Menstrual disorders

A menstrual disorder is an abnormal condition in a woman's menstrual cycle.

Women can have various problems with periods / menstruation them. The problem may be not menstruate at all to severe and prolonged menstruation.

Menstrual pattern may be irregular, but if the distance between menstruation less than 21 days or more than 3 months, or if your period lasts more than 10 days then you should be aware of the existence of ovulation problems or other medical conditions.

1. Amenorrhea
Amenorrhea is no menstruation. 

This term is used for women who have not started menstruating after the age of 15 years (primary amenorrhea) and that stops menstruation for 3 months, but had been periods (secondary amenorrhea).

Primary amenorrhea is usually caused by hormonal disorders or growth problems. Secondary amenorrhea can be caused by low gonadotropin-releasing hormone (menstrual cycle regulator), stress, anorexia, extreme weight loss, thyroid disorders, heavy exercise, birth control pills and ovarian cysts.

2. Premenstrual syndrome (PMS)
Premenstrual syndrome (PMS) is a group of physical symptoms, emotions, and behaviors that commonly occur in the last week of the luteal phase (the week before menstruation). Symptoms usually do not begin until 13 days before the cycle, and completed within 4 days after bleeding begins.

Some of the symptoms of PMS are often perceived:
Breast tenderness and swellingDepressed, irritable, moody and emotional instability (mood swings)Not interested in sex (decreased libido)Acne periodicAbdominal bloating or crampsHeadache or joint painDifficulty sleepingDifficult defecation
3. Dysmenorrhea
Dysmenorrhea is painful menstruation. Menstrual pain occurs in the lower abdomen but can spread to the lower back and thighs. Pain can also be accompanied by severe abdominal cramps. Cramps are from contractions in the uterus, which is a normal part of the process of menstruation, and usually first felt when I started bleeding and continues up to 32-48 hours.

Dysmenorrhea experienced by adolescents are generally not due to disease (primary dysmenorrhea). On older women, dysmenorrhea can be caused by certain diseases (secondary dysmenorrhea), such as uterine fibroids, pelvic inflammation, endometriosis or ectopic pregnancy.

Symptoms of primary dysmenorrhea can be commuted with a pain reliever / anti-inflammatory such as ibuprofen, ketoprofen and naproxen. Exercise, compress with a hot water bottle, and warm baths may also relieve pain.

When menstrual pain is not relieved by pain medication, then chances are secondary dysmenorrhea caused by certain diseases.

4. Menorrhagia
Menorrhagia is the medical term for excessive menstrual bleeding. In a normal menstrual cycle, women on average lose about 30 ml of blood for about 7 days of menstruation. If bleeding exceeds 7 days or too heavy (over 80 ml), then categorized menorrhagia.

The main cause of menorrhagia is an imbalance of estrogen and progesterone in the body. The imbalance causes the endometrium continues to form. When the body get rid of the endometrium through menstruation, bleeding becomes severe.

Menorrhagia may also be caused by thyroid disorders, blood disease, and inflammation / infection of the vagina or cervix.

5. Abnormal Bleeding
Abnormal vaginal bleeding (excluding menses), among others:

Bleeding between menstrual periodsBleeding after sexBleeding after menopause
Abnormal bleeding caused by many things. Your doctor may start by examining the most common problems in your age group. Serious problems such as uterine fibroids, polyps, or even cancer can be the cause of abnormal bleeding.

Both the adolescents and women approaching menopause, hormonal changes can cause irregular menstrual cycles.

What are the mostly  causes of mentraul disorders 

The causes of various menstrual disorders can be summarized as follows:

• Hormonal
• Clotting Disorder
• Anatomic
• Medication and Supplements
• The “Apparently” Normal Uterus
• Miscellaneous causes.

