Menstruation Problems

What are Menstruation Problems?

Menstruation problems, also known as menstruation disorder or period problems, signify abnormality in one’s menstruation cycle. Menstruation experiences are subjective and problems manifest differently for different women. Heavy bleeding, no bleeding, and irregular bleeding are all symptoms of menstrual problems.

Problems often go undiagnosed and untreated due to the normalisation of pain and discomfort associated with periods. Particularly in Asian cultures, a lack of education, information, and discussions about menstruation further disempowers women from seeking treatment where menstruation problems occur.

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What are the common causes of Menstruation Problems in Singapore?

There are various reasons why one is dealing with menstruation problems.

Below are some possibilities of why menstruation problems occur:

  • Female reproductive disorder: the problems of menstruation could serve as a warning sign of reproductive disorders such as endometriosis (link to service page), fibroids (link to service page), ovarian cysts (link to service page), and congenital genital tract (link to service page).
  • Hormonal imbalances: disruption in levels of oestrogen, progesterone, prostaglandins, prolactin, testosterone, thyroid, cortisol, and luteinising hormone can lead to the manifestation of menstrual problems. The root cause of these imbalances can usually be traced back to underlying health conditions or environmental and genetic factors.
  • Side effects of other health conditions: the presence of a myriad of other health conditions such as diabetes, Von Willebrand disease (bleeding disorder), and eating disorders (anorexia or obesity) will also have an impact on one’s menstrual cycle.
  • Genital tract precancer or cancer: Cervical dysplasia or abnormal cells caused by HPV infection, excessive thickening of the endometrium (endometrial hyperplasia) or even endometrial cancer can manifest as menstrual disorders.

What are the usual symptoms for Menstruation Problems in Singapore?

It is important that you have an idea of what a normal cycle looks like to ensure that you are aware of when abnormalities occur. Sometimes, these changes are normal and do not pose or signify any threat. However, certain symptoms should be taken seriously and require medical intervention.

Menstruation problemSymptoms that require medical intervention
Absence of menstruation (amenorrhoea)

● Absence of menstruation cycle for over three months.

● Girls who do not menstruate by the age of 15 or have shown no signs of pubertal changes (no development of breasts or pubic hair growth).

Debilitating pain during menstruation cycle  (dysmenorrhoea)

● Cold sweats from feeling feverish.

● Chronic pain in the lower abdomen and lower back.

● Restriction in your ability to conduct daily routines (mundane activities like walking and showering).

● Reliant on painkillers for 2 or more days during menstruation.

● 3 months of consistent pain patterns.

Heavy and excessive blood flow (menorrhagia)

● Discharge in the form of blood clots that are the size of a 50-cent coin.

● Requiring frequent changes of pads or relying on super-sized pads to avoid blood leakage.

● Menstruation lasts more than 7 days.

● Dizziness and fatigue during menstruation cycles.

Irregular period cycles

● Period cycles that last less than 21 days or are more than 42 days apart.

● Irregular patterns are consistently present for three or more months.

Abnormal bleeding

● Spotting or heavy bleeding between period cycles (outside of menstruation days) known as breakthrough bleeding.

● Bleeding patterns that do not resolve within a month.

If you notice any of the symptoms stated above, make an appointment (link to contact us) today to get an accurate diagnosis and effective treatment.

Menstruation problems

Who is at risk of Menstruation Problems in Singapore?

It can be generally concluded that women of all ages are at risk of menstruation problems and symptoms appear in different forms and patterns. 

However, period problems tend to show the likelihood of occurring among:

  • Smokers
  • Highly athletic women
  • Women with eating disorders (anorexia, bulimia, binge eating, obesity)
  • Women who lead stressful lifestyles

It is best to seek expert advice to identify the cause. Given the possibilities, it is best that women are alert to their bodily changes so necessary precautions can be taken.

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How is it diagnosed?

To establish if you are facing period problems, it is important that the history of your period cycles is provided to your doctor. It is important to gauge what your normal cycles are like to understand if a deviation has occurred or if consistency in problematic cycles is evident

Following the review of your history, you may be advised to undergo the following:

  • Pelvic examination: conducted to identify any abnormalities of reproductive organs. A pelvic examination is a normal part of a women’s wellness screening and can be used to identify anomalies of the female reproductive system.
  • Pap smear: pap smears are conducted to identify the presence of cancerous cells, inflammation, or infections.
  • Imaging tests: an ultrasound or magnetic resonance imaging (MRI) may be requested to obtain clearer visualisation of the condition of reproductive organs.
  • Diagnostic laparoscopy: laparoscopy would enable your obstetrician/gynaecologist to obtain a clearer image of the root cause of menstruation issues with a camera through small incisions at the abdomen.

What are the treatment options available for Menstruation Problems in Singapore?

Depending on your condition, treatment options vary.

Below are some treatments your obstetrician/gynaecologist may prescribe:

  • Medication: you may be prescribed nonsteroidal anti-inflammatory drugs and painkillers to manage inflammation and reduce cramping.
  • Hormone therapy and contraceptives: depending on your condition, appropriate hormone therapy may be suggested. Contraceptives may also be prescribed to reduce menstruation frequency and flow.
  • Laparoscopic surgery: keyhole surgery for the removal of cysts, endometrial tissue, and abscess in reproductive organs.
  • Cervical polypectomy: a cervical polypectomy may be necessary to remove polyps in the cervix if polyps are found to be the cause of menstrual problems.
  • IUCD insertion: an intrauterine device  may be inserted to regulate excessive bleeding and heavy menstruation problems if deemed as a productive solution.
Laparoscopic surgery

Frequently asked questions

What menstruation problems cause black blood?

Black blood discharge is a result of blood oxidation in the uterus. It is typically referred to as “old blood” or retained menses. It is common to have black blood at the start or end of menstruation. However if accompanied by a foul smell, itching, and fever, you may be exhibiting symptoms of vaginal blockage or infections. . It may also indicate old blood trapped in the uterus or fallopian tubes that discharges itself later in the cycle.

When should I worry about my period?

It is common for patients to undermine symptoms as a one-off problem or temporary irregularities. If you find your menstrual cycle has abruptly changed and these changes persist for 3 cycles or more, seek medical intervention from a gynaecologist. If your periods are causing significant deterioration in your quality of life, it is also a sufficient indication to seek gynaecological aid. Clear communication of symptoms to your gynaecologist is vital for accurately determining the diagnosis.

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