Woman's Sexual & Reproductive Health

Menstrual Issues.

Problem # 1

1: Dysmenorrhea:
Dysmenorrhea is also known as Menstrual cramps or Painful periods. It refers to the pain during menstruation.The most common problem women face during periods is the Pain. More than half of women who have periods get some pain around their period. Some women may get just a feeling of heaviness in the abdomen or tugging in the pelvic area. Other women experience severe cramps different from premenstrual syndrome (PMS) pain

Types of Dysmenorrhea:
A: Primary Dysmenorrhea
B: Secondary Dysmenorrhea

Primary Dysmenorrhea :
This type is most common and due to the contractions of the uterus pain is caused. The uterus contracts during your period to help the uterine lining leave the body. Teens may get dysmenorrhea soon after they get their first period.

Secondary Dysmenorrhea :
Secondary occurs due to a specific cause or other health problems. Secondary dysmenorrhea pain usually gets worse when women grew older. It also lasts longer than regular menstrual cramping. There are some problems that are the main cause of secondary dysmenorrhoea and they are as follow:

  • Endometriosis
  • Ovarian cysts
  • Uterine fibroids
  • Endometriosis: Endometriosis is a condition in which cells similar to those in the endometrium, the layer of tissue that normally covers the inside of the uterus, grow outside it. Endometriosis is most commonly seen in ovaries, fallopian tubes and tissues around the uterus and ovaries; however, it can also occur in other parts of the body in rare cases. In response to monthly changes in levels of the hormone estrogen, this lining breaks down and bleeds outside of the uterus and can cause swelling and pain..

The major symptoms of endometriosis are

➢ Pelvic Pain:
Recurrent pelvic pain is a major symptom of endometriosis. The pain can range from mild to extreme cramping or stabbing pain that occurs on both sides of the pelvis, in the lower back and rectal region and also down the legs.

➢ Infertility:
Infertility is the inability of a person, animal or plant to reproduce by natural means. In humans, infertility is the inability to become pregnant after one year of intercourse without contraception involving a male and female partner. About a third of women with infertility have endometriosis. Among women with endometriosis about 40% are infertile

• Uterine Fibroids: Uterine fibroids, also known as uterine leiomyomas or fibroids, are benign smooth muscle tumors of the uterus. Fibroids are tumors that grow in or on the wall of the uterus. They are almost always not cancerous. About 20% to 80% of women develop fibroids by the age of 50. In 2013, it was estimated that 171 million women were affected worldwide. They are typically found during the middle and later reproductive years.

• Ovarian cysts: An ovarian cyst is a fluid filled sac within the ovary. They also do not cause symptoms. Occasionally , they may cause bloating, lower abdominal pain or lower back pain. Most of the cysts are harmless. If the cyst breaks or causes the ovary to twist, it can cause intense pain,

Problem # 2

Irregular Menstruation:
Irregular menstruation is a menstrual condition that involves both irregular cycle lengths and metrorrhagia (vaginal bleeding between expected periods). Periods are known to be abnormal if the menstrual cycle is shorter or longer than the average. This means that the time from the first day of your last period to the beginning of your next period is less than 24 days or more than 38 days. Irregular periods are normal for adolescent girls and perimenopausal women. Teen girls' periods may be irregular for the first few years before they become more regular. During the transition to menopause, known as perimenopause, menstrual cycles may become more irregular over time.

Causes: A number of factors increase the chance of irregular menstruation. These are:

  • Pregnancy
  • Hormonal birth control
  • Breastfeeding
  • Perimenopause
  • Polycystic Ovary Syndrome (PCOS)
  • Thyroid Problems
  • Uterine Fibroids
  • Endometriosis
  • Obesity

Problem # 3

Menorrhagia (heavy menstrual bleeding):
Menorrhagia is the medical term for menstrual periods with abnormally heavy or prolonged bleeding. It lasts more than 7 days. Untreated heavy or prolonged bleeding can stop you from living your life to its fullest. It can cause anemia too. Anemia is a common blood problem that can make you feel tired or weak. Bleeding problem may lead to other health problems.


  • Hormonal Imbalance: In a typical menstrual cycle, the equilibrium between the hormones estrogen and progesterone controls the build-up of the lining of the uterus (endometrium) which is shed throughout menstruation. If there is a hormonal imbalance, the endometrium develops in excess and eventually sheds through heavy menstrual bleeding.
  • Uterine Fibroids: Uterine fibroids are non-cancer (benign) tumors of the uterus appear during your childbearing years. Uterine fibroids can cause more severe than normal or prolonged menstrual bleeding.
  • Adenomyosis: This condition occurs when glands from the endometrium become embedded in the uterine muscle, often causing heavy bleeding and painful periods.
  • Medications: Certain medications, including anti-inflammatory medications, hormonal medications such as estrogen and progestins, and anticoagulants such as warfarin (Coumadin, Jantoven) or enoxaparin (Lovenox), can contribute to heavy or prolonged menstrual bleeding.
  • Obesity: The extra fat in the body makes the hormone estrogen. The extra estrogen changes the normal menstrual cycle and can cause missed, irregular, or heavy periods.
  • Thyroid problems. Heavy bleeding can be a sign of hypothyroidism or underactive thyroid. Hypothyroidism happens when your thyroid does not make enough thyroid hormones.

Problem # 4

Amenorrhea is the absence of menstruation — one or more missed menstrual periods. The absence of menstrual periods before menopause is called amenorrhea. Amenorrhea happens in 3% to 4% of women. Amenorrhea that is not triggered by pregnancy or breastfeeding means that ovaries have stopped producing regular amounts of the hormone estrogen.


  • Pregnancy: period stops during pregnancy because ovaries no longer release eggs.
  • Anorexia Nervosa: Amenorrhea can happen if body fat drops so low that ovulation stops. Anorexia often causes extreme weight loss leading to a very low body weight that is not healthy. This can cause periods to be less regular or stop completely.
  • Stress. Long-term, severe stress can affect the part of your brain that controls reproduction. As a result, ovulation and your period can stop. Managing the stress can help restore normal menstrual cycles