Menstrual disorders explained
The ‘Let’s Talk About Periods’ Series - Menstrual Disorders Explained
For some women, their periods come every month like clockwork. It’s as predictable as the tides washing over the shores, the moon changing its shape, and all of the other natural analogies we hear so often.
But for other women, menstrual disorders come into the picture that can dramatically affect their day-to-day physical and/or emotional well-being - whether in the lead up to their period, during their period, or even the potential to impact their fertility. From the absence of periods, to heavy bleeding, extremely painful periods, or highly irregular cycles, menstrual disorders are actually more common than you might think.
Up to 91% of women between the ages of 18 -25 experience some kind of menstrual problems at some stage, such as irregular bleeding, amenorrhoea, menorrhagia and menstrual pain.
In the coming weeks, we’ll be discussing the common menstrual disorders and what they mean for a woman’s fertility potential.
At a glance, the common menstrual disorders include:
- Irregular periods, often associated with Polycystic Ovary Syndrome (PCOS)
- The lack of periods, or amenorrhoea;
- Heavy or prolonged periods, called menorrhagia;
- Painful periods, or dysmenorrhea.
First, let’s talk about the lack of periods. This is referred to as ‘amenorrhoea’.
This menstrual disorder can sometimes present itself for women who are experiencing a temporarily stressful time in their lives, extreme weight loss, or intense physical training.
After pregnancy is excluded, it is important to seek help within 3 months of amenorrhoea because there could be long term consequences associated with amenorrhoea.
Of course, the most common “cause” of amenorrhoea is actually pregnancy! Oftentimes, if a woman comes in to see their doctor or specialist having not had a period in some time, they will immediately request a pregnancy test to rule this out.
Another reason for a prolonged absence of periods could be a hormonal imbalance.
You may have heard of the hypothalamus as the “control centre” of the brain. Well, the hypothalamus is the one in charge of stimulating the pituitary gland to produce hormones. These hormones in turn stimulate the ovary each month to produce an egg, and result in your monthly cycle. An imbalance in any these hormones either from polycystic ovary syndrome (more on this later), or thyroid disorders, might be the culprit for the lack of periods.
More rarely, amenorrhoea could actually be due to premature ovarian failure, or early menopause.
While early menopause is uncommon for women of reproductive age, it’s important to seek help from your GP or fertility specialist to combat the lack of oestrogen that comes with this diagnosis. It is possible for women with premature menopause to still carry a child, however an egg donor will be required. At IVFAustralia and our sister clinics Melbourne IVF, Queensland Fertility Group, and TasIVF, we have a comprehensive donor program that can help you navigate this process, if needed.
The final, less common reason you might be experiencing a lack of periods could be due to recent surgery or scarring on the cervix. Sometimes this can prevent the flow of menstrual blood. If this is found to be the case, it’s possible for an experienced surgeon to open the scarring and return the uterine lining to normal functioning. If you’re hoping to have a family in the near future, this could be an option for you.
All of these conditions can be diagnosed with appropriate investigations, and treatment depends on the cause and the woman’s individual situation.
And oftentimes, if you’re dreaming of starting a family, simple ovulation induction medication can help overcome amenorrhoea relatively easily.
If you’re experiencing a lack of periods for longer than 3 months, and you are not pregnant, we recommend seeing your GP or a fertility specialist. It is especially important to seek advice if you want to conceive in the near future.- Dr Iris Wang
Next up, we’ll discuss a menstrual disorder that occurs when experiencing heavy or prolonged periods, otherwise known as ‘menorrhagia’.