Common menstrual and Reproductive health conditions
Polycystic ovarian syndrome (PCOS)
What it is:
PCOS is a hormonal disorder affecting 5–20% of women of reproductive age. It’s characterized by excess androgens (male hormones), insulin resistance, and irregular ovulation. The ovaries may develop multiple small cysts, though cysts aren’t required for a diagnosis.
Common signs & symptoms:
• Irregular or absent periods (amenorrhea or oligomenorrhea)
• Acne and oily skin
• Excess facial or body hair (hirsutism)
• Weight gain, particularly around the abdomen
• Difficulty losing weight
• Infertility or delayed conception
• Thinning hair on the scalp
Why it happens:
PCOS involves hormonal imbalances, including high androgens and insulin resistance, which interfere with normal ovulation. Genetics, inflammation, and lifestyle factors also play a role.
Link to diet and lifestyle:
Diet and lifestyle are powerful tools in managing PCOS:
• Low-glycemic index (GI) foods: Stabilize blood sugar and reduce insulin spikes, helping regulate ovulation.
• Balanced macronutrients: Emphasizing lean proteins, healthy fats, and fiber-rich carbs supports hormone balance.
• Anti-inflammatory foods: Berries, leafy greens, nuts, seeds, and fatty fish can reduce systemic inflammation linked to PCOS.
• Weight management: Even a 5–10% reduction in body weight can improve menstrual regularity and fertility in women with PCOS.
• Regular exercise: Helps improve insulin sensitivity, supports weight management, and boosts mood.
Fibroids
What it is:
Fibroids are benign growths of uterine muscle tissue. They are hormone-sensitive, particularly to estrogen and progesterone.
Common signs & symptoms:
• Heavy or prolonged menstrual bleeding
• Pelvic pressure or pain
• Frequent urination
• Constipation or lower back pain
Why it happens:
Fibroids develop due to genetic factors and hormonal stimulation. High estrogen levels can contribute to growth, which is why they often shrink after menopause.
Management:
• Minimally invasive procedures (e.g., uterine artery embolization)
• Surgery for severe cases
Irregular cycles
What it is:
Cycles that are unpredictable, shorter than 21 days, or longer than 35 days.
Common signs & symptoms:
• Missed or late periods
• Spotting between cycles
• Hormonal imbalance symptoms: acne, hair changes, mood swings
Why it happens:
Causes include PCOS, thyroid disorders, stress, rapid weight changes, or perimenopause.
Management:
• Tracking cycles to identify patterns
• Addressing underlying hormonal or thyroid issues
• Stress reduction and lifestyle adjustments
Endometriosis
What it is:
Endometriosis occurs when tissue similar to the uterine lining grows outside the uterus, often affecting ovaries, fallopian tubes, and the pelvic lining.
Common signs & symptoms:
• Severe menstrual cramps and pelvic pain
• Painful intercourse
• Heavy or irregular periods
• Infertility
• Digestive symptoms (bloating, nausea, diarrhea) during periods
Why it happens:
The ectopic endometrial tissue responds to hormonal cycles like the uterine lining, causing inflammation, pain, and sometimes adhesions or scar tissue.
Management:
• Anti-inflammatory diet and supplements
• Surgery in severe cases
Menorrhagia (heavy bleeding)
What it is:
Excessive menstrual bleeding that impacts daily life.
Common signs & symptoms:
• Soaking multiple pads or tampons per hour
• Periods lasting longer than 7 days
• Fatigue or anemia
Why it happens:
Caused by hormonal imbalances, fibroids, endometriosis, polyps, or clotting disorders.
Management:
• Iron supplementation
• Treating underlying causes (e.g., surgery for fibroids)
Dysmenorrhea
What it is:
Severe menstrual cramps that interfere with normal activity.
Common signs & symptoms:
• Lower abdominal cramps
• Back or leg pain
• Nausea, headaches, or diarrhea
Why it happens:
• Primary dysmenorrhea: Caused by prostaglandins, which trigger uterine contractions.
• Secondary dysmenorrhea: Caused by underlying conditions like endometriosis or fibroids.
Management:
• Heat therapy
• Lifestyle strategies: regular exercise, stress management
Amenhorrea
Primary Amenorrhea
Primary amenorrhea occurs when a person has not started menstruating by age 15–16, even if other signs of puberty, such as breast development, are present. It can also be diagnosed earlier if there is no sign of puberty by age 13. This condition often signals an underlying hormonal, genetic, or structural issue preventing the menstrual cycle from initiating. Common causes include genetic disorders like Turner syndrome (where one X chromosome is missing or altered), problems with the hypothalamus or pituitary gland that disrupt hormone release, and structural abnormalities of the reproductive tract, such as an absent uterus or imperforate hymen. Symptoms may include delayed breast development, lack of pubic or underarm hair, or other signs of hormonal imbalance. Early evaluation is important, as treatments may involve hormone therapy, surgical correction, or addressing genetic or endocrine conditions to support overall health and, in some cases, future fertility.
Secondary Amenorrhea
Secondary amenorrhea occurs when a person who previously had regular menstrual cycles stops menstruating for three months or longer (or six months for those with irregular cycles). This is typically caused by a disruption in the hormonal signals that regulate ovulation and menstruation, and it can be triggered by a wide range of factors:
• Pregnancy – the most common cause.
• Polycystic Ovary Syndrome (PCOS) – hormonal imbalance that disrupts ovulation.
• Thyroid disorders – overactive or underactive thyroid affects menstrual hormones.
• Hyperprolactinemia – high prolactin levels from pituitary issues.
• Stress or significant lifestyle changes – emotional or physical stress can temporarily halt cycles.
• Young athletes and excessive exercise – high-intensity training can lower estrogen and disrupt the hypothalamic-pituitary-ovarian axis, leading to missed periods.
• Eating disorders or low body weight – conditions like anorexia nervosa or restrictive diets reduce fat stores and energy availability, impairing hormone production and ovulation.
Symptoms vary based on the underlying cause but may include weight changes, hair growth or loss, skin changes, fatigue, mood shifts, and fertility issues. Management involves identifying and addressing the root cause. For athletes or individuals with eating disorders, restoring a healthy energy balance, adequate nutrition, and moderated exercise is critical to re-establish regular cycles. Hormonal treatments may also be used in some cases to support menstrual health and protect bone density.
Why it matters
Amenorrhea is not just a menstrual issue—it can be a sign of broader hormonal, metabolic, or nutritional imbalance. Timely evaluation by a healthcare provider is important to prevent long-term complications such as decreased bone density, fertility challenges, and cardiovascular concerns.