Menstruation refers to the discharge of blood and mucosal tissue together known as menses, regularly from the inner lining of uterus and vagina. The time around which the first period begins is known as menarche. It is usually between 12-15 years of age. However, at times periods may begin as early as 8 years of age and is still considered normal. On average, the length of time between the first day of one period and the first day of the next period is 28days. However, it may normally vary from 21-45days. Menstrual bleeding typically lasts from 2-7days and measures about 5 tablespoons. Menstruation stops occurring between 45-55 years of age and is known as menopause. The menstrual cycle occurs due to variation in levels of certain hormones throughout the month. Under the hormonal influence, there is thickening of inner lining of the uterus with growth of one egg in an ovary. Then this egg is released from an ovary around day 14 of the cycle and the thickened lining of the uterus provides nourishment to it after implantation. If pregnancy does not occur, this lining is released in what is known as menstruation.
Also, many women tend to have some signs and symptoms prior to menstruation, such as acne, bloating, tenderness in breast, fatigue, irritability and mood swings. In about 20-30% of women, they may interfere with daily routine and are known as premenstrual syndrome.
TYPES OF MENSTRUAL DISORDERS
If someone experiences one or more distressing symptoms before or during menstruation, it is called a menstrual cycle disorder. Common menstrual cycle disorders are:-
- Abnormal uterine bleeding- This may include heavy menstrual bleeding, no menstrual bleeding, or bleeding between periods.
- Dysmenorrhoea- It refers to painful menstrual periods.
- Premenstrual syndrome
SYMPTOMS AND CAUSES OF COMMON MENSTRUAL DISORDERS
- Heavy menstrual disorder- Bleeding is said to be heavy if it affects normal activities and the female may bleed as much as 10-25 times the normal amount each month. It is common if it occurs during teen years or as one gets closer to menopause. Common causes of heavy menstrual bleeding are:-
- Hormonal imbalances i.e., when the body produces too much or not enough reproductive hormones, namely estrogen and progesterone.
- Polyps or fibroids in the uterus
- Medical conditions- This includes thyroid problems, blood clotting disorders, idiopathic thrombocytopenic purpura (ITP) with too few platelets in the blood, liver or kidney disease, leukemia.
- Medications- This includes anticoagulants and some synthetic hormones.
- Complications from IUD
- Ectopic pregnancy
- Precancerous conditions of the uterine lining cells
- No menstrual bleeding/ amenorrhoea- It is when there is no menstrual period even after 16years of age or for more than 90 days at a stretch. This condition is normal before puberty, after menopause and during pregnancy.
- Causes of primary amenorrhoea i.e., when no menses occur till 16yrs age are:-
- Delayed maturing of the pituitary gland
- Low body weight due to eating disorders.
- Excessive exercise
- Certain medications
- Ovarian, hypothalamic or genetic abnormalities
Common causes of secondary amenorrhoea i.e., when one had regular periods but then suddenly they don’t appear for more than three months are:-
- Pituitary gland disorders which cause elevated prolactin levels
- Hypo or hyperthyroidism
- Ovarian causes such as ovarian cyst, ovaries removed surgically or problems that affect ovaries such as stress, weight loss, exercise or illness.
- Severe menstrual cramps/ dysmenorrhoea- It refers to painful and persistent cramps before or during menstruation. It is due to uterine contractions under the influence of prostaglandins produced by uterine lining cells. These prostaglandins also cause contractions in intestines resulting in diarrhea and relax the blood vessels leading to low blood pressure.
- Premenstrual syndrome (PMS) – It occurs due to rise and fall in levels of estrogen and progesterone, which may influence brain chemicals. Physical symptoms associated with PMS are:-
- Swollen and painful breasts
Emotional symptoms associated with PMS are:-
- Anxiety or confusion
- Mood swings and tension
- Crying and depression
- Inability to concentrate
DIAGNOSIS OF MENSTRUAL DISORDER
This may include:-
- Ultrasound of pelvic region
- Endometrial biopsy
- Blood tests for anemia
- Urine test to rule out pregnancy
MANAGEMENT OF MENSTRUAL DISORDERS
One can take the following steps to prevent or minimize menstrual cycle related problems such as cramping or premenstrual syndrome.
- Change diet by reducing refined sugars, salt, nicotine, caffeine and alcohol.
- Increase calcium in diet from sources such as low fat dairy products, soy products, dark greens and calcium fortified orange juice.
- Increase complex carbohydrates in the diet and include more fruits, vegetables, grains and beans in diet.
- Exercise for at least 20- 30 minutes, ideally three times a week.
- Have fixed sleeping hours to help the mind relax better for sleeping.
- Keep a symptom checklist to be prepared for highs and lows.
Homeopathy for menstruation problem
Homeopathy has a significant role to play in the treatment of the menstrual problem. Homeopathy provides a highly effective, safe and lasting solution for various menstruation troubles. Best homepathic medicine for menstruation is the one most similar to disease manifestation, elicited from both mental and physical sphere of the patient in each case. Homeopathic treatment for menstruation trouble does not have any adverse effects.
Common homeopathic medicines for menstruation troubles are:-
Belladonna– Is indicated for heavy menses which are bright red, too early and too profuse. The menstrual blood is very offensive and hot. There is associated bearing down the pain as if all the viscera will protrude at the genitals.
Millefolium – Is indicated for heavy periods that are painless and with bright red blood. There may be a history of falls from a height or over lifting as a likely cause.
Hamamelis Virginica– Is indicated for heavy menstrual bleeding and intermenstrual bleeding where the menses are dark, profuse, with soreness in the abdomen.
Magnesia Phosphorica– Is indicated for menses which get better by pressure and hot application.