8 Types of Abnormal Menstruation: Symptoms and Diagnosis

What is Abnormal Menstruation?

Abnormal menstruation is when a woman's menstrual cycle deviates from typical patterns, potentially indicating underlying health problems. It's vital for identifying issues not only in the reproductive system but could also signal broader health concerns. The main types of abnormal menstruation include:

• Heavy menstrual bleeding (Menorrhagia)
• Absent menstruation (Amenorrhea)
• Irregular menstruation
• Painful menstruation (Dysmenorrhea)
• Prolonged menstruation
• Spotting between periods
• Severe Premenstrual Syndrome (PMS)
• Menstruation that stops suddenly

Types of Abnormal Menstruation

1. Heavy Menstrual Bleeding (Menorrhagia)

Menorrhagia is characterized by menstrual periods that are excessively heavy or prolonged. It can significantly interfere with a woman's physical, emotional, and social life, and may lead to other health issues like anemia. Key points to know include:

Causes: Hormonal imbalances, uterine fibroids, polyps, or disorders of the uterine lining can contribute to menorrhagia. Other potential causes include blood clotting disorders and certain medications.

Symptoms: Soaking through one or more sanitary pads or tampons every hour for several consecutive hours, needing to use double sanitary protection, or experiencing menstrual flow for more than a week.

When to see a doctor: If menstrual bleeding is heavy or prolonged, it's important to consult a healthcare professional to determine the cause and appropriate treatment.

2. Absent Menstruation (Amenorrhea)

Amenorrhea occurs when a woman misses one or more menstrual periods. Women should be aware of two types:

• Primary Amenorrhea: When a girl has not started menstruating by age 15.
• Secondary Amenorrhea: When a woman who has had normal menstrual cycles stops getting her periods for 3 or more months.

Causes: Can range from genetic abnormalities and hormonal imbalances to lifestyle factors like excessive exercise, stress, and extreme weight loss.

Symptoms: Beyond the absence of menstruation, symptoms might include hair loss, headache, vision changes, or facial hair growth.

When to see a doctor: If you've missed three or more periods in a row or if you haven't started menstruating by age 15.

3. Irregular Menstruation

Irregular menstruation encompasses a variety of conditions where menstrual cycles are inconsistent. This might mean the length of the cycle changes dramatically from month to month, or periods come unpredictably.

Causes: Stress, hormonal imbalances, and conditions like polycystic ovary syndrome (PCOS) can lead to irregular periods. Lifestyle factors, such as significant weight gain or loss, can also play a role.

Symptoms: Periods that come more frequently than 21 days or less often than 35 days, unpredictable menstrual cycles, or skipping periods without being pregnant.

When to see a doctor: Consult a healthcare provider if you experience significant changes in your menstrual cycle pattern, especially if these changes cause concern or disrupt your life.

4. Painful Menstruation (Dysmenorrhea)

Dysmenorrhea is marked by painful menstrual cramps, which can be debilitating. The condition is categorized into two types:

• Primary Dysmenorrhea: This refers to common menstrual cramps that occur without an underlying disorder. The pain is typically related to the menstrual cycle and doesn't stem from any disease affecting the reproductive organs.
• Secondary Dysmenorrhea: This type is caused by a disorder in the reproductive organs, such as endometriosis, adenomyosis, uterine fibroids, or cervical stenosis. The pain from secondary dysmenorrhea tends to start earlier in the menstrual cycle and last longer than primary dysmenorrhea.

Causes: For primary dysmenorrhea, the cause is typically the production of too many prostaglandins. Secondary dysmenorrhea can be caused by conditions such as endometriosis, adenomyosis, or fibroids.

Symptoms: Symptoms include throbbing or cramping pains in the lower abdomen, which can begin shortly before or at the start of the period and continue for 2 to 3 days. Symptoms can also include nausea, loose stools, headache, and dizziness.

Prevalence: According to stats from a Pubmed study, the prevalence of dysmenorrhea varies between 16% and 91% in women of reproductive age, with severe pain affecting 2%-29% of the women studied. This wide range underscores the variability of menstrual experience among women and highlights the importance of addressing this common health issue.

