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menstrual disorders

The menstrual cycle is an extremely precise process. In order for the process to run correctly, specific events must happen at exactly the right moment and in exactly the right way. Any disruption of the cycle can reduce fertility. A regular cycle, varying from between 26 to 36 days, is usually associated with regular ovulation.

  • abnormal menstrual pattern
  • abnormal (heavy or lengthy) menstruations
  • absence of menstruations (amenorrhoea)

abnormal menstrual pattern

There are a number of different types of menstrual (bleeding) disorders. Women may experience one or multiple disorders. The absence of, or irregularity (too little) in menstruation can indicate an ovulation problem as the cause of the female infertility. Any women with very irregular bleeding should consult their GP/gynaecologist in order to get to the root of the problem sooner rather than later, particularly if they wish to have children at some point in the future.

Menstrual disorders are classified as follows:

Amenorrhoea

Absence of menstruation or in intervals of > 6 months; as a general rule, regarded as anovulation.

Oligomenorrhea

Intervals of > 35 days and < 6 months between consecutive menstruations.

Polymenorrhea

Intervals of < 24 days between consecutive menstruations.

Your GP can inform you whether your menstrual pattern is abnormal. If so, he/she will also want to know whether your cycle has always been irregular or has changed and if so when.

One of the following diagnoses could be suggested:

  • Anovulation
  • Hyperprolactinemia
  • Polycystic Ovarian syndrome (PCO)
  • Luteal phase insufficiency (LI)
  • Premature menopause (PM)

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abnormal (heavy or lengthy) menstruations

As well as abnormalities in the timing of bleeds, there can also be abnormalities in the duration or heaviness of the bleed.

Hypermenorrhoea

Excessive blood loss but with normal intervals between bleeds and normal duration of bleeds.

Menorrhagia

Normal intervals between bleeds but the long duration bleeds (whether or not it is excessive).

Metrorrhagia

Bleeds at irregular intervals, often too long and excessive (random pattern).

There could also be blood loss in between the normal menstruations or bleeds. Abnormal bleeding during menstrual cycles can be an indication of one of the following infertility diagnoses::

  • Endometriosis
  • Fibroid
  • Congenital (disorders in the uterus/vagina)

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absence of menstruations (amenorrhoea)

Amenorrhoea is the medical term indicating that a woman doesn’t bleed (or no longer bleeds) on a monthly basis or with a frequency of more than 6 months. If a woman stopped having monthly cycles but previously had normal cycles, she is said to have secondary amenorrhoea. If the woman has never had menstrual cycles, then the condition is referred to as primary amenorrhoea. Regular menstruation is a good indication that ovulation (egg release) is taking place. If a woman does not menstruate, or no longer menstruates, it is a sure sign that something is not functioning correctly.

Diverse factors can contribute to the development of amenorrhoea, including:

  • Anovulation
  • Hyperprolactinemia (excessive production of the hormone prolactin)
  • Congenital disorders of the uterus/vagina

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