This document discusses various conditions related to menstruation and the female reproductive system. It provides information on normal menstrual cycles and what constitutes irregular or abnormal bleeding. It describes specific conditions such as amenorrhea, dysmenorrhea, menorrhagia, oligomenorrhea, premature ovarian failure, uterine fibroids, and endometriosis. For each condition, it outlines common signs and symptoms women may experience.

2. After a teen has been
menstruating for a few years, her
menstrual cycle typically becomes
more regular. For most women, a
normal menstrual cycle ranges
from 21 to 35 days.
However, up to 14% of women
have irregular menstrual cycles or
excessively heavy menstrual
bleeding.

3. Amenorrhea
(uh-men-o-REE-uh) is the
absence of menstruation —
one or more missed
menstrual periods. Women
who have missed at least
three menstrual periods in
a row have amenorrhea, as
do girls who haven't begun
menstruation by age 15.

4. The main sign of amenorrhea is
the absence of menstrual
periods. Depending on the
cause of amenorrhea, you
might experience other signs or
symptoms along with the
absence of periods, such as:
• Milky nipple discharge
• Hair loss
• Headache
• Vision changes
• Excess facial hair
• Pelvic pain
• Acne

5. Menstrual cramps (dysmenorrhea) are throbbing or cramping pains in the lower
abdomen. Many women experience menstrual cramps just before and during
their menstrual periods.
For some women, the discomfort is merely annoying. For others, menstrual
cramps can be severe enough to interfere with everyday activities for a few
days every month.

6. Most young women who have dysmenorrhea
• Have lower back pain and cramping in the lower area of the abdomen during their
periods
• This pain can range from dull to throbbing
• Some girls may have other symptoms during their period such as nausea, vomiting,
loose bowel movements/diarrhea, constipation, bloating in the belly area, headaches,

7. Heavy or prolonged menstrual periods, or menorrhagia, are the
most common type of abnormal bleeding from the uterus. Periods
are considered heavy if there is enough blood to soak a pad or
tampon every hour for several consecutive hours.

8. Other symptoms of a heavy period can
include:
• Nighttime bleeding that requires getting
up to change pads or tampons
• Passing large blood
clots during menstruation
• A period that lasts longer than seven
days
In severe cases, heavy menstruation can
interfere with sleep and daily
activities. Blood loss from heavy
periods can also lead to anemia, causing
symptoms such as fatigue and shortness of
breath.

9. Oligomenorrhea is the term for by light or infrequent menstrual
periods. It occurs in women of childbearing age. Some variation in
menstruation is normal. A woman who regularly goes more than
35 days without menstruating may be diagnosed with

10. • See your doctor if you go more than
35 days without a period and are
not on birth control medication. If
your cycle suddenly changes,
always contact your gynecologist
• Some women who skip a period
experience a heavier one the next
time. This is normal and usually
does not indicate a miscarriage
• Adolescent girls should see a doctor
if they don't begin their period by 15
years of age

11. Premature ovarian failure — also known
as primary ovarian insufficiency — refers
to a loss of normal function of your
ovaries before age 40. If your ovaries
fail, they don't produce normal amounts
of the hormone estrogen or release eggs
regularly. Infertility is a common result.
Premature ovarian failure is sometimes
referred to as premature menopause,
but the two conditions aren't exactly the
same. Women with premature ovarian
failure may have irregular or occasional
periods for years and may even become
pregnant. Women with premature
menopause stop having periods and
can't become pregnant.

12. Signs and symptoms of premature
ovarian failure are similar to those
experienced by a woman going
through menopause and are typical of
estrogen deficiency. They include:
• Irregular or skipped periods
(amenorrhea), which may be
present for years or may develop
after a pregnancy or after stopping
birth control pills
• Hot flashes
• Night sweats
• Vaginal dryness
• Irritability or difficulty concentrating
• Decreased sexual desire

13. Uterine fibroids are noncancerous growths of the uterus that often appear
during childbearing years. Also called leiomyomas (lie-o-my-O-muhs) or
myomas, uterine fibroids aren't associated with an increased risk of uterine
cancer and almost never develop into cancer.
Fibroids range in size from seedlings, undetectable by the human eye, to bulky
masses that can distort and enlarge the uterus. They can be single or multiple,
in extreme cases expanding the uterus so much that it reaches the rib cage.

14. In women who have symptoms, the most
common symptoms of uterine fibroids include:
• Heavy menstrual bleeding
• Prolonged menstrual periods — seven days
or more of menstrual bleeding
• Pelvic pressure or pain
• Frequent urination
• Difficulty emptying your bladder
• Constipation
• Backache or leg pains

15. Endometriosis (en-doe-me-tree-O-sis) is
an often painful disorder in which tissue
that normally lines the inside of your
uterus — the endometrium — grows
outside your uterus (endometrial
implant). Endometriosis most commonly
involves your ovaries, bowel or the
tissue lining your pelvis. Rarely,
endometrial tissue may spread beyond
your pelvic region.

16. Common signs and symptoms of endometriosis
may include:
• Painful periods (dysmenorrhea). Pelvic pain and
cramping may begin before and extend several
days into your period and may include lower
back and abdominal pain
• Pain with intercourse. Pain during or after sex is
common with endometriosis
• Pain with bowel movements or urination. You're
most likely to experience these symptoms during
your period
• Excessive bleeding. You may experience
occasional heavy periods (menorrhagia) or
bleeding between periods (menometrorrhagia)
• Infertility. Endometriosis is first diagnosed in
some women who are seeking treatment for
infertility
• Other symptoms. You may also experience
fatigue, diarrhea, constipation, bloating or
nausea, especially during menstrual periods

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