Understanding Menstrual Disorders

Menstruation is a normal bodily function where the body periodically expels blood through the vagina. The sequence of occurrence is fairly predictable, the volume of blood is fair in volume and events before / during one’s days aren’t very intense.

Menstrual disorders are abnormal conditions that affect a woman’s menstrual cycle, leading to symptoms such as very painful cramps, irregular periods, heavy bleeding, or absence of menstruation. These are important symptoms to look out for.

Menstrual disorders manifest in various ways, including intense pain during menstruation, heavy or prolonged bleeding, missed periods, or irregular cycles. They can significantly impact a woman’s physical and emotional well-being.

Common Types of Menstrual Disorders

It is important to know that know every woman and girl receive menstrual health the normal way. There are a number of women and girls who experience severe and non-severe menstrual health disorders as described below:

1. Amenorrhea:

Amenorrhea refers to the complete absence of periods. There are two types of amenorrhea: Primary amenorrhea: This occurs when a girl is above the age of 16 and has not yet experienced her first period. Secondary amenorrhea is the absence of menstruation for three or more months. This can be caused by hormonal imbalances, stress, excessive exercise, or underlying health conditions like polycystic ovary syndrome (PCOS).

Girls usually get their first menstrual period when they’re 12 or 13. A delay in starting periods isn’t usually anything to worry about. However, if you haven’t started your period by around 16, it’s a good idea to see your doctor to find out why it hasn’t happened yet.

Some people start their periods later than others, and that’s normal. But by age 15, 98% of teens have started their periods. When this transformative milestone unfolds much later than expected, it gives rise to a condition known as delayed menarche.

Delayed menarche refers to the delayed onset of the first menstrual period beyond the typical age range (12-14).  This may impact psychological well-being, as girls might face emotional challenges related to differences from their peers.

This delay can stem from various factors, including genetic predispositions, nutritional influences, chronic illness, stress, or intense physical activity.

Effects of delayed menarche include; delayed puberty milestones, psychological or emotional challenges due to perceived differences from peers and bone density effects.

• Dysmenorrhea:

Severe menstrual cramps and pain that can interfere with daily activities. This condition may be associated with endometriosis or fibroids.

Menstrual cramps are throbbing or cramping pains in the lower abdomen that occur just before or during a menstrual period. They are often caused by uterine contractions during menstruation and can vary in intensity and duration, affecting daily activities for some individuals.

The intensity and timing of period cramps vary from person to person, as does finding the right combination of remedies for relief. Herbs, minerals, exercise, and certain foods can help ease cramps.

Menstrual cramps themselves usually don’t cause complications, other than disrupting your daily life. Still, If you have severe or unusual menstrual cramps or cramps that last for more than three days, contact a healthcare provider.

The goal of the examination is to determine if a medical condition is causing painful periods. If there isn’t an apparent cause, your provider will diagnose you with primary dysmenorrhea. However, if your provider thinks you may have secondary dysmenorrhea (caused by another health condition), you may need additional tests.

Both primary and secondary menstrual cramps are treatable, so it’s important to get checked.

• Menorrhagia:

Heavy or prolonged menstrual bleeding that can lead to anemia and other health issues. Common causes include fibroids, hormonal imbalances, or certain medications.

A person with menorrhagia is one who experiences bleeding that lasts longer than 7 days or very heavy bleeding that causes them to soak through one or more tampons or pads every hour for several hours in a row.

Our average blood loss during menstruation is about two – three table spoons equating to 30–45 milliliters, over 4–5 days. However, a person with menorrhagia loses more the 80mls.

Heavy menstrual bleeding is very common, and about 33% of females seek treatment for it. The statistics signify a more serious health problem.

Signs you’re losing too much blood during your period include feeling weak, dizzy or lightheaded, pale skin, have trouble breathing, very painful cramps, changes in consciousness and shortness of breath. A period is considered heavy when you bleed for more than seven days, pass large clots, or have to change your pad or tampon every one to two hours. These could be signs that your body is losing too much blood too quickly, or that there’s a more serious issue that needs urgent care.

Abnormally heavy or prolonged menstrual bleeding has many causes. These causes of menorrhagia fall under three major categories: uterine-related problems, hormone-related problems, and other illnesses or disorders.

The doctor will consider the person’s age, general health, and medical history, as well as their preferences and needs regarding menstruation. This information feeds into the eventual course of treatment.

• Irregular Periods:

Cycles that are shorter than 21 days or longer than 35 days. Irregularities are common in adolescents and women approaching menopause. Irregular menstruation is a menstrual disorder whose manifestations include irregular cycle lengths as well as metrorrhagia (vaginal bleeding between expected periods).

Primary amenorrhea is the lifelong absence of menses. This requires evaluation if menarche has not occurred by age 15. Secondary amenorrhea is characterized by cessation of previously regular menses for three months or previously irregular menses for six months. Both types warrant examination.

Irregular periods are more common among adolescents in the ages 9 to 14 and around age 50 or just before menopause. The causes of irregular menstruation vary from person to person but the common factors are related to lifestyle, changes in hormone levels, stress, certain health conditions, medications, body weight, smoking status and more.

There are many causes of irregular periods, ranging from stress to more serious underlying medical conditions.

