Menstrual disorders

Menstrual disorders cover a broad spectrum of abnormalities related to the menstrual cycle. These conditions, frequently experienced by women, significantly influence reproductive health, daily life, and overall well-being. For healthcare professionals, a deep understanding of these disorders is fundamental for effective diagnosis and management.

Lining of Uterine Wall

Classification

Menstrual disorders can be grouped based on their manifestations:

• Amenorrhea - Absence of menstrual periods
  • Primary amenorrhea: Absence of menstruation by age 15 or within 5 years of breast development.
  • Secondary amenorrhea: No menstruation for three consecutive cycles or six months in previously menstruating women.
  • Exercise amenorrhea: Cessation of menstruation due to excessive physical activity.
  • Functional hypothalamic amenorrhea: Resulting from stress, weight loss, or excessive exercise.

• Anovulation - Absence of ovulation
• Dysmenorrhea - Painful menstruation
• Hematocolpos - Accumulation of menstrual blood in the vagina
• Hypogonadism and Hypergonadism - Reduced and increased functional activity of the gonads respectively
• Hypergonadotropic hypergonadism - Elevated gonadotropin and sex steroid levels
• Hypomenorrhea - Scanty menstrual flow
• Polymenorrhea and Oligomenorrhea - Frequent and infrequent menstrual cycles, respectively
• Oligoamenorrhea - Infrequent menstruation
• Polymenorrhagia - Excessive and frequent menstruation
• Menometrorrhagia - Heavy menstrual bleeding at irregular intervals
• Catamenial pneumothorax - Lung collapse related to menstrual cycle
• Intermenstrual bleeding - Bleeding between periods
• Heavy menstrual bleeding - Excessive menstrual blood loss
• Metropathia haemorrhagica - Irregular bleeding due to prolonged estrus
• Gonadotropin-resistant ovary syndrome - Ovaries that do not respond to gonadotropins

Etiology

The origins of menstrual disorders are diverse, often including:

• Hormonal imbalances
• Structural abnormalities in the reproductive tract
• Stress, significant weight gain or loss, and excessive exercise

Diagnosis

Correctly identifying menstrual disorders often involves:

• Comprehensive medical history
• Physical and pelvic examinations
• Laboratory tests, including hormone level evaluations
• Imaging modalities such as ultrasound, MRI, and hysteroscopy

Management

Treatment strategies hinge on the specific disorder and its root cause:

• Hormonal therapy
• Non-steroidal anti-inflammatory drugs (NSAIDs) for pain
• Surgical interventions like Dilation and curettage (D&C)
• Lifestyle adjustments

Prognosis

Proper diagnosis and management usually allow most affected women to experience symptom relief and maintain a regular reproductive lifespan.

References

• Apgar BS, Kaufman AH, George-Nwogu U, Kittendorf A. (2007). Treatment of menorrhagia. *American Family Physician*, 75(12), 1813-1819.
• Fraser IS, Critchley HO, Broder M, Munro MG. (2011). The FIGO recommendations on terminologies and definitions for normal and abnormal uterine bleeding. *Seminars in Reproductive Medicine*, 29(5), 383-390.
• Harlow SD, et al. (2014). Executive summary of the Stages of Reproductive Aging Workshop + 10: addressing the unfinished agenda of staging reproductive aging. *Climacteric*, 15(2), 105-114.

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