Everything You Should Know About Menstrual Disorders
Why are Menstrual Disorders a Cause for Concern?
According to a research conducted by U.S National Library of Medicines, National Institute of Health, 75% of adolescent girls across the world report having menstrual dysfunction. Delayed, irregular, painful and heavy menstrual bleeding is common at a younger age and the leading reasons to visit a physician’s office at adolescence. By 2013, every family in India had a girl who was suffering from irregularities in the menstrual cycle.
In an interview to The Times of India in 2013, Dr. Nikhil Datar said, “In the past decade, we have seen approximately a 20% increase in the number of teenaged girls coming in with irregularities in their menstrual cycles.” This number is worrying, given that young girls today are more aware than they were 10 years ago. Gynecologist in Bangalore and Mumbai have reported a drastic increase in women complaining of amenorrhea for three months at a stretch.
What are the Different Disorders?
According a report by European Society of Human Reproduction and Embryology, India was on top of the list countries with the largest number of unwanted pregnancies at 17.1%. Health concerns were the most common reason behind not using contraception. Even women from larger cities like Delhi, Mumbai and Bangalore didn't use contraception.
Some of the common menstrual disorders experienced in India are:
- Dysmenorrhea: 50% of the post pubescent women in the world are affected by this order, with 5% of them being incapacitated for 1-3 days each month. Primary dysmenorrhea is usually brief and happens on the first day of menstruation. It causes pain, without evidence of any organic lesion. Secondary dysmenorrhea, which develops later than the primary dysmenorrhea, accounts for 20% of the cases.
- Abnormal Uterine Bleeding: Any bleeding that involves pregnancy, hormonal imbalance, cancer and structural abnormalities, and has excessive duration, frequency or amount of blood, falls under this category. If the woman is ovulatory, causes are endometrial polyps, submucous fibroids and chronic endometritis. If the patient is anovulatory, the causes are extrinsic hormone effects, menarche, dysfunctional uterine bleeding (DUB) and peri-menopausal bleeding.
Treatment for Menstrual Disorders
The first step of treatment is to evaluate the problem as early as possible, according to gynecologists at Bangalore. Here are some of the treatments offered by these professionals:
- Primary Dysmenorrhea: The treatment is usually aimed at prostaglandin inhibition or suspension of cycles. Narcotis are not used but other methods, such as heat, mild analegics and exercise are encouraged. The use of contraceptives depends on whether the woman has any other complaints, which make the suppression of menses favorable.
If yes, the treatment includes:
- Oral contraceptives.
- Continuous progesterone
If no, gynecologists in Bangalore recommend:
- Non-steroidal anti-inflammatory agents: mefenamic acid (Ponstel 500mg t.i.d.), naproxen (naprosyn, anaprox 550mg stat, then 275 mg q.i.d.)
- If not helpful, consider suppression of menses.
- Secondary Dysmenorrhea: the treatment includes correcting the following problems:
- Adenomyosis: Gland-like growth into myometrium.
- Endometriosis: Ectopic Endometrial Tissue.
- Fibroids: (covered separately).
- Intrauterine Devices (IUD).
- Endometritis: Chronic Infection of Uterus.
- Congenital Uterine Anomalies: Menstrual flow may lack an outflow tract.
- Other: Ovarian cysts, pelvic varicosities.
- Abnormal Uterine Bleeding: Treatment of abnormal uterine bleeding:
- In case of anatomic abnormality, polyps or fibroids are removed surgically. For chronic edometritis, antibiotic therapy is used or an IUD may be removed.
- In case of anovulation abnormality, exogenous progestins, estrogens, or combination therapy is used.