Menstrual Disorders
- Dysmenorrhea refers to painful cramps during menstruation.
- Premenstrual syndrome refers to physical and psychological symptoms occurring prior to menstruation
- Menorrhagia is heavy bleeding, including prolonged menstrual periods or excessive bleeding during a normal-length period
- Metrorrhagia is bleeding at irregular intervals, particularly between expected menstrual periods.
- Amenorrhea is the absence of menstruation.
Treatment for Menstrual Disorders
Acetaminophen (Tylenol) or nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin) and naproxen (Aleve) can help provide pain relief for cramps.
Oral contraceptives (birth control pills) can help regulate menstrual periods and reduce heavy bleeding. Newer continuous-dosing oral contraceptives reduce or eliminate menstrual periods. Progesterone injections (Depo-Provera) are another option. The LNG-IUS (Mirena), a progesterone intrauterine device (IUD), is often recommended as a first-line treatment for heavy bleeding.
Endometrial ablation is a surgical option.
In cases where medical therapy is not successful, hysterectomy may be considered.
The Menstrual Cycle
The menstrual cycle is regulated by the complex surge and fluctuations in many different reproductive hormones. These hormones work together to prepare a women's body for pregnancy. The hypothalamus (an area in the brain) and the pituitary gland control six important hormones:
- Gonadotropin-releasing hormone (GnRH) is released by the hypothalamus.
- GnRH stimulates the pituitary gland to produce follicle-stimulating hormone (FSH) and luteinizing hormone (LH).
- Estrogen, progesterone, and the male hormone testosterone are secreted by the ovaries at the command of FSH and LH.