Tackling abnormal periods

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There is a difference between having periods that are irregular or a bit annoying, and having abnormal periods that cause serious problems in your life or suggest a possible health problem.

In this write-up, we shall be looking at some of the different types of abnormal periods that females can suffer from.

Heavy or long periods - Menorrhagia

No period - Amenorrhea

Painful periods - Dysmenorrhea

Very light periods, or periods that don’t come very often - Oligomenorrhea

Bleeding between periods or with sexual intercourse

If you think you might be suffering from any of these problems, you can meet a Family Planning physician for medical examination.

MENORRHAGIA (pronounced men-o-RAGE-a)

Menorrhagia (very heavy or long periods) is the most common type of abnormal bleeding from the uterus. Although many women experience heavy bleeding at some point in their life, most women don’t experience bleeding heavy enough to be menorrhagia.

Symptoms:

Very heavy periods - you soak through a tampon or pad every hour for several hours, you have to double up with tampons and pads, or you wake up in the night to change your tampon or pad

Long periods - your period lasts more than 7 days with moderate to heavy bleeding every day

Heavy bleeding and cramping that is so bad, you dread your period or have to miss work or school

Menorrhagia can be a sign of:

Hormone imbalance such as when first starting to have periods or before menopause

Uterus-related problems, like uterine fibroids

Using contraception like the copper IUD

Problems related to pregnancy, such as miscarriage or ectopic pregnancy (in the fallopian tubes).

A hormone imbalance, which can lead to a period without an egg being released (ovulation), is the most common cause of menorrhagia. Ovulation causes the production of progesterone – the hormone most responsible for controlling periods. Without ovulation, there isn’t enough progesterone to control bleeding and this can result in heavy bleeding. This is most common in teenage girls who have recently started getting their period, and women who are close to menopause.

If you leave these symptoms without seeing a doctor, menorrhagia may lead to anaemia, leaving you feeling tired.

AMENORRHEA (pronounced a-men-o-REE-a)

Amenorrhea is having no period. A woman is considered to have amenorrhea if she misses six periods in a row or if she has not had her first period by the age of 15.

Symptoms:

The main symptom of amenorrhea is no period, but there might be other symptoms, such as:

Facial hair growth

Pimples

Nipple discharge (liquid from your nipples).

Amenorrhea can be caused by:

Pregnancy/breast feeding

Menopause

Contraception, such as the hormone releasing IUD, implant and injection.  

Some medications

Stress

Low body weight

Exercising too much

Hormone imbalance, caused by pituitary tumours

Problems such as uterine scarring.

If the lack of periods is due to not ovulating (releasing an egg), you may find it difficult to get pregnant. You may also be at risk of osteoporosis (weak bones). Treatment will vary, depending on the cause of your amenorrhea. It may range from hormone therapy, to taking the contraceptive pill or other medications, to surgery.

DYSMENORRHEA (pronounced dis-men-o-REE-a)

Dysmenorrhea is the medical term for painful periods. More than half of women experience period pain or cramps for 1-2 days each period. Pain can include cramping, pain in the back or lower stomach, feeling sick, vomiting and diarrhoea.

There are two types of dysmenorrhea:

1. Pain caused by having your period

This is pain just before your period starts, or for the first few days of your period. It is very common. For many women, the pain that comes with having your period gets better as you get older, or after having a first baby.

2. Pain caused by other health-related issues

Period pain can also be a sign of other issues such as:

Endometriosis – when tissue that usually lines the uterus grows outside the uterus, for example on the ovaries, fallopian tubes, intestines or other organs.

Adenomyosis - when tissue that usually lines the uterus grows into the muscular wall of the uterus.

Having a copper IUD. A hormonal IUD like Mirena or Jaydess can help, as you are likely to have less bleeding and pain.

If you are experiencing really bad period pain, you don’t need to put up with it. Tests can check if there is a medical reason for the pain, and treatment will usually help.

Treating period pain - There are a few ways to reduce period pain:

Exercise

Try some relaxation techniques

Heat pads (wheat bag/hot water bottle)

Taking pain relief medication like ibuprofen, paracetamol

Talk to a nurse or doctor about what types of contraception might help your period pain.

OLIGOMENORRHEA (pronounced olli-go-men-o-REE-a) 

Oligomenorrhea means having very light periods or periods that don’t come very often (if you go more than 35 days without your period). It is normal for your period to change over time, either how often you get it or how long it lasts. It is also normal to sometimes experience irregular periods.

Having a very light period, or having a long wait between periods, is not usually a sign of a problem and can often be caused by:

Taking the pill – this is a normal side effect of taking the pill

Exercising too much

Stress

Low body weight

Some medications

Usually, oligomenorrhea is nothing to worry about, but it can sometimes be a sign of another condition, like polycystic ovarian syndrome (PCOS), diabetes, or thyroid problems. If you have no more than 3 or 4 periods a year or other unusual symptoms, make an appointment to talk to a nurse or doctor.

BLEEDING BETWEEN PERIODS, AFTER SEX, OR AFTER MENOPAUSE

Bleeding between periods can happen when using contraception such as the pill, the injection, implant, and copper or hormone releasing IUDs.

However bleeding between periods, after sex, or after menopause can be caused by a number of other things such as infection, an abnormal cervix or uterus lining.  It is best to see a doctor or nurse if you experience these symptoms to find out why it is happening.

WHAT SHOULD I DO IF I THINK I HAVE AN ABNORMAL PERIOD?

If you are experiencing any of these abnormal periods and it’s making your life difficult, it’s not something you have to put up with – make an appointment at Family Planning to see what options are available for you.