All About Menstrual Disorders - Part II

In the first part of this blog series on menstrual disorders, we learned about the different types of conditions and their causes and symptoms. Part II will now delve into the diagnosis and treatment options for these disorders.

As we are aware, menstrual disorders are marked by disruptive physical and emotional symptoms that arise during menstruation or just before it. These symptoms may include heavy bleeding, missed or irregular periods, and intense mood swings. A proper diagnosis and treatment are required for treating these conditions. 

If you notice variations in your menstrual cycle, start keeping track of when your periods come and go. Take note of any symptoms, the volume of flow, intensity of cramps, bleeding between periods, and large blood clots. All of these are beneficial to discuss with your healthcare practitioner. Let us closely look at the diagnosis and treatment of each of the menstrual disorders!

Amenorrhea: 

If you have primary or secondary amenorrhea caused by lifestyle factors, it is important to look into the following: 

• Weight: Being either overweight or underweight might have an impact on your menstrual cycle. Regulating your weight and transforming it to a healthy level can help balance the hormones and restore your menstrual cycle.
• Stress: Assess the sources of stress in your life and eliminate those stressors. If you are unable to reduce stress on your own, seek assistance from family, friends, a health care practitioner, or a professional therapist.  

Depending on your age and the findings of the ovarian function test, your doctor may prescribe cautious waiting for primary amenorrhea. Menstruation may be delayed if an ovarian function test reveals low levels of follicle-stimulating hormone (FSH), or luteinizing hormone (LH). In some cases, this condition can be caused due to chromosomal or genetic problems and may require surgery. 

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For secondary Amenorrhea, below are some of the common treatments that are recommended:

• Clomiphene citrate (CC) therapy is often prescribed to help trigger ovulation.
• Estrogen replacement therapy (ERT) may help balance hormonal levels and the menstrual cycle in women with primary ovarian insufficiency (POI) etc.
• Uterine scarring is a surgical treatment recommended in certain conditions after uterine fibroid removal. 
• Omega-3 fatty acids are crucial for the body's hormone synthesis, which might raise FSH levels. Among other foods, fatty fish (such as salmon, mackerel, and sardines), walnuts, and seaweed, are good sources of omega-3.

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Premenstrual Syndrome (PMS):

There are women who suffer from severe premenstrual syndrome (PMS) symptoms prior to their period, which can prevent them from performing their usual activities. While PMS can be treated with various medications, only a few have proven effective for this purpose. Hormonal medications are often used to alleviate common PMS symptoms by inhibiting the production of specific hormones in the body that interfere with the menstrual cycle. 

Additionally, other medications include antidepressants, painkillers, diuretics, and GnRH (Gonadotropin hormone-releasing hormone) analogues. These are commonly used to treat PMS. 

Some women opt for natural remedies like herbal items and nutritional supplements, including calcium, pyridoxine (vitamin B6), magnesium, evening primrose oil, chaste tree extracts (Vitex agnus castus), St. John's wort, saffron, and  Ginkgo biloba to alleviate their PMS symptoms. However, we need more studies to establish a concrete effect of all the above-mentioned remedies on PMS. 

Being metabolically fit and practising the following can help control PMS:

• Drink lots of water to relieve belly bloating. Herbal teas, like chamomile tea, may help with cramping.

• Consume a well-balanced diet rich in fruits, vegetables, and whole grains.
• Reduce your intake of sugar, salt, caffeine, and alcohol.
• Increase your vitamin D intake by natural sunshine, diet, or supplementation. The other micronutrients that can improve the Symptoms of PMS are B-complex, Iron, Magnesium and Zinc. 
• 7-9 hours of sleep to relieve fatigue and improve overall well-being
• Exercise can help reduce not just bloating and cramps, but also anxiety and depression symptoms.

Premenstrual Dysphoric Disorder (PMDD)

Premenstrual dysphoric disorder (PMDD) is a significantly more severe variant of PMS. PMDD symptoms might mimic those of other diseases or medical issues, such as a thyroid imbalance, depression, or an anxiety disorder. For a diagnosis, always consult with a healthcare practitioner.

PMDD is a persistent illness that requires medical attention. Several of the treatments listed below may help relieve or reduce the intensity of PMDD symptoms:

• Regular exercise
• Stress management
• Dietary changes that enhance protein and carbs while decreasing sugar, salt, caffeine, and alcohol.
• Supplements such as vitamin B6 and magnesium.
• Calcium-rich foods such as millet, and seafood such as mackerel, salmon, and sardines.
• Anti-inflammatory medicines

The severity of symptoms grows with time for some women and lasts till menopause. As a result, a woman may require therapy for a more extended period of time. The dose of medications may vary over the course of treatment.

