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67 views31 pagesUnderstanding Menstrual Disorders and Causes
The document discusses menstrual disorders and their causes, features, and risk factors. Key disorders covered include dysmenorrhea (painful cramps), menorrhagia (heavy bleeding), amenorrhea (absence of menstruation), and PMS. Causes can include hormone imbalances, genetic factors, diseases like endometriosis, and lifestyle factors.
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0% found this document useful (0 votes)
67 views31 pagesUnderstanding Menstrual Disorders and Causes
The document discusses menstrual disorders and their causes, features, and risk factors. Key disorders covered include dysmenorrhea (painful cramps), menorrhagia (heavy bleeding), amenorrhea (absence of menstruation), and PMS. Causes can include hormone imbalances, genetic factors, diseases like endometriosis, and lifestyle factors.
Uploaded by
Mutai KiprotichCopyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
Menstrual disorders
Menstrual disorders
Problems that affect a woman’s normal
menstrual cycle.
They include:
painful cramps during bleeding
abnormally heavy bleeding
Not having any bleeding.
Causes
can be triggered by:
hormone imbalances
genetic factors
clotting disorders
pelvic diseases.
Features of Menstruation
1. Onset of Menstruation (Menarche)
Typically begins between the ages of 12 -
13 years.
occurs 2 - 3 years after initial breast
development.
A higher body mass index (BMI) during
childhood is associated with earlier puberty
and menarche.
Environmental factors and nutrition may
also affect when menstruation begins.
Features of Menstruation
2. Length of Monthly Cycle.
The average menstrual cycle is about 28 days
(21-35 days)
Cycles longer during the teenage years and after
40s.
Cycle length is most irregular around menarche
and menopause
Features of Menstruation
3. Duration of Periods.
Around 3 - 5 days but a normal period can last
anywhere from 2 - 7 days.
4. Normal (physiological) Absence of
Menstruation.
Occurs during:
pregnancy.
breastfeeding
Perimenopause
Contraceptive use
Menstrual Disorders
1. Dysmenorrhea
2. Menorrhagia
3. Amenorrhea
4. Oligomenorrhea
Dysmenorrhea (Painful Cramps)
Severe, frequent cramping during menstruation.
Pain occurs in the lower abdomen but can
spread to the lower back and thighs.
a) Primary dysmenorrhea.
cramping pain caused by menstruation.
The cramps occur from contractions in the
uterus and are usually more severe during heavy
bleeding.
b) Secondary dysmenorrhea
Menstrual-related pain that accompanies
another medical or physical condition, such
as endometriosis or uterine fibroids.
Causes of Dysmenorrhea
Primary dysmenorrhea is caused by prostaglandins
that are produced in the uterus and cause the
uterine muscle to contract. Prostaglandins also play
a role in the heavy bleeding that causes
dysmenorrhea.
Secondary dysmenorrhea can be caused by a
number of medical conditions e.g.:
i) Endometriosis: is a chronic and often progressive
disease that develops when the endometrium grows
onto other areas, such as the ovaries, bowels, or
bladder. It often causes chronic pelvic pain.
Causes of Dysmenorrhea
ii) Uterine Fibroid: noncancerous growths that
grow on the walls of the uterus. They can
cause heavy bleeding during menstruation
and cramping pain.
iii) Pelvic inflammatory disease
iv) ovarian cysts
v) ectopic pregnancy
vi) intrauterine device (IUD)
Menorrhagia (Heavy Bleeding)
menstrual flow that lasts longer and is heavier
than normal.
The bleeding occurs at regular intervals (during
periods).
It usually lasts more than 7 days and women
lose an excessive (more than 80 mL) amount of
blood.
Menorrhagia is often accompanied by
dysmenorrhea because passing large clots can
cause painful cramping.
Causes of Menorrhagia
Hormonal Imbalances. Imbalances in estrogen
and progesterone levels
Ovulation Problems (anovulation)
Uterine Fibroids.
Uterine polyps (small benign growths)
Endometriosis and Adenomyosis.
Medications and Contraceptives. Certain drugs,
including anticoagulants and anti-
inflammatory medications, can cause heavy
bleeding. Problems linked to some birth
control methods, such as pills or intrauterine
devices (IUDs)
Causes of Menorrhagia
Bleeding Disorders. E.g. hemophilia, Von
Willebrand disease.
Cancer. uterine, ovarian, and cervical cancer can
cause excessive bleeding.
Infection. Infection of the uterus or cervix
Pregnancy or Miscarriage.
Other Medical Conditions. Systemic lupus
erythematosus, diabetes, pelvic inflammatory
disorder, cirrhosis, and thyroid disorders.
Metrorrhagia
Also called breakthrough bleeding, refers to
bleeding that occurs at irregular intervals and
with variable amounts.
The bleeding occurs between periods or is
unrelated to periods.
