Most Common Menstrual Disorders


This menstrual disorder, the absence of menstrual bleeding, is normal for women before puberty, after menopause, and during pregnancy. If you don’t fit into one of these categories, then you need to discuss this condition with your healthcare provider.

There are two types of amenorrhea, primary and secondary. Primary amenorrhea is diagnosed if you have turned 16 and haven’t started to menstruate. Primary amenorrhea is usually caused by some problem in your endocrine system, which regulates your hormones. The condition may also be due to low body weight associated with an eating disorder, excessive exercise or medications.

Secondary amenorrhea is diagnosed if you had regular periods, but they suddenly stopped for 3 months or longer. Secondary amenorrhea is caused by problems that affect estrogen levels, such as stress, weight loss, exercise or illness. It can also be caused by problems that affect the pituitary gland, such as elevated levels of the hormone prolactin or thyroid problems such as hyperthyroidism or hypothyroidism.


Dysmenorrhea is the medical term for severe menstrual cramps. Many women experience menstrual cramps during their periods, but dysmenorrhea refers to especially painful and persistent cramps. Menstrual cramps are caused by uterine contractions triggered by prostaglandins, hormone-like substances that are produced by the uterine lining cells and circulate in your bloodstream.

Some patients who experience severe menstrual cramps also have issues with diarrhea or an occasional feeling of faintness. This is because prostaglandins speed up contractions in your intestines, resulting in diarrhea, and lower your blood pressure by relaxing blood vessels, leading to lightheadedness.


Menorrhagia is the medical term for menstrual bleeding that lasts more than 7 days. It can also be bleeding which is very heavy. Untreated heavy or prolonged bleeding can significantly reduce the quality of your life and cause a host of uncomfortable symptoms.

If you have menorrhagia, you might have symptoms like:

  • Soaking through a tampon or menstrual pad every hour for several hours
  • Waking up at night with a need to change your tampon or pad
  • Menstrual bleeding that lasts longer than a week
  • Large blood clots (bigger than the size of a quarter)
  • Menorrhagia can also cause symptoms of anemia, like fatigue or shortness of breath.

One in five women bleeds so heavily during their periods that they have to put their normal lives on hold just to deal with the heavy blood flow. If you need to change your tampon or pad after less than 2 hours or you pass clots the size of a quarter or larger, that is heavy bleeding. If you have this type of bleeding, you should see a doctor.

Several factors can lead to the development of menorrhagia. Some common causes are:

  • Hormonal Imbalance: If your key female hormones — estrogen and progesterone — are out of balance, this can cause excess endometrial tissue to develop during your menstrual cycle. When you have your period, this leads to heavier bleeding. Hormonal issues can also cause problems in the ovaries, fibroids, polyps, or other conditions of the reproductive organs that may bring on menorrhagia.
  • Bleeding Disorders: If you have a bleeding disorder like von Willebrand’s disease, you might be missing blood-clotting factors. This can lead to heavier menstrual bleeding.
  • Medications: Certain medications can cause heavier bleeding, including anti-inflammatory drugs, hormone replacement medications, or anticoagulants.
  • Underlying Health Conditions: For some women, other underlying health conditions — like liver or kidney disease — cause menorrhagia.

Treatment of menorrhagia depends on the cause. Some common methods for addressing this condition include:

  • Antibiotics
  • Hormone replacement therapy
  • Birth control

If medical therapy is unsuccessful, you may need surgical treatment to improve your symptoms. Surgical treatment options may include:

  • Dilation and Curettage: In this procedure, the doctor opens (dilates) your cervix and then scrapes or suctions tissue from the lining of your uterus to reduce menstrual bleeding.
  • NovaSure Endometrial Ablation: This procedure is a one-time, 5-minute procedure that can safely and effectively reduce or eliminate heavy menstrual bleeding. The endometrial ablation procedure is designed to remove just the uterine lining-the endometrium–which is the part of your body that can cause heavy periods. No incisions are required. Recommended for women who are finished with childbearing and want relief from heavy bleeding.
  • Hysterectomy: This is surgery to remove your uterus and cervix. It is a permanent procedure that causes sterility and ends menstrual periods.
  • Myomectomy: This procedure involves the surgical removal of uterine fibroids.

