What is abnormal menstruation or periods?

Most of the women have normal menstrual periods that last four to seven days. Ideally, a woman’s period occurs every 28 days, but normal menstrual cycles can range from 21 days to 35 days.

Examples of abnormalities in menstrual problems include:

• Periods that occur either less than 21 days or more than 35 days apart
• Missing three or more consecutive periods
• Bleeding that’s much heavier or lighter than usual
• Periods that last longer than seven days
• Periods that are amid pain, cramping, nausea or vomiting
• Bleeding or spotting that happens between periods, after menopause or following sex

Examples of abnormal menstruation include the following:

• Amenorrhea may be a condition during which a woman’s periods have stopped completely. The absence of a period for 90 days or more is taken into account abnormal unless a lady is pregnant, breastfeeding, or nearing menopause. Failure to menstruate by age 15 or 16 or within three years after the breasts begin to develop (thelarche) is also considered as amenorrhoea.
• Oligomenorrhea refers to periods that occur infrequently i.e more than 35 days cycle.
• Dysmenorrhea refers to pain in lower abdomen during periods. Some discomfort during the cycle is normal for many women.
• Abnormal uterine bleeding may apply to a range of menstrual irregularities, including: a heavier menstrual flow; blood flow that lasts longer than seven days; or bleeding or spotting in between periods, after sex, or after menopause.

What causes abnormal menstruation or periods?

There are many causes of abnormal periods of which the most important are:

• Stress and lifestyle. Significant amount of weight gain or loss, dieting, changes in exercise routines, travel, illness, or other disruptions during a woman’s daily routine can have an impression on her menstrual cycle.
• Birth control pills. Most contraception pills contain a mixture of the hormones estrogen and progestin (some contain progestin alone). Going on or off contraception pills can affect menstruation. On discontinuation, the contraception pills can sometimes cause irregular or missed periods. This can be important in women who are planning conception. Women who take contraception pills that contain progestin only may have bleeding between periods.
• Uterine polyps and fibroids. Uterine polyps are small benign (noncancerous) growths within the lining of the uterus. Uterine fibroids are tumors arising from the wall of the uterus.. These tumors are usually benign, but they can cause heavy bleeding and pain. If the fibroids are large, they could put pressure on the bladder or rectum, causing discomfort.
• Endometriosis. The endometrial tissue that lines the uterus breaks down monthly and is discharged with the menses. Endometriosis occurs when the endometrial tissue starts to grow outside the uterus. Often, the endometrial tissue attaches itself to the ovaries or fallopian tubes; it sometimes grows on the intestines or other organs within the lower alimentary canal and within the area between your rectum and uterus. Endometriosis may cause abnormal bleeding, cramps or pain before and through periods, and painful intercourse.
• Pelvic inflammatory disease. It refers to the infection of upper part of female genital system. Bacteria may enter the vagina via sexual contact then spread to the uterus and upper genital tract. Bacteria may additionally enter the reproductive tract via gynecologic procedures or through childbirth, miscarriage, or abortion. Symptoms of PID include an important discharge with an unpleasant odor, irregular periods, pain within the pelvic and lower abdominal areas, fever, nausea, vomiting, or diarrhea.
• Polycystic ovary syndrome. In polycystic ovary syndrome (PCOS), the ovaries make large amounts of androgens, which are male hormones. Small fluid-filled sacs (cysts) may form in the ovaries. These can often been seen on an ultrasound. The hormonal changes can prevent eggs from maturing resulting in anovulation. Sometimes a lady with polycystic ovary syndrome will have irregular periods or may stop menstruating completely. In addition, the condition is related to obesity, infertility and hirsutism (excessive hair growth and acne). This condition could also be caused by a hormonal imbalance, although the precise cause is unknown. Treatment of PCOS depends on whether a lady desires pregnancy. If pregnancy isn’t a goal, then weight loss, pill pills, and therefore the medication Metformin (an insulin sensitizer utilized in diabetes) can regulate a woman’s cycles. If pregnancy is desired, ovulation-stimulating medications are often tried.
• Premature ovarian insufficiency. This condition occurs in women under age 40 whose ovaries don’t function normally. The menstrual cycle stops, similar to menopause. This can occur in patients who are being treated for cancer with chemotherapy and radiation, or if you’ve got a case history of premature ovarian insufficiency or certain chromosomal abnormalities. If this condition occurs, see your physician.

