Rare Period Disorders, Explained

One of the most common things that patients consult their gynecologist about are period disorders. Menstrual disorders refer to any problems with a woman’s normal menstrual cycle, resulting in symptoms that can impact their daily life.

It’s important to be cognizant of abnormalities with your menstrual cycles and talk to your gynecologist about any concerns because menstrual disorders are often symptomatic of deeper underlying issues that may require timely correction.

If you suffer from these period disorders, know that you’re not alone – the more we talk about the physiology of periods and menstrual disorders, the more people can connect and normalize menstruation. This article discusses different types of menstrual disorders and some potential conditions they are linked to.

How They’re Diagnosed

When you go to your OB/GYN for a menstrual disorder, they will first obtain your full medical history and then give you a physical exam, which includes a pap smear and a pelvic exam. Sometimes they will ask you to keep a record of your menstrual cycles and write down the amount of flow, dates, and other symptoms such as pain or nausea that occur. Some other tests they may run include:

• Hormonal tests
• Blood tests
• Ultrasound
• Hysterosonography (a type of uterine ultrasound)
• MRI
• Laparoscopy
• Hysteroscopy
• Taking tissue samples through dilation and curettage 
• Endometrial biopsy

Types Of Period Disorders

Dysmenorrhea

Does your period come with significant amounts of pain and cramping? This condition is known as dysmenorrhea, and depending on the cause, may be primary or secondary. Primary dysmenorrhea is when a chemical imbalance causes abnormal uterine contractions, and secondary dysmenorrhea typically is caused by medical conditions like uterine fibroids, tumors, infections in the pelvic cavity, and pelvic inflammatory disease. Symptoms include:

• Dizziness
• Fatigue
• Nausea
• Pain or cramping in the lower abdomen
• Vomiting
• Pain in the lower back and legs
• Headaches

Some risk factors for dysmenorrhea include excessive drinking, smoking, obesity, and early menstruation.

Amenorrhea

When menstrual periods disappear altogether, or never begin at all, it is known as amenorrhea. If a female turns 16 and still hasn’t started her period, the cause is typically related to the endocrine system, which is what controls the hormones that regulate periods. Low body weight can also delay maturity of the pituitary gland; estrogen levels come into play when a female who has had regular periods suddenly experiences amenorrhea for three months or longer. Other causes of amenorrhea include: 

• Eating disorders
• Breastfeeding
• Pregnancy
• Menopause
• Abnormal ovulation
• Birth defects
• Excessive amounts of exercise
• Thyroid disorder

Premenstrual Dysphoric Disorder (PMDD)

Premenstrual dysphoric disorder, or PMDD, is basically trusty old premenstrual syndrome (PMS) times a hundred. PMDD is more severe and chronic than PMS that may require attention and treatment, and impacts many women of childbearing age. Symptoms may be managed with medicines and lifestyle changes.

Unfortunately, PMDD is still somewhat of a mystery to doctors, so there aren’t any specific known causes, but it is likely an abnormal reaction to the hormonal changes that happen during each menstrual cycle. Sufferers may have significantly low levels of serotonin during their periods, which ends up resulting in mood changes and physical symptoms.

Although we still know so little about the condition, the following groups have higher incidences of developing PMDD:

• Women who have a personal or family history of mood disorders, depression, or postpartum depression
• Women who have a family history of PMDD or severe PMS
• Lower education and cigarette smoking are also linked to PMDD, although this may be correlative to mental health in general

While there aren’t any acute treatments for the condition, it’s important to seek help from your OB/GYN who may refer you to a therapist or endocrinologist, as the condition can have a significant impact on your life and work.

Menorrhagia & Polymenorrhea

One of the most prevalent kinds of menstrual bleeding is menorrhagia, or prolonged, heavy bleeding- sometimes to the point of disrupting normal daily activities. The opposite of menorrhagia is hypomenorrhea, or abnormally light periods, which may be the result of certain contraceptives as well as low body fat, stress, or hormonal imbalances. Some conditions that fall under menorrhagia include:

• Polymenorrhea – periods that are too frequent
• Postmenopausal – periods that continue after menopause
• Metrorrhagia – bleeding between periods

The most common causes of menorrhagia include but are not limited to:

• Uterine fibroids
• Hormonal imbalance
• Pelvic inflammatory disease (PID)
• Miscarriage and other forms of abnormal pregnancy
• Platelet or bleeding disorder
• Pelvic cavity infections or tumors
• High concentration of endothelin

If you’re bleeding so much that you’re scared to be away from a bathroom for a long time because you constantly have to change sanitary pads or tampons, or your periods regularly drag on for over a week, you should consult with your doctor. Other things to watch for include spotting or bleeding between menstrual periods or during pregnancy. 

When diagnosing menorrhagia, your doctor will first rule out other potential menstrual disorders, medication, or medical conditions that may be causing the heavy periods before running diagnostic tests like those we reference above.