A. Hormonal Causes

• Pituitary gland problems
• Thyroid gland abnormalities
• Adrenal gland abnormalities
• Ovarian dysfunction

B. Clotting Abnormalities

Clotting abnormalities may be responsible for 5% of cases of abnormally heavy menstrual bleeding. Women with clotting abnormalities generally have a history of easy bruisability or excess bleeding from relatively minor cuts and scrapes. Additional abnormalities might include:

• Platelet dysfunction abnormalities such as Thrombocytopenia
• Clotting factor abnormalities such as Von Willebrand Disease

C. Anatomic Problems

About 25% of women with heavy menstrual periods have one of the anatomic reasons listed below. In our practice, the most common anatomic reason for heavy menstrual bleeding is uterine fibroids, which account for the majority of “anatomic problems” that cause abnormally heavy menstrual bleeding. A summary of “anatomic problems” include:

• Uterine Fibroids (these benign tumors originate from the uterine muscle)
• Polyps (these originate from the uterine lining)
• Adenomyosis (lining tissue of the uterus is found within the muscle of the uterus)
• Decreased uterine contractile strength
• Endometrial cancer
• A uterus with a large surface area

There are several important things to remember about “anatomic problems” that cause abnormally heavy periods. First, uterine cancer accounts for less than 1% of these. Although cancer is among the causes of abnormal uterine bleeding it is rare in women under the age of 50 and, if caught early, is a very curable disease. Second, once your health care provider has determined that you don’t have cancer the treatment is generally one of choice rather than necessity.

Though this may be obvious to your physician or nurse practitioner it bears repeating that the majority of women in their 30’s and 40’s who have periods that are heavy because of anatomic reasons, do not have cancer. For most women it is at least comforting to know that however inconvenient or disabling their symptoms may be, it is the rare woman with heavy periods that has uterine cancer.

FIBROIDS: THE MOST COMMON BENIGN TUMOR IN WOMEN

The uterus contains two types of tissue—an inner lining (endometrium) that sheds each month with your period and the muscular portion (myometrium).Both of these tissue types can develop growths. When the lining tissue develops growth, they’re called polyps. When the overgrowth of muscle tissue causes tumors, they are referred to as myomas (or fibroids). Fibroids mostly produce two types of symptoms: abnormal uterine bleeding and infertility (although other symptoms occur less frequently). Many women with fibroids don’t have symptoms and the majority of them can simply choose to live with these benign tumors. Fibroids, as you can see from the drawing, can grow anywhere in the uterus. In general, the closer a fibroid is to the center of the uterus (the inner cavity) the more troublesome they become—causing heavy menstrual bleeding and infertility (or miscarriages).

• How we diagnose uterine fibroids >
• Treating uterine fibroids >

ENDOMETRIAL POLYPS – A VERY COMMON CAUSE OF ABNORMAL PERIODS

Endometrial polyps, though not as common as fibroids, are a significant cause of heavy menstrual bleeding. In addition, they are often the cause of post-menopausal bleeding (bleeding which occurs one or more years after menopause) as well as intermenstrual bleeding (bleeding that occurs between menstrual cycles). On ultrasound they may sometimes be confused with fibroids.

What’s the difference between fibroids and polyps?

Remember that the uterus contains 2 types of tissue—muscle tissue and tissue which lines the inside of the uterine cavity. Both of these tissue types can cause benign “tumors”. Fibroids originate from muscle tissue while polyps (also called ‘endometrial polyps’) originate from lining (endometrial) tissue.

Do endometrial polyps cause cancer?

Although endometrial polyps are generally benign they can be associated with malignancy—particularly in older, postmenopausal women. The only way to know for sure is to remove them and send to a pathologist for testing. This is routinely done.

D. Medications & Supplements That Cause Menstrual Disorders

There are a variety of medications that can cause menstrual disorders. These include:

• Aspirin
• Estrogens
• Coumadin or Heparin
• Vitamin E
• Ginkgo biloba
• Nonsteroidal anti-inflammatory drugs such as ibuprofen or naproxen

E. The “Apparently” Normal Uterus

The vast majority of women we see with abnormal uterine bleeding have what appears to be a “normal looking” uterus—which is to say that there’s no evidence of fibroids, polyps, hyperplasia or cancer. Additionally, these women turn out to have normal thyroid functions, normal clotting abilities and no evident “hormonal” problem. So why do these women bleed heavily?

This is a complex and compelling issue. Medical logic tells us that if there’s a problem, we need to find the cause in order to treat it. In theory that would be intellectually and scientifically rewarding but life and medicine are imperfect. It turns out that often the diagnostic procedure may be more uncomfortable than the problem or the treatment.

Here are two examples:

There are a substantial number of women who have a uterine abnormality called adenomyosis. Adenomyosis is a disease in which there are pockets of uterine-lining tissue (endometrium) buried within the muscular wall (myometrium) of the uterus.

