Menstrual conditions

An introduction to menstrual conditions

If your periods are especially troublesome – perhaps you have particularly heavy, painful or irregular periods, or if you suffer from a number of additional symptoms as well as problem periods – it’s possible that an underlying condition could be at play.

A useful first step is to keep a record of your periods and the associated symptoms for a minimum of three cycles. Then, from this, if you still suspect that something isn’t quite right, you can visit your doctor with the information you’ve collated.

Common conditions affecting periods

From heavy to irregular, problem periods are often the most common symptom associated with menstrual disorders. Common conditions to be aware of include the following:

• PMS – Pre-menstrual syndrome (PMS) symptoms can range in severity, but up to 30% of women are thought to experience PMS to some degree. PMS is characterised by a range of monthly symptoms, typically occurring in the few days before a period is due. PMS is thought to include a number of physical, mental and behavioural symptoms, from painful period cramps, to low mood. Depending on the type of PMS, periods can vary from being heavy and more frequent, to light and irregular

• Endometriosis - Endometriosis occurs when tissue from the lining of the womb grows outside of the uterus – this can affect the ovaries, the fallopian tubes, the pelvic wall or in extreme cases, it can even interfere with the surrounding bowels or bladder. Endometriosis can often give rise to particularly painful, heavy or irregular periods

• Fibroids - Fibroids are benign growths that form within the womb. Fibroids are fairly common and often don’t translate into any symptoms at all. However, depending on their size and location they can, in some cases, give rise to more painful, heavy or irregular periods

• PCOS - Polycystic ovary syndrome, or PCOS, involves problems with insulin sensitivity and an imbalance in sex hormones. PCOS is also characterised by a woman’s ovaries containing a number of harmless cysts which can affect ovulation and the menstrual cycle. Irregular periods are a symptom of PCOS along with a number of more general symptoms. Up to 10% of the population are thought to be affected by PCOS to some degree.

• PID – Pelvic inflammatory disease, is as the name suggests, inflammation of the reproductive organs, and is typically caused by an infection. If left untreated this can become quite serious, so if in any doubt, always visit your doctor.

Common causes of menstrual conditions

There are a number of common causes of menstrual conditions as follows:

• Sex hormone Imbalance – An imbalance in the female sex hormones oestrogen and progesterone is a common cause of many conditions such as PMS, endometriosis and fibroids. Oestrogen dominance is often an issue. Having heavy, long –lasting periods with shorter cycles, is often an indicator of a problem with oestrogen balance

• Imbalance in other hormones – Hormonal problems elsewhere can give rise to issues in the womb. As seen in many cases of PCOS, insulin resistance can affect the ovaries and can upset their release of hormones. The result is often too much testosterone being released relative to the female sex hormone oestrogen. Together with the insulin resistance, this can give rise to irregular periods and a number of other symptoms including excess facial hair and problems with weight management

• Structural problems – Problems with the structure of a female’s reproductive organs can, in some cases, contribute to the onset of symptoms, such as in endometriosis or PCOS. This could be directly affecting the womb itself or elsewhere such as the ovaries, fallopian tubes or vagina.

Symptoms of menstrual conditions

Although having some symptoms around the time of your period is quite normal, if these symptoms are particularly severe, or in combination with a significant number of different symptoms, it could suggest something else is going on. Below are some symptoms to look out for:

• Painful periods – Particularly painful periods could be a sign of an underlying problem. Visit our Painful periods page to help you determine what is considered ‘normal’. Extreme cramps could be an indicator of a hormone imbalance, excess pro-inflammatory chemicals called prostaglandins or an underlying issue which needs to be addressed; such as fibroids or endometriosis

• Heavy periods – Heavy periods often go hand in hand in with painful periods so many of the same underlying issues could be to blame

• Irregular periods – Irregular periods could be a sign of a hormone imbalance or something else such as PCOS. If your periods aren’t regular it can be really useful to keep a periods and symptoms diary so you can track them properly

• Infertility problems – Although infertility issues can arise for a number of reasons –  a number of diet and lifestyle factors should be considered first, conditions of the womb such as PCOS or endometriosis could also be at the root of the problem

• Additional symptoms – Other symptoms including digestive issues, bloating, low energy or low mood could be warning signs that something additional is going on, again it is useful to keep track of when and how severe your symptoms are and how they are affecting your day to day life.

Treatment of menstrual conditions

Depending on the root cause of the problem, there are often a number of different approaches in terms of treatment options. Normally your doctor would be the first port of call if you suspect you have a menstrual condition as they can physically examine you and prescribe any necessary medications or treatments.

In addition to the programme set out by your doctor, there are often self-help tips including diet and lifestyle factors which in many cases can also make a real difference.

For more specific advice for treating PMS, PCOS, endometriosis or fibroids, visit the individual condition pages via the relevant links above.