Menstrual Disorders

Menstrual disorders are problems related to a women’s menstrual cycle. You may have a menstrual disorder if your periods come too frequently (fewer than 21 days apart), not often enough (more than 3 months apart), or last longer than 10 days, and have associated symptoms that disrupt your daily life or affect your ability to become pregnant.

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.

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 may include:

• Abnormal menstrual bleeding
• Pain or cramping
• Depression
• Headaches
• Emotional distress
• Bloating or fullness in the abdomen

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.

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

With the right treatment method, it is possible to relieve the symptoms of menstrual disorders and restore your body to a normal menstrual cycle and experience more freedom and happiness in your life. Contact Newton-Wellesley OB/GYN in Newton at (617) 332-2345 or in Walpole at (508) 668-5555 to schedule an appointment. For your convenience, you may also request an appointment online.