Menstrual Disorders Health Article

Definition

Anything that interferes with the normal menstrual cycle, causing pain, unusually heavy or light bleeding, or missed periods.

Description

Typically, a woman of childbearing age should menstruate every 28 days or so unless she's pregnant or moving into menopause. But numerous things can wrong with the normal menstrual cycle, some the result of physical causes, others emotional. These include amenorrhea, or the cessation of menstruation, menorrhagia, or heavy bleeding, and dysmenorrhea, or severe menstrual cramps. Nearly every woman will experience one or more of these menstrual irregularities at some time in her life.

Amenorrhea

Simply following a healthy exercise and nutritional program can help prevent amenorrhia, as can reducing stress and learning relaxation techniques. Also, avoiding excessive alcohol intake and quitting smoking may prevent missed periods.

Dysmenorrhea

Prevention includes certain dietary supplements and vitamins described above. Exercise may also help.

Menorrhagia

There's little women can do to prevent this menstrual irregularity other than discovering the root cause. One thing they can do, however, is stop using an IUD, which can often cause heavier bleeding.

Diagnosis

Women should seek care from a gynecologist, family practitioner or internist for menstrual irregularities. Depending on the problem, various tests and procedures will be performed, but the one common to any menstrual problem is a pelvic exam. This should be scheduled when women are not menstruating, simply for convenience sake.

Male doctors typically have a female nurse or assistant in the room. The exam begins by checking the external genitalia for any sores or irregularities. Then the doctor inserts a speculum (a metal duckbill-shaped device that holds open the vagina) into the vagina and peers throughout the opening to evaluate the health of the cervix (opening of the uterus), and inside the vagina, looking for growths or any other abnormalities.

The doctor will also manually examine the woman, inserting two fingers into the vagina while pressing on the abdomen, again feeling for any lumps or other abnormalities, checking the size and shape of the reproductive organs, and watching for any signs of infection, such as tenderness or pain. The exam is typically covered by insurance and takes about 10 minutes.

Other tests that will be done for menstrual irregularities include:

• A pregnancy test. The nurse takes some blood from a woman's arm and it is tested for the presence of certain hormones that indicate a pregnancy has occurred.
• Ultrasound. Typically performed by a trained ultrasound technician, it involves using sound waves to get an image of the reproductive system. It is used to look for fibroids and other ovarian abnormalities that may cause heavy bleeding or cramps. Typically, the technician will smear a jelly over the woman's stomach, then place a probe on her stomach and watch the images appear on a computer screen. It is painless. Women may be asked not to urinate for several hours prior to the test, as a full bladder makes it easier to see the other internal organs. The test takes about 20 minutes.
• Endometrial biopsy. Used to check the health of uterine tissue in women who have unusually heavy bleeding, this test should be performed by the physician. Women should take a pain reliever like Motrin or Aleve prior to the procedure, as there may be some cramping. The woman lies back on the table with her feet in stirrups and the doctor inserts a speculum, then opens the cervix slightly with an instrument called a tenaculum. Then the doctor slides a small, hollow catheter into the uterus and sucks a small piece of tissue from the uterine lining out. The tissue is then examined for any abnormalities in a laboratory. The test takes about 30 minutes and is typically covered by insurance. Some bleeding may result afterwards.
• Blood, stool and urine tests may also be conducted to check for levels of various hormones, blood cells, and other chemicals.
• Dilation and curettage (D&C): During this minor surgical procedure, the cervix is opened and the lining of the uterus scraped for a tissue sample.
• Laparascopy and hysteroscopy: in some instances, these surgical procedures, in which a small camera is inserted into the woman to view the inside of the pelvis, abdomen or uterus.