WOMEN: MENSTRUAL PROBLEMS (BLEEDING, DYSMENORRHOEA, HEADACHE)

Posted on Thursday, March 12th, 2009 at 8:34 am

Bleeding between periods

Except for slight spotting at the time of ovulation, all bleeding between periods (and after sex) needs investigation. The most important causes to rule out are cancer of the endometrium or cervix. Other causes include infections and other inflammations of the cervix and uterus, polyps of the uterus and cervix, and hormonal disorders. Ectopic pregnancy and incomplete or missed abortion must be excluded if there is unexpected bleeding and any possibility of pregnancy.

Painful periods (dysmenorrhoea)

There are two types of period pain.

• Primary dysmenorrhea occurs in young women who have normal reproductive organs.

• Secondary dysmenorrhea is menstrual pain that develops in women who have previously had painless periods. It is always a symptom of problems in the reproductive organs.

The most common causes are infection of the pelvic organs (PID) and endometriosis. Less common causes include uterine fibroids and polyps, and uterine adenomyosis.

The cause of secondary dysmenorrhoea always needs to be investigated. Periods become painless when the cause is eliminated.

Menstrual headache

Some women get a particular type of headache with periods. It often starts half a day or so before bleeding and may last for two or three days. This headache is often described as a dull, tight pain around the front and sides of the head. It may be partly relieved by mild painkillers such as aspirin and paracetamol, but it returns after their effect wears off. Menstrual headache can occur both in natural cycles and on the Pill.

This headache is the result of the sudden fall in oestrogen in the blood at the end of the cycle. It can be prevented by taking a very small dose of oestrogen for three or four days starting the day before menstruation is due, or after the last active Pill is taken.

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