Menstrual Disorders: Understanding and Treating Period Problems

What Are Menstrual Disorders?

Menstrual disorders are problems with the timing, amount, duration or comfort of your periods. A period pattern is your body's regular report on hormones, ovulation and the health of the uterus, so a change is worth understanding.

Doctors describe these problems under abnormal uterine bleeding (AUB) and related conditions. The common types are:

• Heavy menstrual bleeding (menorrhagia): bleeding that affects daily life, needs frequent pad or cup changes, or comes with large clots.
• Irregular or infrequent periods (oligomenorrhoea): cycles longer than about 35 days or that vary widely.
• Absent periods (amenorrhoea): no periods for 3 months or more in someone who previously had regular cycles, or none by age 15.
• Painful periods (dysmenorrhoea): pain that is severe or is getting worse.
• Bleeding between periods or after sex (intermenstrual or postcoital bleeding).
• Premenstrual syndrome (PMS) and PMDD: physical and mood symptoms before a period, with PMDD being the severe form.

What it is not: an irregular cycle is not automatically a sign of infertility, and a heavy period is not something to dismiss as normal. Evaluation tells the difference.

Why Periods Go Wrong

Causes are grouped as structural and non-structural. Common ones include:

• PCOS — irregular or absent ovulation, often with acne, excess hair growth or weight gain.
• Thyroid disorders and high prolactin — both disturb the hormones that control ovulation.
• Fibroids and polyps — non-cancerous growths that can cause heavy or prolonged bleeding.
• Adenomyosis and endometriosis — common causes of heavy and painful periods.
• Bleeding or clotting disorders — such as von Willebrand disease, especially if heavy periods started at the first period.
• Perimenopause and premature ovarian insufficiency — changing or failing ovarian function.
• Weight, stress and exercise — very low body weight, sudden weight change, intense training or chronic stress can stop ovulation.
• Medicines and contraception — hormonal methods, copper IUDs and some drugs change bleeding patterns.
• Pregnancy-related causes — including miscarriage or ectopic pregnancy, which must always be excluded.
• Rarely, endometrial hyperplasia or cancer — which is why persistent abnormal bleeding should be checked.

Signs You Should See a Doctor

• Soaking a pad or tampon every hour for several hours, or passing clots larger than a coin.
• Periods lasting longer than 7 days or coming more often than every 21 days.
• No periods for 3 months when you are not pregnant.
• Pain that stops you working, studying or sleeping, or that keeps getting worse.
• Bleeding between periods, after sex or after menopause.
• Tiredness, breathlessness or dizziness, which may signal anaemia from blood loss.
• Trying to conceive for 12 months (6 months if you are over 35) with irregular cycles.

Seek urgent care for very heavy bleeding with dizziness or fainting, severe one-sided pain, or bleeding when you may be pregnant.

How We Evaluate Menstrual Problems

We start with your history and a menstrual diary, then choose tests that fit your symptoms and age:

Treatment Options Compared

Treatment depends on the cause, your age and, importantly, whether you want to conceive now or later:

Periods and Fertility

Regular cycles usually mean regular ovulation, but the reverse is also true: irregular or absent cycles often signal that ovulation is not happening reliably. That is why menstrual problems are among the first things we look at in a fertility evaluation.

Many women with irregular periods do conceive, sometimes after simple treatment such as lifestyle change or ovulation induction. Treating a period problem early can save months of uncertain waiting.

Your Journey at StemRx

Step 1: Consultation and Cycle History

Your specialist reviews your cycle pattern, flow, pain, medicines and family history, and asks about your pregnancy plans.

Step 2: Examination and Tests

Blood tests and a pelvic ultrasound are usually done first, with further tests only when needed.

Step 3: Diagnosis and Explanation

You receive a clear explanation of the likely cause in plain language, and what is or is not serious.

Step 4: Personalised Treatment

The plan is matched to the cause and to your plans, whether that is symptom control, correcting a hormonal problem or a minor procedure.

Step 5: Follow-up

Response to treatment is reviewed, usually after a few cycles, and adjusted. If you want to conceive, we plan that alongside.

Supporting Healthy Cycles Every Day

• Track your cycle with an app or diary, noting dates, flow and pain.
• Keep a healthy weight and avoid crash diets or extreme exercise.
• Eat iron-rich foods such as leafy greens, pulses and lean meat if your periods are heavy.
• Move regularly and manage stress and sleep.
• Do not self-treat with hormones or unproven supplements sold to "regulate periods".
• Do not ignore a change in your usual pattern, especially after age 40.

Frequently Asked Questions

What is a normal menstrual cycle?

Most adults have cycles of 21 to 35 days with bleeding lasting up to 7 days. Teenagers may have longer cycles in the first years after periods begin.

How do I know if my bleeding is too heavy?

If you soak through protection every hour or two, pass large clots, bleed for over 7 days, or feel weak or breathless, it is worth being checked.

Are irregular periods always PCOS?

No. Thyroid disease, high prolactin, stress, weight change and perimenopause can cause the same pattern, so tests are needed.

Is period pain normal?

Mild cramps are common. Severe pain that disrupts daily life is not something to ignore and may point to endometriosis or adenomyosis.

Can I get pregnant with irregular periods?

Often yes, but ovulation may be unpredictable. If you have been trying for 12 months (6 months if over 35), get evaluated.

Will hormonal pills cure my problem?

They control symptoms well in many women, but do not treat every underlying cause, and the problem may return when stopped. Your doctor will explain which applies to you.

Do I need surgery?

Many women do not. Surgery is considered for structural problems such as polyps or fibroids, or when other treatments have not helped.

Will my visit be confidential?

Yes. Your reports and consultations are handled privately.