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Top 5 menstrual dysfunctions

During lifetime almost all women experience different types of menstrual dysfunctions. In general, menstrual cycle can be triggered by several factors including stress, hormonal disorders, weight changes, benign or cancerous tumors, etc.

Menstrual cycle is the most important part of female reproductive system and it is determined genetically and hormonally. Menstrual cycle can vary from woman to woman. Some women could have short menstrual cycles (21-25 days), some women could have long cycles (32-35 days) but majority have average menstrual cycle 28 days long. In most cases healthy women have 11-13 menstrual periods each year (depending on duration of menstrual cycles).

Normal healthy menstrual cycle characteristics:

Normal menstrual cycle is always regular (every month);

Normal duration of menstrual cycle can be 24-37 days long;

Normal duration of menstrual period is 3-7 days.

In general normal regular menstrual periods are signs of normal hormonal development, normal rhythmic female hormones fluctuations, normal menstrual cycles and normal reproduction functions.

Top 5 menstrual dysfunctions

All menstrual dysfunctions can be classified into 5 main groups:

  • Late period,
  • Irregular bleeding,
  • Oligomenorrhea,
  • Amenorrhea,
  • Missed period.

Menstrual dysfunctions – late period

Several factors can be responsible for late period. For many women late period means pregnancy but it is not always the correct guess. If your pregnancy test is negative, here are some other causes for late period that you could consider:

  • Puberty (during first year late periods are very common; body needs some time for full development of mature menstrual cycles);
  • Stress (emotional or physical stress can disturb normal hormonal fluctuations and cause late period);
  • Hormonal dysfunctions (polycystic ovarian syndrome, thyroid disturbances, hyperprolactinemia, premature ovarian failure);
  • Hormonal contraception (birth control pills, Depo Provera, hormone-releasing IUD);
  • General illnesses and chronic diseases (tumors, ovarian transformations, diabetes, infections, etc.);
  • Nutrition and weight problems (malnourished or extremely underweight women as well as overweight and obese women could experience late period);
  • Medications (certain medications such as corticosteroids, antidepressants, antipsychotics, thyroid and some chemotherapy drugs, radiation therapy may cause late period).

Menstrual dysfunctions – irregular bleeding

Irregular uterine bleeding is always subject of concern at any period of life. Bleeding instead of normal menstrual period and even very heavy menstrual flow can be great cause for alarm. Irregular bleeding causes include the following:

  • Ovulation problems (if ovulation does not occur, ovaries continue producing estrogen which stimulate endometrium thickening followed by irregular bleeding);
  • Fibroids (different types of uterine fibroids are comprised of muscle and fibrous tissue, and may cause excessive flow during menstruation or bleeding between periods);
  • Polyps (polyps could appear in cervix and uterus; polyps can trigger irregular bleeding);
  • Adenomyosis (when uterus lining grows into the muscle wall causing unexpected shedding and bleeding);
  • Stress (stress hormones can trigger hormonal imbalance that interfere with ovulation and can result in abnormal uterine bleeding);
  • Birth control pills (wrongly used pills or missed pills can cause irregular bleeding);
  • Pregnancy (interrupted pregnancy, tubal pregnancy, impending miscarriage);
  • Menopause (dysfunctional bleeding due to natural hormonal changes during menopausal transition period);
  • Pelvic inflammatory disease (endometrial inflammation can cause irregular bleeding);
  • Ovarian cysts (irregular bleeding is one of symptoms);
  • Intrauterine devices (IUDs could trigger heavy menstrual bleeding);
  • Uterine cancer (any vaginal bleeding that occurs after menopause could be a symptom of malignant growth in uterus).

Menstrual dysfunctions – oligomenorrhea

Menstrual bleeding at intervals of greater than 35-36 days may indicate oligomenorrhea (abnormally infrequent menstrual bleeding characterized by three to six menstrual cycles per year). Oligomenorrhea causes include the following:

  • Polycystic ovary syndrome (PCOS);
  • Puberty;
  • Female Athlete Triad;
  • Adrenal hyperplasia;
  • Eating disorders (bulimia, anorexia nervosa);
  • Diabetes;
  • Hypothyroidism;
  • Thyrotoxicosis;
  • Hyperprolactinemia (prolactin-secreting pituitary tumor);
  • Stress;
  • Perimenopause;
  • Chronic illnesses and drug abuse.

Menstrual dysfunctions – amenorrhea

Amenorrhea is the absence of menstrual periods for more than 6 months. Amenorrhea could be primary or secondary. Amenorrhea causes include the following:

  • Genetic diseases (gonadal dysgenesis, Turner Syndrome, aplasia, Kallmann syndrome);
  • Premature ovarian failure;
  • Anatomical abnormalities of genital tract or intrauterine adhesions;
  • Anorexia and/or bulimia;
  • Chronic diseases (diabetes, tuberculosis, cancer, etc.);
  • Malnutrition, excessive weight gain or weight loss;
  • Psychiatric disorders and/or depression;
  • Drug addiction and/or drug abuse;
  • Pituitary tumors or hyperprolactinemia.

Menstrual dysfunctions – missed period

Every woman should know that missed period could be a symptom of several health conditions (not only pregnancy!). Missed period causes include the following:

  • Puberty (pubertal hormonal imbalance);
  • Menopause (naturally decreased levels of female hormones);
  • Stress (stress hormones could interfere with female hormones and extend menstrual cycle);
  • Dramatic weight changes (obesity or anorexia);
  • Hormonal dysfunctions (PCOS, thyroid, diabetes, etc.);
  • Birth control pills (due hormonal changes);
  • Pregnancy.

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