Menstruation is usually regular and without significant discomfort, but some women may experience irregular cycles. Delays, excessive bleeding, or severe pain are often a cause for concern. In some cases, these changes are normal, especially as a result of stress or certain lifestyles. However, if menstrual irregularities occur repeatedly, they may indicate hormonal imbalances, reproductive disorders, or other medical conditions that require attention. So what really happens when the menstrual cycle doesn't go as planned?
Normal menstrual cycle
The menstrual cycle is a series of changes in the body to prepare for pregnancy, the cycle lasts about 28 days with a normal range of 21-35 days. Menstrual bleeding occurs for 3-7 days due to the shedding of the uterine lining, which exits through the vagina. This process is regulated by hormones produced by the pituitary gland and ovaries, which play a role in thickening the endometrial layer and stimulating ovulation. If fertilization does not occur, the endometrium decays and is excreted as menstrual blood.
At what age does menstruation usually begin?
Menstruation usually begins around the age of 12, but can occur between the ages of 8 and 16, usually after breast and pubic hair growth. Menopause occurs around age 51 and is characterized by the cessation of ovulation and menstruation for one year.
Types of menstrual disorders to know
Menorrhagia, very heavy menstrual bleeding. This bleeding can last for more than 7 days. Some women experience bleeding outside the menstrual cycle, either earlier, later, or between cycles. This condition is called abnormal uterine bleeding or irregular menstruation.
Dysmenorrhea, a condition of cramping and severe pain during menstruation, can be primary or secondary.
Primary dysmenorrhea occurs from the first menstrual period and lasts a lifetime. It is caused by abnormally strong contractions of the uterus, resulting in frequent and severe cramping.
Secondary dysmenorrhea occurs later in life due to certain medical conditions, such as endometriosis or pelvic inflammatory disease.
Amenorrhea, the absence of one or more menstrual periods, can be divided into two types:
Primary amenorrhea occurs when a person has never had a period before the age of 15, usually due to hormonal imbalances or anatomical problems.
Secondary amenorrhea occurs when a person who previously menstruated stops for three or more consecutive cycles, with pregnancy being the most common cause in addition to hormonal disorders.
Oligomenorrhea, infrequent and unpredictable menstrual cycles. You may often not have a period for more than 35 days. Instead of having a period every month, you may only have six to eight periods a year. Oligomenorrhea is often associated with polycystic ovary syndrome (PCOS). Among women with PCOS, 75% to 85% experience infrequent periods.
Polymenorrhea, a condition in which the menstrual cycle lasts less than 21 days before the next period. One of the typical signs of this condition is menstruation that may occur more than 2 times in 1 month. Although it can occur due to harmless conditions, some of the causes of polymenorrhea need to be watched out for and treated accordingly.
Premenstrual syndrome (PMS), a cluster of physical and emotional symptoms that occur a few days to two weeks before menstruation, is caused by fluctuations in the hormones estrogen and progesterone, which affect serotonin. PMS is more common in women in their 20s and 30s and can worsen with age, stress, or heredity. Symptoms vary and include irritability, bloating, mood swings, anxiety, fatigue, and breast tenderness, although menstrual cramps are not part of PMS.
Premenstrual dysphoric disorder (PMDD), a much more severe form of premenstrual syndrome (PMS). It can affect people of childbearing age. It is a serious and chronic health condition that requires attention and treatment. Lifestyle changes and sometimes medication can help manage the symptoms.
Factors that can disrupt the menstrual cycle
Being pregnant or breastfeeding
Excessive physical activity and nutritional deficiencies
Having certain health problems such as, thyroid dysfunction, Polycystic Ovarian Syndrome (PCOS), endometriosis, uterine / ovarian cancer
Experiencing severe stress
Use of hormonal contraceptives
Perimenopause or early menopause
Adolescence, when first experiencing the menstrual cycle
Having a smoking habit
What are the effects of menstrual irregularities?
Anemia: Menorrhagia in premenopausal women can cause anemia due to blood loss >80 mL per cycle. Mild to moderate anemia causes fatigue, dizziness, and pale skin, while untreated severe anemia risks heart problems.
Osteoporosis: Amenorrhea due to decreased estrogen can lead to osteopenia and osteoporosis, increasing the risk of bone fractures. This loss of bone density is affected by disease, poor diet, hormones, or age. Weight training, strength training, and calcium and vitamin D supplements may help reduce or reverse the effects.
Infertility: Ovulation disorders, fibroids, endometriosis, or PCOS can cause heavy bleeding and infertility. Irregular periods also make conception difficult, but medications or fertility therapy can help restore fertility.
Quality of life: Menstrual disorders, such as pain and heavy bleeding, can interfere with productivity at school, work, and social activities.
How to lower the risk of menstrual disorders?
Try to maintain a healthy lifestyle by exercising regularly and eating nutritious foods.
If you want to lose weight, do it gradually, don't switch to a diet that drastically restricts calorie and food intake.
Make sure you get enough rest.
Practice stress reduction and relaxation techniques.
Reduce exercise routines that are too long or intense.
Use birth control pills or other contraceptive methods as directed.
Change your tampons or pads every four to six hours to avoid toxic shock syndrome and prevent infection.
See your gynecologist and primary care provider for regular check-ups.
How to diagnose menstrual disorders?
Medical history: The doctor will ask about menstrual cycle, duration, frequency, and any associated symptoms such as pain or excessive bleeding. Family history, diet, stress levels, and medication use will also be reviewed.
Physical examination: This exam looks for signs of physical conditions that may affect menstruation, such as thyroid abnormalities or weight problems.
Blood tests: Taking blood samples to check for anemia, thyroid problems, or blood clots.
Pap smear: Removal of cells from the cervix to check for infection, inflammation, or cell changes that may be cancerous or could lead to cancer.
Endometrial biopsy: Takes a sample of tissue from the lining of the uterus to see if you have cancer or other abnormal cells.
Transvaginal ultrasound: This imaging test is used to check the condition of the ovaries, uterus, or fallopian tubes and may help detect abnormalities such as fibroids, polyps, or ovarian cysts.
If you are experiencing menstrual problems such as excessive bleeding, irregular cycles, or bothersome menstrual pain, do not hesitate to consult our doctors at K-Lab Medical Center. We are ready to provide consultation services as well as examination recommendations that are appropriate for your condition. For more information, please contact our clinic WhatsApp at 081381367915.
Source:
Mayo Clinic – Womens Health
Cleveland Clinic – Menstrual cycle
Cleveland Clinic – Why is my period late?
Mayo Clinic – menorrhagia
Hopkins Medicine – dysmenorrhea
Healthywomen.org –premenstrual syndrome pms
Hopkins Medicine – premenstrual dysphoric disorder pmdd
Cleveland Clinic – oligomenorrhea
Alodokter– polimenorea ketahui tanda penyebab dan penanganannya
CDC.gov – Heavy menstrual bleeding.
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