses high-frequency sound waves to produce a clear picture of the uterus. It will help her to identify any deformity in the uterus. To perform this procedure, it is required to fill the uterus with a saline solution.
- Dilation and curettage. In this procedure, the cervix is widened and medical instruments are used for scraping the uterine lining. It is performed under local anesthesia.
Treating Menstrual Problems
Having diagnosed the problem that is causing the menstrual disorder, your doctor will make a comprehensive plan of action to treat the disorder effectively. Some of the treatments that can be advised are as follows:
- Birth control pills helps to reduce the severity of PMS symptoms, and regulate heavy blood flows.
- If a woman notices low or heavy blood flow due to thyroid or any other hormone-related disorder, then hormone replacements are seen to be potent in establishing a regularity in periods.
- Dysmenorrhea is related to hormones and need further medical help to address the issue. This includes prescription of antibiotics for the treatment of pelvic inflammatory ailment.
- There are no specific diagnostic tests advised for PMDD, and PMS. Your doctor will advise you to note down the signs. A checklist of premenstrual symptoms is commonest way to evaluate these symptoms. This tool allows you to track the severity, and type of symptoms for identification of a pattern.
At the time of initial health evaluation with the doctor, you can consult on following areas:
- existing medications
- details about flow of menstrual blood and length of menstrual cycle
- gynecologic disorders, or surgery
- history of STD
- history of the use of contraceptive pills
- hereditary of fibroids and conditions linked with AUB
- history of discharge from breasts
- blood clotting disorders within family members.
Irregularity between menstrual periods is quite common. Occasional heavy, or light blood flow is not a worrisome issue. However, if you experience heavy flow with severe pain and blood clots, then you need to immediately call the doctor. It is advised to get medical attention if you get period within twenty days, or after thirty-five days.
Do not compare your menstrual cycle, and symptoms with other women. As everyone’s body composition is different, your experiences can also be different. If you find any abnormality in your regular menstrual cycle, then it is best to seek advice of your doctor, and get it treated at the earliest.
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