Menstrual Difficulties

Menstruation is a woman's monthly bleeding. It is also called menses, menstrual period, or period. With menstruation, come menstrual difficulties like menstrual cramps also known as dysmenorrhea and pre-menstrual stress (PMS). Women can experience cramps during menses and the following before period, like lower abdominal pain, bloating, lower backache as well as breast tenderness, acute burning sensation when urinating, giddiness, nausea and some may even feel lethargic.

To understand some of these problems, we need to know what takes place during menses. When a woman has her period, she is menstruating. The menstrual blood is partly blood and partly tissue from the inside of the uterus (womb). It flows from the uterus through the small opening in the cervix, and passes out of the body through the vagina. Most menstrual periods last from three to five days.

During the menstrual period, the thickened uterine lining and extra blood are shed through the vaginal canal. A woman's period may not be the same every month, and it may not be the same as other women's periods. Periods can be light, moderate, or heavy, and the length of the period also varies. While most menstrual periods last from three to five days, anywhere from two to seven days is considered normal. For the first few years after menstruation begins, periods may be very irregular. They may also become irregular in women approaching menopause. Sometimes birth control pills are prescribed to help with irregular periods or other problems with the menstrual cycle.

Women can have various kinds of problems with their periods, including pain, heavy bleeding, and skipped periods. Some of them are:

· Dysmenorrhea - painful periods, including severe menstrual cramps
Dysmenorrhea is simply the medical term for menstrual cramps, that dull or throbbing pain in the lower abdomen many women experience just before and during their menstrual periods. For some women, the discomfort is merely annoying. For others, it can be severe enough to interfere with everyday activities for a few days every month.

Dysmenorrhea can be primary or secondary. Primary dysmenorrhea involves no physical abnormality. These so-called normal cramps affect 50 percent to 90 percent of all menstruating women. Primary dysmenorrhea usually begins within three years after a girl begins menstruating. Secondary dysmenorrhea involves an underlying physical cause, such as endometriosis or uterine fibroids.

If you have primary dysmenorrhea, there are some measures you can take to ease the discomfort. You also can take comfort in knowing that cramps tend to decrease in intensity as you get older, and often disappear after a pregnancy.

In younger women, there is often no known disease or condition associated with the pain. A hormone called prostaglandin is responsible for the symptoms. Some pain medicines available over the counter, such as ibuprofen, can help with these symptoms. Sometimes a disease or condition, such as uterine fibroids or endometriosis, causes the pain. Treatment depends on what is causing the problem and how severe it is.

For secondary dysmenorrhea, managing your cramps involves treating the underlying cause. The complications of secondary dysmenorrhea depend on the underlying cause. For instance, pelvic inflammatory disease can scar your fallopian tubes and compromise reproductive health. The scarring also can lead to an ectopic pregnancy, in which the fertilized egg stays in the fallopian tube rather than traveling through the tube to implant in your uterus, or it implants somewhere else outside your uterus. Endometriosis, another possible cause of secondary dysmenorrhea, can lead to impaired fertility.

On the other hand, some women can have lack of menstrual period.

· Amenorrhea - the lack of a menstrual period
This term is used to describe the absence of a period in young women who haven't started menstruating by age 16, or the absence of a period in women who used to have a regular period. Causes of amenorrhea include pregnancy, breastfeeding, and extreme weight loss caused by serious illness, eating disorders, excessive exercising, or stress. Hormonal problems (involving the pituitary, thyroid, ovary, or adrenal glands) or problems with the reproductive organs may be involved.

Most women also experience PMS (Pre-menstrual stress) and usually treatment or lifestyle can help manage PMS. An estimated 70 percent to 90 percent of menstruating women experience some form of PMS. These problems are more likely to trouble women in their 20s and 30s, and they tend to recur in a predictable pattern. Yet the physical and emotional changes you experience may be more or less intense with each menstrual cycle. Still, you don't have to let these problems control your life.

Although the list of potential signs and symptoms is long, most women with PMS experience only a few of these problems. For an estimated 30 percent to 40 percent of women, the physical pain and emotional stress are severe enough to affect their daily routines and activities. For most of these women, symptoms disappear as the menstrual period begins.

Abnormal uterine bleeding-vaginal bleeding that is different from normal menstrual periods. It includes very heavy bleeding or unusually long periods (also called menorrhagia), periods too close together, and bleeding between periods. In adolescents and women approaching menopause, hormone imbalance problems often cause menorrhagia along with irregular cycles. Sometimes this is called dysfunctional uterine bleeding (DUB). Other causes of abnormal bleeding include uterine fibroids and polyps. Treatment for abnormal bleeding depends on the cause.

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