Menstrual Disorders
Most Common Menstrual Disorders
The most common menstrual disorders are:
- Amenorrhea
- Dysmenorrhea
- Menorrhagia
- Premenstrual Dysphoric Disorder
- Premenstrual Syndrome (PMS)
Amenorrhea (the absence of menstrual bleeding). This menstrual disorder, the absence of menstrual bleeding, is normal for women before puberty, after menopause, and during pregnancy. If you don’t fit into one of these categories, then you need to discuss this condition with your healthcare provider.
Dysmenorrhea. Dysmenorrhea is the medical term for severe menstrual cramps. Many women experience menstrual cramps during their periods, but dysmenorrhea refers to especially painful and persistent cramps. Menstrual cramps are caused by uterine contractions triggered by prostaglandins, hormone-like substances that are produced by the uterine lining cells and circulate in your bloodstream.
Menorrhagia or heavy menstrual bleeding. Menorrhagia is the medical term for menstrual bleeding that lasts more than 7 days. It can also be bleeding which is very heavy. Untreated heavy or prolonged bleeding can significantly reduce the quality of your life and cause a host of uncomfortable symptoms. Learn More
Premenstrual Dysphoric Disorder (PMDD). PMDD is a similar but more serious disorder than PMS. PMDD causes severe irritability, depression, or anxiety in a week or two before your period starts. Like PMS, researchers don’t know the direct cause for PMDD but hormonal changes throughout the menstrual cycle may play a role as well as a brain chemical called serotonin. Serotonin levels change throughout the menstrual cycle, and some women may be more sensitive to these changes.
Physical symptoms include cramps, bloating, breast tenderness, headaches, and joint or muscle pain. Emotional symptoms may include
- Lasting irritability or anger
- Feelings of sadness or despair
- Feelings of tension or anxiety
- Panic attacks
- Mood swings or crying
- Lack of interest in daily activities and relationships
- Trouble thinking or focusing
- Trouble sleeping
- Food cravings or binge eating
To be diagnosed with PMDD, you must have five or more PMDD symptoms, including one mood-related symptom.
Premenstrual Syndrome (PMS). PMS is a combination of physical and emotional symptoms that many women get about a week or two before their period. Symptoms may include bloating, headaches, and moodiness. About 30 to 40 percent of women experience symptoms severe enough to disrupt their lifestyles.
Causes of Menstrual Disorders
There are a number of factors that can cause menstrual disorders including:
- Uterine Fibroids
- Hormone Imbalance
- Clotting Disorders
- Cancer
- Sexually Transmitted Infections (STIs)
- Polycystic Ovary Syndrome
- Genetics
Symptoms of Menstrual Disorders
Symptoms of menstrual disorders may include:
- Abnormal menstrual bleeding
- Pain or cramping
- Depression
- Headaches
- Emotional distress
- Bloating or fullness in the abdomen
Diagnosing Menstrual Disorders
During your appointment, your Newton-Wellesley OB/GYN physician will ask you questions about your medical history and will conduct a physical exam, including a pelvic exam and Pap smear.
Your doctor may also order additional diagnostic tests, such as
- Blood tests
- Hormonal tests
- Ultrasound – a diagnostic medical test that uses high-frequency sound waves to produce visual images to detect conditions that may be causing menstrual disorders.
- Hysterosonography – a transvaginal ultrasound exam that captures images of inside the uterus.
- MRI – a magnetic resonance imaging scan uses a magnetic field and computer-generated radio waves to create detailed images of the uterus and surrounding organs.
- Hysteroscopy – uses a small lighted telescope (hysteroscope) inserted through the vagina and cervix to examine the uterus for fibroids, polyps, or other areas of concern.
- Laparoscopy – looks for abnormalities of the reproductive organs using a tiny lighted instrument with a camera on the end (laparoscope) inserted through a small incision in the abdomen.
- Endometrial biopsy – a small sample of the lining of the uterus is removed to examine for abnormal cells.
