What are menstruation and the menstrual cycle?

The menstrual cycle is the process by which a woman’s body gets ready for the chance of a pregnancy each month.

Menstruation is the part of a woman’s monthly menstrual cycle in which blood and tissue are discharged from the vagina.  It is also commonly called a period or menstrual period. 

What are menstrual irregularities?

Sometimes women have problems in their menstrual cycle - called menstrual irregularities.  They may not get periods, get periods too frequently, have unpredictable menstrual bleeding, or they may have painful periods.

When not caused by pregnancy, menstrual irregularities are usually a sign of a larger condition or problem.  There are many conditions that can cause menstrual irregularities.

  • Amenorrhoea - Amenorrhoea occurs when a woman does not get her period by age 16, or when she stops getting her period for at least three months and is not pregnant.

  • Amenorrhoea is not a disease. Instead, it is a symptom of another condition.  Possible causes can include moderate or excessive exercising, eating disorders (such as anorexia nervosa), physical or psychological stress, tumours, and hormonal problems.  Women with polycystic ovary syndrome (PCOS) may also experience amenorrhoea.

    It is important for you to see your health care provider to determine the cause of amenorrhoea. Treatment for amenorrhoea depends on the underlying cause.  Sometimes lifestyle changes can help if weight, stress, or extreme physical activity is causing the amenorrhoea.  Other times, medications and oral contraceptives can help the problem.

  • Oligomenorrhoea - This term refers to infrequent menstrual periods, or having a period only now and then.  Like amenorrhoea, oligomenorrhoea is not a disease itself, but is a symptom of a larger condition.  For example, many women with polycystic ovary syndrome (PCOS) have oligomenorrhoea.

  • Premature Ovarian Failure (POF) - POF describes a stop in the normal functioning of the ovaries in a woman younger than age 40.  Women with POF may not have periods or may get them irregularly.  Although getting pregnant is difficult for women with POF, it may still be possible.

  • There is no proven treatment to make a woman’s ovaries work normally again.  However, estrogen replacement therapy (ERT) gives women the estrogen and other hormones their bodies are not making and can help women have regular periods and lower their risk for osteoporosis. 

  • Uterine Fibroids - Uterine fibroids are the most common, non-cancerous tumours in women of childbearing age.  Most women with fibroids do not have problems with fertility and can get pregnant. But some women with fibroids may not be able to get pregnant naturally.

  • Women who have uterine fibroids but show no symptoms may not need any treatment.  Some women with fibroids have heavy menstrual periods, and some may bleed in between periods.  Medications can often offer relief from many of the symptoms of fibroids, such as pain, and can even slow or stop their growth.  There are also several types of surgery that can remove the fibroids.

  • Endometriosis - Endometriosis occurs when tissues that usually grow inside a woman’s uterus grow on the outside instead.  Endometriosis may cause pain before and during the first few days of the menstrual period.  About 30 percent to 50 percent of women with endometriosis are infertile, making it one of the top three causes for female infertility.  Women with endometriosis may also have very heavy periods.

  • There are several ways to treat pain, including pain medication, hormone therapy, and surgery. 

    There are also some treatments for infertility associated with endometriosis.  In vitro fertilization often works to improve fertility in women with the condition.  Hormone treatments and surgery offer other infertility treatment options.

  • Dysmenorrhoea - Dysmenorrhoea refers to painful periods, including severe menstrual cramps.  The condition is usually not serious, although it can sometimes be caused by infection, endometriosis, or ovarian cysts.

  • Painful periods can sometimes be eased by using heating pads or taking a warm bath. Over-the-counter pain relievers can also help with the pain.  Your health care provider might recommend birth control pills or a birth control shot to make periods less painful.

  • Menorrhagia - Menorrhagia referes to abnormal, heavy bleeding that is different from a normal menstrual period. In adolescents and women approaching menopause, hormone imbalance problems often cause menorrhagia along with irregular cycles. Treatment for abnormal bleeding depends on the cause.
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