Menstrual Disorders

Types of Menstrual Disorders

Menstrual disorders include:

• Painful cramps (dysmenorrhea) during menstruation.

• Heavy bleeding (menorrhagia) includes prolonged menstrual periods or excessive bleeding.

• Absence of menstruation (amenorrhea).

• Infrequent menstruation (oligomenorrhea) refers to menstrual periods that occur more than 35 days apart.

Treatment Options

Treatment may include:

• Dilation and curettage may help restore your normal cycles.

• Endometrial ablation is a surgical option. This should only be considered when you are done childbearing, and you should use a highly effective form of birth control.

• Hysterectomy may be the treatment of choice for some women.

Heavy, Painful & Irregular Bleeding

Dysmenorrhea (Painful Cramps)

Dysmenorrhea is severe, frequent cramping during menstruation. Pain occurs in the lower abdomen but can spread to the lower back and thighs.

Menorrhagia (Heavy Bleeding) 

Menorrhagia is the medical term for significantly heavier periods. A rough gauge is changing your pad more than 3-6 times per day. Women should consult their doctor if any of the following occurs:

• Soaking through at least one pad or tampon every 1 - 2 hours for several hours

• Heavy periods that regularly last 7 or more days

• Bleeding between periods or during pregnancy. Spotting or light bleeding between periods is common in girls just starting menstruation and sometimes during ovulation in young adult women, but it is still a good idea to speak with a doctor. Women who experience any post-menopausal bleeding should definitely contact their doctors.

• Flow that is longer or heavier than your normal.

Metrorrhagia (Irregular bleeding)

Metrorrhagia also called breakthrough bleeding. The bleeding occurs between periods or is unrelated to periods.

DYSMENORRHEA (PAINFUL PERIODS): Causes

Dysmenorrhea is caused by prostaglandins, hormone-like substances that are produced in the uterus and cause the uterine muscle to contract. Prostaglandins also play a role in the heavy bleeding that causes dysmenorrhea.

Dysmenorrhea can be caused by a number of medical conditions.

• Endometriosis is a chronic and often progressive disease that develops when the tissue that lines the uterus (endometrium) grows onto other areas, such as the ovaries, bowels, or bladder.

• Uterine Fibroids are benign growths that grow in the muscular wall of the uterus. They can cause heavy bleeding during menstruation and cramping pain.

• Other Causes. Pelvic inflammatory disease, ovarian cysts, ectopic pregnancy, and the intrauterine device (IUD) contraceptive can also cause dysmenorrhea.

SURGICAL OPTIONS

Women with heavy menstrual bleeding, painful cramps, or both have surgical options available to them. Most procedures eliminate or significantly affect the possibility for childbearing, however.

Endometrial Ablation destroys the entire lining of the uterus (the endometrium). For most women, this procedure stops the monthly menstrual flow. In some women, menstrual flow is not stopped but is significantly reduced.

Endometrial ablation is not appropriate for women who:

• Have recently been pregnant

• Would like to have children in the future

• Have certain gynecologic conditions such as cancer of the uterus, endometrial hyperplasia, uterine infection, or an endometrium that is too thin

Hysterectomy is the surgical removal of the uterus. However, with newer medical and surgical treatments available, hysterectomies are performed less often than in the past. Hysterectomy, unlike drug treatments and less invasive procedures, cures menorrhagia completely, and most women are very satisfied with the procedure. Hysterectomy may or may not be done with or without removal of your ovaries.