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Menstrual Disorders: Types, Causes, Symptoms And Its Treatment

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Menstrual Disorders: Types, Causes, Symptoms And Its Treatment

Menstrual Cycle: The cyclical shedding of the endometrium with an average period of 28 days is called a menstrual cycle.

It is a regular and natural hormonal process which occurs in the female reproductive system that makes pregnancy possible. In most women, the cycle lies between 24 to 32 days.

Every month ovulation takes place, a process of releasing eggs from the ovaries. At the time of ovulation, the hormonal changes develop the uterus ready for pregnancy. If the released egg is not fertilized, the lining of the uterus (endometrium) is shed through the vagina during menstruation. This is commonly referred to as menses.

Young girls often experience their first period between 8 and 15 years, this is called menarche.the average age of menarche in India is 13.75 years.The average menstrual cycle in women lasts for every 28 days. Typically periods last for 3 to 7 days, and the amount of blood loss varies. Usually, the bleeding is heavier on the 1 st and 2nd day. It gradually reduces over the next 3 days.

Menstrual Disorders: 

Most of the women get through their monthly periods easily with few or without any concerns. However, any abnormal condition in a woman’s menstrual cycle like disorders of ovulation, disorders of cycle length, disorders of flow, too heavy or too light menstruation, the complete absence of the cycle etc., lead to menstrual disorders.

There were several different menstrual problems that a woman may experience which include:

Premenstrual Syndrome (PMS)

Premenstrual syndrome refers to physical and emotional changes that occur before a woman’s monthly period. It’s estimated that nearly 3 of every 4 menstruating women experience premenstrual syndrome at some time. PMS shows up a variety of signs and symptoms and varies from person to person, including mood swings, tender breasts, fatigue, depression etc. which may last from a few hours to days.

PMDD – Premenstrual Dysphoric Disorder is a much more severe form of PMS and affects approximately 3%-8% of reproductive-aged women.

Causes Of Premenstrual Syndrome(PMS)

The exact cause of premenstrual syndrome (PMS) is  not known, but several factors may lead to the condition like

Cyclic Changes In Hormones: The hormonal fluctuations may also contribute to this condition and often the signs and symptoms of PMS change or disappear with pregnancy and menopause.

Chemical Changes In brain: Fluctuations of serotonin (a brain chemical called neurotransmitters) are thought to play a significant role in mood states could trigger the symptoms of PMS.

Depression: Often women with severe PMS have undiagnosed depression, though depression alone might not cause all the symptoms.

Symptoms Of PMS

The list of potential signs & symptoms of PMS are long, but most of the women experience only a few of them.

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Emotional and behavioural signs & symptoms:

  • Tension or anxiety
  • Mood swings like irritability, anger or crying
  • Depression
  • Insomnia (Trouble falling asleep)
  • Changes in appetite
  • Food cravings
  • Lack of concentration
  • Social withdrawal
  • Changes in libido

Physical signs & symptoms

  • Abdominal bloating
  • Swelling of fingers, ankles and feet
  • Breast tenderness
  • Headache, Vertigo, Fainting
  • Muscle spasms
  • Heart palpitations
  • Allergies & Infections
  • Vision problems & Eye infections
  • Constipation or diarrhoea
  • Hot flashes

The physical pain and emotional stress during PMS are severe enough to affect the routine of women. Irrespective to the severity of the symptom, the signs and symptoms usually disappear within a few days of the start of the menstrual period in most women.


Amenorrhea is characterized by the absence of menstruation for more than three menstrual cycles and girls who haven’t begun the menstrual cycle by age 15. In most women with amenorrhea, the ovaries don’t release an egg, women with such condition can’t become pregnant.

Amenorrhea is of two types

  1. Primary Amenorrhea: In this condition, menstrual periods never start. Usually, if periods don’t start then, girls don’t undergo through puberty. It may lead to improper development of secondary sexual characteristics like breasts and pubic hair.
  2. Secondary Amenorrhea: This is a condition where the women had normal and regular menstrual periods will stop. Secondary amenorrhea is more common than the primary.

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Causes Of Amenorrhea 

The cause can be physiological like pregnancy and lactation or pathological.