These are normal glands in an abnormal place. Adenomyosis is a specific type of endometriosis. Unfortunately, it is difficult to diagnose without surgery. In fact, the diagnosis of adenomyosis is often made after hysterectomy. Today we have other methods to diagnose adenomyosis but they still involve at least some surgical biopsies. The point is that there are other ways to treat women with suspected adenomyosis and avoid biopsies altogether. Some of these methods are as simple as a low-dose oral contraceptive or a hormone containing intrauterine device (IUD). Therefore, in situations where the diagnosis is more invasive than the treatment it’s wise to treat rather than biopsy—it’s less invasive, risky and costly.

A second example is one that is rarely written about—the uterus that doesn’t function normally. We know that after childbirth, some women bleed heavily and even hemorrhage because of the failure of their uterus to properly contract. Immediately following childbirth, the uterus is often massaged in order to stimulate its contraction. In many cases medications are administered that have similar effects. Apparently, strong uterine contractions are necessary to limit blood loss after childbirth. One can also postulate that some women experience heavy periods as a result of their uterus’ inability to adequate contract. In this example, the uterine may look normal (even microscopically) but doesn’t function normally. There’s no way to test for this problem yet it too can be treated with minimally invasive approaches. Some recently published work even suggests that the “aging” uterus may contain small arteries that lose their ability to contract and therefore control bleeding.

F. Miscellaneous Causes of Abnormal Bleeding

There are other uncommon and even rare causes of abnormal uterine bleeding. Some of these include:

• Cervical cancer
• Uterine infections
• Severe liver or kidney disease
• Rare ovarian tumors
• Unsuspected pregnancy
• Miscarriage
• Acute emotional stress
• Obesity

What are the common treatments for menstrual irregularities?

Treatment for menstrual irregularities that are due to anovulatory bleeding (absent periods, infrequent periods, and irregular periods) include^1,2:

     Oral contraceptives

     Cyclic progestin Treatments foran underlying disorder that is causing the menstrual problem, such as counseling for an eating disorder or extreme excercise

    Treatment for menstrual irregularities that are due to ovulatory bleeding (heavy or prolonged menstrual bleeding) include^1,3,4,5,6

   Insertion of a hormone-releasing intrauterine deviceUse of various medications (such as those containing progestin or tranexamic acid) or nonsteroidal anti-inflammatory medications

     If the cause is structural or if medical management is ineffective, then the following may be considered:

     Surgical removal of polyps or uterine fibroidsUterine artery embolization, a procedure to block blood flow to the uterusEndometrial ablation, a procedure to cauterize blood vessels in the endometrial lining of the uterusHysterectomy

    Treatment for dysmenorrhea (painful periods) include⁷:

    Applying a heating pad to the abdomenTaking nonsteroidal anti-inflammatory medication

   Taking contraceptives, including injectable hormone therapy or birth control pills, using varied or less common treatment regiment 

HOME REMEDIES FOR IRREGULAR PERIODS

1. Ginger

Ginger greatly helps regulate monthly periods in women. It promotes menstruation flow and also relieves women from the unbearable pain. Just boil ½ tsp of freshly grounded ginger in one cup of water for 5-10 minutes. Then add a little sugar or honey to enhance the taste. Strain this mixture and drink three times a day after every meal for around one month.

2. Turmeric

The warming properties of turmeric improve the hormonal imbalance and regulate the menstruation cycle. Its anti-inflammatory and antispasmodic properties reduce the cramping. Take a ¼ teaspoon of turmeric powder and add it to the lukewarm milk. Take it every day, until you see improvement.

3. Coriander Seeds

Take two cups of water and add one teaspoon of coriander seeds to it. Boil them until the quantity of water reduces to half. Strain the solution and drink it three times a day for a few days prior the onset of your period. Follow this remedy for one or two months. Alternatively, you can also drink coriander juice on a daily basis.

4. Carrot Juice

Carrots are the good source of iron and regulate proper functioning of the hormone. One should drink a glass of carrot juice regularly for three months to normalize the irregular menstruation cycle.

5. Fennel

Being an effective emmenagogue fennel aids in promoting menstruation flow. Apart from this, its antispasmodic properties relieve cramping associated with premenstrual syndrome. Take two tablespoons of fennel seeds and soak them in a glass of water overnight. Strain this solution in the morning and drink it. Do this daily for a month to see effective results.

