Menstrual Disorders in Singapore - Dr Ma Li Clinic - Women's Specialist in Singapore

What are menstrual disorders?

Menstrual disorders are menstruation-related issues that affect a woman’s menstrual cycle and cause symptoms such as severe menstrual cramps or even the absence of menstruation. The most common menstrual disorders include:

Amenorrhoea: amenorrhoea is a condition characterised by the absence of menstruation and are grouped into 2 categories:
- Primary amenorrhoea: primary amenorrhoea is more common among girls who have yet to have their first menstruation by 16 years old. Girls who show no signs of puberty such as breast development, or pubic hair, are encouraged to be evaluated for this condition.
- Secondary amenorrhoea: secondary amenorrhoea indicates when women, who have had regular menstruation cycles in the past, suddenly experience an absence of menstruation longer than 3 months that is not pregnancy or breastfeeding-induced.
Dysmenorrhoea: dysmenorrhoea is a condition whereby a woman experiences severe menstruation cramps. It is categorised into 2 types, namely:
- Primary dysmenorrhoea: this refers to abdominal pain that is caused by menstruation as the uterus contracts, even more so during heavy bleeding.
- Secondary dysmenorrhoea: this refers to menstrual-related pain that is accompanied by other conditions such as endometriosis, or uterine fibroids.

Premenstrual Syndrome (PMS) / Premenstrual Dysphoric Disorder (PMDD): PMS, and PMDD refer to a recurring pattern of mood swings, behavioural changes, and physical symptoms that emerge before menstruation and subside after period in women of reproductive age

Menometrorrhagia: menometrorrhagia refers to menstrual conditions based on the extent of their menstrual bleeding, such as:
- Menorrhagia: menorrhagia is a condition whereby the women experience heavy bleeding during menstruation, or prolonged menstruation lasting longer than 10 days.
- Metrorrhagia: metrorrhagia is when women experience menstrual bleeding at irregular intervals between menstruation cycles.

Menstrual disorder is a cluster of menstruation issues that cause symptoms that can affect a woman’s quality of life and fertility.

What are some of the known common causes of menstrual disorders?

There are several factors that can disrupt a woman’s menstruation such as hormonal imbalances and structural issues of reproductive organs– either underdeveloped or abnormally formed. Additionally, issues in the hypothalamus (a structure in the brain) can also cause menstrual disorder as the hypothalamus controls the functions of the pituitary gland– a gland responsible for producing hormones that affect ovulation.

Impaired function of the hypothalamus can, in turn, disrupt the pituitary gland's role in producing ovarian hormones

What are the risk factors associated with menstrual disorders?

Certain factors increase the risk of some menstrual disorders such as;

Chronic illnesses: women with chronic illnesses such as kidney diseases or inflammatory bowel disease (IBD) are at an increased risk of developing amenorrhoea.
Family history: women with a family history of amenorrhoea, early menopause, and ovarian tumours are more likely to develop menstrual disorders in their lifetime.
Elevated prolactin levels: non-expectant women with an elevated prolactin level are at risk of amenorrhoea.
Genetic conditions: women diagnosed with genetic conditions, such as Turner syndrome, are likely to experience amenorrhoea.
Medical history: women with a history of polycystic ovary syndrome (PCOS), adrenal disorders, adenomyosis, fibroids, polyps, uterine cancer or cervical cancer are at risk of developing menstrual disorders.
Lifestyle choices: women with lifestyle choices that consist of over-exercising are at increased risk of menstrual dysfunction.
Structural issues: women with structural issues with their uterus, such as congenital deformity, underdeveloped reproductive organs, or scarring from previous surgeries have a higher risk of developing menstrual disorders.
Weight management: women who are either underweight or obese are at risk of developing menstrual disorders.
Early menarche age: women who get their first menstruation before 12 years old are more likely to develop dysmenorrhoea.

What are the common symptoms of menstrual disorders?

Amenorrhoea

Acne.
Excessive facial, and body hair.
Headaches.
Hot flashes.
Nipples leaking milk (for women with a history of pregnancy)
Vaginal dryness.
Vision changes.

Dysmenorrhoea

Aching, and throbbing pain in the abdomen.
Aching pain in the hips, lower back, and inner thighs.
Headaches, or dizziness.
Nausea.

PMS/PMDD

Physical symptoms:

Acne flare-ups.
Abdominal pain.
Bloating.
Breast tenderness.
Constipation, or diarrhoea.
Headaches.
Low back pain.
Menstruation cramps.