Menometrorrhagia
heavy and prolonged bleeding that occurs at
irregular intervals.
Menometrorrhagia combines features of
menorrhagia and metrorrhagia. The bleeding
can occur at the time of menstruation (like
menorrhagia) or in between periods (like
metrorrhagia).
Dysfunctional uterine bleeding (DUB)
A general term for abnormal uterine bleeding
that usually refers to extra or excessive
bleeding caused by hormonal problems,
usually lack of ovulation (anovulation).
DUB tends to occur at menarche or just
before menopause, but it can occur at any
time during a woman's reproductive life.
Amenorrhea (Absence of Menstruation)
The absence of menstruation.
Primary amenorrhea
occurs when menstruation does not begin by
age 16.
Girls who show no signs of sexual
development (breast development and pubic
hair) by age 13 should be evaluated.
Secondary amenorrhea
Occurs when periods that were previously
regular stop for at least 3 months.
Oligomenorrhea (Light or Infrequent Menstruation)
A condition in which menstrual cycles are
infrequent, greater than 35 days apart.
It is very common in early adolescence and
does not usually indicate a medical problem.
Common during menarche and
perimenopause
Causes of Amenorrhea and Oligomenorrhea
Delayed Puberty.
Hormonal Changes
Weight Loss and Eating Disorders. Eating disorders are
a common cause of amenorrhea in adolescent girls.
Extreme weight loss and reduced fat stores lead to
hormonal changes that include low thyroid levels
(hypothyroidism) and elevated stress hormone levels
(hypercortisolism). These changes produce a reduction
in reproductive hormones.
Polycystic Ovarian Syndrome (PCOS). a condition in
which the ovaries produce high amounts of androgens
(male hormones), particularly testosterone.
Endometriosis and adenomyosis.
Causes of Amenorrhea and Oligomenorrhea
Hyperprolactinemia reduces gonadotropin
hormones and inhibit ovulation, thus causing
amenorrhea.
Premature Ovarian Failure (POF): the early
depletion of follicles before age 40. leads to
premature menopause and is a significant cause of
infertility.
Structural Problems or scarring in the uterus may
prevent menstrual flow. Inborn genital tract
abnormalities may also cause primary amenorrhea.
Stress. Physical and emotional stress may block
the release of luteinizing hormone, causing
temporary amenorrhea.
Causes of Amenorrhea and
Oligomenorrhea
Athletic Training. Amenorrhea or oligomenorrhea
associated with vigorous activity may be related to stress
and weight loss. Female athletes who use anabolic
steroids will often have amenorrhea or oligomenorrhea.
A syndrome known as the female athlete triad is associated
with hormonal changes that occur with the combination
of eating disorders amenorrhea, and osteopenia (loss of
bone density) in young women who excessively exercise.
Other Medical Conditions. Epilepsy, thyroid problems,
celiac sprue, metabolic syndrome, and Cushing's disease
are associated with amenorrhea.
Premenstrual Syndrome (PMS)
A set of physical, emotional, and behavioral
symptoms that occur during the last week of the
luteal phase (a week before menstruation) in most
cycles.
The symptoms typically start around day 13 in the
cycle, and resolve within 4 days after bleeding
begins.
Symptoms may begin at any time during the
reproductive years, but are more common in the
late 20s to early 40s.
Once established, the symptoms tend to remain
fairly constant until menopause, although they
can vary from cycle to cycle.
Clinical Manifestations of PMS
Headache
fatigue
low back
pain, painful breasts, and a feeling of abdominal
fullness.
General irritability
mood swings
fear of losing control
binge eating
crying spells
NB:Symptoms vary widely from one woman to
another and from one cycle to the next in the
same person.
Risk Factors for menstrual disorders
1. Age:
Early menarche is a risk factor for severe pain, longer
periods, and longer menstrual cycles. Adolescents may
develop amenorrhea before their ovulation cycles become
regular.
Women who are approaching menopause (perimenopause)
may also skip periods. Occasional episodes of heavy
bleeding are also common as women approach menopause.
2. Weight.
Being either excessively overweight or underweight can
increase the risk for dysmenorrhea and amenorrhea.
3. Menstrual Cycles and Flow. Longer and heavier menstrual
cycles are definitely associated with painful cramps.
Risk Factors for menstrual disorders
4.Pregnancy History.
Multiparous women are at increased risk for
menorrhagia.
Nulliparous women have a higher risk of dysmenorrhea
women who first gave birth at a young age are at lower
risk.
5. Smoking.
increases the risk for heavier periods.
6. Stress.
Physical and emotional stress may block the release of
luteinizing hormone, causing temporary amenorrhea.
Complications
Anemia
Osteoposis
Infertility
Quality of Life
Menstrual disorders, particularly pain and
heavy bleeding, can affect school and work
productivity and social activities.
