Period Problem

Menstruation is a period during which female hormones prepare the uterus to support a pregnancy. A monthly cycle, or period, is normal vaginal bleeding that happens as part of a woman’s monthly cycle. Each month, your body plans for pregnancy. If no pregnancy occurs, the uterus, or womb, sheds its lining. The menstrual blood is partly blood and partly tissue from the interior of the uterus. Each woman’s period is diverse.

Most women’s menstrual cycles run between 21 and 35 days or up to 45 days for teenagers. Menses last between 3 and 7 days. Women need to understand their patterns.

There are often uncomfortable symptoms leading up to your period. The most common symptoms of premenstrual syndrome (PMS) are cramping and fatigue, but they usually go away when your period arrives. A woman’s PMS usually begins one to two weeks before her period. There are a variety of physical and emotional symptoms experienced by some women. Others experience few symptoms or even none at all.

PMS can cause:
Bloating, Acne, Irritability, Backaches, Headaches, Sore breasts, Depression, Anxiety, Food cravings, Excessive fatigue, Stress feelings, Insomnia, Constipation, Mild stomach cramps, Diarrhea

Extreme pain during a period is not normal. It may indicate an underlying health condition. Similarly, severe mood changes or depression that only occurs before a period is also not typical for PMS. A person should consult a doctor if either occurs.

Menstrual Irregularities (Period Issue)

Changes in the menstrual cycle that result in missed periods, irregular periods, or heavy bleeding are known as menstrual irregularities. Menstrual abnormalities include not receiving your period or not getting it on time. Bleeding that’s much heavier or lighter than usual, or having severe cramps, pain, nausea, or vomiting.

The following are some examples of abnormal menstruation:

• Absent periods (amenorrhea): The absence of menstruation, often known as amenorrhea, is described as missing one or more menstrual periods. The absence of menstruation in someone who has not had a period by the age of 15 is known as primary amenorrhea. Secondary is the absence of three or more periods in a row in a woman who has previously had periods. It may be due to a problem with the pituitary gland, a congenital defect of the female reproductive tract, or a delay in puberty.
• Infrequent Periods (Oligomenorrhea): In this condition, you miss your periods for 35 days or more and have just four to nine periods per year.
• Heavy Periods (Menorrhagia): Bleeding that’s much heavier than usual during your period. Your period could last longer, five to seven days. It is due to imbalances in hormone levels, especially progesterone, and estrogen.

There are four main phases of the menstrual cycle.

Menstruation: Also called period. During menstruation, your uterus lining sheds and flows out of your vagina. Your period contains blood, mucus, and cells from your uterus lining. The average length of a period is three to seven days.
You may have period symptoms like these: Cramps, Irritability, Tiredness, Bloating, Mood swings, Tender breasts, Headaches, and Low back pain.

Follicular phase: The follicular phase starts on the first day of your period (so there is some overlap with the menstrual phase) and ends when you ovulate. It begins when your hypothalamus releases follicle-stimulating hormone (FSH) from your pituitary gland. After that, ovaries produce around 5 to 20 small sacs called follicles by stimulation of FSH. Each follicle contains an immature egg. Only the healthiest egg will eventually mature. An increase in estrogen causes the uterine lining to thicken during maturation and creates a nutrient-rich environment for an embryo to grow in. It takes about 16 days for the follicular phase to complete. It can range from 11 to 27 days, depending on your cycle.

Ovulation phase: An egg is released from an ovary and moves down a fallopian tube towards your uterus during ovulation. It usually happens once each month, about two weeks before your next period. Ovulation can last from 16 to 32 hours. The ovulation phase is the only time during your menstrual cycle when you can get pregnant. When you have a 28-day cycle, ovulation occurs around day 14 – right in the middle of your menstrual cycle. It lasts about 24 hours. Without fertilization, the egg will die or dissolve after a day.