- Dilation and Curettage (D&C) – refers to the dilation of the cervix and surgical removal of part of the lining of the uterus and/or contents of the uterus by scraping and scooping. It may be done after a first-trimester miscarriage or to relieve heavy bleeding.
At the conclusion of your visit, your doctor may ask you to keep a diary of your menstrual cycles, including dates, amount of flow, pain, and any other symptoms.
Treatment Options for Menstrual Disorders
Your Newton-Wellesley OB/GYN physician will determine the best treatment option for you depending on the cause of your menstrual disorder. Treatment options include lifestyle changes, medical management, and surgery, including:
Dietary Changes. You may be advised to reduce salt, caffeine, sugar, and alcohol intake before your period to reduce cramping and other symptoms.
Medical Management. Pain relievers, either over-the-counter medications or prescription medications may be recommended for cramps. Hormonal contraceptives may also be prescribed to help reduce heavy bleeding and regulate, reduce, or even eliminate menstrual periods.
Surgical Treatment. Surgical options may include
- Hysteroscopy
- Laparoscopy
- Endometrial ablation (destroys the lining of the uterus to stop periods)
- Hysterectomy
Menstrual Disorder Treatment at Newton-Wellesley OB/GYN
Hormone Imbalance FAQs
Women who have a hormone imbalance may experience one or more of the following symptoms:
- Heavy, irregular or painful periods
- Osteoporosis (weak, brittle bones)
- Hot flashes and night sweats
- Mood swings and/or depression
- Weight gain
- Fatigue
- Increased sensitivity to cold or heat
- Dry skin
- Puffy face
- Vaginal dryness
- Painful sex due to a lack of
- vaginal lubrication
- Decreased sex drive
- An increase in urinary tract infections (UTIs) due to a thinning of the urethra
- Breast tenderness
- Indigestion
- Headaches
- Constipation and diarrhea
- Acne during or just before menstruation
There are numerous possible causes of hormone imbalance in women. Some causes are due to external factors, such as stress and hormone medications, and other causes may be due to medical conditions such as
- Diabetes
- Polycystic Ovary Syndrome
- Androgen Excess (an overproduction of male hormones that cause menstrual irregularities, infertility, acne, and male pattern baldness)
- Hormone Replacement or Birth Control Medications
- Early Menopause
- Primary Ovarian Insufficiency
- Ovarian Cancer
- Eating Disorders
- Thyroiditis
- Hyperthyroidism
- Hypothyroidism
- Medications
- Cancer Treatments
During your consultation, your Newton-Wellesley OB/GYN physician may order a blood test for you that checks your estrogen, progesterone, and testosterone levels, as well as your thyroxin (thyroid hormone), insulin, and cortisol levels. There may be more tests ordered based on your symptoms.
Your doctor will also conduct a pelvic exam to check for any lumps or cysts. A biopsy may be taken of any abnormally appearing tissue. If required, your doctor may order imaging tests such as an ultrasound, MRI, or thyroid scan for an accurate diagnosis.
Treatment for hormone imbalance depends on the cause. Once your doctor figures out what is causing your hormone imbalance, treatment recommendations may include:
- Hormone control or birth control regulate menstrual cycles and symptoms.
- Vaginal estrogen reduces symptoms of vaginal dryness.
- Hormone replacement medications reduce symptoms associated with menopause like hot flashes and night sweats.
- Eflornithine slows excessive facial hair growth in women.
- Anti-androgen medications help limit severe acne and excessive hair growth or loss.
- Clomiphene (Clomid) and Letrozole (Femara) help stimulate ovulation for women suffering from PCOS.
- Gonadotropin injections increase the chances of pregnancy.
- Metformin helps manage or lower blood sugar levels.
- Levothyroxine helps improve symptoms of hypothyroidism.
- In-vitro fertilization may help those with PCOS complications get pregnant.
- Lifestyle changes (e.g., losing weight, keeping a healthy diet, avoiding stress, getting enough sleep).
