Pregnancy and Menstrual Disorders
Menorrhagia (Heavy Bleeding)
During normal menstruation the average woman loses about 2 ounces (60 ml) of blood or less. If bleeding is significantly heavier, it is called menorrhagia. Women often over estimate the amount of blood lost during their periods.
Physician advice is necessary, if any of the following occurs:
- Soaking through at least one pad or tampon every hour for several hours.
- Heavy periods that regularly lasting 10 or more days.
- Bleeding between periods or during pregnancy.
- Spotting or light bleeding between periods is common in girls just starting menstruation and sometimes during ovulation in young adult women, but consultation with a physician is nevertheless recommended.
Clot formation is fairly common during heavy bleeding and is not a cause for concern.
Other Menstrual Disorders
Amenorrhea (Absence of Menstruation)
: Amenorrhea is the absence of menstruation.
There are two categories: primary amenorrhea and secondary amenorrhea. Such terms are used only to describe the timing of menstrual cessation; they do not indicate any cause nor do they suggest any other information.
Primary amenorrhea occurs when a girl does not even start to menstruate. Girls who show no signs of sexual development (breast development and pubic hair) by age 14 should be evaluated.
Girls who do not have their periods by two years after sexual development should also be checked.
Secondary amenorrhea occurs when periods that were previously regular become absent for at least three cycles.
Oligomenorrhea (Light or Infrequent Menstruation)
: Oligomenorrhea is a condition in which menstrual cycles are infrequent. It is very common in early puberty and not usually worrisome. When girls first menstruate they often do not have regular cycles for a couple of years. Even healthy cycles in adult women can vary by a few days from month to month.
In some women, periods may occur every three weeks and in others, every five weeks. Flow also varies and can be heavy or light.
Skipping a period and then having a heavy flow may occur; this is most likely due to missed ovulation rather than a miscarriage.
Women should be concerned when periods come less than 21 days or more than three months apart, or if they last more than ten days. Such events may indicate ovulation problems.
Dysmenorrhea (Severe Menstrual Cramps)
: Uterine contractions occur during all periods, but in some women these cramps can be frequent and very intense. In such cases the condition is known as dysmenorrhea.
It can be primary or secondary.
is caused by normal uterine muscle contractions and affects more than half of menstruating women. It usually starts two to three years after the periods have started. The pain usually develops when the bleeding starts and continues for 32 to 48 hours.
is menstrually related pain that is caused by other medical conditions, usually endometriosis or pelvic abnormalities.
: In general premenstrual syndrome (PMS) is a set of physical, emotional, and behavioral symptoms that occur during the last week of the luteal phase (a week before menstruation) in most cycles. The symptoms should typically resolve within four days after bleeding starts and not start until at least day 13 in the cycle.
Women may begin to experience premenstrual syndrome symptoms at any time during their reproductive years. Once established, the symptoms tend to remain fairly constant until menopause, although they can vary from cycle to cycle.
What Causes heavy menstrual bleeding
Almost all women, at some time in their reproductive life, experience heavy bleeding during a period. It is the most common gynecologic complaint and the reason for two−thirds of all hysterectomies.
A number of conditions can cause menorrhagia or contribute to the risk, although often the cause of heavy bleeding is unknown. In fact, no abnormalities to explain the bleeding are detected in about half of hysterectomies performed because of menorrhagia.
Factors Associated with a Higher Risk for Heavy Menstrual Bleeding
Certain characteristics are associated with a higher risk for menorrhagia:
- Being taller.
- Being older - Women who are approaching menopause may experience occasional menorrhagia.
- Having a higher number of pregnancies.