Menstrual cycles are controlled by hormones. If your periods are heavy or painful, speak to your provider. Keep a record of when they start and stop bleeding so they can be tracked later.
If you miss three periods in a row, visit your healthcare provider immediately. Missed periods could indicate an underlying medical condition that affects fertility.
Oligomenorrhea
Variations in menstrual cycles is normal throughout adolescence, pregnancy and postmenopausal years; however, if a woman experiences periods every 35 days or fewer than nine times annually she could be diagnosed with oligomenorrhea.
To diagnose oligomenorrhea, healthcare providers will ask about your regular period’s length and intensity; diet and exercise patterns as well as any medications such as hormonal contraceptives or antipsychotics that could interfere with periods.
Oligomenorrhea can be caused by any number of health conditions. An imbalance of hormones may be treatable while cancer or tumors of reproductive organs require more specialized medical attention.
To maintain an optimal hormonal environment and support ovarian follicle maturation, women need to eat healthily, avoid overexerting themselves and rest properly. Dietary supplements may help restore anabolic activity and decrease catabolic predominance in critical terrain areas; when these areas drop too low a physician can use medicinal plants and oligoelements to bring it back up again; other treatment options could include hormone therapy such as birth control pills or surgery to remove the uterus and fallopian tubes if they cause oligomenorrhea.
Amenorrhea
Women normally cycle every 23-35 days, as determined by the hypothalamus and pituitary gland. LH and FSH hormones from the hypothalamus stimulate ovarian oocytes to release prolactin that causes changes to occur within her uterine lining, leading to her period. If a girl does not start menstruation by age 13 or has missed three periods in a row without explanation or has experienced delayed puberty due to genetic or chromosomal disorder she should consult her physician.
After performing an exhaustive medical, growth, and pubertal history and physical exam, healthcare providers may order blood tests to look for any abnormalities in hormone levels that control the menstrual cycle. A chromosome test (karyotype) can identify missing, extra, or rearrange cells which could be the source of amenorrhea; additionally pelvic ultrasound imaging with an MRI or DXA (bone density scan) may also be required for diagnostic purposes.
Once corrected, amenorrhea will typically return. Treatment options can include birth control pills or other hormonal medications to reset ovulation processes, medication to decrease production of excessive prolactin production, surgery to correct issues with either thyroid glands or pituitary glands or removal of scar tissue caused by prior cesarean sections or surgeries for endometriosis or fibroids tumors.
Menorrhagia
Heavy periods can severely diminish daily life activities and quality of life, so accurate diagnosis is key in treating them effectively. Treatment options depend on severity of bleeding symptoms, age and health history – medications or procedures could include birth control pills (pill, patch, ring or shot), progesterone injections (Depo-Provera), or LNG-IUS intrauterine devices that reduce or stop menstruation flow.
Women experiencing abnormally heavy menstrual bleeding that lasts more than seven days or has blood clots larger than an inch should seek medical advice immediately. Signs of menorrhagia include frequently needing to change tampons or pads, having to wake up during the night for this purpose, severe pelvic pain or needing more than one pad per hour.
Menorrhagia can be caused by uterine fibroids, polyps or cancer as well as hormonal disbalances; older women can use hysterosalpingogram to help determine the source of their Menorrhagia using an ultrathin, lighted tube inserted vaginally; other diagnostic tests include sonohysterogram which injects saline directly into their uterus through another small tube as well as endometrial ablation or endometriectomy as additional sources. If bleeding persists then hysterectomy may be required.
Ovarian Hyperstimulation
If a woman is experiencing difficulty becoming pregnant, fertility treatments to increase egg production may help her. This involves taking medicine containing LH and FSH which stimulate multiple egg production instead of only one, like normally occurs during her menstrual cycle. Unfortunately this process can cause her ovaries to swell significantly with fluid leakage into her belly and chest – known as Ovarian Hyperstimulation Syndrome or OHSS; mild cases typically affect one out of every three women who receive fertility treatments, though severe forms are very rare but can potentially life threatening.
OHSS symptoms include abdominal swelling, pain and feeling very full quickly. It can also lead to difficulty breathing and decreased urination. Diagnosing OHSS involves both a physical exam and ultrasound of the ovaries to see if they have become enlarged as well as any free fluid accumulation in the abdomen.
OHSS is one of the most severe treatment-related complications from gonadotropin stimulation used for in vitro fertilization and other assisted reproductive technologies, such as IVF. To reduce its risks, patients must be carefully evaluated, paying particular attention to risk factors for OHSS, and employing primary prevention methods. Early identification can also help by measuring levels of human chorionic gonadotropin and employing coasting strategies which minimize medication use in IVF cycles.