Premenstrual Dysphoric Disorder (PMDD)

Premenstrual Dysphoric Disorder (PMDD) is a similar but more serious disorder than PMS. PMDD causes severe irritability, depression, or anxiety in a week or two before your period starts. Like PMS, researchers don’t know the direct cause for PMDD but hormonal changes throughout the menstrual cycle may play a role as well as a brain chemical called serotonin. Serotonin levels change throughout the menstrual cycle, and some women may be more sensitive to these changes.

Physical symptoms include cramps, bloating, breast tenderness, headaches, and joint or muscle pain. Emotional symptoms may include

  • Lasting irritability or anger
  • Feelings of sadness or despair
  • Feelings of tension or anxiety
  • Panic attacks
  • Mood swings or crying
  • Lack of interest in daily activities and relationships
  • Trouble thinking or focusing
  • Trouble sleeping
  • Food cravings or binge eating

To be diagnosed with PMDD, you must have five or more PMDD symptoms, including one mood-related symptom.

Premenstrual Syndrome (PMS)

PMS is a combination of physical and emotional symptoms that many women get about a week or two before their period. Symptoms may include bloating, headaches, and moodiness. About 30 to 40 percent of women experience symptoms severe enough to disrupt their lifestyles.

Researchers don’t know the direct cause of PMS but believe that changes in hormone levels during the menstrual cycle may play a role.

Menstrual Disorders FAQ
  • What causes menstrual disorders?

    There are several factors that can cause menstrual disorders including:

    • Uterine Fibroids
    • Hormonal Imbalances
    • Clotting Disorders
    • Cancer
    • Sexually Transmitted Infections (STIs)
    • Polycystic Ovary Syndrome
    • Genetics

  • What are the symptoms of menstrual disorders?

    Symptoms of menstrual disorders may include:

    • Abnormal menstrual bleeding
    • Pain or cramping
    • Depression
    • Headaches
    • Emotional distress
    • Bloating or fullness in the abdomen

  • How are menstrual disorders diagnosed?

    During your appointment, your doctor will ask you questions about your medical history and will conduct a physical exam, including a pelvic exam and Pap smear.

    Your doctor may also order additional diagnostic tests, such as

    • Blood tests
    • Hormonal tests
    • Ultrasound: A diagnostic medical test that uses high-frequency sound waves to produce visual images to detect conditions that may be causing menstrual disorders
    • A transvaginal ultrasound exam that captures images of inside the uterus.
    • MRI. A magnetic resonance imaging scan uses a magnetic field and computer-generated radio waves to create detailed images of the uterus and surrounding organs.
    • Uses a small lighted telescope (hysteroscope) inserted through the vagina and cervix to examine the uterus for fibroids, polyps, or other areas of concern
    • Laparoscopy. Looks for abnormalities of the reproductive organs using a tiny lighted instrument with a camera on the end (laparoscope) inserted through a small incision in the abdomen
    • Endometrial biopsy. A small sample of the lining of the uterus is removed to examine for abnormal cells
    • Dilation and Curettage (D&C). Refers to the dilation of the cervix and surgical removal of part of the lining of the uterus and/or contents of the uterus by scraping and scooping. It may be done after a first-trimester miscarriage or to relieve heavy bleeding.

    At the conclusion of your visit, your doctor may ask you to keep a diary of your menstrual cycles, including dates, amount of flow, pain and any other symptoms.

  • What treatment options are available for menstrual disorders?

    Your doctor will determine the best treatment option for you depending on the cause of your menstrual disorder. Treatment options include lifestyle changes, medical management, and surgery, including:

    • Dietary Changes. You may be advised to reduce salt, caffeine, sugar, and alcohol intake before your period to reduce cramping and other symptoms.
    • Medical Management. Pain relievers, either over-the-counter medications or prescription medications may be recommended for cramps. Hormonal contraceptives may also be prescribed to help reduce heavy bleeding and regulate, reduce, or even eliminate menstrual periods.
    • Surgical Treatment. Surgical options may include:
      • Hysteroscopy
      • Laparoscopy
      • Endometrial ablation (destroys the lining of the uterus to stop periods)
      • Hysterectomy

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This information is provided for informational educational purposes only, and should not be considered as individual medical advice. Please discuss your specific situation with your medical provider.

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