We know it can sometimes be confusing when you are told that “normal” for you is actually something that needs treatment—after all, menstruation is different from woman to woman, right? The fact is that your body can have problems you don’t feel, but that do produce signs a doctor can recognize. A classic example is high blood pressure, which doesn’t usually have symptoms, but can damage the heart and blood vessels, increasing the risk of heart attack or stroke.
Your menstrual cycle may seem normal—especially if you’ve been living with issues, like a heavy flow, for years and accepting them as “normal for you.” But irregularities may signal hormone imbalances or other issues that could impact your future health and fertility. It’s your doctor’s job to spot signs early to prevent the long-term consequences of a menstrual disorder.
According to the U.S. National Institutes of Health (NIH), menstruation irregularities occur in 14% to 25% of women of childbearing age. If you need to find a gynecologist to help monitor your menstrual symptoms, we can help. Just call our free Nurses-On-Call line at 877-769-6636 to find a physician or just get some advice. It’s open 24 hours a day, seven days a week, a free service of HCA Midwest Health.
Types of Menstrual Irregularities
Just as normal menstruation can vary from woman to woman, so can menstrual disorders. Menstrual irregularities include:
- Amenorrhea — the absence of menstruation, defined as not getting a first period by age 16 or the lack of menstruation for 3 months or more without a pregnancy.
- Oligomenorrhea — infrequent periods, defined as occurring more than 35 days apart.
- Polymenorrhea — much less common, frequent periods that occur less than 21 days apart.
- Menorrhagia — heavy menstrual periods.
- Prolonged menstrual bleeding — when menstrual bleeding in a single cycle lasts more than eight days.
- Shortened menstrual bleeding — much less common, when menstrual bleeding in a single cycle lasts less than 2 days.
- Dysmenorrhea — painful periods that may include severe menstrual cramps. It’s important to note that other causes of period pain, such as endometriosis, are possible, so the dysmenorrhea is usually reserved for severe period pain that doesn’t have a specific, known cause.
- Irregular periods — when a women’s cycle varies more than 20 days from one cycle to another (e.g., last four cycles were 21, 43, 18 and 30 days apart).
- Intermenstrual bleeding (also called spotting) — brief episodes of bleeding in between periods.
Causes & Diagnosis of Menstrual Irregularities
Your reproductive cycle involves a delicate balance of hormones that can be thrown off for a variety of reasons, from an underlying disease to certain medications. Of course, pregnancy and perimenopause are two completely normal reasons for changes in menstruation. Gynecological conditions like polycystic ovarian syndrome (PCOS) and uterine fibroids or polyps can also lead to menstruation issues.
But there are also many conditions you probably don’t realize impact your menstrual cycle, including diabetes, thyroid disorders, cortisol levels, leukemia and other blood disorders, and sexually transmitted diseases (STDs).
Diagnosing the cause of menstrual problems typically includes physical and pelvic exams, blood tests and one or more of these tests:
- Ultrasound — for menstrual disorders, you may have both a pelvic ultrasound (like the kind typically associated with pregnancy) and a transvaginal ultrasound (the sound-producing transducer is inserted through the vagina).
- Sonohysterography — an ultrasound of the uterus taken while it is filled with sterile saline (salt water).
- Hysteroscopy — a scope that allows physicians to examine the inside of the uterus.
- Endometrial biopsy — removal of a small area of tissue from the lining of the uterus for lab examination.
Getting Help for Menstrual Irregularities
It’s important to follow up with your ObGyn about any menstruation issues. Even if you were told years ago that something is normal, you should talk to your gynecologist and primary care physician about it regularly. Over time, research may provide insights that change the way we think and treat certain problems. And with such a wide variation of “normal,” even a small change to your menstruation pattern can be significant.
So talk to your doctor or call our nurse help line for information and access to services across the Kansas City area — 877-769-6636. It’s open 24/7 and completely free — a service of HCA Midwest Health.