Emotional symptoms:

Anger, or irritability
Brain fog.
Cravings, or loss of appetite.
Difficulties in concentrating.
Feeling anxious, or depressed.
Insomnia.

Menometrorrhagia

Abdominal pain.
Anemia.
Bleeding through 1 or more pads, or tampons for 2 hours.
Bleeding between period cycles, or after intercourse.
Exhaustion, caused by anaemia.
Irregular menstrual cycles.
Long menstruation length.
Passing of blood clots.

How are menstrual disorders diagnosed in Singapore?

When it comes to diagnosing menstrual disorders, Dr. Ma Li often starts by assessing your symptoms. She will also review your family’s medical history to determine if you are at risk of any genetic or predisposed conditions that could be causing your symptoms. Having a comprehensive idea of your menstruation health, medical condition, and family’s medical history help her identify any abnormalities with your menstruation.

Additionally, a pelvic examination will be done to assess your reproductive organs and determine if your vagina, or cervix are inflamed. In some cases, she will recommend a pap smear to eliminate cancer as one of the suspects behind your symptoms. Dr. Ma Li will also run some blood tests to determine if your menstrual symptoms and disorders are caused by hormonal imbalances. Some of the additional tests that Dr. Ma Li may order to diagnose your menstrual disorder are:

Endometrial biopsy: an endometrial biopsy is done to extract tissue samples from the uterine lining, and then analyse them to determine if there are any abnormalities.
Hysteroscopy: a hysteroscopy is a diagnostic procedure where a small camera is inserted into the uterus to look for any abnormalities within the uterus.
Ultrasound: an ultrasound can help Dr. Ma Li have a better visualisation of the condition of your uterus.

How are menstrual disorders treated in Singapore?

The treatment approach for menstrual disorders will depend on the type of disorders and symptoms manifestation. Generally, treatment would involve;

Medications: medications such as birth control pills, or hormonal medications are prescribed to address menstrual cycle abnormalities.
Surgical intervention: surgery is often done to correct physical abnormalities that hinder menstrual blood from flowing normally.
Nonsteroidal anti-inflammatory drugs (NSAIDs): NSAIDs like ibuprofen, or naproxen work by lowering prostaglandin levels, which slows down uterus contractions during menstruation.
Hysterectomy: in rare cases, a hysterectomy may be recommended which is a surgical procedure whereby the uterus is removed. It may be recommended if your condition is caused by ovarian cancer, or by changes induced by cancerous cells in the endometrium.
Diuretics: diuretics are recommended to address symptoms apart from menstrual abnormalities such as abdominal bloating and breast tenderness.

Myomectomy: a myomectomy is a minimally invasive surgical procedure that removes fibroids from the uterus, without risking your chances of future pregnancies.

Essentially, treatment is not merely intended to address menstrual abnormalities affiliated with menstrual disorders but also the underlying condition, or simply put the root cause.

Birth control pills are effective at relieving menstrual cramps, and breast tenderness, and reducing menstrual blood flow.

Dr Ma Li Clinic For Women & Advanced Pelvic Surgery

We understand that menstruation problems can cause emotional, and mental distress. Whether you are an adult looking to have your menstruation health evaluated, or to have your menstruation disorder treated, or a mother looking for treatments, and solutions for your daughter’s menstruation problems, our doors are open.

Dr. Ma Li is an accredited Obstetrics and Gynaecology specialist with vast experience in treating women's health-related issues. With a keen interest in women’s health, and dedication to her field, rest assured that Dr. Ma Li will not only provide an accurate diagnosis of your condition but will also offer treatments that will alleviate your symptoms and improve your quality of life and menstrual health.

FAQs

Frequently asked questions

Can these menstrual disorders be prevented?

There are certain precautionary measures that you can take to reduce your chances of developing menstrual disorders. These include:

Avoid smoking and excessive alcohol consumption.
Consuming a healthy, and well-balanced diet.
Exercise regularly.
Keep a menstrual diary, to monitor your menstrual health.

Are menstrual disorders considered hereditary conditions?

Yes, some menstrual disorders are hereditary. Additionally, you may inherit some genetic conditions from your parents that can result in menstrual disorders.

Is it possible for a woman to have multiple menstrual disorders?

Yes, it is possible to be diagnosed with multiple menstrual disorders. That is why it is encouraged to seek medical consultation if you are experiencing symptoms or are at risk of menstrual disorders.

What is the average length, and duration of a normal menstrual cycle?

The average length is 7-10 days, while the average cycle is 28 days.

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