Heavy menstrual bleeding, intermenstrual bleeding, bleeding more than 23 days and later than 35 days, bleeding lasting more than 7 days, bleeding after intercourse, amenorrhea, postmenopausal menstruation, and painful menstruation are considered menstrual irregularities.
Most women with heavy menstrual bleeding do not have a pathological finding. These are the conditions where the bleeding cannot be stopped with intrauterine tissue endometrium hemostasis, ie stopping bleeding abnormality or intrauterine prostaglandin abnormalities. It can be controlled with various drugs. Myoma is the main cause of bleeding in 30% of women. Myoma is a benign smooth muscle tumor located in the uterus. Endometrial Polyp caused by intrauterine tissue growth is active in 10% of women. Chronic pelvic infection, ovarian tumors, endometrial and cervical cancers can often cause vaginal bleeding. Thyroid diseases, hemostatic diseases such as von Willebrand, and anticoagulant therapy may cause increased menstrual bleeding.
Cause-oriented treatments are applied. Laparoscopic or hysterescopic fibroid removal if it is caused by fibroids, hysterescopic fibroid removal if it is caused by polyps, hormonal intrauterine devices and medical bleeding-reducing drugs and hormonal treatments if a definite cause cannot be revealed, endometrial biopsies can be performed if there is intrauterine thickening. It may be recommended to remove the uterus in uncontrollable advanced age bleeding and cancer precursor lesions.
Menstrual cutting is divided into 2 groups. The absence of menstruation until the age of 16 is called primary amenorrhea, while the cessation of menstruation for more than 6 months is called secondary amenorrhea. The most common occurrence of primary amenorrhea is delayed puberty, that is, adolescence. There are cases of absence of menstruation due to stenosis of the cervix, hymen closure or a curtain in the vagina. The cause of secondary amenorrhea may be the possibility of pregnancy in reproductive age, polycystic ovary syndrome, hyperprolactinemia or early menopause.
The painful onset of menstruation in women of reproductive age is called primary dysmenorrhea, and the transformation of normal painless menses into painful with advancing age is called secondary dysmenorrhea. Primary dysmenorrhea is associated with uterine contractions and decreased blood supply to the uterus due to increased prostaglandin level in the endometrium. Secondary dysmenorrhea is often associated with inguinal problems. The most common causes are fibroids, adenomyosis, endometriosis or chocolate cyst disease, inguinal infection or ovarian cysts and tumors.