Menstrual disorders

Among the syndromes that can cause hormonal alterations we can find:

• El Polycystic ovary syndrome, appearance of small cysts on the ovaries.
• La endometriosis , excessive growth of the endometrium, which can spread outside the uterus, and can give rise to cysts on the ovaries called endometriomas.
• Hyperprolactinemia, elevated level of a hormone called prolactin, which stimulates milk production.
• Alterations in the thyroid gland (hyperthyroidism or hypothyroidism).
• Obesity
• Taking certain medications, changes in diet and stress.
• Misuse of contraceptives.

Variations in the cycle can be satisfactorily resolved if they are dealt with in time.

In most causes of abnormal losses can occur at any age. Despite this, some are likely to occur more frequently at any given time. Depending on the age of onset, the causes can also be suspected, as well as the medications necessary to care for the patient's health.

Losses in little girls 

An unexpected loss before menarche, before a girl's first period, is always abnormal. The cause of bleeding may be trauma, a foreign body (such as toys, coins, or toilet paper), irritation of the genital area (due to soaps, lotions, or infections) or urinary tract problems. Sometimes it is necessary to rule out sexual abuse.

Menstrual disorder in adolescents

Many girls have irregular losses during the first few months of their period. These episodes generally resolve without treatment as the girl's hormonal cycle normalizes and until she matures with age. Despite this, if the loss is irregular, persists, or is very intense, you will need to see a specialist doctor to rule out menstrual disorders or other syndromes.

Changes in women of reproductive age

There are many reasons or existing syndromes that can produce these affectations. Among them we highlight:

• The existence of hormonal variations at the time of ovulation.
• The use of contraceptive methods (pill and copper intrauterine devices (IUDs)).
• Irregular ovulations.
• Fibroids or uterine fibroids (benign muscle growths).
• Endometrial polyps (irregular growth).
• Pregnancy or gestation.
• Cancer or precancerous lesions.
• Infection or inflammation of the cervix or endometrium.
• Blood clotting problems.
• Medical conditions such as hypothyroidism, chronic liver or kidney disease.

When menopause approaches

Before menopause hits, you go through a period of hormonal irregularities called perimenopause. During this time, the menstrual cycles change and ovulation becomes less regular.

During this time, the endometrium can overgrow, increasing the chances of developing polyps or hyperplasia (thickened lining that can progress to cancer).

In perimenopause whenever abnormal bleeding occurs, the following must be ruled out: cancer, infections and general illnesses.

We must not forget that even at these ages, women still ovulate and can become pregnant.

The pregnancy itself can also cause abnormal bleeding.

Menopausal women

Menopausal women should not produce episodes of blood loss. Despite this, after menopause, several pathologies can cause them and always pathological:

• Women taking hormone replacement therapy (HRT) may experience some cyclical bleeding.
• Atrophy, or excessive thinning of the tissue lining the vagina and uterus, caused by low hormone levels.
• Cancer or precancerous changes (hyperplasia) of the uterine lining.
• Polyps or fibroids.
• Infections of the uterus.
• Use of anticoagulants.
• Side effects of radiation therapy.

Any bleeding that occurs during the menopause is abnormal and should also be investigated.

Symptoms

The symptoms of menstrual disorders that can be seen are of varied and different forms.

Some women have disorders in the menstrual calendar, while others do not have their period, others suffer heavy bleeding and in some, their main problem is the pain of their period.

Here are some of the symptoms:

Irregular Periods

Disorders in the menstrual calendar can appear more frequently in adolescence and even at older ages such as perimenopause.

Both periods are characterized by the existence of a certain immaturity in the hormonal axis that governs the period. The mechanism that controls it lacks maturation, as is the case with adolescents, or is already somewhat exhausted in older perimenopausal patients.

These menstrual disorders can also cause cycles in which you don't ovulate correctly and the bleeding can be abundant and irregular.

Heavy bleeding

The reasons for these Menstrual disorders can be hormonal, but also other causes such as fibroids and endometrial polyps among others.

You should always consult a specialist.

If adequate treatment is not given, they can trigger states of anemia with general affectation of women.

Amenorrhea or absence of the period

Sometimes it may even be that a patient does not have her period.

If you've never had it, we talk about primary amenorrhea, and if it disappears after having already had periods, we refer to secondary amenorrhea.

The causes that we can see in both entities may be different. Hormonal reasons are frequent, but as always it is better to see a specialist to rule out other pathologies or responses.

Menstrual pain or dysmenorrhea

Pain accompanies a high percentage of patients.

Some already have pain with the expulsion of the ovum, but in most cases it starts with menstruation.

The causes of the dysmenorrhea can be several and different.

Sometimes you don't know why it happens. A good diagnosis and treatment can improve the quality of life of these women. Medications such as pain relievers can help improve.

What tests are performed on abnormal bleeding? 

Given this affectation, we have to look at what stage or years of life it appears.

Subsequently, and according to the information available, the doctor will study the problem through the following tests to obtain an answer:

• Study of abnormal medical history and review of the duration and amount of bleeding.
• Physical exam to assess the general health of women. There will be a pelvic exam to find out if the discharge or bleeding is coming from the uterus or another site.
• Laboratory tests: in premenopausal women, a possible pregnancy or future baby is always ruled out first. It is studied if there is any cervical pathology. At the same time, blood tests can be done to find out if there is anemia or if there are problems with blood clotting or other diseases.
• More tests to find out if you ovulate correctly.
• Endometrial study by other means:
  • Transvaginal ultrasound.
  • Endometrial biopsy.
  • Hysteroscopy: During this test, a small camera is inserted to look through the cervix and into the cervix.
  • Endometrial dilation and curettage: This test usually requires anesthesia.