Patient's Complete Guide to Menstruation Problems

Overview of Menstruation Problems

Menstruation cycle (ماہواری کا بے ترتیب کرنا/Mahwari ka Betartib Kerna) is the monthly hormonal cycle in which the women's reproductive system prepares for reproduction. The cycle involves the production of oocytes and the building up of the uterus lining for pregnancy. The cycle is generally completed in 28 days, after which women experience menstruation (periods).

Menstrual cycles are usually associated with a variety of uncomfortable symptoms. Menstruation problems vary from one woman to another.

Types of Menstruation Problems

There are various forms of menstruation problems that you may experience such as.

1. Premenstrual Syndrome (PMS)

PMS occurs 1-2 weeks before the starting of your periods. Some women experience many physical and emotional symptoms before the onset of their periods. However, in others, the symptoms are either mild or absent. PMS can cause:

  • Backaches
  • Bloating
  • Irritability
  • Acne
  • Headaches
  • Breast soreness
  • Depression
  • Food cravings
  • Excessive fatigue
  • Insomnia
  • Anxiety
  • Feelings of stress
  • Mild stomach cramps
  • Constipation
  • Diarrhoea

These symptoms and their severity can be different every month. Although PMS makes you uncomfortable it is not worrisome unless it interferes with your daily activities.

2. Heavy Periods/Heavy Bleeding

Heavy bleeding is another typical menstrual problem. It is also known as menorrhagia. In this condition, you may experience more bleeding than normal. Your periods may last for longer than an average of 5-7 days.

Heavy periods mostly happen due to an imbalance of hormones such as progesterone and estrogen.

Some other common reasons for heavy bleeding are:

  • Vaginal infections
  • Puberty
  • Inflammation of the cervix
  • Noncancerous uterus tumors (fibroids)
  • Underactive thyroid gland (hypothyroidism)
  • Changes in diet or exercise

3. Painful Periods

Painful periods are another irritating menstrual problem. During PMS, cramps normally occur due to the contraction of the uterus before the beginning of periods. However, some women experience severe and unbearable pain. This condition is also known as dysmenorrhea. Painful periods mostly occur due to medical problems such as:

  • Abnormal tissue growth outside of the uterus (endometriosis) 
  • Pelvic inflammatory disease
  • Fibroids

4. Absent Periods

In some cases, women don’t get their periods, a condition called amenorrhea

Types of Amenorrhea

  • Primary Amenorrhea happens if you don’t get your first period by age 16. Its possible reason could be the improper functioning of the pituitary gland, a congenital malformation of the female reproductive system.
  • Secondary Amenorrhea occurs if you don’t get regular periods or with a six or more months gap. 

Some common causes of primary and secondary amenorrhea in teenagers are:

  • Ovarian cysts
  • Anorexia
  • Overactive thyroid gland (hyperthyroidism)
  • Pregnancy
  • Sudden weight gain or loss
  • Birth control

However, in adults the reasons for absent periods are different. The most common reasons are:

  • Stopping birth control
  • Premature ovarian failure
  • Breastfeeding
  • Pelvic inflammatory disease (a reproductive infection)
  • Pregnancy
  • Menopause

Risk Factors of Menstruation Problems

Age plays a vital role in causing menstrual problems. Girls who start menstruating at a younger age are more likely to experience severe pain and longer cycles.

Women who are approaching menopause or premenopause may also start skipping periods. Episodes of occasional heavy bleeding are also common as women approach menopause.

Some other risk factors include:

  • Weight: Being overweight and underweight can increase the risk of menstrual issues. People with weight fluctuations often have dysmenorrhea (painful periods) and amenorrhea (absent periods).
  • Pregnancy History: Women who have had a higher number of pregnancies are at a risk for menorrhagia (heavy bleeding). Women who have never given birth have a risk of dysmenorrhea, while women who gave birth at a younger age are at lower risk.
  • Smoking: Smoking can be a huge cause of heavy and painful periods.
  • Menstrual Cycles and Flow: Longer and heavier menstrual cycles are associated with painful periods.

