Menstrual Disorder
- Apr 1
- 3 min read
INTRODUCTION:
Menstrual disorders are abnormalities in the menstrual cycle, including changes in frequency, duration, amount, or associated symptoms like pain.
Following menstrual Disorder are being described :-
Premenstrual syndrome
Dysmenorrhoea
Cryptomenorrhoea
Menorrhagia
Metrorrhagia
1️⃣PREMENSTRUAL SYNDROME (PMS)
📚INTRODUCTION
Common condition affecting women before menstruation due to hormonal changes.
♦️DEFINITION
A group of physical, emotional, and behavioral symptoms occurring 1–2 weeks before menstruation and relieved after onset of menses.
⭕CAUSES
Hormonal imbalance (estrogen & progesterone)
Neurotransmitter changes (serotonin)
Stress
Poor diet (caffeine, salt)
Lack of exercise
🔷CLINICAL MANIFESTATIONS
Mood swings, irritability
Breast tenderness
Bloating
Headache
Fatigue
Depression/anxiety
🧪DIAGNOSIS
Symptom history (cyclical pattern)
Symptom diary (2–3 cycles)
Rule out other disorders
👨🏻⚕️TREATMENT
Lifestyle changes (diet, exercise)
Reduce caffeine & salt
NSAIDs for pain
Oral contraceptive pills (OCPs)
Antidepressants (SSRIs)
2️⃣. DYSMENORRHOEA
📚INTRODUCTION
Painful menstruation; very common in young women.
♦️DEFINITION
Severe lower abdominal pain during menstruation.
🎢TYPES
Primary (no pathology)
Secondary (due to disease)
🔷CAUSES
Prostaglandin excess (primary)
Endometriosis
Fibroids
Pelvic infection
⭕CLINICAL MANIFESTATIONS
Cramping lower abdominal pain
Backache
Nausea, vomiting
Diarrhea
Sweating
🧪DIAGNOSIS
History & physical exam
Ultrasound
Laparoscopy (if needed)
👨🏻⚕️TREATMENT
NSAIDs (Ibuprofen)
Heat therapy
Exercise
Hormonal therapy (OCPs)
Treat underlying cause
3️⃣CRYPTOMENORRHOEA
📚INTRODUCTION
Rare condition where menstrual blood is formed but not discharged.
♦️DEFINITION
Menstruation occurs internally but blood is retained due to obstruction.
⭕CAUSES
Imperforate hymen
Vaginal septum
Cervical stenosis
🔷CLINICAL MANIFESTATIONS
Primary amenorrhea
Cyclic abdominal pain
Pelvic mass
Urinary retention
🧪DIAGNOSIS
Physical examination
Ultrasound
MRI (if needed)
👨🏻⚕️TREATMENT
Surgical correction (hymenotomy, septum removal)
4️⃣MENORRHAGIA
📚INTRODUCTION
Excessive menstrual bleeding affecting daily life.
♦️DEFINITION
Menstrual bleeding >7 days or >80 ml blood loss per cycle.
⭕CAUSES
Hormonal imbalance
Uterine fibroids
Endometrial hyperplasia
Thyroid disorders
IUCD use
🔷CLINICAL MANIFESTATIONS
Heavy bleeding
Passage of clots
Fatigue (anemia)
Shortness of breath
🧪DIAGNOSIS
History (pad count)
Hb level (anemia)
Ultrasound
Thyroid function test
👨🏻⚕️TREATMENT
Iron supplements
NSAIDs
Hormonal therapy (OCPs, progesterone)
Tranexamic acid
Surgery (D&C, hysterectomy in severe cases)
5️⃣ METRORRHAGIA
📚INTRODUCTION
Irregular uterine bleeding not related to normal cycle.
♦️DEFINITION
Bleeding between menstrual periods at irregular intervals.
⭕CAUSES
Hormonal imbalance
Endometrial polyps
Cancer (endometrial/cervical)
Infection
Stress
🔷CLINICAL MANIFESTATIONS
Irregular bleeding
Spotting between periods
Sometimes heavy bleeding
Diagnosis
Pelvic exam
Ultrasound
Pap smear
Endometrial biopsy
👨🏻⚕️TREATMENT
Hormonal therapy
Treat underlying cause
Surgery if needed
🚀Here’s a short “exam trick” version for Menstrual Disorder — super quick points you can remember
1.Premenstrual Syndrome (PMS)
Intro: Symptoms before menstruation
Definition: Physical & emotional symptoms before menses
Causes: Hormonal imbalance, stress
Symptoms: Mood swings, bloating, breast pain
Diagnosis: Symptom history & diary
Treatment: Lifestyle change, NSAIDs, OCPs
2. Dysmenorrhoea
Intro: Painful menstruation
Definition: Severe lower abdominal pain during menses
Causes: Prostaglandins, endometriosis
Symptoms: Cramps, nausea, back pain
Diagnosis: History, USG
Treatment: NSAIDs, heat, OCPs
3. Cryptomenorrhoea
Intro: Hidden menstruation
Definition: Blood formed but not discharged
Causes: Obstruction (imperforate hymen)
Symptoms: Amenorrhea + cyclic pain
Diagnosis: Exam, USG
Treatment: Surgery
4. Menorrhagia
Intro: Heavy bleeding
Definition: Excessive/prolonged menstrual bleeding
Causes: Hormonal imbalance, fibroids
Symptoms: Heavy flow, clots, anemia
Diagnosis: Hb, USG
Treatment: Iron, hormones, surgery
5. Metrorrhagia
Intro: Irregular bleeding
Definition: Bleeding between periods
Causes: Hormones, polyps, cancer
Symptoms: Spotting, irregular bleeding
Diagnosis: Pap smear, biopsy
Treatment: Hormones, treat cause
Here’s a set of 07 MCQs on Menstrual Disorder for practice:
1. Premenstrual syndrome mainly occurs:
a) During menstruation
b) After menstruation
c) Before menstruation ✅
d) At ovulation
2. The main cause of primary dysmenorrhoea is:
a) Infection
b) Prostaglandin excess ✅
c) Tumor
d) Trauma
3. Cryptomenorrhoea is characterized by:
a) Excess bleeding
b) No menstruation formation
c) Retained menstrual blood due to obstruction ✅
d) Irregular cycles
4. Menorrhagia is defined as:
a) Painful menstruation
b) Bleeding between cycles
c) Excessive menstrual bleeding ✅
d) Absence of menstruation
5. Metrorrhagia refers to:
a) Heavy bleeding
b) Painful menstruation
c) Bleeding at irregular intervals ✅
d) Delayed menstruation
6. First-line treatment for dysmenorrhoea is:
a) Antibiotics
b) NSAIDs ✅
c) Antifungals
d) Chemotherapy
7. Common symptom of menorrhagia is:
a) Amenorrhea
b) Spotting only
c) Heavy bleeding with clots ✅
d) No pain
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