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Menstrual problems: Types, causes and treatment

Menstrual Problems

Menstruation is a part of women’s lives. It hits them at an early age of 12 yrs and remains throughout till the age of 45-55 years. Majority of woman considers motherhood as a blessing in disguise and it is the occurrence of regular menstrual periods that helps a woman to attain motherhood. But menstruation is not always a smooth phenomenon and in majority of the time takes a toll on a woman’s body and mind. Excessive, scanty and irregular periods along with heavy pain and discomfort are a common scenario. Sometimes faulty periods are a result of underlying diseases. Hence, it is an absolute necessity to have proper knowledge about menstruation.

This article aims to guide you on the types, causes and the treatments of menstrual problems.

1. Amenorrhoea

When a girl or a woman suffers from complete absence of menstruation, it is known as amenorrhoea. It can be further divided into two types,

a. Primary Amenorrhoea: A girl normally starts to menstruate by the tender age of 12 years. This is when she attains her puberty. Signs of sexual development take place like breast development along with the growth of pubic hair. But a girl suffering from amenorrhoea doesn’t have her first period even at the age of 14, along with the complete absence of sexual development. In other case, a girl of sixteen who otherwise has normal sexual development but hasn’t yet has her first menstruation (also known as menarche), also suffers from primary amenorrhoea.

b. Secondary Amenorrhoea: If a woman/girl who otherwise has regular periods misses it for over a time span of six consecutive months, suffers from Secondary Amenorrhoea. If we exclude the case of pregnancy, around 20-30% of women suffers from it sometime during their reproductive life.

Causes

Hormonal disbalances such as under activity of hypothalamus or pituitary gland or existence of tumor inside them are one of the major causes. Extreme weight loss and anorexia, excessive exercise, and high level of stress and depressions also lead to amenorrhoea. Kindly take notice of any kind of problem inside ovary as these may lead to this disease. Some of the signs that you should be cautious of are:

i. High blood levels of male hormones

ii. Genetic disorders. For example: Turner syndrome

iii. Premature ovarian failure

iv. Polycystic ovary syndrome (PCOS)

Treatment

Well, it depends upon the actual cause. What actually the woman wants also plays a crucial role in its treatment. There are many women out there who don’t consider amenorrhoea a problem until and unless they have plans to start a family. But one must always keep in mind that even when she suffers from it, she may be fertile and can reproduce. So, if one is not planning to start a family, it is always advisable to opt for contraceptive precautions.

2. Oligomenorrhoea

It is the occurrence of irregular and infrequent periods. Normally menstrual periods happens at an interval of 28 to 30 days but here, it occurs at intervals greater than 35 days. As a result only four to nine periods occur in a year.

Causes

Major causes are Polycystic ovary syndrome (PCOS), prolactinomas (tumor inside anterior pituitary), thyrotoxicosis (increased thyroid hormones inside blood), and hormonal changes. In PCOS, there are developments of small cysts inside the ovaries which make women infertile. It also makes the hormonal changes more complex which leads to excessive growth of body hair and excessive weight gain. Exercise such as running and swimming, which demands high endurance level, can also make a woman prone to Oligomenorrhoea. Female athletes and ballet dancers suffer more from this type of menstrual problem as compare to non-athlete females.

Treatment

Same as in the case of Amenorrhoea, here again it depends upon the underlying cause along with the wants of the women. Contraceptive precautions must be taken in case there is no plans of becoming pregnant as the woman may still be fertile.

3. Dysmenorrhoea

It is the occurrence of excessive and almost unbearable discomfort and pain during the menstrual periods.

Causes

Majority of the times there are no such underlying causes. It is considered absolutely normal to suffer from certain amount of pain and discomfort. It assures that the movements of hormones, chemicals and womb, during this time of the month are taking place properly. Dysmenorrhoea occurs when the pain and discomfort attains the level excessiveness. In fact, it becomes so much unbearable that it starts to interfere in the daily lives of the women. The pain generally hits the area across lower abdomen and pelvis and can spread to back and thighs and can last as long as 72 hours. Diarrhoea, headache, nausea, vomiting, dull ache and/or cramps in lower abdomen and pelvis are the symptoms. Heavy or scanty bleeding, painful bleeding and bleeding after intercourse are some more symptoms.

Some underlying diseases such as endometriosis (a condition where cell found in the lining of the womb are present in places other than womb) and fibroids (non-cancerous or benign growths in the uterus) are the reason behind dysmenorrhoea. In such cases, immediate treatments are absolute necessity.

Some less common causes for this problem are infection in the pelvis area and/or previous pelvic surgeries.

Treatment

Analgesia with a non-steroidal anti-inflammatory drug such as ibuprofen are sufficient to cure the pain and discomfort when there are no underlying causes. Applying hot-water bottle to the area of discomfort helps a lot in subsiding the pain. Acupuncture and TENS therapy also provides a lot of comfort. Combined oral contraceptive pills also help a lot. When it comes to diseases like endometriosis, they can be easily treated with hormones or surgery.

4. Premenstrual syndrome (PMS)

It is the most common form of menstrual problem and the symptoms shows before a day or two of the onset of monthly periods and cease to appear once the period begins. The girl/woman suffers from subtle to severe physical changes and mood swings, making her cranky, irritable, angry, low on patience and somewhat frustrated. Here, the symptom count exceeds 150 but the common ones are: low mood and irritability, bloating and breast tenderness.

Causes

Causes are not known but it is generally associated with the hormonal changes. The severity increases manifold during the time of hormonal surge, such as pregnancy and puberty. Women in the age bracket of 30-35 and ones who are at the verge of menopause suffer from the severe forms of PMS.

Treatments

Adopting a healthy lifestyle that includes balanced diet, regular exercise and stress management can surely help to a greater degree. Hormonal contraceptives, drugs and some non-hormonal alternatives (vitamin B6) are used for treatments. Evening primrose oil and diuretics can also help a great deal.

5. Menorrhagia

Here, recurrent heavy bleeding takes place. In normal condition, a woman loses up to 40ml of blood because of menorrhagia, she may lose up to 80ml or more blood. It makes her to use double sanitary protections. The blood also contains large clots of blood. Moreover this acts as a hindrance in many of the daily activities.

Causes

No causative abnormality has been identified yet. But some of the causes can be associated with the problems of endometriosis, fibroids, coagulation disorder and excessive build-up in endometrial lining.

Treatment

As no such causes are there, treatment depends upon the symptoms. In the absence of any underlying problem, bleeding can be reduced with the help of non-hormonal tablets, such as, tranexamic acid, oral contraceptives. Many a times a contraceptive coil that releases progesterone is fitted into the womb. Depending upon the woman’s wish and decision, the uterus can be removed through surgery. It is always advisable to consume iron and folic acid supplements in case heavy blood loss has lead to anaemia.

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