Or else, grind one teaspoon of fennel seeds to make a fine powder. Add this to one cup boiling water and steep it for five minutes. Then, strain this mixture and drink it.

6. Sesame Seeds and Jaggery

Sesame seeds and jaggery do wonder when it comes to cure the problem of irregular periods. Take a handful of sesame seeds and roast them. Then, grind them with one teaspoon of jaggery to form a fine powder. Consume one teaspoon of this powder every day on an empty stomach, two weeks before your periods begin. Follow this for a few months.

• Alternatively, simply eat a piece of jaggery before periods commence.

Note: Do not use this remedy during your periods.

7. Cinnamon

The warming effect of cinnamon reduces menstrual cramps, and its hydroxychalcone element helps regulate the insulin levels. Take a ½ teaspoon of cinnamon powder and add it to a glass of milk. Drink this daily for a couple of weeks.

• Moreover, you can also drink cinnamon tea, sprinkle cinnamon powder on your toasts, or chew cinnamon sticks frequently.

8. Unripe Papaya

It is very useful for irregular menstruation resulted due to stress and menopause. It helps contract muscle fibers in the uterus that induce periods. Drink unripe papaya juice or eat chopped papaya for a few months.

Note – Do not drink it during your periods.

9. Grapes

Have grape juice daily to prevent irregularity in periods. Or else, incorporate raw grapes in your daily diet in a moderate amount.  Excess consumption of grapes may result in loose motions.

10. Parsley

Parsley juice is considered as one of the most effective home remedies for menstruation-related problems. Crush parsley and grind them in a blender along with some water to prepare its juice. It is an excellent substitute for medicine.

11. Figs

Take 5 figs and boil them in a cup of water. Then strain this decoction and consume it daily. It will certainly regularize your menstrual cycle.

12. Saffron

Boil 1 teaspoon of saffron in a ½ cup of water. Simmer until its quantity reduces to 1 tablespoon. Divide this infusion into three portions and take it with equal quantities of water, thrice daily for a couple of days.

13. Bitter Gourd

Bitter gourd proved very effective for the treatment of irregular periods. Drink its juice once or twice every day for a few weeks. Apart from this, bitter gourd juice protects your body from diabetes.

14. Buttermilk and Radish Seeds

Grind some radish seeds and add two large spoons of its powder in one cup of buttermilk. Stir properly. Drink this mixture daily for at least three months. You will notice improvement.

15. Apple Cider Vinegar

Apple cider vinegar reduces the insulin and blood sugar levels that help regulate the periods naturally. Intake of 1-2 tbsp of apple cider vinegar with water once a day before your meal prevents irregular periods.

16. Cumin and Sesame Seeds

Take cumin seeds and sesame seeds in equal amount and grind them to form a powder. Then add honey to this mixture. Consume one tablespoon of it daily.

17. Vitamin C

Vitamin C largely contributes to the production of estrogen that builds the uterine lining that handles your periods. Take high doses of vitamin C if your periods do not occur in 30 or 35 days. You can include orange, apple, tomatoes, berries, etc in your diet.

Note – Large dosage of vitamin C is not suggested for pregnant women as it may cause miscarriage.

18. Asafoetida

Asafoetida is a popular ingredient that has immense medicinal value. It contains chemical compounds that can treat the hormonal disorder. Take a small amount of powdered asafoetida and fry it in the clarified butter. Add it to the goat’s milk with some honey. The recommended dose of asafoetida is 200 to 500 mg a day.

19. Sugarcane Juice

Drink sugarcane juice for a week prior your expected periods to regularize your menstruation cycle.

HERBAL REMEDIES FOR IRREGULAR PERIODS

20. Chaste Tree

It is one of the best herbs for regulating your menses. The active ingredient found in chaste tree regularizes the working of the pituitary gland; thus, balancing the hormonal discharge from the ovaries. It should be regularly consumed to normalize the timing of the menstrual cycle. A standard dose of 30 to 40 mg is considered safe.

Note –

• This herb is not recommended if you are taking any fertility drug.
• It should not be consumed during pregnancy.

21. Bark of Saraca Asoca

Take a bowl; add one cup of milk, two tbsp of bark extract and a glass of water. Simmer this mixture until it reduces to half. Take this on the 3rd and 4th day of your period, at least three times a day.

