Menstruation, also called menses, is a normal part of being a healthy female of reproductive age. In a woman who is not pregnant, the menstrual cycle occurs approximately every 28 days, however it may vary. There is huge discrepancy among women in the length and duration of their menstrual cycle and whether they bleed a lot or a little.

Many different reasons can cause menstrual disorders, such as hormone imbalances, genetic aspects, clotting disorders, and pelvic diseases or it can be for unknown reasons.

Menstrual disorders are problems that affect a woman’s normal menstrual cycle. There are many different types of disorders.

Dysmenorrhoea (Painful Menses)

Dysmenorrhea is the medical word for pain with menses.

Dysmenorrhea (also called Menstrual cramps) are pains in the lowest part of the pelvis a few days before, during, or after a menstrual period, which can sometimes extent to lower back and legs.

It’s a throbbing or cramping pain that can be intense dull & constant, and may spread to the lower back and thighs. Associated symptom may include –

  • Nausea, vomiting
  • Diarrhoea, dizziness
  • Fainting or headache

The pain tends to be most intense about 24 hours after periods begin and to subside after 2 to 3 days. There are two types of dysmenorrhea: “primary” and “secondary”. Dysmenorrhea is usually referred to as primary or secondary.

  • Primary Dysmenorrhea

Cramping pain which is due to contractions of uterus, with no identifiable cause.

  • Secondary Dysmenorrhea

Menstruation pain that accompanies a medical condition. This is mainly caused by endometriosis, fibroid, adenomyosis. Other causes can be pelvic inflammatory disease, ovarian cysts, ectopic pregnancy, intrauterine device (IUD) contraceptive

It is recommended to seek gynaecologist’s view if menstrual cramps disrupt one’s life every month or symptoms progressively worsen. In women with dysmenorrhea, certain symptoms that can be cause for concern are unexpected severe pain, fever, discharge from the vagina (pus like).

Ignoring medical attention for menstrual cramp can lead to anaemia, osteoporosis and infertility in view of the underlying cause for the same.

Menorrhagia (Heavy bleeding)

Menorrhagia is the medical word for considerably heavier menses. Menses are considered heavy if there is sufficient blood to soak a pad or tampon each hour for many hours. Menorrhagia is a kind of abnormal uterine bleeding. Metrorrhagia, Menometrorrhagia, Dysfunctional uterine bleeding (DUB) are other kind of bleeding disorder.

Though heavy bleeding may be common during premenopausal or early start of menses, women can check for any of the below symptoms are seen:

  • Changing pads or tampons during night
  • Large blood clots
  • Menses continues longer than 10 days

In certain cases, the cause of heavy menstrual bleeding is unidentified, still there are many probable causes for heavy bleeding:

  • Hormone imbalance
  • Ovulation problems
  • Uterine fibroids or polyps
  • Endometriosis and adenomyosis
  • Medications and contraceptives
  • Complications of pregnancy
  • Cancer, infection, bleeding disorders

Menorrhagia is frequently accompanied by dysmenorrhea as passing large clots can origin painful cramping. Unnoticed Menorrhagia can lead to anaemia and lot of pain suffering.

Hypomenorrhea (Scanty Menses)

Scanty menses are menses in which the duration of blood flow is less than two days or the amount of blood flow is less than normal.

Mostly Hypomenorrhea is not a serious medical disorder, yet, it is vital to diagnose the underlying cause to avoid future worries. Some common causes can be

  • Hormonal Imbalance
  • Hereditary
  • Prolonged use of contraceptives
  • Nutritional deficiencies
  • Uterine problems
  • Others – Excessive exercise, low body weight, stress, sorrow

Sometimes scanty menses makes achieve pregnancy difficult.


To determine if a woman has a menstrual disorder, gynaecologist will take a medical history and ask questions about woman’s menstrual cycle. Gynaecologist need to know what has changed from past normal periods. A pelvic exam may also be needed with blood tests also may be used to measure the levels of hormones in the body.


Treatment for menstrual disorders may include:

  • Medical treatment:  This may include hormonal therapies, pain relievers, iron supplements.
  • Surgical treatment: Menstrual disorders can be caused by endometrial polyps, fibroids, and adenomyosis.  Doctor may recommend surgery to treat these conditions. This may require a vaginal procedure called hysteroscopy, or a laparoscopic procedure including removal of fibroids or hysterectomy.