Dysmenorrhea:

• Dysmenorrhea is the medical term for painful periods or menstrual cramps. If you experience cramps, it may be helpful to use a heating pad or hot water bottle on your lower back or abdomen. It's best to avoid consuming foods that contain caffeine, as well as smoking cigarettes and drinking alcohol. Engaging in regular exercise and massaging your lower back and abdomen may also be beneficial.

• Other alternative therapies to relieve period pain include yoga, acupuncture, consumption of anti-inflammatory foods like leafy vegetables, turmeric (curcumin), ginger and herbal tea. Also support your diet with vitamin D and magnesium supplements, which may help to reduce inflammation.

Menorrhagia:

Menorrhagia, also referred to as heavy menstrual bleeding, is characterized by periods that are heavier than the typical limit of 80 ml per cycle or that last longer than 7 days. 

There are various steps you can take to relieve your symptoms and restore your menstrual cycle to its typical rhythm: 

• Consume foods rich in Vitamin B6 and Vitamin C. Vitamin B6 plays a vital role in the production of new red blood cells, which compensate for the amount of blood lost due to long-term menorrhagia. Vitamin B6-rich foods include chicken liver, beef liver, salmon, lentils, tomatoes, and bananas. Vitamin C helps to absorb iron easily in the body preventing anaemia caused by iron deficiency. Vitamin C-rich foods include tomatoes, kiwi, oranges, grapefruit, tangerines, strawberries, papaya, etc. 
• Magnesium is a mineral element found in the human body that aids in the reduction of menstrual bleeding. Furthermore, magnesium supplementation helps women alleviate stress, sleeplessness, irregular pulse, and blood pressure.
• Omega-3 is a beneficial fatty acid present in a variety of fish. Omega-3 fatty acids aid in reducing damage by decreasing inflammation, improving heart function and regulating hormones. Salmon, mackerel, sardines, herring, tuna, anchovies and caviar are all high in Omega-3. One can also opt for a good Omega-3 supplement.
• Drink plenty of water. Our bodies are composed of 80% water. Water is also an essential component of the female body, particularly during menorrhagia. Not only does drinking enough water make you feel more calm and more active.
• The amount of menstrual blood can be effectively reduced by drinking a cup of ginger tea.
• Remove spicy foods such as chilli peppers and acidic foods such as pickles. Reduce your intake of fatty meals, processed foods, and fast foods, which cause gas, bloating, and worsen period cramps. Cold foods, such as melons, seaweeds, pears, and squash should be avoided since they stimulate circulation and raise the body's temperature.
• Caffeine has the power to inhibit iron absorption in the body therefore avoid carbonated beverages and soft drinks. Phosphates in carbonated soft drinks have a similar impact in that they both make the body's absorption of iron from other meals harder.

Using a functional nutrition approach to make lifestyle changes may help you get your menstrual cycle back on track. Consult your healthcare professional if you are concerned about your dysfunctional periods. Based on your individual scenario, they can give a full examination and propose appropriate treatment alternatives. It is essential to seek the advice of a healthcare expert to guarantee an appropriate diagnosis and the best possible care for your menstrual health!

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Reference:

1. All about Menstrual Disorders- Part I - iThrive 

           https://www.ithrivein.com/blog/all-about-menstrual-disorders-part-i

2. What are the treatments for Amenorrhea - National Institute of Health

https://www.nichd.nih.gov/health/topics/amenorrhea/conditioninfo/treatments

3. Premenstrual Syndrome- Treatment for PMS - National Library of Medicine

https://www.ncbi.nlm.nih.gov/books/NBK279264/

4. Premenstrual Dysphoric Disorder- Johns Hopkins Medicine

https://www.hopkinsmedicine.org/health/conditions-and-diseases/premenstrual-dysphoric-disorder-pmdd

5. Dysmenorrhea- Menstrual Cramps - Cleveland Clinic

https://my.clevelandclinic.org/health/diseases/4148-dysmenorrhea#:~:text=Eating%20anti%2Dinflammatory%20foods%20like,which%20may%20help%20reduce%20inflammation

6. What to eat with Menorrhagia- Vinmec

https://www.vinmec.com/en/news/health-news/obstetrics-gynecology-and-assisted-reproductive-technologies-art/what-to-eat-with-menorrhagia/

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