8 Types of Abnormal Menstruation: Causes, Symptoms, and Management

Introduction

Period is a normal part of a woman’s reproductive cycle, and many women experience occasional changes. But what happens when they become irregular, heavy, light, or even disappear? It can be frustrating and might even panic you, right? But worry not, as in this article, we’ll discuss eight types of abnormal menstruation, their causes, symptoms, and how to manage them.

What Is Abnormal Menstruation?

Abnormal menstruation refers to changes in your menstrual cycle that differ from your usual pattern, such as cycle length, flow intensity, or unexpected symptoms. These can include irregular periods, unusual heavy or light bleeding, or significant discomfort during menstruation.

8 Types of Abnormal Menstruation

Types of abnormal menstruation include:

• • Metrorrhagia: Bleeding between menstrual periods
  • Oligomenorrhea: Infrequent periods with cycles longer than 35 days
  • Amenorrhea: Missed periods for three or more months
  • Menorrhagia: Excessively heavy or prolonged menstrual bleeding
  • Dysmenorrhea: Painful menstrual cramps affecting daily activities

• • Hypomenorrhea: Unusually light or short menstrual bleeding

• • Polymenorrhea: Frequent periods occurring in cycles shorter than 21 days

• • Hypermenorrhea: Extremely heavy menstrual bleeding lasting more than seven days

1. Metrorrhagia (Bleeding Between Periods)

Metrorrhagia is a condition that happens when you experience unexpected bleeding between your periods. The bleeding can be light to heavy and occurs unexpectedly. 

Causes

• • Hormonal Imbalances: Fluctuations can disrupt the normal menstrual cycle, leading to irregular bleeding
  • Uterine Fibroids or Polyps: Noncancerous growths can lead to abnormal bleeding patterns
  • Infections: Pelvic inflammatory disease(PID) or sexually transmitted infections(STIs) can lead to inflammation and cause bleeding
  • Certain Medications: Blood thinners or hormonal contraceptives like Birth control pills or IUDs might contribute

Symptoms

• • Light Spotting or heavy bleeding between periods

• • Lower abdominal pain or discomfort

• • Fatigue or dizziness if bleeding is heavy

• • Unusual vaginal discharge if an infection is present

3. Amenorrhea (Absence of Period)

Amenorrhea is a medical condition that happens before puberty and when you miss your period for three or more months in a row (you’re not pregnant or breastfeeding). It is not a disease but indicates underlying health issues which may need medical attention. There are two kinds:  primary and secondary amenorrhea.

Primary Amenorrhea: This happens when a girl hasn’t had her first period by age 15 or 16 if other normal physical development has not occurred. If the individual has also not developed secondary sexual characteristics by age 13, this is a more severe form of primary amenorrhea. It might be because of genetics,  hormones, or problems with how your reproductive system is developed.

Secondary Amenorrhea: This occurs when a woman previously had regular periods but then stops menstruating for three months or more. Common causes include issues with estrogen levels such as stress, illness, weight loss, physical activities, hormonal changes, or some medical conditions.

Causes

• • Hormonal Imbalances: Polycystic Ovary Syndrome (PCOS), thyroid disorders, or low estrogen levels can disrupt hormone levels

• • Excessive Exercise or Stress: Intense physical activity, significant weight loss, and emotional stress can affect hormone production that can stop periods

• • Chronic Illnesses or Medications: Certain illnesses like diabetes and celiac disease, as well as medicines, can affect menstrual cycles

• • Eating disorder: Severe weight loss due to eating disorders like anorexia nervosa can lead to amenorrhea by disrupting hormone production necessary for ovulation and menstruation

Symptoms

• • No menstrual bleeding for several months

• • Changes in breast size and Possible milky nipple discharge

• • Hair loss or excessive facial hair growth(common in PCOS cases)

• • Headaches or vision changes (if caused by hormonal issues)

• • Hot flashes or night sweats (if related to menopause or hormonal disorders)

4. Menorrhagia (Heavy Periods)

Menorrhagia involves excessively heavy or prolonged menstrual bleeding lasting for more than seven days or the usual period days. This abnormal bleeding can significantly impact daily life and may indicate an underlying condition.

Causes

• • Hormonal fluctuations: High estrogen and low progesterone levels can cause the endometrium to develop excessively and can disrupt the normal menstrual cycle

• • Endometriosis: A condition where the tissue resembling the uterine lining begins to develop outside the uterus, leading to painful and heavy periods

• • Uterine Fibroids: These tumors can cause heavier bleeding than regular periods

• • Bleeding Disorders: Conditions like von Willebrand disease can lead to heavy menstrual flow

• • Medications: Certain anti-inflammatory drugs can increase bleeding risk during menstruation

Symptoms

• • Need to change pads or tampons every hour

• • Periods lasting longer than seven days

• • Passing large blood clots. (about quarter-sized)

• • Fatigue or shortness of breath(if anemia develops)

5. Dysmenorrhea (Painful Periods)

Dysmenorrhea is commonly known as menstrual cramps that interfere with daily life. It affects a significant portion of women worldwide and is mainly of two main types: primary and secondary.

