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Amenorrhea (Stoppage of menstruation)

What is amenorrhea?

Amenorrhea is the medical term for the absence of menstrual periods, either on a permanent or temporary basis. Amenorrhea can be classified as primary or secondary. In primary amenorrhea, menstrual periods have never begun (by age 16), whereas secondary amenorrhea is defined as the absence of menstrual periods for three consecutive.

Primary amenorrhea is most of the time idiopathic (without any perceptable cause) or the cause is most of the time limited to some obstruction or surgical reasons. But in secondary amenorrhea, there are different causes due to the amenorrhea like Pregnancy and Lactation (physiological cause), hypothalamic amenorrhea in this there are different hormonal deficiencies are responsible. Other causes include, extreme weight loss, emotional or physcial stress, rigorous exercise and severe illness. Pre-mature meopause, elevated levels of androgen, and hypo-thyroidism are among the other causes. When a woman would stop taking the oral contraceptive pills, might be without periods for the next 3 months.

Complications if mal-treated or un-treated:

Infertility is a significant complication of amenorrhea for women who desire to become pregnant. Osteopenia (a reduction in bone density) or osteoporosis is a complication of low estrogen levels, which may occur with prolonged amenorrhea. Other than this, amenorrhea due to elevated levels of androgen and hypothyroidism is having its own potent chance of complications.

Present-day conventional treatments are very much limited for the treatment of amenorrhea. For the Primary amenorrhea, there is absolutely no treatment if there is no surgical factor involved. For secondary amenorrhea, the conventional treatment is limited with hormonal replacement therapy or suporting treatment for the underlying disorder that is present. This medications are having only temporary result and is having long-lasting complications.

Dysmenorrhea (Painful menstruation)

What is dysmenorrhoea [painful menstruation]?

Dysmenorrhoea refers to the painful menstrual period. The pain may occur before or during the menstrual period.
There are two types of dysmenorrhea: – primary and secondary dysmenorrhoea.
Primary dysmenorrheal: This is common menstrual cramps and there is no cause or pathology behind these painful periods. These cramps usually begin one to two years after a woman starts getting her periods. Pain starts before or during the periods and stays for 3-4 days.
These pains may stop completely after the woman has her first baby.
Secondary dysmenorrheal: This pain is caused by a disorder in the woman’s reproductive organs such as endometriosis, uterine fibroids, infection; these pain usually begin earlier in the menstrual cycle and last longer than normal menstrual cramps.

Symptoms of dysmenorrhoea:

• Aching pain in the lower abdomen, back and thighs.
• Feeling of contractions and pressure in abdomen.
• Pain may be associated with nausea, vomiting and loose stools.

Common causes of dysmenorrhoea:

Menstrual cramps are caused by contractions in the uterus. If uterus contracts too strong, it can press against the nearby blood vessels and thus the pain results when part of a muscle briefly loses its supply of oxygen.

Causes of dysmenorrhoea due to disease in reproductive organs of a woman:

• Pelvic inflammatory disease: is infection of uterus and may spread to other reproductive organs.
• Endometriosis: in this condition the tissue lining the uterus found outside the uterus.
• Tumors or fibroids on the inner wall of the uterus.
• Stenosis –narrowing of the cervix.
• Adenomyosis: in which lining of the uterus grows into the muscle of the uterus.

Complications of dysmenorrhoea:

• Dysmenorrhoea can interfere in daily routine activities such as schoolwork and social activity.
• Certain disease can cause complications for example endometriosis can cause
• Pelvic inflammatory disease can scar fallopian tubes increasing the risk of ectopic pregnancy. It can also cause fever ,malaise, and weakness .

Dos and don’ts of dysmenorrhoea:

• Apply hot water pad to the thighs ,back or lower abdomen or take warm water bath cause great relief in pain and congestion.
• Perform Exercise like yoga regularly it is also helpful in painful menstruation.
• Cut down use of spicy, salty, and sweet foods.
• Avoid smoking and alcohol.
• Avoid tea, coffee coke, chocolate during periods.
• Try not to take food at one stent.
• Food rich in calcium like broccoli, milk, cabbage, and yogurt can help to fight muscle spasms.
• Follow active and healthy life style.

Menorrhegia or Metrorrhegia (Heavy or irregular- menstruation)

What is Abnormal menstruation ?

Abnormal menstruation is a flow of blood from vagina that occurs either at the wrong time during the month or in inappropriate amounts. Irregular menstrual bleeding (metrorrhegia), excessive menstrual bleeding (menorrhegia) and scanty or very less menstrual bleeding (oligomenorrhea), these three types of abnormal menstrual bleedings are there.

Causes of different types of abnormal menstruation:

Menorrhegia (excessive vaginal bleeding): The common causes of metrorrhegia are uterine fibroid, endometrial polyps, adenomyosis, intrauterine devices (IUD’s), and hypothyroidism. Certain conventional medicines are there which can cause excessive of blood clotting that might cause metrorrhegia.

Metrorrhegia(irregular vaginal bleeding): The common causes of metrorrhegia are growths in the cervix, such as cervical polyps, infections of the uterus (endometritis) and use of birth control pills (oral contraceptives). Ladies at the perimenopausal age may develop irregular vaginal bleeding.
Perimenopause is the time period approaching the menopausal transition. It is often characterized by irregular menstrual cycles, including menstrual periods at irregular intervals and variations in the amount of blood flow. Menstrual irregularities may precede the onset of true menopause (defined as the absence of periods for one year) by several years.
Every woman who thinks she has an irregular menstrual bleeding pattern should think carefully about the specific characteristics of her vaginal bleeding in order to help her doctor evaluate her particular situation. Her doctor will require the details of her menstrual history. Each category of menstrual disturbance has a particular list of causes, necessary testing, and treatment.

