MENSTRUAL DISORDERS

While the ideal time interval between periods is considered to be 26 to 30 days, with the menstrual flow lasting 3 to 7 days, a greater variability is not considered to be of major significance by some authorities. However, when the menstrual cycles are chronically prolonged or shortened by a week or more, one has to consider the possibility of a serious disorder of which the menstrual irregularity is but a symptom. Menstrual irregularity is relatively common in young girls, but its persistence for more than one to two years after the onset of the menstruation should ring a warning bell that something may be wrong and that the cause of the possible abnormality should be investigated. The most common causes of menstrual irregularities are disorders of ovulation (ovulatory dysfunction) which are in most instances hormonal in nature. They may involve abnormalities (including tumors) of the hypothalamus, the pituitary, the thyroid, the adrenal glands or the ovaries. In most instances, a specific diagnosis can be made, the condition treated and more serious complications (severe hormonal imbalances, severe menstrual bleeding, major surgery later in life, infertility, etc.) prevented.

Diagnostic Evaluation

The diagnostic evaluation usually requires an examination of two menstrual cycles or, if the patient does not menstruate, at least six (6) weeks of observation. During this time blood hormone levels are measured and the chart of the daily basal body temperatures (BBT) is recorded; when indicated, X-rays, ultrasound, or other studies are performed. A specific diagnosis is usually established by the end of this time.

Treatment

Treatment is directed toward correction of the hormonal imbalance found during the diagnostic evaluation (e.g., excessive production of prolactin by the pituitary gland, overproduction of male sex hormones by the adrenal glands, etc.) Correction of these hormonal abnormalities will result in improvement of the ovulatory dysfunction leading to the menstrual disorder. Thus, treatment is directed toward correction of the hormonal cause of the problem rather than “regulating” the cycle with birth control pills.

Previous page
Home Page