Menstrual disorders frequently affect the quality of life of adolescents and young adult women and can be indicators of serious underlying problems. Menstrual disorders are most frequently gynaecological complaints. Normal menstrual cycle is a tightly coordinated cycle and stimulatory and inhibitory effects of hormones that result in a release of single mature oocyte from the pool of hundreds of primodial oocytes. There are two stages of menstrual cycle: Follicular phase (proliferative phase) and Luteal phase (secretory phase). The Luteal phase lasts for 12-16 days.

Organs involved in Menstrual Cycle:

• Hypothalamus
• Anterior Pituitary
• Ovary
• Uterus (Endometrium)

What are Menstrual Disorders?  

Menstrual disorders is a vague term, it includes:

• Bleeding at unexpected time
• Abnormal Uterine bleeding
• Heavy bleeding
• Too little bleeding
• Too often bleeding
• Intermenstrual bleeding
• No bleeding at all (Amenorrhea)
• Premenstrual syndrome
• Dysmenorrhoea (Painful menstruation)

Difference between Normal and Abnormal Menstruation:  

To understand the difference between normal and abnormal menstrual cycles we have to know what normal menstruation is. Details such as duration of menstrual blood, loss in 2-7 days, etc are important. Average 5 days cycle length in 5-9 % cases is 23-39.4 days and the average is 29.6 days. Amount of blood loss is 80ml/cycle, approximately bleeding is more than 7 days in excessive bleeding.

Abnormal menstruation is bleeding at any time outside the normal menstruation and any variation outside the defined limit. The causes can be central, intermediate or end organ and physiological also. 50-75% of menstrual flow is blood. The rest is made up of the fragments of endometrium tissue and mucus. Endometrium contains large amount of fibrin degradation products. When blood loss is excessive, lytic substances that are rapidly consumed leads to the prevalence of clots in menstrual flow.

What is Abnormal Uterine Bleeding?

 The duration is >7 days or flow more than > days, or occurs more frequently than 21 or occurs more than 90 days apart or inter-menstrual or post coital bleeding. There are different terminologies for different type of bleeding:

• Menorrhagia: Excessive flow during periods occurring at regular intervals.
• Oligomenorrhea: Menstrual bleeding occurs after more than 35 days and flow is scanty
• Metrorrhagia: Uterine bleeding occurring at irregular interval
• Polymenorrhea: Uterine bleeding occurring after 21 days or less after regular intervals
• Intermenstrual bleeding: Bleeding cycle which is occurring at any time
• Amenorrhea: No bleeding at all

Dysmenorrhoea: Blood flow is excess and associated with pain. There are cramps in lower abdomen.