It can be unnerving and downright scary to see changes in our menstruation, and not understand what's happening.
The following list simplifies the different types of abnormal (dysfunctional) uterine bleeds for you - because as women, it's important to understand our body. And after all, knowledge is power...
The absence of menstrual periods. This condition may be further classified as:
Primary amenorrhea. Also known as delayed menarche. The lack of first menstrual period by the age of 16 years.
Secondary amenorrhea. This the absence of a menstrual bleed in women who previously menstruated.
The periods must be absent for at least three months to be considered amenorrhea. This can happen due to your hypothalamus simply stopping production of hormone required for menstruation (GnRH). This can occur in response to things like emotional stress, excessive exercise or very low caloric intake.
This is pain associated with your period.
Primary dysmenorrhea. Painful menstrual periods that are not caused by a specific underlying disease or condition. Commonly the result of inflammation from prostaglandins which contract the uterus.
Secondary dysmenorrhea. This involves painful menstrual periods caused by an underlying disease or condition. Commonly Endometriosis to Adenomyosis, cysts, fibroids or infection.
This is the medical term for excess / heavy menstrual bleeds. Identified when a woman loses 80ml+ of blood per cycle over several menstrual cycles in a row; soaks through one or more pads every hour for several hours; has long menstrual periods (lasting 7+ days); needs to wake up at night to change pads; or passes large clots frequently throughout the menses.
The causes can vary but include: oestrogen dominance, a thyroid condition, clotting disorders, uterine fibroids, Endometriosis, Adenomyosis &/or pituitary dysfunction.
Oligo-ovulation or Anovulation
Oligo-ovulation defines when we ovulate less often than we should (normal is once in your cycle, commonly around day 14 of a 28-day cycle). It is also possible though for women to not ovulate at all. This is referred to as an ‘anovulatory bleed’ or cycle.
This is a serious condition as ovulation is not only important for fertility, but ovulation is the way we make estradiol and progesterone - which play an important role in various functions of our body.
Reasons for lack of ovulation include Polycystic Ovarian Syndrome (PCOS), thyroid imbalances, recent cessation of the oral contraceptive pill, stress, weight loss or over-exercise.
Hypomenorrhea or Hypermenorrhea
This is the term for abnormally low or abnormally high bleeding.
Hypomenorrhea refers to scant bleeding, substantially less than 30 ml per menstrual cycle. Hypermenorrhea refers to excessive bleeding, over 90 ml in a cycle of normal duration.
This refers to unusually infrequent menstruation and a scattered pattern. It's where a woman goes for longer than 35 days without bleeding. The diagnosis changes to Amenorrhea if more than 90 days pass without a period.
Some of the reasons this commonly manifests include side-effects from the use of hormonal birth control, heavy exercise, eating disorders, diabetes, thyroid issues, certain medications and perimenopause.
Polymenorrhea refers to unusually frequent menstrual periods. It generally refers to a menstrual interval of fewer than 21 days and can be linked to certain medications, bleeding disorders, sexually transmitted infections, pelvic inflammatory disease, or hormonal imbalances including thyroid, adrenal, or pituitary gland dysfunction.
If you can relate to many of these types of bleeding, don't feel overwhelmed. Thankfully, as Naturopaths, we are acutely aware of the delicate balance within the endocrine system, and how that balance affects women's health and their cycle.