Medical conditions and irregular periods

Certain health conditions are associated with missed menstrual periods. They include:

• Endometriosis; this occurs when endometrial tissue grows outside of your uterus. The tissue often attaches itself to your ovaries or fallopian tubes. Endometriosis may cause abnormal bleeding, cramps or severe pain before and during your period.
• Pelvic inflammatory disease (PID); this is a bacterial infection that affects the female reproductive organ. It’s typically caused by an untreated sexually transmitted infection (STI). Bacteria enter your vagina and spread to your uterus and upper genital tract. Symptoms of PID include a heavy vaginal discharge with an unpleasant odor, irregular periods and pelvic pain.
• Polycystic Ovary Syndrome; In polycystic ovary syndrome (PCOS), your ovaries make large amounts of androgens which are a type of hormone. This hormone prevents or delays ovulation, causing irregular periods. People with PCOS may stop menstruating completely.
• Primary Ovarian Insufficiency; This condition occurs in women under age 40 whose ovaries don’t function as they should, causing missed or irregular periods. It can occur during treatment for cancer with chemotherapy and radiation or if you have certain autoimmune conditions.

• Premenstrual Syndrome (PMS):

A range of emotional and physical symptoms that occur in the lead-up to menstruation, including mood swings, bloating, and irritability. In some cases, symptoms can be severe enough to be classified as Premenstrual Dysphoric Disorder (PMDD).

Common Causes of Menstrual Disorders

Menstrual disorders can arise from various factors, including:

1. Hormonal Imbalances: Fluctuations in hormones can disrupt the menstrual cycle.
2. Stress and Lifestyle Factors: High stress levels, significant weight changes, and excessive exercise can affect menstruation.
3. Medical Conditions: Conditions such as PCOS, endometriosis, and uterine fibroids can lead to menstrual irregularities.
4. Menstrual disorders like clotting disorders can have broader health implications, including infertility, anemia, and osteoporosis.
5. They can also affect a woman’s quality of life, leading to emotional distress and physical discomfort.

If you experience significant changes in your menstrual cycle or symptoms that disrupt your daily life, it is essential to consult a healthcare professional for proper diagnosis and treatment options. Early detection and management can help minimize complications and improve overall health.

Key points to note and ponder during your menstruation period.

• It is important to maintain proper hydration during menstruation. Drinking an adequate amount of water is beneficial for flushing toxins from the body and keeping the urinary tract clean. The body can replenish these fluids and prevent dehydration, which can lead to symptoms such as fatigue, headaches, bloating, and constipation.
• It is important to avoid using scented or fragrant pads, tampons, or any other products for the genital areas. The genital area is sensitive and using scented products can disrupt this delicate balance, leading to infections, inflammation, or other complications.
• Tracking your menstrual cycles and keeping a check on them with period tracker tools allows you to anticipate your upcoming periods so you can plan accordingly.
• It is important to take care of overall general hygiene during periods. Bathe or take a shower regularly, wash your hands every time after using the toilet, and change your underwear repeatedly.
• Prioritize rest and self-care during menstruation. The menstrual cycle can be physically and emotionally exhausting, leading to fatigue, mood swings, and cramps. Therefore, getting enough rest and taking care of yourself is important during this time.
• Failing to change sanitary products regularly or neglecting to clean the genital areas can trap moisture and irritate the skin, leading to rashes, redness, and itching.
• Regularly changing your menstrual products helps prevent the production of unpleasant odors caused by blood.
• Periods are already physically and mentally draining. Ensuring good hygiene during periods helps individuals stay comfortable and confident. Practicing good hygiene also boosts self-esteem.

v If you do not follow hygienic measures and do not pay heed to cleanliness, it can result in many complications. Some of the consequences of unhygienic menstrual practices are: dermatitis, reproductive tract infections, urinary tract infections, Bacterial vaginosis, Toxic shock syndrome (TSS), Candidiasis etc.

• While some mild discomfort and change in physical sensations can be expected during the menstrual cycle. If symptoms such as persistent itching, burning, redness, or unusual discharge occur, it’s important to seek medical advice, as these may indicate conditions like dermatitis, bacterial vaginosis, or candidiasis.
• High fever, rash, sudden dizziness, confusion, and muscle aches are serious symptoms and may indicate toxic shock syndrome, which requires immediate medical attention.
• Yes, you can use multiple sanitary products. You can alternate between pads and tampons or others, depending on your comfort and satisfaction.
• It is safe to wear a pad and a tampon simultaneously if you require extra protection, such as during heavy flow days or for overnight use.
• Yes, there are menstrual products specifically designed for overnight use, such as overnight pads or extra-absorbent tampons. Alternatively, you can consider using a menstrual cup, which can be safely worn for up to 12 hours, including overnight.
• If you experience irritation or discomfort from using sanitary products, it is advisable to try different brands or types to see if that helps. If the problem persists, it’s best to consult with a healthcare professional for guidance and advice.
• There are natural / homemade remedies that can help alleviate menstrual cramps, such as applying a heating pad to the lower abdomen, taking a warm bath, practicing relaxation techniques, or using herbal remedies like ginger or chamomile tea.

Visit a healthcare provider for your annual check-up. An annual wellness exam is a full check-up that includes a pap smear, a pelvic exam, and a breast exam. These exams are essential for good reproductive health as they can catch early signs of cancer or other health issues.

Talk to a doctor or medical practitioners if you experience a change in vaginal odor, have extreme or unusual pain, or have more severe period symptoms than usual (such as a heavier flow or longer period).