Problems Related To Menstruation

 Some common problems include:

  • Amenorrhea: means a lack of menstrual period, which may occur:
    • With young women not starting their period by age 15 years called primary amenorrhea
    • With women who do not have a period for 90 days (secondary amenorrhea) which can be due to:
      • Pregnancy
      • Breastfeeding
      • Extreme weight loss
      • Eating disorders
      • Excessive exercising
      • Stress
      • Other medical conditions like polycystic ovary syndrome (PCOS), etc
  • Dysmenorrhea: means painful periods, which in teens is due to excessive progesterone and in adults due to uterine fibroids or endometriosis
  • Pre-menstrual syndrome: symptoms starts a few days before periods and goes away with start of the bleeding. Symptoms include:
    • Bloating
    • Irritability
    • backaches
    • headaches
    • breast soreness
    • acne
    • food cravings
    • excessive fatigue
    • depression
    • anxiety
    • feelings of stress
    • insomnia
    • constipation
  • Abnormal uterine bleeding includes:
    • Bleeding between periods
    • Bleeding after sex
    • Spotting anytime in the menstrual cycle
    • Heavy bleeding during period
    • Longer periods for more than 7 days
    • Bleeding after menopause

Causes include but not limited to:

  • Fibroids, polyps or cancers
  • Systemic disorders of blood coagulation
  • Hypothyroidism
  • Cirrhosis
  • Threatened, incomplete or missed abortion
  • Endometriosis
  • Dysfunctional uterine bleeding
  • Premature ovarian failure
  • Pelvic inflammatory disease
  • Vaginal or cervical infections

Investigations: may be done as required. The doctor will first do a physical examination and a vaginal examination to assess the problem.

  • Blood tests: hemoglobin levels, thyroid profile, liver function tests, hormone levels, coagulation profile
  • Ultrasound abdomen and pelvis or transvaginal ultrasonography
  • Dilatation and curettage
  • Hysteroscopy
  • Laparoscopy

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