About the disease

Menstrual disorder is a combination of painful abnormalities during the menstrual cycle. They include cramps, irregular periods and heavy bleeding. Menstrual disorder is also diagnosed if a woman does not have menstruation or it is very infrequent with intervals longer than 2-3 months. If a woman has menstruation longer than10 days, it is also an indicator of menstrual disorder.

Overall, menstruation is the monthly blood flow from the uterus, which is an indicator of a woman not being pregnant. Normal menstruation occurs every 28 days with variations in several days. menstruation lasts between puberty and menopause and usually begins at 12-14 years of age.

Most often menstrual disorder occurs because of hormonal misbalance. Usually, if there is misbalance of such hormones as estrogen and progesterone, a woman can have painful periods. Problems with ovulation and infertility, which can have genetic character or be triggered by environmental factors, also affect menstrual cycle very often. Endometriosis, which is a condition, during which the tissue of the uterus grows to other parts of reproductive system, can also cause heavy bleeding and clotting. In adult women fibroids are likely to trigger menstrual disorder. Stress and athletic training, as well as miscarriage and abortion, also cause this condition. Overall, more than 60% of all females have some kind of menstrual disorder in their lifetime.  

Symptoms

• Cramps
• Excessive bleeding
• Irregular periods
• Painful sensations before and during menstruation
• Bleeding during pregnancy

Diagnosis

• During general examination a doctor will ask patient about menstrual cycle patterns to determine if there are any abnormalities. A gynecologist will also examine vagina and uterus to check for any inflammation and signs of infection.
• Blood test is conducted to know the level of estrogen in the woman's body, which can be abnormal in case of menstrual disorder.
• Hormonal test is used to see if other hormones cause problems with menstruation. Ultrasound of the uterus is ordered if there is suspicion of endometriosis or fibroids.

Treatment

• Conservative treatment usually uses hormonal drugs and pain relievers, which can eliminate the cramps during period and normalize the blood flow. Anti-inflammatory drugs can also alleviate the uterine contractions. Oral contraceptives are ordered in case menstrual disorder was caused by lack of estrogen in the body, as all oral contraceptives contain this hormone. Progestin, which is another group of drugs, can efficiently restore normal duration of the periods. In some cases women are recommended to get pregnant in order to restore the function of the reproductive system.
• Surgery is used in cases of fibroids or endometriosis and in this case a surgeon resects the formation or normalizes the structure of uterus. 

Authors: Dr. Nadezhda Ivanisova, Dr. Farrukh Ahmed