Menstrual disorders

Menstrual disorders can be caused by disturbances in the hormonal control system or by structural changes in the uterus such as fibroids or mucous polyps. Other factors that can influence the delicate hormone balance are a much too high or low body weight, internal disorders, physical or emotional stress, hormone therapy, and many more. Disorders that do not affect the gestational hormone system, eg thyroid disorders or pathologically elevated levels of prolactin, a hormone that stimulates lactation, may also cause menstrual disorders. Furthermore, the menstrual cycle generally becomes irregular when menopause sets in.

Bleeding disorders bear a number of health risks such as excessive bleeding or, more importantly, underlying diseases. Hormonal imbalances existing for a long time and excessive body fat resulting in increased oestrogen secretion may carry the risk of malign changes in the endometrium (uterine lining). Symptoms of such malignities may be changes in the menstruation patterns or the recurrence of menstruation long after it has stopped due to menopause. Any bleedings occurring after menopause are generally suspected to be caused by a malignity until there is conclusive proof to the contrary.

Regular precautionary medical check-ups increase the chances of detecting a malignity before it reaches an advanced stage. If a woman presents with menstrual disorders, physicians should always rule out hormone or organic disorders as causes, or, if there are any, treat them, which will often restore the patient’s previously impaired quality of life.

The most common causes for complaint are mid-cycle bleedings and menstrual bleedings occurring at shorter intervals that last longer and are accompanied by increased blood flow and more pain. Missed periods or considerably extended intervals between bleedings may also be signs of a disease – or a happy event, depending on the circumstances, of course....

Diagnosis is based on a comprehensive medical history and the menstrual development in relation to the patient’s age. Tests include examination of organ status, sonography, pap smear microscopy.
The hormone status will only be evaluated if any findings from the other tests suggest that this might be helpful or necessary.

Structural changes such as polyps or fibroids should be eliminated as causes (sonography), or be treated. Today’s most common treatment methods include minimally invasive procedures, eg endoscopic procedures such as laparoscopy or hysteroscopy. Many hormonal disturbances can be cured with a specific therapy using drugs or other methods to restore a normal hormone cycle. Non-drug therapy can include naturopathy, acupuncture and dietary intervention.

Anaemia caused by too frequent and/or too heavy bleedings is a common condition in women and leads to a loss in productivity, exhaustion, poor concentration and poor quality of sleep. In addition to treating the primary condition, a resolute therapy over several weeks to replenish the body’s iron stores will be necessary.

Especially in cases where cancer cannot be ruled out as a cause for menstrual disorders treatment should not be delayed until the final diagnose is available. Contrary to the widely held belief that “it is too late now anyway”, a timely start of treatment following an early, maybe preliminary diagnose allows physicians to choose a gentle and often organ-retaining therapy that will most likely result in a lasting recovery.