Pathological causes could be:

Polycystic ovaries


  • Thyroid disorder
  • Sudden weight loss
  • Contraceptives
  • Eating disorders
  • Obesity
  • Strenuous exercise
  • Perimenopausal syndrome
  • Pituitary Tumours

Symptoms of Amenorrhea

The absence of menstrual periods is the main sign of amenorrhea. Depending on the causes, one might experience some other signs or symptoms such as:

  • Acne
  • Milky nipple discharge
  • Hair loss
  • Excess facial hair
  • Headache
  • Pelvic pain
  • Vision problems

These are a spectrum of likely symptoms one may or may not have with irregular periods, if you have irregular menstruation for more than 2 cycles you must see a gynaecologist.


Dysmenorrhea means painful menstruation. It is a symptom complex consisting of lower abdomen pain, law backache, cramps in the legs, nausea, headache, loss of appetite and generalised weakness.

Most women have one or two symptoms of the above and the severity may vary from person to person.

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Causes Of Dysmenorrhea

The cause of dysmenorrhea could be primary or secondary.

Primary Dysmenorrhea: Usually, it starts during adolescence and might compromise with the age and after pregnancy. Women with this condition may experience abnormal uterine contractions resulting in pain abdomen and low backache.

This is usually due to the release of prostaglandins which causes cramps in the uterus.

Secondary Dysmenorrhea: This condition usually starts during adulthood. This condition is often caused by some problems in the reproductive system.

The possible causes may include:

  • PID – Pelvic Inflammatory Disease
  • Uterine fibroids
  • Cervical stenosis
  • Abnormal pregnancy
  • Adenomyosis
  • Infection or polyps in the pelvic cavity
  • Cysts and tumours in the ovaries
  • Endometriosis
  • Intrauterine devices

Certain conditions related to menstrual cramps can create further complications. For instance, endometriosis can lead to fertility problems. PID can damage your fallopian tubes which increase the risk of ectopic pregnancy. These conditions need thorough investigations to find the root cause.

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Symptoms of Dysmenorrhea

The most common symptoms may include:

  • Intense cramping pain in the lower abdomen
  • Pain radiating down the legs
  • Lower back pain
  • Diarrhoea
  • Nausea & Vomiting
  • Fainting
  • Fatigue
  • Headaches & dizziness
  • Feeling weak


Menorrhagia refers to prolonged and heavy menstrual periods. In this condition, the periods are long and last for more than a week that involve excessive bleeding with ‘flooding’ or clots.

Causes Of Menorrhagia

There were several possible causes for menorrhagia

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  • Hormonal imbalances like menstrual cycles with no egg
  • Bleeding or platelet disorders
  • Uterine fibroid
  • Abnormal pregnancy like miscarriages, ectopic pregnancies
  • Polyps
  • Endometriosis
  • PCOS – polycystic ovary syndrome
  • Liver or kidney disease
  • Thyroid disease
  • PID – Pelvic inflammatory disease
  • High levels usage of endothelins
  • High levels usage of prostaglandins
  • Usage of certain birth control devices like intrauterine devices (IUDs)

Symptoms of Menorrhagia

Signs and symptoms of menorrhagia include

  • Soaking of one or more sanitary pads or tampons every 4 to 6 hrs.
  • Passage of clots
  • Bleeding for more than a week
  • Symptoms of anaemia like tiredness, fatigue or shortness of breath

Treatments For Menstrual Disorders

Treatment for menstrual disorders varies from person to person and depends on its causes and symptoms. However, discuss symptoms of your menstrual disorder with your doctor and she will suggest the investigations and treatment which can reduce or relieve your symptoms. Some of the treatments include

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  • Dietary modifications
  • Oral contraceptives
  • Vitamin or mineral supplements
  • Hormone supplements
  • Tranquilisers
  • Diuretics
  • Antidepressants
  • Prostaglandin inhibitors
  • Regular exercise
  • Surgery

Early diagnosis and treatment can reduce further complications of menstrual disorders. Never take a chance over menstrual disorders; they may affect your pregnancy in some cases. We, Sunshine Hospitals have an expert team of doctors and resources and provides treatment care. We always strive hard to reduce the complications for the best outcome and long-term health of our patients. If you are suffering from any menstrual problems contact our experts right away to get the best treatment options.

About Sunshine Hospitals: 

A Multi Super Speciality Institution, 500 bedded Sunshine Hospitals (Paradise Circle, Secunderabad) is promoted by globally reputed Joint Replacement Surgeon Dr AV Gurava Reddy (Orthopedic Doctor) and like-minded associates who share the objective of making world-standard healthcare available, affordable and accessible to the common man. Sunshine has now become one of the best hospitals for many treatments including Orthopedic, Gastroenterology, Cardiology, Trauma and Neurology.

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