What kind of menstrual disorders require medical attention?

What should I do if I don’t have my period? What should I do if I have menstrual disorders? Is it normal to have a small amount of menstrual flow? What’s wrong with a heavy menstrual flow?... Various menstrual problems bother women. Let’s see if there is an answer for you here.

Question 1: At what age is menarche considered normal?

Q: I am 18 years old, but I have not had my period. Please tell me, at what age should girls start menstruating? Is my situation normal?

Answer: The time of women's menarche is constantly changing with the progress of the times. In the 1940s, it was considered normal to have menstruation around the age of 18.

But modern people have better nutrition and their menarche is gradually coming earlier. Nowadays, most girls have their first menstruation around the age of 12. If a girl over 16 years old does not have her period and her secondary sexual characteristics such as breasts, pubic hair and armpit hair are not developed, she should go to the hospital for a check-up as soon as possible. If you are over 14 years old and have developed secondary sexual characteristics but have not had your period, you should also see a doctor.

Question 2: Why don’t I have my period after losing weight?

Question: Some time ago, I successfully lost 20 pounds, but my menstruation stopped. why is that?

Answer: Being too fat or too thin can cause menstrual disorders. Women who are too fat may suffer from polycystic ovary syndrome; simple obesity can also cause endocrine disorders and irregular menstruation; women who are too thin, especially those who lose more than 10 pounds in a month, are very likely to suffer from malnutrition, anorexia nervosa, and finally lead to amenorrhea. Even if the latter regains weight, it will still take about a year for menstruation to slowly resume. Therefore, people who are not fat do not need to lose weight at all, and should never try to lose weight blindly.

Question 3: What to do if menstrual disorders occur during adolescence?

Q: I have had my periods for two years, but they have never been regular. Will this last?

Answer: In the first year after menarche, most girls have irregular menstruation. Even by the third year, half of the people were still irregular. Most people will form their own cycle 2-3 years after the onset of menstruation. If an adolescent girl has irregular menstruation, with periods only occurring once every two or three months, it may be due to "anovulatory functional uterine bleeding during puberty". She should go to the hospital for examination in time and use progesterone or other progestogens to promote ovulation under the guidance of a doctor.

Hormone drugs such as progesterone are classic medicines for treating irregular menstruation. They are safe and effective and there is no need to worry.

Question 4: Is it normal to have very little menstrual flow?

Question: My menstrual flow is very light, only one or two days each time. A pack of ten sanitary napkins can last me three months. Is this normal for me?

Answer: Generally, there is no big problem with small menstrual flow, so don’t worry. If you already have children or have no desire to have children, you don't need to worry about it after tuberculosis is ruled out. If you want to have children but cannot get pregnant, you should go to the hospital to check whether you have endometrial lesions. The causes include tuberculosis and endometrial damage caused by repeated abortions, curettage, etc.

Question 5: What causes heavy menstrual flow?

Q: My menstrual period lasts eight or nine days each time, and the amount of blood is very heavy. Will it have any effect on my body? Will it cause premature menopause?

Answer: The most direct consequence of heavy menstrual flow and prolonged bleeding is anemia, but it will not lead to premature menopause. There are two main reasons for excessive menstruation: First, organic diseases such as uterine fibroids and adenomyosis. Second, functional lesions, the problem lies in endocrine disorders, which may be due to hyperactivity of the local fibrinolytic system in the uterus, that is, poor hemostatic mechanism. The former situation should be treated according to the cause. For the latter, you can take birth control pills, antifibrinolytic drugs or a progestin-releasing contraceptive ring under the guidance of a doctor.

Question 6: Is frequent menstruation considered a disease?

Question: Since my menarche, my period has always come early, sometimes two or three days, sometimes a week, and it has been almost 5 years. Other people have their periods twelve or thirteen times a year, but I wish I could have them seventeen or eighteen times. Is there any treatment for a situation like mine?

Answer: According to the consensus of clinical doctors, a menstrual cycle of 24-35 days is normal, so if a woman like this has her period two or three days early every time, there is no problem. If the menstrual cycle is only about 20 days, you should go to the hospital for examination to rule out pathological factors.

Question 7: Why is menstruation always delayed?

Q: My menstruation is always delayed, often coming once every two or three months. I wonder if this menstrual cycle will affect pregnancy?

Answer: This situation has a great impact on fertility. One menstruation means one ovulation, and the cycle is two to three months. The ovulation cycle is longer than others, or even there is no ovulation, and the difficulty of conception will increase. People with long menstrual cycles may suffer from polycystic ovary syndrome, hyperprolactinemia, hypopituitarism, etc., and should seek medical attention promptly.

Question 8: Will my menstruation become irregular if I am approaching menopause?

Q: I heard that women who are approaching menopause either don’t have their periods, or when they do, they last a month with very heavy periods. How long does this phase last?

A: The menopausal transition lasts an average of three and a half years. Treatment should be tailored to the different needs of women. If there is only menstrual disorder but no menopausal symptoms such as irritability and hot flashes, progesterone can be supplemented periodically; if there are menopausal symptoms, estrogen needs to be added; if there is still a need for contraception, a new generation of contraceptives can also be used. It should be noted that women over 40 years old who smoke should use contraceptives with caution. If your menstruation is irregular for a long time, you should go to the hospital for regular check-ups to rule out endometrial lesions.