When to see a doctor: It's advisable to seek medical advice if menstrual pain is severe enough to disrupt your daily activities, or if it has started later in life and is progressively getting worse.

5. Prolonged Menstruation

Prolonged menstruation, also known as menometrorrhagia, is when menstrual bleeding lasts for more than 7 days. This can indicate various underlying health issues or hormonal imbalances.

Causes: Potential causes include uterine fibroids, hormonal imbalances, polyps, or conditions like adenomyosis. Sometimes, the use of certain medications or birth control methods can also extend the duration of menstrual bleeding.

Symptoms: The main symptom is bleeding that lasts longer than a week, but it may also be accompanied by symptoms like fatigue, weakness, or cramping.

When to see a doctor: If you consistently experience periods that last longer than 7 days, it’s important to seek medical evaluation to identify any underlying issues and discuss possible treatments.

6. Spotting Between Periods

Spotting refers to light bleeding that occurs outside of your regular periods. It can be normal in some cases, but it can also indicate health issues.

Causes: Hormonal fluctuations, starting or stopping birth control pills, certain medications, stress, or conditions like polycystic ovary syndrome (PCOS) and endometriosis can cause spotting.

Symptoms: Light bleeding or spotting that isn't part of your regular menstrual cycle. This can vary in color from pink to red or brown.

When to see a doctor: It's wise to consult a healthcare professional if spotting becomes frequent or if you're concerned, as it might be a sign of hormonal imbalances or other conditions that require attention.

7. Severe Premenstrual Syndrome (PMS)

Premenstrual Syndrome (PMS) affects a woman's emotional and physical health during certain phases of the menstrual cycle, typically before menstruation starts. Severe PMS can significantly impact daily life.

Causes: While the exact cause is unknown, changes in hormone levels and serotonin may play roles. Genetics might also contribute to the severity of symptoms.

Symptoms: Severe PMS encompasses a wide range of symptoms, including but not limited to mood swings, depression, irritability, headaches, bloating, and changes in appetite or sleep patterns.

When to see a doctor: If PMS symptoms severely impact your life, making daily tasks difficult, consulting with a healthcare provider is crucial. They can offer strategies or treatments to help manage symptoms.

8. Menstruation That Stops Suddenly

An abrupt halt in menstruation, when not caused by pregnancy, menopause, or contraceptive methods, can be concerning and warrants investigation.

Causes: Sudden cessation can result from stress, significant weight loss, excessive exercise, or medical conditions like polycystic ovary syndrome (PCOS) or thyroid disorders.

Symptoms: The primary symptom is the unexpected stop of menstrual periods for three months or more.

When to see a doctor: If your periods stop suddenly and you know you’re not pregnant, it's important to seek medical advice to determine the cause.

Recognizing symptoms early and understanding their potential causes is vital for health. If you're experiencing any signs of abnormal menstruation, using an online tool like the Docus Symptom Checker can be a helpful first step. This tool allows you to input your symptoms and provides you with a list of possible conditions, which can be useful information when discussing your health with a professional.

Diagnosing Abnormal Menstruation

Diagnosing abnormal menstruation typically involves a combination of medical history evaluation, physical examination, and diagnostic tests. Healthcare professionals may use the following methods to diagnose the condition:

• Medical History: This includes discussing your menstrual cycle, symptoms, and any other health issues.
• Physical Examination: A comprehensive examination, sometimes including a pelvic exam, to check for any abnormalities.
• Blood Tests: These can check for hormonal imbalances, thyroid function, and signs of anemia or other health conditions.
• Ultrasound: To get a detailed view of the uterus, ovaries, and pelvis, looking for any abnormalities that could affect menstruation.
• Endometrial Biopsy: A procedure to take a small sample of the uterine lining for testing, used in cases where abnormal uterine bleeding is suspected.
• Hysteroscopy: A procedure that involves inserting a thin, lighted instrument through the vagina and cervix into the uterus, which allows the doctor to look for abnormalities.