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Many women experience menstrual cycles that may not be “regular.” There are some reasons that can be pinpointed as to why this may occur.
What happens during the menstrual cycle?
Normal menstrual rhythm and cycling involves complex interactions between areas of the brain, the ovaries, and the uterus.
Regions of the brain stimulate the ovary to function. The ovary produces the hormone estrogen, which signals growth and thickening of the endometrium (the lining of the uterus). An egg is released from the ovary and moves into one of the fallopian tubes. The ovary also produces the hormone progesterone, which stops the growth of the endometrium. If the egg is not fertilized, the hormone levels decrease, resulting in the shedding of the uterine lining – which is the menstrual flow.
Many factors can interfere with the menstrual process, causing it to be “irregular:”
- The age of a woman can influence how the brain stimulates the ovary, and whether or not the ovary can respond.
- The ovary may not cycle properly. It is ovulation (which is the production of an egg) that results in the proper rhythm of production and secretion of these hormones.
- The uterus itself may have muscle growths, or changes in the glandular lining, which can alter regularity.
- Also, issues such as infection, pregnancy, blood clotting/bleeding abnormalities, and other illnesses can also interfere with menstrual rhythm.
Is it normal to have pain during menstruation?
Mild cramping in the lower abdomen or pain in the lower back is normal. Usually, exercising or placing a heating pad or hot water bottle on your stomach helps with mild cramping.
What is Dysmenorrhea?
If you suffer from severe cramps, nausea, or pain so intense that it keeps you from your usual daily activities, you may suffer from dysmenorrhea. Dysmenorrhea is defined as menstrual periods that are accompanied by severe pain in the lower abdomen or pelvis region that is either extremely sharp or dull, aching pain. This is not uncommon: painful menstruation affects approximately 50% of menstruating women, and 10% are incapacitated for up to 3 days. Menstrual cramps can dramatically improve with physical therapy.
What is Amenorrhea?
Amenorrhea is when a period never starts or a menstrual cycle stops completely. You should see your doctor if you have not started having periods by age 15 years or if you have not had a period for 3 months.
What can cause a missed period?
The most common reason is pregnancy. Other reasons you might miss your period include the following:
• Sudden change in weight
• Extreme exercise
• Hormone problems
• Taking certain medications
In summary, regular and predictable menstrual rhythm is a complicated process involving several factors. Problems in a number of possible areas that involve the reproductive system can all result in menstrual irregularities. Diagnosis can, at times, be complicated.
Your doctor may choose to use ultrasound evaluation, laboratory evaluation, and history with physical exam to fully evaluate your unique symptoms.
Dr. Beth Helgerson is an Obstetrician/Gynecologist at the Appleton and Waupaca locations of Women’s Care of Wisconsin. Contact Dr. Helgerson at 920-729-7105 or meet her here.
About Women’s Care of Wisconsin
The physicians at Women’s Care of Wisconsin are devoted to you and your health. That means having the most advanced techniques, up-to-date educational information and a compassionate, caring staff. Our providers offer a well-rounded approach to your OB/GYN care, one that meets both your physical and emotional needs throughout every phase of your life. We call it our Circle of Care. From adolescence through menopause and beyond, you can depend on us. Meet our providers and learn more about gynecology, pregnancy care, midwifery services, infertility, procedures and surgery, incontinence, osteoporosis, menopause management and more at www.womenscareofwi.com.