22. Banyan Tree Roots

Boil banyan tree roots in a cup of water for around 10 minutes. Add 2-3 tablespoons of cow’s milk to this decoction and take it before you hit the bed.

23. Aloe Vera

Take out some fresh aloe vera gel from its leaf and mix one teaspoon of honey in it. Take this mixture daily before your breakfast for around three months. The amazing healing properties of this mixture can cure many disorders.

• Or else, squeeze out fresh pulp from three aloe leaves and boil it till the color of gel turns brown. After it cools down, take one tsp with a cup of water. Have it early in the morning on an empty stomach.

Note:  Don’t consume it during your menstruation.

24. Mint

A combo of one teaspoon each of honey and dried mint powder is an excellent treatment for irregular menstrual periods. Consume it three times a day for some weeks.

25. Bamboo

Boil handful of bamboo leaves in some water. Strain the decoction and consume it regularly until you see the improvements. It has therapeutic properties that regularize the menstruation flow.

26. Calendula

Calendula, also termed as garden marigold, is a rich source of flavonoids and quercetin that balances the blood circulation. The analgesic properties of this flower relieve premenstrual pain. Simply, add 2 grams of dried calendula flowers in 200 ml boiled water. Let them steep. Strain and drink this infusion two times a day.

27. Blue Cohosh

Blue cohosh works as an emmenagogue that stimulates the menstrual flow. Intake of this herb expands the blood vessels in the uterus and leads to proper circulation. Have its tincture or extract prior your menstrual period. For its accurate dosage, consult a healthcare physician.

Warning

• A high dose of this herb may cause headache, nausea, and high blood pressure.
• This remedy is not recommended for pregnant women.

28. Motherwort

Volatile oils and alkaloids in motherwort treat inconsistent periods in women. Prepare herbal decoction from its leaves or have its tincture to obtain its health benefits.

29. Yarrow

The flowering part of this plant can be used to treat menses problem. Have its tincture or brew the herbal infusion or drink its juice to cure irregular periods.

30. Black Cohosh

Phytoestrogens present in this herb normalizes the working of hormones in the body; thus, helps deal with the menstruation issues. Use its extract or tincture to regularize the periods.

31. Shepherd’s Purse

This herb is also termed as Chinese cress that works as an astringent. It tightens the uterine muscles, which treats not only irregular periods, but also prevents excessive bleeding as well. Consume this herb in the form of tincture or extract, to experience its health benefits.

32. Lady’s Mantle

This herb contains tannins that help prevent menstruation irregularities. Besides, it has salicylic acid that soothes your muscles and eases cramps.

33. Banyan Tree Roots

Boil fresh roots of a banyan tree in a cup of water for 10 minutes. Afterward, include three tablespoons of cow’s milk to the solution. Have it every day before your bedtime to regularize your menstruation.

34. Holy Basil Leaf

Crush some fresh basil leaves to extract its juice. Combine one tsp each of honey and basil juice. Now, sprinkle a dash of pepper powder on this mixture and have it two times a day to treat the problem of irregular menstruation.

35. Indian Lilac

Pour two cups of water in a bowl and soak three cups of Indian lilac bark in it for 20 minutes. Strain the decoction and have one cup three times a day. Follow this remedy until you notice improvement.

36. Hibiscus Flower

Take five fresh hibiscus flowers and crush them in a juicer to form a smooth paste. Have this with some water in the morning prior your breakfast.  It should be taken seven days before your menstruation cycle starts. This remedy helps balance the estrogen and progesterone level in the body and regulate the monthly cycle.

These remedies can regularize the periods. Also to this, try to maintain a healthy lifestyle. If you constantly face irregular periods, then consult a gynecologist for proper treatment, especially if you are above 40 years.

Note: Before you start with any of the above herbal remedies, consult a physician.

DO’S

• Exercise regularly.
• De-stress yourself by practicing relaxation techniques like yoga or meditation.
• Take multi-vitamins.
• Maintain a healthy body weight.
• Take a nutritious diet.
• Have vegetable juices.
• Include corn, beets, lettuce, drumsticks, and pumpkin seeds in your daily diet.

DON’T

• Avoid over-exercising.
• Avoid smoking and drugs.
• Say no to excessive traveling.
• Don’t overdose birth control pills.
• Do not take an excessive quantity of carbohydrates.
• Refrain from caffeinated and alcoholic beverages.