What is a menstrual disorder?

While some women are able to experience regular periods each month with usual premenstrual symptoms, beginning and ending at almost the same time each month, other women do not always experience this and may have a menstrual disorder which may be a burden on their quality of life. When it comes to the symptoms of menstruation and PMS, not everything should be regarded as usual, and if you experience overwhelming symptoms during menstruation, you should seek medical advice from Dr Tini to find out how best to make your menstrual cycle tolerable.

What is normal?

The menstrual cycle includes a menstrual period of bleeding roughly every 28 days. On average your menstrual bleeding should last between 3 and seven days, and experience the following premenstrual syndrome (PMS) symptoms, which may be uncomfortable but not unbearable:

  • Mood swings such as sadness, irritability and anxiety
  • Abdominal cramping
  • Back pain
  • Headaches
  • Bloating
  • Swelling of fingers and feet due to fluid retention
  • Acne
  • Vertigo
  • Fainting
  • Muscle spasms
  • Allergies
  • Infections
  • Eye and sight problems
  • Decreased coordination
  • Lowered sex drive
  • Hot flashes
  • Changes in eating habits and appetite

If you are experiencing these symptoms, but find them unbearable or problematic you may have a menstrual disorder.

The following are menstrual disorders:


Amenorrhea is a type of menstrual disorder in which menstrual periods are absent for more than three months on end. This menstrual disorder can occur at any stage in a woman’s life. There are two kinds of amenorrhea:

  • Primary amenorrhea: Menstruation which doesn’t begin at puberty or by the age of 16 years old.
  • Secondary amenorrhea: initially, routine and regular menstrual periods which later become abnormal or absent.

What causes Amenorrhea?

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It may be caused by breastfeeding, pregnancy or menopause. Otherwise, medications or medical problems such as abnormal ovulation, birth defects, eating disorders, obesity, thyroid disorder or excessive exercise may cause Amenorrhea.


Severe and frequent menstrual cramps and pain that is related to menstruation may be signs of Dysmenorrhea. The most common symptoms include cramping or pain of the lower abdomen, lower back pain, nausea, diarrhoea, headaches, fainting and fatigue.

What causes Dysmenorrhea?

Dysmenorrhea may be caused by small chemical imbalances in the body or by other medical conditions such as:

  • Endometriosis
  • Pelvic inflammatory disease (PID)
  • Fibroids or polyps
  • An ectopic pregnancy
  • Miscarriage
  • Infection or a tumour in the pelvic area


Menorrhagia is one of the most common menstrual disorders and is characterised by heavy periods and prolonged menstrual bleeding. The symptoms of this abnormal uterine bleeding typically include heavy bleeding to the point that sanitary towels or tampons are needing to be changed every hour, or menstrual bleeding that lasts longer than seven days as well as spotting or bleeding between menstrual periods. Other types of this condition include:

  • Polymenorrhea – a menstrual cycle which occurs more often than every 28 days.
  • Oligomenorrhea – a light or infrequent period.
  • Postmenopausal bleeding – bleeding which occurs well after menopause.

What causes Menorrhagia?

The following factors may cause this menstrual disorder:

  • Hormonal imbalances
  • Pelvic inflammatory disease (PID)
  • Fibroids or polyps
  • An ectopic pregnancy
  • Miscarriage
  • Infection or a tumour in the pelvic area
  • Some physical birth control devices like IUD’s may cause Menorrhagia
  • Bleeding disorders
  • A liver, kidney or thyroid disease
  • High levels of endothelins or prostaglandins

Premenstrual Dysphoric Disorder (PMDD)

The premenstrual dysphoric disorder is a severe menstrual disorder which is rare but affects the functioning of a woman’s life. Premenstrual dysphoric disorder is a severe form of premenstrual syndrome (PMS) in which the symptoms are heightened to the point that they are unbearable. Common symptoms include heightened irritability, anxiety and mood swings which are experienced during menstruation, feelings of hopelessness, paranoia, emotional sensitivity, severe abdominal cramping, headaches, fatigue and sleep problems. The emotional and psychological symptoms are associated with the menstrual cycles, and once menstruation ceases, these symptoms subside.

What causes premenstrual dysphoric disorder?

The exact cause of this menstrual disorder is still unknown; however, it is believed that the hormones involved during menstruation impair the neurotransmitters of serotonin. Those with a family history of depression, mood disorders and postpartum depression have a higher risk of developing this disorder.

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