Most women and girls from the age of thirteen must endure it on a monthly basis: menstruation. This monthly blood loss is a result of shedding of the uterine glue. This tissue is not used for the implantation of a fertilised egg and is therefore driven out of the body. In itself a perfectly normal and healthy process, but one that may be associated with quite a few inconveniences. Many women and girls suffer from menstrual disorders. In this article, we will highlight the most common menstrual problems.
Severe blood loss
Normally a woman loses an average of 50 ml of blood per menses. However, if you lose more than 120 ml of blood per month, this is considered excessive blood loss, also called hypermenorrhea. Violent menstruation is often accompanied by the loss of blood clots. Moreover, sanitary napkins and tampons have to be changed more often than usual, even at night. An increase in blood loss is more common in women approaching menopause. The changing hormone levels are responsible for this. Other causes of substantial blood loss may include:
Wearing a copper IUD
Swallowing drugs that affect blood clotting
A disorder of the thyroid gland
A fibroid or polyp in the uterus
For most women, however, no cause is found for the hypermenorrhoea. Prolonged heavy blood loss can cause anaemia. This is recognisable from symptoms such as fatigue, pallor and lethargy. If you suffer from severe blood loss during menstruation, a doctor can determine the cause and appropriate treatment, or refer you to a gynaecologist.
Too short, too long or irregular cycle
The average menstrual cycle takes about 28 days. But in some women, it takes much longer or shorter before they have their next period. If the cycle is shorter than 22 days, we speak of polymenorrhoea. If the cycle is longer than 35 days, it is called oligomenorrhea.
In addition, many women suffer from irregular periods. It is unknown when the next period starts and how long it lasts.
The cause of abnormal menstrual cycles is often related to hormones. The cycle is controlled by a combination of sex hormones such as oestrogen and progestin. When the hormonal balance is not optimal, this can cause for the cycle to become too short, too long or irregular. Especially girls who have recently begun to ovulate, often have irregular periods. This usually improves after several years. Women who are menopausal can be faced with an irregular cycle. Other causes for a menstrual disorder pattern are:
Side effects of certain medications;
Wearing an IUS
A polyp or other abnormality in the uterine lining
A doctor can determine the cause of an abnormal menstrual cycle. There are also medications that help to normalise the cycle, such as the contraceptive pill.
Periods are never a picnic, but in some women and girls, menstruation is extremely painful. Severe abdominal cramps with radiation to the back and legs can be quite disrupting your daily life. Menstrual pain is most common in young women between 14 and 18 years, but can also affect other women. The cause is usually unknown. It is also not clear why some women suffer from it and other women do not. However, there are some medications that can help with the pain, such as anti-inflammatory painkillers. In the case of menstrual pain (also called dysmenorrhea) accompanied by severe blood loss, the pill may provide a solution. A doctor can advise you about this.
Bleeding between periods
Bleeding between regular menstrual periods may indicate a malfunction of the endocrine system, but can also be caused by a side effect of certain medications. Usually, interim blood loss does not hurt and resolves itself naturally. If the problem persists for a prolonged period of time or if it is accompanied by pain, it would be wise to consult a GP. Also, consult with your doctor when the bleeding occurs after intercourse. In some cases, there may be another cause, such as a polyp in the uterus or an STD (sexually transmitted disease). The doctor can determine the cause of the mid-term blood loss and possibly treat it.
Lack of first menstruation
Most girls get their period around their thirteenth. If the first period has not yet occurred in the sixteenth year of life, then this is called primary amenorrhea. For example, the underlying causes could be a problem with the development of the sex organs, a disease or a genetic disorder. Other factors that may play a role are:
Eating disorders (anorexia)
A closed hymen
However, there is often no explanation for the lack of the first period. If there is no clear medical cause, and the menstrual cycle has not yet begun at eighteen years old, a gynaecologist or an endocrinologist can do further research and possibly start a treatment.
Lack of menstruation
Sometimes a woman is suddenly no longer menstruating while she previously had a regular menstrual cycle. If the lack of menstruation persists for six months or more without any logical explanation (such as a pregnancy or menopause), then doctors call it secondary amenorrhea. The prolonged absence of menstruation can be caused by factors such as stress, a one-sided diet (strict weight-loss diet) or a low body weight. Also, strenuous exercise or medication side effects can affect the menstrual cycle. A Lack of menstruation does not mean that you are not fertile. Do continue to use a contraceptive to prevent an unwanted pregnancy. As with other menstrual problems, it is advised to talk to a doctor if the symptoms persist for too long.