Because of fluctuations in hormone levels during the menstrual cycle,
there may be various physical changes in most of the women. This
includes muscle contractions of the uterus (menstrual cramping) that can
precede or accompany menstruation. Water retention, changes in sex
drive, fatigue, breast tenderness, or nausea may be there in few cases.
Breast swelling and discomfort may be caused by water retention during
A healthy diet, reduced consumption of salt, caffeine
and alcohol, and regular exercise may be effective for women in
controlling some symptoms.
Painful cramps, also known
as dysmenorrhea is experienced by many women during menstruation. Pain
results from ischemia and muscle contractions. When spiral arteries in
the secretory endometrium constrict, the uterine lining slough off. The
myometrium contracts spasmodically in order to push the menstrual fluid
through the cervix and out of the vagina. The contractions are mediated
by a release of prostaglandins.
Dysmenorrhea can be primary or secondary.
excess of prostaglandin release results in painful menstrual cramps
that is known as primary dysmenorrhea. Non-steroidal anti-inflammatory
drugs (NSAIDs) and hormonal contraceptives can be used for the
treatment. NSAIDs prevent prostaglandin production. With long-term
treatment, hormonal birth control reduces the amount of uterine
fluid/tissue expelled from the uterus resulting in shorter, less painful
Risk factors for primary dysmenorrhea include: early
age at menarche, long or heavy menstrual periods, smoking, and a family
history of dysmenorrhea. Regular physical activity may limit the
severity of uterine cramps.
When menstruation pain is a secondary
cause to another disorder such as endometriosis, uterine fibroids, and
uterine adenomyosis is called as secondary dysmenorrhea.
malformations, intrauterine devices, certain cancers, and pelvic
infections can also be a cause of secondary dysmenorrhea. Symptoms
include pain spreading to hips, lower back and thighs, nausea, and
frequent diarrhea or constipation. If the pain lasts longer than the
first few days of the period, or does not get relieved by the use of
non-steroidal anti-inflammatory drugs (NSAIDs) or hormonal
contraceptives, women should be evaluated for secondary causes of
When severe pelvic pain and bleeding suddenly occur or
worsen during a cycle, the woman should be evaluated for ectopic
pregnancy as it may be life threatening.
fluid contains some blood, as well as cervical mucus, vaginal
secretions, and endometrial tissue. Menstrual fluid is reddish-brown, a
slightly darker color than venous blood. Menstrual fluid is harmless and
no toxins are released in menstrual flow. About half of menstrual fluid
is blood and this blood contains sodium, calcium, phosphate, iron, and
chloride, the extent of which depends on the woman. Vaginal fluids in
menses mainly contribute water, common electrolytes, organ moieties, and
at least 14 proteins, including glycoproteins.
Blood clots during
menstruation that appear as clumps of blood may look like tissue which
can be confirmed by examination under a microscope if it was
endometrial tissue or pregnancy tissue. The amount of iron lost in
menstrual fluid is relatively small for most women. However, heavy
menstrual bleeding, occurring monthly, can result in anemia.
Mood and behavior:
one or two weeks before the period, some women experience emotional
disturbances which stops soon after the period has started. Symptoms may
include mental tension, irritability, mood swings, problems with
concentration and memory. There may also be depression or anxiety.
Extreme psychological stress can also result in periods stopping.
are several ways that someone's menstrual cycle can differ from the
normal. The underlying cause should be identified and treated
accordingly. These may include:
- Infrequent periods
- Short or extremely light periods
- Too frequent periods ,defined as more frequently than every 21 days
heavy or long periods, for example soaking a sanitary napkin or tampon
every hour or so, or menstruating for longer than 7 days
- Extremely painful periods
- Breakthrough bleeding also called spotting between periods which is normal in many females
- Absent periods
uterine bleeding is a hormonally caused bleeding abnormality which
occurs in premenopausal women who do not ovulate normally.
these bleeding abnormalities need medical attention. They may indicate
hormone imbalances, uterine fibroids, or other health problems.