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Menstrual problems

  1. Irregular menstrual patterns, too much or too little blood loss, no menstruation, excruciating pains during menstruation and even ovulation, severe mood disturbances in the week before the menstrual period � The list of problems surrounding menstruation does not seem to stop. In most cases there is nothing serious at all, and even the most severe symptom is just the result of a minor disturbance in the hormone balance. What are the most common complaints?

The normal menstrual cycle

  1. Menstruation is the bleeding caused by detachment and expulsion of the endometrium from the uterus. It is the result of a combination of hormones that are produced by various organs. Normal cycle length is around 28 days, although there can be wide individual differences. The first half of the hormone cycle starts with egg cells maturing in the ovaries, and those eggs, called follicles, produce estrogen. This hormone causes the growth of the endometrium.

Menstrual irregularities

  1. Oligomenorrhea is the medical term for irregular periods. If a woman has fewer than the usual eleven to thirteen menstrual periods per year and therefore has a cycle that lasts longer than about four weeks, this is called irregular in technical terms. However, these are normal and are generally preceded by ovulation. A long cycle duration but regular, for example once every five to nine weeks, often means that ovulation starts with difficulty. Once there has been ovulation, there is always a period after fourteen days. Most often, an irregular cycle occurs in the early years after the first menstrual period, and when the woman reaches menopause (very last menstrual period). The condition is harmless and treatment is usually not necessary unless the woman wants to become pregnant.

No menstruation

  1. Primary Amenorrhea is the term for temporary or permanent absence of menstrual periods. It is called primary amenorrhea when menstruation does not start during puberty. In most cases this is due to a late onset of puberty, but occasionally it may be due to a birth defect in the reproductive or hormonal system.


  1. The absence of menstruation in a woman who previously had a regular cycle is called secondary amenorrhea. This is due to a change in the hormonal balance that controls the release of an egg from an ovary or pregnancy. Disruptions in the hormonal balance can quickly occur, for example due to emotional factors such as arguments or a new job, exhaustion and stress. Sudden weight loss, excessive exercise, certain medication and illness can also be causes. After stopping the contraceptive pill, it is not uncommon for your periods to be absent for several months. Finally, certain pituitary abnormalities are a further possibility of the absence of menstruation, although rarely. Of course, menstruation will stop completely at some point when the woman has reached the end of the menopause, around the age of 50.

Heavy and / or prolonged menstruation

  1. The medical term for heavy periods is menorrhagia. This is the case if menstruation lasts longer than seven days, there are clots and heavy flow. But what is heavy flow? What is a lot for one woman, is nothing special to another woman. Blood loss is generally said to be significant if the clots are more than a few centimeters in size and / or if you have to stay at home to monitor the flow. Usually it is a simple hormone imbalance, but it can also develop with benign growths such as fibroids, polyps, endometriosis, or pelvic inflammatory disease. An IUD can also cause heavy blood loss. Although sometimes frightening, heavy periods are not dangerous in principle.

Painful periods

  1. Painful menstruation is also called dysmenorrhea. A distinction is made between primary dysmenorrhea and secondary dysmenorrhea. What happens is that the uterus contracts to release the mucous membrane.


  1. This form occurs within three years after the start of menstruation and is a result of natural hormonal changes. Period pain is more or less proof that ovulation occurred two weeks before. The pain can be very severe and resemble contractions during childbirth. Usually the phenomenon occurs on the first day of menstruation and to a lesser extent on the second day. The recurring phenomenon may continue until the woman has a child.


  1. If the woman who has been menstruating for some time suddenly has a remarkably painful period, something else could be wrong. The cause may be fibroids, endometriosis or inflammation. In this case, see a doctor. Period pain is in almost all cases described as minimally a nagging pain in the lower abdomen to severe cramps from a clearly contracting uterus. The pain can also be felt in the back, can lead to nausea and even dizziness. Pill use will improve or even take away the pain. A simpler remedy is to take painkillers, paracetamol being preferred as aspirin can increase blood loss.

Premenstrual syndrome

  1. Premenstrual tension occurs in all degrees and manifestations and has a hormonal cause. PMS, as the phenomenon is also called, occurs after ovulation has taken place, then increases up to about seven days before menstruation, remains stable or weakens slightly in the days before menstruation, and disappears completely after menstruation has started. As some women say when they have their period, "As if the fog has lifted." Suddenly they feel a lot better.

Ovulation pain

  1. Ovulation pain or also middle pain can occur two weeks before menstruation when an egg is released by one of the ovaries and some fluid is released into the abdominal cavity. This pain is characteristic and can be accompanied by a range of symptoms. Often it is actually felt in the lower left or right side of the abdomen, it radiates to the back and resembles severe persistent menstrual pain. The pain usually lasts for several hours and comes on suddenly. It can range from mild pain to immense pressure with sharp stitches through the pelvic area. Sometimes the pain occurs a number of cycles at the bottom left, and then again occurs a number of cycles at the bottom right. It can also change every month. Very minor bleeding may occasionally occur. Ovulation pain disappears with the use of the pill because then ovulations no longer take place, although this is a 'horse cure' for a natural event that only occurs once a month.

Other bleeds

  1. Bleeds that are sometimes mistaken for periods but are not include the following. Always consult a doctor in these cases.

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