Luteal phase: Cells in the ovary (the corpus luteum) release progesterone and estrogen after ovulation. It causes the lining in the uterus to thicken in preparation for pregnancy, and your body will produce human chorionic gonadotropin (hCG) if you become pregnant. This hormone test detects pregnancy. HCG (human chorionic gonadotropin) maintains the uterine lining and corpus luteum. In the absence of pregnancy, the corpus luteum shrinks and resorbs. As a result, estrogen and progesterone levels decrease, which causes your period to begin. During your period, your uterine lining will shed. In this phase, if you don’t become pregnant, you may experience premenstrual syndrome (PMS), and your period will restart.

In addition to a few medications, some diseases, and hormonal imbalances may contribute to period problems. Here are some:

• Polycystic ovary disease – PCOD (Polycystic Ovarian Disease) occurs when a woman’s ovaries produce too many immature or partially mature eggs…Read more
• Thyroid Disorders: Thyroid problems can lead to irregular menstruation because the thyroid gland plays an essential role in your reproductive health. Directly and indirectly, your thyroid affects your ovaries through sex hormone-binding globulin (SHBG). It is a protein that binds reproductive hormones to transport them throughout the body…Read more
• Endometriosis: It is a condition in which tissue develops outside the uterus (womb). Endometriosis commonly affects your ovaries, fallopian tubes, and pelvic tissue. It is rare to find endometrial-like tissue outside the pelvic organ area. Pain is a common symptom of endometriosis, particularly during menstruation. Fertility problems also may develop. Fortunately, effective treatment is available.
• Uterine polyps or Fibroids: A uterine polyp, also called an endometrial polyp, is a small, soft growth inside a woman’s uterus. They come from the tissue that lines the uterus, called the endometrium. Most uterine polyps aren’t cancer. Symptoms aren’t always present in all women, and some don’t need treatment at all. Some things might make you more likely to have polyps. One is age; they are more common in your 40s or 50s. Changes in estrogen levels may be responsible for it before and during menopause.
• Pelvic inflammatory disease: Inflammation of the female reproductive organs causes pelvic inflammatory disease or PID. It most often occurs when sexually transmitted bacteria spread from your vagina to your uterus, fallopian tubes, or ovaries. The symptoms and signs of pelvic inflammatory disease can be subtle or mild. Some women don’t experience any signs or symptoms. You might not realize you have it until you have difficulty getting pregnant or experience chronic pelvic pain. A common source of PID infection is unprotected sex, but 15% of infections do not spread this way. During sexual activity, bacteria can enter the reproductive system and infect the organs.
• Diabetes: Researchers believe hormonal imbalances may be responsible for the link between irregular menstruation and type 2 diabetes. Diabetes women are at a higher risk of menstrual abnormalities due to anovulation. Anovulation occurs when the ovary fails to release an egg into the fallopian tube during the menstrual cycle…Read more

Lab tests are a complete analysis of your whole body. Blood tests are done:

• To diagnose any kind of symptoms.
• To find out how well our organs are working.
• It can monitor chronic health conditions and diseases and find out problems in their early stages.

To find out the cause of your menstrual abnormalities following tests are done :

• Follicle-Stimulating Hormone (FSH)
• Luteinizing hormone (LH)
• Anti-Mullerian hormone (AMH)
• Estradiol (E2)
• Thyroid Hormones
• Insulin
• Cortisol
• Testosterone
• Progesterone

Treatment for menstrual irregularities varies a lot depending on the type of irregularity and some lifestyle factors, including whether a woman is planning to get pregnant.

Menstrual irregularities caused by anovulatory bleeding (missing periods, infrequent periods, and irregular periods) can be treated using a variety of methods. Here are some :

• Oral contraceptives
• Cyclic progestin
• Nutritional therapy for an eating disorder

Menstrual abnormalities due to ovulatory bleeding (heavy or extended menstrual flow) are treated as follows:

• Intrauterine hormone-releasing device insertion
• Medications containing progestin or tranexamic acid, as well as nonsteroidal anti-inflammatory drugs (NSAIDs).

If the problem is structural or medical treatment isn’t working, the following options may be considered:

• Polyps or uterine fibroids are removed surgically.
• Uterine artery embolization is a procedure to block blood flow to the uterus.
• Endometrial ablation is a treatment in which blood veins in the uterine endometrial lining are cauterised (removed or closed up by burning).
• Hysterectomy