Authored by

DR. NISHITA RANKAMD (Gynaecology)Consultant Obstetrician & Gynaecologist

The Anomalies Of Menstruation

Nearly 44% of all girls are unaware of what is happening to them when they start their first period. Understandably, they are unable to differentiate between normal menstrual cycles and the anomalies related to their menses. In the manner that abnormal blood pressure, heart rate, or respiratory rate may be pointers to diagnosing potentially grave health conditions, information on abnormal menstrual patterns in adolescence may improve early identification of potential health concerns for adulthood.

+ Understanding Menstrual Health

A regular monthly discharge of blood and mucosal tissue from the inner lining of the uterus through the vagina marks the onset of pubertal growth in women, beginning at the age of 12 or 15. Menstrual cycles are often irregular during adolescence , with some females bleeding for 2-7 days during their first menses Short cycles of less than 20-days or long cycles of more than 45-days may occur by the third year after menarche. In adults, 60ÔÇô80% of menstrual cycles are 21ÔÇô34 days long is typical. Between the ages of 45 to 55, menstruation becomes less regular and eventually stops. The end of fertility period in a woman is called menopause. While some women breeze through their menstruation without any pain or discomfort, some others experience uncomfortable symptoms.

+ Physical & Emotional Symptoms of Menstruation

1. Severe cramps known as Dysmenorrhea 2. Heavy Bleeding during the first and the second day of their menstruation 3. Unpredictable timing and variable amount of flow called Abnormal Uterine Bleeding caused by ovulatory dysfunction 4. Excessive discharge of menstrual fluid leads to iron deficiency causing Anemia 5. Grounds for Gastrointestinal Diseases 6.Emotional ups and downs like extreme mood swings, crying spells, mood disorders , anxiety and depression. This is a part of the Premenstrual Syndrome (PMS), and is estimated to occur in 30 to 40% of women. However, when the symptoms of depression get severe, they can cause Premenstrual Dysphoric Disorder or PMDD, which is characterized by aggression, feeling of hopelessness, either oversleeping or insomnia and suicidal thoughts.

+ Menstrual Abnormalities requiring Evaluation

As recommended by the American College of Obstetricians and Gynecologists (ACOG)1. Girls with more than 90 days between periods 2. Menstrual periods that have not started by 14-15 years of age with signs of hirsutism3. Menses that last for more than 7 days 4. Periods that require frequent pad or tampon changes (soaking more than one every 1-2 hours). 5. Menstrual periods that either occur more frequently than every 21 days or less frequently than every 45 days 6. Menses associated with heavy bleeding and a history of excessive bruising or bleeding or a family history of bleeding disorder


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