Monthly Mysteries: Decoding Menstrual Cycle Disorders
Every month, a woman’s body prepares itself for a possible pregnancy.
The menstrual cycle, typically lasting around 28 days, usually gets on without a hitch. Each month, a mature egg is released from the ovary and travels along the fallopian tube towards the uterus.
If the egg is not fertilized along the way, a signal is sent to the uterus (which has been preparing for implantation), to shed its linings. This shedding is what we normally call a period, and it’s like the body saying, “There’s no baby on the way.”
There’s a great degree of individual variation for the “regular” menstrual cycle.
For example, some women have their first period (menarche) as early as 9 years old. Others can be as late as 16.
Some young women have cycles that last as long as 45 days. Others are considerably shorter at 21 days.
Some women experience menopause before 40. Others experience it at 60.
So depending on genetics, diet, lifestyle, and hormones, different women have their own personal experiences with the menstrual cycle.
That said, the issues we’ll be talking about here lie outside these broad variations.
The 5 Most Common Menstrual Disorders
1) Heavy menstrual bleeding (Menorrhagia)
The condition is called menorrhagia and involves excessive blood loss.
Around 9-14% of women regularly suffer heavy bleeding.
The bleeding is also often prolonged and lasts longer than 7 days. Women go through sanitary pads or tampons quickly, needing to change them frequently during the day, passing large blood clots, and experiencing fatigue or anemia due to blood loss.
Women often feel weak and sluggish as a result.
Menorrhagia can be caused by various factors, including hormonal imbalances, certain medical conditions (like bleeding disorders or thyroid problems), uterine fibroids or polyps or adenomyosis, blood clotting disorders, liver disease, kidney disease, and leukemia.
Complications or infections in the use of IUDs can also be a cause.
Because there are a lot of factors involved, a visit to the doctor is often warranted to help determine its cause, as well as the appropriate course of treatment.
2) Very light menstrual bleeding (Hypomenorrhea)
The opposite of the condition above is hypomenorrhea. This is when the bleeding is over in less than 48 hours and has a volume of less than 80ml.
Like above, there’s a wide range of reasons for the condition. It can happen as a result of:
stress
hormonal imbalance,
excessive exercise
contraceptives
low body fat
thyroid disorders
Depending on the underlying cause, hypomenorrhea can sometimes be associated with fertility issues. Irregular or very light menstrual periods may indicate ovulatory problems, which can affect a woman's ability to conceive.
Treating it may include hormonal therapies to regulate menstrual cycles, addressing lifestyle factors like excessive exercise or low body weight, or managing underlying medical conditions.
3) Frequent menstrual bleeding (Polymenorrhea)
Women can sometimes have shorter menstrual cycles. This results in more frequent and irregular periods.
Now this can be normal, but it can also be a symptom of an underlying condition.
Polymenorrhea can be because of a short luteal phase. But like the previous two conditions, it can also be brought about by a broad range of reasons: stress, STDs, endometriosis, adenomyosis, polyps, fibroids, malignant tumors, menopause, etc.
Women do not only get faint and weak because of the frequent bleeding. The condition could lead to anemia.
And with cycles less than 21 days, the periods are irregular and unpredictable. As a result, fertility becomes an issue. According to a study of over 2000 women who wanted to get pregnant, those with irregular cycles are less likely to become successful.
Some women are irregular and do not have an underlying condition. For others, it can be a symptom. The only way this can be sorted out is for the individual to see their doctor and undergo medical tests and assessment.
4) Rare menstrual bleeding (Amenorrhea)
Girls who have not yet reached puberty, pregnant women, breastfeeding, or approaching menopause do not have their periods.
But when a woman is of age, like when she has turned 16 but has not yet had her first menstruation, there might be some issues with the endocrine system, which regulates hormones. This is called primary amenorrhea—which refers to the absence of periods in a woman of age.
Besides endocrine issues, genetic disorders, chronic illnesses, and reproductive organ problems may cause primary amenorrhea.
There’s also something called secondary amenorrhea. This is when a woman who has already experienced menstrual cycles in the past suddenly stops having them (for 3 or more consecutive months).
Secondary amenorrhea can be caused by things like stress, excessive exercise, sudden weight loss or gain, hormonal imbalances such as Polycystic Ovary Syndrome (PCOS), thyroid disorders, pituitary gland disorders, or certain medications.
Amenorrhea can have various impacts on a woman's health, including potential fertility issues. Moreover, it can also indicate underlying health problems that need to be addressed. Diagnosis involves a thorough medical evaluation, including medical history, physical examination, and sometimes blood tests or imaging studies.
5) Dysmenorrhea
The regular monthly period already is an uncomfortable experience. Dysmenorrhea takes the pain and discomfort to excessive levels—characterized by severe cramps and abdominal pain.
Dysmenorrhea affects a lot of women and is usually not a cause for concern, but the pain and discomfort can be disruptive to daily activities. Besides the sharp, throbbing pain in the lower abdomen, women also experience backache, leg pain, nausea, vomiting, diarrhea, headache, and fatigue.
Dysmenorrhea has two main types:
Primary Dysmenorrhea
This is the most common type and is experienced by young women when they begin menstruating. The pain is felt in the lower abdomen and can range from mild to severe.
It is not associated with any underlying medical conditions and is considered a normal part of the menstrual cycle. The resulting pain is caused by the release of certain chemicals called prostaglandins in the uterine muscle. These chemicals cause the uterine muscles to contract more forcefully, which can lead to pain and discomfort.
Over-the-counter pain relievers like ibuprofen or naproxen can help alleviate the pain and reduce inflammation. (For severe cases, prescription medications may be considered.)
Heat therapy, such as a heating pad or warm bath, can provide relief.
Finally, lifestyle changes, like regular exercise and a balanced diet, may help reduce the severity of dysmenorrhea.
Secondary Dysmenorrhea
This is the more problematic type. Not just because of the severe pain involved, but because it is most likely a symptom of an underlying medical condition.
Unlike primary dysmenorrhea, secondary dysmenorrhea usually develops later in life and may even be more severe.
The pain in secondary dysmenorrhea is often related to issues in the reproductive organs or the pelvic region. The issue could be endometriosis, fibroids, Pelvic Inflammatory Disease (PID), or adenomyosis.
Treating the underlying condition can alleviate the pain associated with secondary dysmenorrhea.
How do you know if the pain is primary or secondary dysmenorrhea? That’s an important question.
The menstrual cycle is a complex interplay of many factors. You may have noticed in this post that there are often no straight answers to the conditions mentioned. It’s a testament to the complexity of the female body.
It takes close cooperation between patient and physician, and some tests to get a complete picture of the issue, whether it’s dysmenorrhea, amenorrhea, polymenorrhea, etc.
Because the menstrual cycle is closely associated with reproductive potential, any menstrual issue can potentially have an impact on fertility. Couples who want to conceive can benefit from understanding menstrual conditions.
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