Menstrual Disorders

Menstrual disorders include physical and/or emotional symptoms during any phase of the menstrual cycle and can include heavy bleeding, missed periods, and unmanageable mood swings that may largely affect a woman’s quality of life.

Most menstrual cycle problems have a straightforward explanation and a range of treatment options that exist to relieve symptoms.

Types of Menstrual Disorders:

If one or more of the symptoms you experience before or during your period causes a problem, you may have a menstrual cycle “disorder.” These include:

• abnormal uterine bleeding (AUB), which may include heavy menstrual bleeding, no menstrual bleeding (amenorrhea) or bleeding between periods (irregular menstrual bleeding)
• dysmenorrhea (painful menstrual periods)
• premenstrual syndrome (PMS)
• premenstrual dysphonic disorder (PMDD)

To diagnose heavy menstrual bleeding, also referred to as menorrhagia, we will conduct a full examination to see if your condition is related to an underlying medical problem. This could be structural, such as fibroids or polyps, or hormonal. The examination involves a series of tests including a urine pregnancy test and bloodwork. Some other diagnostic tests may include:

• Ultrasound. High-frequency sound waves are reflected off pelvic structures to provide an image. Your uterus may be filled with a saline solution to perform this procedure, called a sonohysterography. No anesthesia is necessary.
• Endometrial biopsy. A scraping method is used to remove some tissue from the lining of your uterus. The tissue is analyzed by a pathologist to identify any possible problem, including cancer.
• Dilation and curettage (D&C). During a D&C, your cervix is dilated and instruments are used to sample your uterine lining. A D&C may also be used as a treatment for excessive bleeding and for bleeding that does not respond to other non-surgical treatments. It is performed on an outpatient basis under anesthesia.

There are no specific diagnostic tests for PMS and PMDD. You may be asked to keep track of your symptoms and write them down. A premenstrual symptom checklist is one of the most common method used to evaluate symptoms by tracking the type and severity of symptoms in order to help identify a pattern.

Treatments for menstrual disorders can range from over-the-counter medications to surgery. Your treatment options will depend on your diagnosis, its severity, which treatment you prefer, and your health history.