Other causes of abnormal menstruation include:

• Uterine cancer or cervical cancer
• Medications, such as steroids or anticoagulant drugs (blood thinners)
• Medical conditions, like bleeding disorders, an under or overactive thyroid, or pituitary disorders that affect hormonal balance
• Complications related to pregnancy, including miscarriage or an extrauterine pregnancy (the embryo is implanted outside the uterus; for instance, within the fallopian tube)

How is abnormal menstruation or periods diagnosed?

If any aspect of your cycle has changed, you ought to keep an accurate record of when your period begins and ends, including the quantity of flow and whether you pass large blood clots. Keep track of the other symptoms, like bleeding between periods and menstrual cramps or pain.

Your doctor will ask you about your cycle and medical record. He or she is going to perform a physical examination, including a pelvic exam and sometimes a Pap test. The doctor may additionally order certain tests, including the following:

• Blood tests to rule out anemia or other medical disorders
• Vaginal cultures, to look for infections
• A pelvic ultrasound exam to check for uterine fibroids, polyps or an ovarian cyst
• An endometrial biopsy, during which a sample of tissue is taken from the inner most lining of the uterus, to diagnose endometritis, hormonal imbalance, or cancerous cells. Endometriosis or other conditions may also be diagnosed using a laparoscopy.

How is abnormal menstruation or periods treated?

The treatment of abnormal menstruation depends on the underlying cause:

• Regulation of the menstrual cycle: Hormones like estrogen or progestin could be prescribed to assist control heavy bleeding.
• Pain control: Taking an over-the-counter pain reliever, like ibuprofen or acetaminophen, can relieve mild to moderate pain or cramps. Aspirin isn’t recommended because it’d cause heavier bleeding. Taking a warm bath or shower or employing a hot pad might help to alleviate cramps.
• Uterine fibroids: These can be treated medically and/or surgically. Initially, most fibroids that are causing mild symptoms are often treated with over-the-counter pain relievers. If you experience heavy bleeding, an iron supplement could be helpful in preventing or treating anemia. Low-dose contraception pills or progestin injections may help to regulate heavy bleeding caused by fibroids. Drugs called gonadotropin-releasing hormone agonists could also be used to shrink the dimensions of the fibroids and control heavy bleeding. These drugs reduce the body’s production of estrogen and stop menstruation for a short time. If fibroids do not respond to medication, there are a variety of surgical options that can remove them or lessen their size and symptoms. The type of procedure will depend on the size, type and location of the fibroids. A myomectomy is that the simple removal of a fibroid. In severe cases where the fibroids are large or cause heavy bleeding or pain, a hysterectomy could be necessary. During a hysterectomy, the fibroids are removed along with the uterus. Other options include embolization of the uterine artery, which cuts off the blood supply to the active fibroid tissue.
• Endometriosis: Although there is no cure for endometriosis, over-the-counter or prescription pain relievers may help to lessen the discomfort. Hormone treatments like contraception pills may help prevent overgrowth of uterine tissue and reduce the quantity of blood loss during times. In more severe cases, a gonadotropin-releasing hormone agonist or progestin could also be used to stop menstrual periods. In severe cases, surgery could also be necessary to get rid of excess endometrial tissue growing within the pelvis or abdomen. A hysterectomy might be required as a last resort if the uterus has been severely damaged.
  There are other procedural options, which may help heavy menstrual bleeding. A five-year contraceptive intrauterine device (IUD), called Mirena, has been approved to help lessen bleeding, and can be as effective as surgical procedures such as endometrial ablation. This is inserted in the doctor’s office with minimal discomfort, and also offers contraception. Endometrial ablation is another option. It uses heat or electrocautery to destroy the liner of the uterus. It is usually only used when other therapies have been tried and failed. This is because scars from the procedure can make monitoring the uterus harder if bleeding persists within the future.

How can the danger of abnormal menstruation or periods be reduced?

Here are some recommendations for self-care:

• Attempt to maintain a healthy lifestyle by exercising moderately and eating nutritious foods. If you’ve got to reduce weight, do so gradually rather than turning to diets that drastically limit your calorie and food intake.
• Make sure you get enough rest.
• Practice stress reduction and relaxation techniques.
• If you’re an athlete, crop on prolonged or intense exercise routines. Excessive sports activities can cause irregular periods.
• Use birth control pills or other contraceptive methods as directed.
• Change your tampons or sanitary napkins approximately every four to 6 hours to avoid toxic shock syndrome syndrome and stop infections.
• See a doctor for regular check-ups.