Complications associated with Menstrual Problems

A number of complications might occur when you have menstrual problems. These include:

  • Anemia

Heavy menstrual bleeding is the most common cause of anemia (reduction in red blood cells), especially in premenopausal women. A blood loss that is more than 80 ml per menstrual cycle can eventually lead to anemia.

Severe anemia if not treated can cause heart problems.

  • Osteoporosis

Absent or irregular periods can cause the estrogen levels to reduce, which leads to osteopenia (loss of bone density) and osteoporosis (severe bone loss that increases the risk of fractures).

  • Infertility

Some of the conditions associated with heavy bleeding such as fibroids, ovulation abnormalities, and endometriosis can contribute to fertility. Irregular periods occurring because of any cause can make it difficult for you to conceive.

Prevention

Here are some of the recommendations for self-care and preventing menstrual problems:

  • Maintain a healthy lifestyle by exercising moderately and have healthy nutritious food options. If you are losing weight, do it gradually and don’t turn to diets that drastically limit your calorie and food intake.
  • Rest plays a very vital role. Make sure to give your body the rest that it requires.
  • Cut back on prolonged and intense exercises in case you are an athlete. Excessively done sports activities can cause irregular periods.
  • Use birth control pills or other contraceptive methods as directed. Avoid self-medication.
  • Change your sanitary napkins every four to six hours to avoid toxic shock syndrome and prevent infections.

Diagnosis

Your doctor will diagnose your menstrual problem in the following manner

  • Physical Exam: During this, the doctor will inquire about your symptoms and their duration. For this, the gynecologist will require complete notes about the regularity and symptoms of your periods. This will help the doctor to find the abnormality responsible for menstrual issues.
  • Pelvic Exam: This test helps the doctor to assess the reproductive organs and to determine if the vagina or cervix is inflamed. Through a pelvic exam, your doctor assesses the reproductive organs and determines if your vagina or cervix is inflamed.
  • Blood Tests: Blood tests help to determine hormonal abnormalities causing menstrual problems. If the doctor suspects that you are pregnant, other blood or urine pregnancy tests will be performed. 

Other tests that are performed to diagnose the source of menstrual problem include: 

  • Endometrial Biopsy: A tissue sample from the uterus is extracted and analyzed. 
  • Hysteroscopy: A testing method in which a small camera is inserted inside the uterus to locate the abnormalities.
  • Ultrasound: Used to see a detailed image of your uterus.

Treatment of Menstruation Problems | When to Consult a Doctor

Menstrual problems are treated in various ways from home remedies to advanced medical treatment depending upon the severity of the condition. 

Home Remedies of Menstrual Problems

  • Yoga: As per studies, 35-40 minutes of yoga for 6 months helps to reduce hormonal irregularities that cause menstrual problems. It also helps in the management of emotional issues.
  • Healthy Weight: Maintain a healthy weight to overcome menstrual problems. Being overweight or underweight increases the chances of menstrual problems.
  • Exercise: Regular exercise not only maintains a healthy weight but also reduces the pain during and after periods.
  • Use of Ginger: Although no scientific proof is available, it is believed that the use of ginger can relieve PMS symptoms.
  • Vitamins: As per studies, Vitamin D and B-6 intake can relieve menstrual problems especially symptoms of PMS, heavy bleeding, and PCOS.
  • Drink Apple Cider: The use of apple cider helps in the treatment of irregular periods.
  • Pineapple: Pineapple helps in the relief of PMS symptoms, especially headaches and cramps.

Medications

  • The cause of the problem often determines the method of treatment. Usually, to relieve PMS symptoms or heavy bleeding, birth control pills are recommended.
  • Hormone replacement therapy is used if your menstrual problems are due to hormonal imbalance.
  • Pelvic inflammatory diseases are treated by the use of antibiotics.

If you notice the following menstrual problems consult a Gynecologist:

  • Haven't got your periods for 90 days
  • Have a period more often than every 21 days
  • Periods become unusually heavy
  • Sudden irregularity in periods
  • Bleeding between periods
  • The period lasts for more than a week
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