Menstrual disorder: Type, Causes,Investigation, and Treatment | Doctors Gang

Menstrual Disorder or Irregular periods in Women     

Menstrual disorder:Menorrhagia, Metrorrhagia, oligomenorrhea, Hypomenorrhea, Oligomenorrhea, Polymenorrhea, Amenorrhea and Dysmenorrhea.


excessive bleeding in normal period more than 80 ml each cycle.

Cause of Menorrhagia :

Pelvic pathology :

  • Fibroid uterus
  • Pelvic endometriosis
  • Intra uterin device in utero
  • Chronic tubo-ovarian mass
  • Retro-verted Uterus
  • Granulossa cell tumor

Systemic cause:

  • Liver dysfunction
  • Congestive cardiac failure
  • Systemic Hypertension

Endocrinal cause :

  • Hypothyroidism
  • Hyperthyroidism

Hematological cause  :

  • Idiopathic thrombocytopanic purpura
  • Leukemia
  • Von willbrand  disease
  • Platelet  deficiency

Immotional upset


What is Metrorrhagia?

Definition of metrorrhagia:

Irregular acyclic bleeding,contact bleeding and intramuscular bleeding   From the uterus is called metrorrhagia

Cause of metrorrhagia:

Cause of acyclic bleeding:

  • Dysfunctional Uterine bleeding
  • Submucous fibroid
  • Uterine polyp
  • Carcinoma of cervix
  • Endometrial carcinoma

Cause of contact bleeding:

  • Carcinoma of cervix
  • Mucoid polyp cervix
  • Vascular ectopy of the cervix
  • Chalamydial cervicitis
  • Cervical endometroisis

Cause of intramuscular bleeding:

  • Urethral carbuncle
  • Ovular bleeding
  • Breakthrough /spotting  bleeding in pill user
  • IUCD in utero
  • Decubitus ulcer

Meanstrual  disorder :Breakthrough bleeding or spotting bleeding


What is Hypomenorrhea?

Definition of Hyppmennorhea:when menstrual bledding is scanty and last for less than two days is called hypomenorrhea.

Cause of hypomenorrhea:

  • Uterine synechiae
  • Endometrial tuberculosis
  • Thyroid dysfunction
  • Oral contraceptive


What is Oligomenorrhea? 
Definition of Oligomenorrhea :when each menstrual cycle More than 35 days is called Oligomenorrhea.

Cause of oligomenorrhea:

  • PCOS(Polycystic Ovarian syndrome)
  • Adolocents
  • Weight reletd obesity
  • Stress
  • Hyperprolactinaemia
  • Hyperthyroidism
  • Androgen Producing Tumor
  • Tubercular Endometeiosis
  • Drugs-cimetidine,methyledopa


What is Polymenorrhea?

Definition of Polymenorrhea:When menstrual cycle  less than 21 days is called Pylomenorrhea

Cause of plolymenorrhea: 

  • Dysfunctional uterine bleeding

Learn more: Modern Family Planning Method in Bangladesh


What is Amenorrhea?

Definition of Amenorrhea:Absence of menstruation minimum three periods is called  amenorrhea.

Cause of  amenorrhea :

1.Natural amenorrhea

  • Pregnancy
  • Breast-feeding
  • Menopause


3.Drug induced amenorrhea :

  • Antipsychotics
  • Cancer chemotherapy
  • Antidepressants
  • Anti hypertensive  drugs
  • Anti-allergic drugs

4.Life style factor

  • Low body weight.
  • Excessive  exercise
  • Stress

5.Hormonal imbalance

6. Structural problems

  • Uterine scarring (sherman's syndrome,) a
  • Lack of reproductive organs. 
  • Structural abnormality of the vagina.


What is Dysmenorrhea?

Definition of Dysmenorrhea:

Painful menstruation is called dysmenorrhea

Primary dysmenorrhea

Primary Dysmenorrhea is caused by excessive levels of prostaglandins, hormones that causes uterus contract during menstruation and childbirth.

The pain results from the release of these Prostaglandins and  hormones when the lining epithelium (endometrium) is sloughing off during menstruation. 
Dysmenorrhea is a painful menstrual condition.


Factors that cause worse pain of primary dysmenorrhea

  • Retroverted Uterus
  • Irregular Menstrual period
  • Lack of exercise
  • Smoking
  • Drinking alcohol
  • Obesity
  • Family history
  • starting menstruating before age 12.

Secondary dysmenorrhea

Secondary Dysmenorrhea may be caused by a number of following conditions, including:

  • fibroids :- benign tumours that develop within the wall of uterus or are attached to uterine wall
  • adenomyosis :-  the tissue that lines the uterus is called the endometrium which begins to grow within its muscular walls
  • sexually transmitted infection (STI)
  • endometriosis :-  fragments of the endometrial lining epithelium  that are found on another pelvic organs outside the uterus.
  • pelvic inflammatory disease (PID):-  which is mainly an infection of the uterine tubes, but can also affect the uterus, ovaries, and cervix.
  • ovarian cyst/ tumour
  • Use of an intrauterine device or a birth control method

Laboratory investigation of menstrual disorder  :

  • CBC,ESR,Hb for exclud anaemia 
  • Ultrasonogram  for fibroid tumor polyps etc
  • TVS
  • Endometrial biopsy for carcinoma, tuberculosis etc.
  • Pap smear
  • Via test 

Treatment of Menstrual Disorder 

Menstrual disorder treatment by following 

  • Treat the patients according to cause.
  • Medication 
  • Anticholinergic medication for colicy pain.
  • Mefenamic acid for dysmenorrhea. 
  • Hormaonal treatment for amenorrhea and other irregular period disorder. 
  • Anti-fibrinolytic such as Tranexamic acid for severe bleeding.
  • Use Orall Contraceptive pill to regulate hormone level according to your gynaecology specialist doctors 
  • Life style change 
  • Exercise 
  • Operation need for some case.


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