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Menstrual Disorders


Normal menstruation begins for a woman around the age of 13. A normal menstrual cycle typically lasts 21 to 35 days, with menstruation lasting approximately four to eight days. Menopause typically occurs around age 50, with symptoms beginning in the mid-40s. Though “normal” in regard to menstruation varies a great deal, there are a variety of menstrual disorders that affect women during the years they should be experiencing normal menstruation. Problems can range from mild and bearable to severe and in need of treatment or surgery.


Women suffering from dysmenorrhea experience severe cramping during menstruation. The pain can be located in the lower abdomen, thighs, or lower back. Primary dysmenorrhea occurs when the uterus contracts. The pain begins with the onset of menstruation and typically lasts a day or two during menstruation. About half of menstruating women suffer from primary dysmenorrhea. Secondary dysmenorrhea is the result of another issue, such as uterine fibroids or endometriosis.

Heavy Bleeding

There are three categories of heavy bleeding: menorrhagia, which is long-term or excessive bleeding; metrorrhagia, which is irregular bleeding; and menometrorrhagia, which is a prolonged episode of or irregular bleeding. Normal bleeding for a menstruating woman is about one ounce of blood. Heavy bleeding is defined as soaking more than six pads or tampons per day. You should consult your doctor if you are using more than one pad or tampon per hour for a period of several hours, suffer from periods lasting more than 10 days, or bleed between periods.


Amenorrhea is the absence of menstruation. Primary amenorrhea occurs when a girl fails to menstruate by age 16. Secondary amenorrhea occurs when menstruation stops for at least three months. A number of things can cause amenorrhea, including hormonal changes, weight loss, polycystic ovarian syndrome, premature ovarian failure, stress, structural problems, and elevated prolactin levels.


Oligomenorrhea is light or infrequent menstruation. This is not considered a problem in the first few years of menstruation, but can be a concern once a woman is regularly menstruating.

Premenstrual Syndrome

Premenstrual syndrome is a term used to describe a variety of emotional, physical, and behavioral symptoms that occur in the days leading up to menstruation each month. These symptoms usually ease within four days of menstruation.


Dysmenorrhea is severe menstrual pain. There are a variety of types of dysmenorrhea, including uterine contractions, abnormalities in the uterus, abnormal nervous system response, genetics, uterine fibroids, pelvic inflammatory disease, ectopic pregnancy, and endometriosis.

Abnormal Uterine Bleeding

This includes bleeding or spotting between periods, bleeding heavier than normal, bleeding after intercourse, or bleeding after menopause. Dysfunctional uterine bleeding is often caused by hormonal problems. Other causes of abnormal uterine bleeding include fibroids, bleeding disorders, contraceptives, medication, miscarriage, cancer, pelvic inflammatory disorder, diabetes, lupus, cirrhosis, and thyroid disorders.

There are a number of controllable risks that increase the likelihood a woman will suffer from menstrual disorders. These include excessive weight gain or loss, being excessively over or under weight, smoking, excessive alcohol use, stress, and pregnancy. In some cases, exercise or oral contraceptives ease the symptoms associated with the menstrual disorder.

There are also a number of complications that can arise from menstrual disorders. Since some menstrual disorders cause excessive loss of blood, imbalanced hormones, and pain, other conditions might arise. These include anemia, osteoporosis, and infertility. Though not physically serious, menstrual disorders can also cause embarrassment, discomfort, and a reduced quality of life.

Diagnosing Menstrual Disorders

A visit to the doctor concerning a menstrual disorder will likely include a discussion about your menstrual cycle, a discussion of family history, an evaluation of pelvic pain, an evaluation of your diet, a review of your medications, a review of your sexual history, and an evaluation of your contraceptive use. You might be asked to keep a menstrual diary to track symptoms and you will likely be given a pelvic exam.

If no diagnosis can be made following a pelvic exam and discussion, blood and hormone tests will be ordered. In addition to these tests, your doctor might also request an ultrasound, a hysteroscopy, a laparoscopy, or an endometrial biopsy, depending on your symptoms.

As a result of your diagnosis, your doctor will suggest a treatment plan. This might include a combination of measures you can take to ease pain and reduce symptoms, as well as procedures that need to be done by your doctor or in a hospital. These include:

  • Lifestyle changes, such as a change in diet, exercise, or sexual activity
  • Alternative treatments such as acupuncture, yoga, massage, or herbal supplements
  • The use of pain relievers or oral contraceptives
  • Surgery
  • Endometrial ablation
  • Hysterectomy

If you suffer from a menstrual disorder, it is important to speak with your doctor. Even if the symptoms seem mild or normal, your doctor needs to know your menstrual routines, so he or she can more easily diagnose a serious problem, should one occur. For more information, speak to a doctor at Women’s Health care of Georgia.