Menstrual Disorder Management (PCOS, Heavy Bleeding, Irregular Cycles)

Menstrual Cycle is a natural phenomenon in women’s body. Periods are usually 2-7 days and occur every 21-35 days. Some women may have irregular periods, heavy bleeding or a failure to get a periods

Menstrual disorders can start after puberty of any age. This can be caused by hormonal imbalances, stress, weight gain or loss, thyroid problems, abnormal hormone levels, pregnancy or other medical conditions.

If diagnosed and treated properly, women will remain healthy with no complications. Any changes in periods should not be ignored by women, particularly if these continue for several months.

What are the menstrual disorders?

The conditions that affect normal menstrual cycle are labelled as menstrual disorder. These disorders can affect daily routine, overall health and fertility. They are very common and due to stress, hormonal imbalance and medications.

These include:

• Heavy menstrual bleeding.- In terms of amount of blood loss or lasting for more number of days.
• Very painful periods.
• Missed periods.
• Frequent or delayed periods very often (or more than twice a month)

These issues could impact daily living, school, work and emotional wellness.

Causes of Menstrual Disorder-

• Thyroid problems.
• Pituitary Tumours.
• Medication and therapies.
• Chromosomal or genetic abnormalities.

What is a normal menstrual cycle?

The average length of a menstrual cycle is 28 days. In healthy reproductive- age women a normal menstrual cycle lasts 21-35 days.

Normal periods will have these characteristics:

• Occurs every 21–35 days.
• Bleeding lasts 2–7 days.
• Blood loss 30-40 ml and up to 80 ml is considered as normal.
• Some mild cramps are a normal phenomenon.

Phases of menstrual cycle –

• Menstrual phase (Days 1-5).
• Follicular phase (Days 1-13).
• Ovulation (Around day 14 in a 28- days cycle).
• Luteal phase (Day 15-28).

What are Irregular Periods?

Irregular periods are defined as those that occur more often than normal, or have     changed in some way.

Irregular periods are when the period cycle is not regular.

Examples:

• The occurrence of periods that are too early.
• Any missing period that occurs more than two weeks after the period due date.
• Missing periods.
• Bleeding between periods.
• If periods are irregular, this is common in younger years (during puberty) and in older years (around the menopause), but should be investigated if the irregular periods persist.

What is PCOS?

Polycystic Ovary Syndrome (PCOS) is a frequent condition affecting women of childbearing age.

One of the main causes of PCOS is extra male hormones (androgens) being produced by the ovaries, which causes some disruption to the ovulation process.

Common symptoms include:

• Abnormal menstruation.
• Weight gain.
• Acne
• Facial and body hair that is more than normal.
• Difficult to conceive pregnancy.

PCOS can be managed over the long-term but it is treatable.

What causes PCOS?

The actual cause is not known, but it may be due to:

• Hormonal imbalance.
• Family history.
• Insulin resistance.
• Obesity
• Lifestyle factors.

It is difficult for women who have PCOS to let out eggs regularly.

What is heavy menstrual bleeding?

Heavy menstrual bleeding is defined as bleeding more than usual during periods.

Signs include:

• Thought fully changing pads 1-2 times an hour.
• Bleeding for longer than 7 days.
• Cleaning up large blood clots.
• Weakness, tiredness from blood loss.

Any heavy bleeding should be assessed by a health care provider.

What causes Heavy Bleeding problems?

Common causes include:

• Hormonal imbalance.
• Uterine fibroids.
• PCOS
• Adenomyosis
• Thyroid disorders.
• Blood clotting disorders.
• Certain medicines.

What tests may be needed?

• Medical history.
• Physical examination.
• Pregnancy test.
• Blood tests.
• Thyroid function test.
• Blood sugar test.
• Hormone tests.
• Pelvic ultrasound.

These tests are used to determine the exact cause.

What are the treatments for menstrual disorders?

Treatment will vary based on the cause.

This includes:

• Lifestyle changes.
• Healthy diet.
• Regular exercise.
• Weight management.
• Stress reduction.
• Good sleep.
• Medicines

Doctors may prescribe:

• Hormonal tablets.
• Birth control pills.
• Antibiotics to prevent infection from surgery wounds (if needed).
• Iron supplements in case of anaemia.
• Medicines that reduce insulin resistance in PCOS: Medicines that help insulin resistance in PCOS.

Can lifestyle changes help PCOS?

Yes, lifestyle changes are a great help for PCOS Healthy lifestyle habits are one of the best treatment of PCOS.

Helpful habits include:

• Engaging in walking or physical activity for 30-45 minutes a day.
• Cheese, milk and milk-based products.
• Choosing whole grains.
• Reducing sugary beverages & junk food.
• The primary factor is to keep body weight within the normal range.
• Weight loss, even between 5–10% of total body weight can help alleviate symptoms.

Does menstrual disorders impact pregnancy?

Yes, Women who do not receive treatment for PCOS or irregular ovulation may find it difficult to become pregnant. But, many of the women with menstrual disorders manage to conceive successfully after proper treatment. If pregnancy is desired, it is recommended to consult with the gynaecologist at an early stage.

When should you see a doctor?

Visit a doctor if:

• Periods stop for >3 months (excluding pregnancy)
• Heavy bleeding
• Blood clots slowly (more than 7 days)
• The pain is so intense it happens each month.
• Women are at risk of developing osteoporosis after menopause.
• Bleeding between periods – menstruation
• Get dizzy or very weak
• You experience irregular periods and have acne or excessive facial hair (PCOS)
• It is important to treat early to prevent complications.

Is there a way to avoid menstrual disorders?

While some menstrual disorders can’t be prevented, healthy habits can decrease the risk.

These include:

• Keeping a healthy weight.
• Regular physical activity.
• Balanced Healthy diet.
• Managing stress.
• Sleeping well.
• In line with the doctor’s recommendations.
• Regular health check-ups.

What problems might occur if menstrual disorders are left untreated?

Ignoring menstrual problems may lead to:

• Heavy bleeding which causes anaemia. (AUB)
• Infertility
• Hormonal imbalance.
• Emotional stress.
• These problems can result in a poor quality of life for a family.
• With early diagnosis these problems can be avoided.

Menstrual problems, such as abnormal uterine bleeding, including heavy periods and irregular periods, as well as polycystic ovarian disease, are common and can be treated.

Any woman should feel confident in talking to her health care provider about her menstrual issues. Symptoms and health can be improved significantly through a healthy lifestyle, regular physical activity, good nutrition, appropriate medical care and regular follow-up.

 Menstrual health education empowers women to look after themselves on time and to live their life to its full potential.