Excessively heavy menstrual bleeding (menorrhagia)

Excessively heavy menstrual bleeding, called menorrhagia, is menstrual bleeding of greater than 5 tablespoons per month. This condition occurs in about 10% of women. The most common pattern of menorrhagia is excessive bleeding that occurs in regular menstrual cycles and with normal ovulation.

There are several important reasons that menorrhagia should be evaluated by a doctor. First, menorrhagia can cause a woman substantial emotional distress and physical symptoms, such as severe cramping . Second, the blood loss can be so severe that it causes a dangerously lowered blood count (anemia), which can lead to medical complications and symptoms such as dizziness and fainting. Third, there can be dangerous causes of menorrhagia that require more urgent treatment.

Ovarian Cyst (PCOS)

What is poly cystic ovarian syndrome pcos?

Pcos is most common hormonal disorder among the women of reproductive age .
women with pcos have enlarged ovaries that contains fluid filled cysts in the ovaries as the name suggests.these cysts Can lead to hormonal imbalance.
Pcos can typically affect women’s menstrual periods and ability to have children.
Every 6th girl out of 10 girls do not have regular menstrual periods and day by day it is getting worse.

Causes of pcos :

1. Genetic cause : if mother and sister is having similar disease you are most likely to suffer .
2. Hormonal imbalance : main underlying cause behind pcos is hormonal imbalance … in .pcos patients ovaries will produce more androgens than normal and high level of androgens affect development and release of eggs during ovulation.
3. Excess insulin : many patient having pcos have too much insulin in their bodies because they have problems using it and excess insulin increase production of androgen which can lead to obesity, abnormal facial hair growth and acne .

Symptoms of pcos :

1. Irregular or absent and scanty menstrual cycle.
2. Infertility –in most of the cases of pcos
3. Unexplained weight gain–espcially weight around waist .
4. Acne formations .
5. Abnormal hair growth face, chest, stomach.
6. Thinning of hair or male pattern baldness.
7. Lower abdomen pain.

Complication of pcos :

Having pcod makes these complications more likely especially if obesity is also a symptom:
• High blood pressure .
• Infertility.
• Type 2 diabetes.
• High cholesterol and abnormal lipids level such as high triglycerides and low HDL [good cholesterol].
• Increased risk of heart disease.
• Abnormal uterine bleeding.
• Anxiety and depression .
• Endometrial cancer due to continued exposure of high level of oestrogen.


By just loosing 5-10 % of body weight you can get you normal menstrual cycle, regulate blood sugar level.

• Always have your regular and healthy meals. Your meals should have vegetables, fruits, whole grain food ,lean meats, milk, low fat cheese ,whey protein .
• Always maintain a healthy weight and follow regular exercise plan.
• Have adequate sleep.
• Keep record of the menstrual period.


• Don’t skip meals eat three major meals with snakes in between.
• Avoid excess sugar ,salt, bread, pasta, cereal, rice, caffeine. fast food [chips ,cookies and candies] sugary drinks like juices and soda.
• Avoid smoking and alchol .
• Avoid soya as it mimics estrogen and can imbalance the hormone level.



What is fibroadenoma ?

Fibroadenoma is most common non cancerous tumor of the breast. It is most common tumor in women in their 20s and 30s . they are made up of breast gland tissue and connective tissue.

Fibroadenomas are round and have borders that are distinct from the surrounding breast tissue. They often feel like marble within the breast. You can move them under the breast as they are firm but not tender.

A woman can have one or more fibroadenoma and can affect one or both breast.

Cause of fibroadenoma :

Though exact cause is unknown but common casues are :

Reproductive hormone –estrogen in child bearing age plays important role in growth of this tumor .

Oral contraceptive pills –these female hormones combination pills can cause fibroadenoma breast.
Hormone replacement therapy -in few cases of menopause HRT may lead to fibroadenoma formation.

Symptoms of fibroadenoma :

• Fibroadenomas are generally painless. But pain may be there before and during the periods. And subsides after periods .
• They are firm, round easily movable under the skin that is why they are also called “breast mouse”.
• They may grow in size especially during pregnancy .
• They have well defined edges and smooth shape in most of the cases .

Complication of fibroadenoma :

In most of the cases fibroadenoma is harmless but complex fibroadenomas may increase the risk of cancer.

Psychological issues : though this disease is harmless but some times due to fear of cancer these patients may be anxious and can have depression .

Difference between breast cancer and fibroadenoma :

Fibroadenoma tumor is harmless , smooth ,more mobile under breast tissue .
Affects women below 30 years ,tumor may appear and disappear it generally dosnt cause any disfigurement of breast.

Breast cancer is more common in women above 35 yrs …lump in breast should be investigated with FNAC AND MAMOGRAM.

Cancerous tumor is more harder and attached and fixed to the surrounding tissues. Patient may present with dimpling,puckering of overlying skin ,nipple retraction,discharge through the nipple . Cancer is painless in most of the cases .

females with these symptoms should visit physician for further check-ups.