- by Motherhood Hospital
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- Feb 28 2017
Women Care-Menstrual disorders
Menstruation occurs during the years between puberty and menopause. Menstruation, also called a “period,” is the monthly flow of blood from the uterus through the cervix and out through the vagina.
Menstrual disorders include:
- Painful cramps (Dysmenorrhea) during menstruation. Primary dysmenorrhea is caused by menstruation itself. Secondary dysmenorrhea is triggered by another condition, such as endometriosis or uterine fibroids.
- Heavy bleeding (Menorrhagia) includes prolonged menstrual periods or excessive bleeding.
- Absence of menstruation (Amenorrhea). Primary amenorrhea is considered when a girl does not begin to menstruate by the age of 16. Secondary amenorrhea occurs when periods that were previously regular stop for at least 3 months.
- Light or infrequent menstruation (Oligomenorrhea) refers to menstrual periods that occur more than 35 days apart. It usually is not a cause for concern, except if periods occur more than 3 months apart.
Age plays a key role in menstrual disorders. Girls who start menstruating at age 11 or younger are at higher risk for severe pain, longer periods, and longer menstrual cycles. Adolescents may develop amenorrhea before their ovulation cycles become regular.
Women who are approaching menopause (perimenopause) may also skip periods. Occasional episodes of heavy bleeding are also common as women approach menopause.
Other risk factors include:
- Weight – Being either excessively overweight or underweight can increase the risk for dysmenorrhea and amenorrhea.
- Menstrual Cycles and Flow – Longer and heavier menstrual cycles are definitely associated with painful cramps.
- Pregnancy History – Women who have had a higher number of pregnancies are at increased risk for menorrhagia. Women who have never given birth have a higher risk of dysmenorrhea, while women who first gave birth at a young age are at lower risk.
- Smoking – Smoking can increase the risk for heavier periods.
- Stress – Physical and emotional stress may block the release of luteinizing hormone, causing temporary amenorrhea.
Diagnosis – Your medical history can help us determine whether a menstrual problem is caused by another medical condition.
For example, non-menstrual conditions that may cause abdominal pain include appendicitis, urinary tract infections, ectopic pregnancy, and irritable bowel syndrome.
Your doctor may ask questions concerning:
- Menstrual cycle patterns — length of time between periods, number of days that periods last, number of days of heavy or light bleeding
- The presence or history of any medical conditions that might be causing menstrual problems
- Any family history of menstrual problems
- History of pelvic pain
- Regular use of any medications (including vitamins and over-the-counter drugs)
- Diet history, including caffeine and alcohol intake
- Past or present contraceptive use
- Any recent stressful events
- Sexual history
Menstrual Diary – A menstrual diary is a helpful way to keep track of changes in menstrual cycles. You should record when your period starts, how long it lasts, and the amount of bleeding and pain that occurs during the course of menstruation.
Pelvic Examination – A pelvic exam is a standard part of diagnosis. A Pap test may be done during this exam.
Blood and Hormonal Tests – Blood tests can help rule out other conditions that cause menstrual disorders. For example, your doctor may test thyroid function to make sure that low thyroid (hypothyroidism) is not present.
Ultrasound – Imaging techniques are often used to detect certain conditions that may be causing menstrual disorders. Imaging can help diagnose fibroids, endometriosis, or structural abnormalities of the reproductive organs.
Ultrasound and Sonohysterography – Ultrasound is the standard imaging technique for evaluating the uterus and ovaries, detecting fibroids, ovarian cysts and tumors, and finding obstructions in the urinary tract. It uses sound waves to produce an image of the organs. Ultrasound carries no risk and causes very little discomfort.
Transvaginal sonohysterography – uses ultrasound along with saline (salt water) injected into the uterus to enhance the visualization of the uterus.
Other Diagnostic Procedures
Hysteroscopy – Hysteroscopy is a procedure that can detect the presence of fibroids, polyps, or other causes of bleeding. It may miss cases of uterine cancer, however, and is not a substitute for more invasive procedures, such as dilation and curettage (D&C) or endometrial biopsy, if cancer is suspected.
Laparoscopy – Diagnostic laparoscopy, an invasive surgical procedure, is currently the only definitive method for diagnosing endometriosis, a common cause of dysmenorrhea. It may also be used to treat endometriosis. Laparoscopy normally requires a general anesthetic, although the patient can go home the same day.
The procedure involves
- Inflating the abdomen with gas through a small abdominal incision.
- A fiber optic tube equipped with small camera lenses (the laparoscope) is then inserted.
- The doctor uses the laparoscope to view the uterus, ovaries, tubes, and peritoneum (lining of the pelvis).
Dietary Factors – Making dietary adjustments starting about 14 days before a period may help some women with certain mild menstrual disorders, such as cramping.
The general guidelines for a healthy diet apply to everyone; they include
- Eating plenty of whole grains
- Fresh fruits and vegetables
- Avoiding saturated fats
- Avoiding Commercial junk foods.
- Limiting salt (sodium) may help reduce bloating.
- Limiting caffeine, sugar, and alcohol intake may also be beneficial
Other Lifestyle Measures
- Exercise – Exercise may help reduce menstrual pain.
- Sexual Activity – There have been reports that orgasm reduces the severity of menstrual cramps.
- Applying Heat – Applying a heating pad to the abdominal area, or soaking in a hot bath, can help relieve the pain of menstrual cramps.
Menstrual Hygiene – Change tampons/ sanitary napkins every 4 – 6 hours. Avoid scented pads and tampons; feminine deodorants can irritate the genital area.Bathing regularly is sufficient.
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