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.