A menstrual cycle refers to a series of monthly changes a woman experiences as her body prepares for a
possible pregnancy. In a normal menstrual cycle, each month one of the ovaries will release a mature
egg, which will travel down the fallopian tube and into the uterus to await fertilization. At the same
time, hormones cause the uterine lining (endometrium) to thicken in order for the fertilized egg to be
implanted comfortably into the womb. If fertilization does not occur, the uterine lining is shed and
expelled from the body through the process of menstruation.
The menstrual cycle, which is counted from the first day of the period up to the first day of the next period, varies from woman to woman. On average, a period occurs every 21 to 35 days and lasts 2 to 7 days. However, it is common and normal for a woman to have shorter or longer cycles.
Any major changes in the frequency, amount of blood flow, and symptoms of a period may indicate menstrual problems which need to be resolved immediately.
Many women will experience menstrual problems at some point in their lives, the most common of which are:
This is an umbrella term for a range of physical and emotional symptoms that a woman experiences before her period. Symptoms in varying intensities include bloating, mood swings, anxiety, headaches, breast tenderness, fatigue and depression. These usually begin one week before the period and go away once it starts. While the exact cause of PMS remains unknown, the condition is often attributed to cyclical hormonal fluctuations.
This condition refers to menstrual bleeding that is so heavy that it interferes with the woman’s normal activities. With menorrhagia, periods may last for more than 7 days, and the woman may soak through tampons or sanitary pads every hour for several consecutive hours. Untreated, it can lead to anaemia, shortness of breath, fatigue and pain. Menorrhagia is said to be caused by hormonal imbalance, fibroids, cancer or other medical conditions.
The opposite of menorrhagia, amenorrhea is the condition where either a woman hasn’t had her first period by 16 years old, or a woman’s period abruptly stops for three months or longer. However, it is normal for a woman to have amenorrhea before puberty, during pregnancy and after menopause. Causes include hormonal imbalance, premature ovarian failure, polycystic ovary syndrome (PCOS) and genetic disorders. Some medications, particularly contraception, can also cause irregular or missed periods.
Typically caused by uterine contractions, dysmenorrhea refers to periods where the woman experiences persistent and debilitating cramps, as well as back or abdominal pain. In more serious cases, symptoms include diarrhoea, light-headedness and fatigue. Dysmenorrhea may also be caused by stress, fibroids, endometriosis and pelvic inflammatory diseases. Remember, while menstrual cramps are normal, they should not be extreme and unmanageable.
In order to properly diagnose the type of menstrual condition that you have, your gynaecologist may perform a combination of these tests:
The type of treatment will depend on what’s causing the problems with your menstrual cycle.
Some cases – such as heavy periods, irregular periods and PMS – may be alleviated by taking contraceptive pills. In other cases where normal menstrual flow is disrupted by a thyroid or hormone issue, hormone treatments may be required.
Should the root cause of the menstrual problem be other underlying medical conditions (e.g. endometriosis, ovarian cysts, pelvic inflammatory disease), those conditions will be promptly targeted for treatment, whether through medical or surgical options.
The cessation of menstruation, known as menopause, will require special menopause treatment.
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