Menstruation occurs when the uterine lining endometrium breaks down, causing bleeding. The menstrual cycle is controlled by hormones. For pregnant women, changes in reproductive organs prepare the body and no bleeding occurs. Normal menstruation has many variations. A period can last 2 — 8 days. A cycle first day of one period to first day of next period can range from 21 — 45 days.
The amount of blood varies by individual but should not be enough to cause anemia. Abnormal uterine bleeding can usually be diagnosed from a medical history and pelvic exam. A record of your bleeding pattern may also be needed. Sometimes, further diagnostic tests such as labs, pelvic sonogram, or endometrial biopsy are necessary. Treatment of abnormal uterine bleeding varies depending on the cause of the problem and may be medical or surgical.
Over half of menstruating women have some pain, usually mild, for 1 — 2 days of their cycle. Sometimes, the pain is so severe that it limits participating in normal activities. This is called dysmenorrhea. Causes of dysmenorrhea are endometriosis, uterine fibroids, and the natural production of prostaglandins that occur at the onset of the menstrual cycle.
To evaluate, your provider may perform a pelvic exam, order labs, or possibly order a pelvic sonogram. In some cases, surgical evaluation is necessary. Treatment for dysmenorrhea may include medications and techniques to relieve pain. If the cause of dysmenorrhea is determined, treatment will focus upon removing or reducing the problem. The endometrium is the lining of the uterus.
Sometimes, endometrial tissue grows elsewhere in the body, usually within the pelvis. When this happens, it is called endometriosis. The main symptom of endometriosis is pelvic pain. Pain may occur with intercourse, during bowel movements or urination, or just before or during the menstrual cycle.
