Menstrual Bleeding - Gynecology

What is Menstrual Bleeding?

Menstrual bleeding, also known as menstruation or a period, is the monthly shedding of the uterine lining in individuals with a uterus. It is a natural part of the reproductive cycle and typically occurs every 21 to 35 days, lasting between 2 and 7 days. Menstrual bleeding is a sign that the body is functioning normally and is capable of reproduction.

What Causes Menstrual Bleeding?

Menstrual bleeding is caused by the hormonal changes that regulate the menstrual cycle. During each cycle, the body prepares for a potential pregnancy by thickening the lining of the uterus. If pregnancy does not occur, the levels of estrogen and progesterone decrease, causing the uterine lining to shed and exit the body through the vagina. This process is known as menstruation.

What is Normal Menstrual Bleeding?

Normal menstrual bleeding varies from person to person but generally includes:
- A cycle length of 21 to 35 days
- Bleeding duration of 2 to 7 days
- Blood loss of about 30 to 40 milliliters (2 to 3 tablespoons)

What are Common Menstrual Disorders?

Common menstrual disorders include:
- Dysmenorrhea: Painful periods or menstrual cramps
- Menorrhagia: Heavy menstrual bleeding
- Oligomenorrhea: Infrequent menstrual periods
- Amenorrhea: Absence of menstrual periods
- Premenstrual Syndrome (PMS): A group of symptoms that occur before the onset of menstruation

What Causes Abnormal Menstrual Bleeding?

Abnormal menstrual bleeding can be caused by a variety of factors, including:
- Hormonal imbalances: Imbalances in estrogen and progesterone can affect the menstrual cycle.
- Uterine fibroids: Noncancerous growths in the uterus that can cause heavy or prolonged bleeding.
- Polycystic Ovary Syndrome (PCOS): A hormonal disorder that can cause irregular periods and excessive bleeding.
- Endometriosis: A condition where the tissue that normally lines the uterus grows outside of it, leading to painful and heavy periods.
- Thyroid disorders: Both hypothyroidism and hyperthyroidism can affect the menstrual cycle.

When Should You See a Gynecologist?

You should see a gynecologist if you experience:
- Extremely heavy bleeding (soaking through a pad or tampon every hour)
- Periods that last longer than 7 days
- Severe pain that interferes with daily activities
- Irregular periods or missed periods
- Symptoms of anemia, such as fatigue, dizziness, or shortness of breath

How is Abnormal Menstrual Bleeding Diagnosed?

To diagnose abnormal menstrual bleeding, a gynecologist may perform:
- A physical examination, including a pelvic exam
- Blood tests to check for hormonal imbalances or other underlying conditions
- Ultrasound to visualize the uterus and ovaries
- Endometrial biopsy to sample the uterine lining for abnormalities
- Hysteroscopy to look inside the uterus with a camera

What are the Treatment Options?

Treatment for abnormal menstrual bleeding depends on the underlying cause and may include:
- Hormonal therapy: Birth control pills, hormone-releasing IUDs, or other hormonal medications
- Non-hormonal medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) or tranexamic acid
- Surgical procedures: Options like endometrial ablation, myomectomy, or hysterectomy
- Lifestyle changes: Maintaining a healthy weight, managing stress, and following a balanced diet

In conclusion, menstrual bleeding is a natural process that signifies normal reproductive health, but abnormal bleeding patterns warrant medical attention. Understanding the causes, symptoms, and treatment options can help individuals manage their menstrual health effectively.