Primary Dysmenorrhea: This occurs without any identifiable underlying medical condition. It typically begins after the first menstrual period and follows a cyclic pattern, peaking on the first day of menstruation. The pain is usually felt in the lower abdomen or pelvis but can radiate to the back and thighs.

Secondary Dysmenorrhea: This arises from an underlying medical issue such as endometriosis, uterine fibroids, or pelvic inflammatory disease. It may develop at any age after the first menstrual period.

Causes

• • High Prostaglandin Levels: These chemicals cause intense uterine contractions

• • Endometriosis or fibroids: Tissue similar to the uterine lining grows outside the uterus, causing pain

• • Cervical stenosis: having a narrow cervical opening can make period blood flow more painful

• • Adenomyosis: The uterine lining breaks through the muscle wall of the uterus

• • Pelvic infections: PID or STIs can lead to inflammation and cramping

Symptoms

• • Severe cramps in the lower abdomen or pelvic bone

• • Pain starting from lower back to thighs

• • Nausea and vomiting or diarrhea

• • Headaches or dizziness

6. Hypomenorrhea (Light Periods)

Hypomenorrhea is a menstrual disorder that refers to unusually light or lasts only a day or two of menstrual bleeding. This condition can be expected for some women, especially if it’s genetic or due to hormonal contraception use. However, it may also indicate underlying health issues that need medical evaluation.

Causes

• • Contraceptives: Some birth control methods, like oral contraceptive pills and hormonal IUDs, can lighten periods

• • Scarring of the Uterus: Uterine scarring from infections or surgeries can reduce menstrual flow

• • Asherman’s Syndrome: Intrauterine adhesions can cause reduced menstrual flow by decreasing the surface area available for bleeding

• • Chronic Pelvic Inflammatory Disease Can lead to lighter periods

• • PCOS or Thyroid Disorders: These conditions can reduce ovulation and lead to less bleeding

Symptoms

• • Very light or short bleeding

• • Missed periods (sometimes confused with amenorrhea)

• • Difficulty getting pregnant

• • Changes in cervical mucus

7. Polymenorrhea (Frequent Bleeding)

Polymenorrhea occurs when your period cycle is shorter than 21-35 days; periods come too often. This condition results in more frequent periods than usual, with normal menstrual flow volume but shorter intervals between cycles.

Causes

• • Hormonal imbalances: conditions such as high prolactin levels and low progesterone levels can lead to abnormal menstruation

• • Anovulation: Failure to ovulate can result in shorter cycles

• • Thyroid disorders: Disrupts hormonal balances that regulate menstrual cycle, leading to more frequent periods

• • Stress and Life Changes: Stressful events can disrupt hormonal balance, leading to irregularities in menstrual cycles

• • Perimenopause: disrupts normal menstrual cycle, leading to more frequent periods due to irregular ovulation 

Symptoms

• • Periods occurring too frequently(In less than 21 days)

• • Light to heavy flow

• • Short luteal phase (which may affect fertility)

• • Loss of interest in sexual activity

• • Fatigue, anemia from frequent blood loss

8. Hypermenorrhea (Excessive Menstrual Bleeding)

Hypermenorrhea is similar to menorrhagia but even heavier and prolonged menstrual bleeding. It involves significant blood loss during menstruation, often lasting more than seven days, and requires changing pads or tampons in less than an hour.

Causes

• • Fibroids or polyps: These growths can disrupt normal menstrual flow by increasing the surface area for bleeding

• • Blood clotting disorders: Conditions affecting clotting ability may contribute to heavier menstrual flows

• • Hormonal imbalances: Imbalances between estrogen and progesterone levels can lead to heavy bleeding

• • Other Medical Conditions: Certain diseases like thyroid disorders can also impact menstrual regularity and heaviness

Symptoms

• • Periods lasting more than 7 days

• • heavy flow that soaks through the pad or tampon within an hour

• • Extreme blood loss leading to anemia

• • Severe cramps and fatigue

• • Weakness or dizziness

• • Pale skin due to low iron levels

When to see a Doctor?

Sometimes, period changes are routine, but it’s good to consult a healthcare provider if something feels off. You should see a doctor if:

• You miss your period for three months or more, and you’re not pregnant or breastfeeding.

• Your period is super heavy, soaking through a pad or tampon every hour.

• Your periods last longer than seven days regularly.

• You have extreme cramps that make it hard to do daily activities.

• You bleed between periods or after menopause.

• You don’t know why your cycle has been irregular for a long time.

• You feel weak, dizzy, or tired (this could be anemia from too much blood loss).

• You notice other unusual symptoms, like severe headaches or extra hair growth on the face.

If you notice any of these symptoms, do not ignore them. Seek medical help as soon as possible for proper diagnosis and treatment. Early intervention can help manage underlying conditions and prevent complications.