Gynaecological problems often present with menstrual abnormalities.
Abnormal vaginal bleeding is one of the most common presenting symptoms for a gynaecologist and always warrants investigations to determine the underlying cause of this troublesome and worrying problem. After a thorough history and examination, the next step will often include a pelvic ultrasound scan to find the cause, which may include conditions such as polyps, fibroids, endometriosis, cervical abnormalities and imbalances.
Menstrual disorders
Menstrual disorders occur if the cycle is less than 21 days or more than 5 weeks. Also if the period of menstruation is more than 7 days and becomes worrisome, or if you have any bleeding in between cycles. Some of the common menstrual disorders and their symptoms and line of treatments are given below.
Periods with heavy bleeding
Some women could experience heavy bleeding during menstruation days. This is more common during the two extremes of reproductive life, puberty and premenopausal age. If it is interfering with your daily life, further investigations and treatment are required. The causes could be hormonal, polycystic ovarian syndrome, adenomyosis, polyps or fibroids.
Irregular bleeding
Abnormal vaginal bleeding between periods is also called intermenstrual bleeding or spotting. When bleeding occurs between normal periods, there are many possible causes. While some causes may be easy to treat, others can indicate a serious underlying condition.
Missing or absent periods
There are a number of reasons why your periods can stop. The most common ones are pregnancy, stress, sudden weight loss or weight gain, being overweight, menopause, polycystic ovarian syndrome and other conditions like uncontrolled diabetes and underactive thyroid.
Post coital bleeding
Post-coital bleeding consists of spotting or bleeding that is not related to menstruation and occurs during or after sexual intercourse. Bleeding after sex can be due to conditions such as infection, pelvic inflammatory disease (PID), vaginal dryness, trauma, cervical abnormalities and polyps.
Spotting
Spotting is defined as light vaginal bleeding that happens outside of your regular periods. Typically, spotting involves small amounts of blood. You may notice it on toilet paper, or in your underwear. This is a common symptom and may be due to a hormonal imbalance or structural abnormalities such as endometrial polyps.
Painful periods
During menstruation, some lower abdomen pain, cramps and discomfort are common for the first 2 to 3 days. The cramps could spread to the lower back and the thighs.
Some women experience more severe pain, which may not be manageable with simple treatments like heat pads or standard painkillers. If the pain interferes with your day to day life, you may require further investigation like an ultrasound scan and hormonal treatment.
Post menopausal bleeding
Post menopausal bleeding is said to occur when you are in the menopause, frequently associated with a serious underlying problem, and needs prompt investigations. It may occur in women who are on HRT, but is especially worrying in women who are not taking any hormonal treatments. It can be associated with vaginal atrophy (thinning of the vaginal walls) which is an innocent condition, or other more serious conditions such as an underlying cancer.