Why is my period 3 weeks
Menstrual cycle disorders and menstrual bleeding disorders
Menstrual cycle disorders(dysfunctional bleeding): Menstrual cycle that deviates from the normal course such as no menstrual bleeding, extended menstrual cycle, shortened menstrual cycle, spotting and intermenstrual bleeding.
Menstrual disorders (Menstrual disorders): Menstrual bleeding that deviates from normal, such as increased, weakened and prolonged menstrual bleeding.
The vast majority of women are affected by these disorders in (at least) one phase of their life. The need for treatment arises from the symptoms or from an infertility associated with the menstrual cycle disorder.
- No bleeding
- Longer or shorter cycle than normal
- Spotting or spotting between periods.
When to the doctor
In the next few weeks if
- the menstrual period suddenly stops for no apparent cause and a pregnancy test you carried out yourself turned out negative.
- spotting occurs for the first time.
- the menstrual period is so frequent and irregular that a rhythm is no longer discernible.
- irregular intermenstrual bleeding occurs.
- the bleeding is too weak and an unfulfilled desire to have children exists.
In the next few days if
- the bleeding is repetitive, excessive or lasts longer than normal.
- the bleeding stops after being regular for a while.
According to their temporal occurrence, a distinction is made between pre- and post-bleeding as well as intermenstrual bleeding. Depending on the cause, it is, on the one hand, hormone-related (dysfunctional) bleeding (ovulation bleeding), on the other hand, organically caused additional bleeding, for example in the case of mucosal polyps or endometritis. Fibroids and endometriosis of the uterine muscles are more likely to cause increased and / or prolonged bleeding. Extra bleeding is also a sign of cervical or endometrial cancer.
The physician differentiates between the following bleeding disorders:
Menstrual cycle disorders = disturbed bleeding frequency
Missing menstrual bleeding (amenorrhea) Missing bleeding for more than 3 months without being pregnant. If there is no bleeding during puberty or until after the 16th birthday, one speaks of primary amenorrhea. If, on the other hand, it does not happen for 6 months or more than three times in a row after a normal cycle has already passed, this is one secondary amenorrhea.
Prolonged menstrual cycle (oligomenorrhea). Menstrual cycle longer than 35 days. This form is also known as infrequent menstrual periods. The bleeding is less frequent, but the strength and duration are normal. The bleeding takes place at intervals of 6–12 weeks (normal cycle: 28 +/- 3 days). The extended menstrual cycle usually only requires treatment if the child wishes to have children.
Shortened menstrual cycle (polymenorrhea). Menstrual cycle lasting less than 25 days. The bleeding is too frequent but of normal severity and duration. Shortened menstrual cycles mainly occur in women over 35 years of age. The disorder is treated if the frequent bleeding is stressful for the woman or the blood loss is too high. Since frequent bleeding also indicates a tumor, especially in older women, a suddenly occurring shortened menstrual cycle should always be clarified by a doctor.
Spotting (spotting, extra bleeding). In addition to the regular menstrual period, slight intermenstrual bleeding. Spotting lasts for 1–2 days and occurs just before the menstrual period (premenstrual bleeding) on or after (postmenstrual bleeding). Spotting in the middle of the cycle just before ovulation is also called Median bleeding (mid-cycle bleeding). The additional bleeding is harmless as long as it appears regular and cycle-dependent. Treatment is then not necessary.
Intermenstrual bleeding (metrorrhagia, dysfunctional permanent bleeding, acyclic permanent bleeding). Irregular continuous bleeding for more than 7 days, which no longer shows a cycle. It occurs particularly frequently during puberty and menopause as well as with inflammation of the uterine lining and with various tumors.
Menstrual bleeding disorders = disturbed bleeding intensity
Increased menstrual bleeding (hypermenorrhea). Heavy bleeding with blood loss of 80 milliliters and more. More than 6 pads or tampons are required daily or more than 20 pads or tampons during the entire period of bleeding over several days. Often larger clots (clots) come off with the menstrual blood. One-time increased bleeding is usually harmless. However, if they remain very strong over several cycles, a specialist medical examination is necessary. The regular additional blood loss leads to fatigue and iron deficiency anemia for months and years.
Poor menstrual bleeding (hypomenorrhea). Decreased bleeding that requires fewer than 2 pads or tampons per day. The weakened menstrual period is too light and of too short a duration. It is usually a sign of a decline in ovarian function during menopause: the ovaries produce lower levels of estrogen. As a result, the lining of the uterus is less built up, so that little bleeding occurs during the bleeding phase.
Prolonged menstrual bleeding (menorrhagia). Menstrual period longer than 6 days with normal cycle length. This could be a sign of an existing bleeding disorder or a uterine tumor that is preventing the uterus from contracting. A prolonged menstrual period must be clarified by a doctor.
Note: Natural contraception methods such as condoms or temperature measurement are not safe for menstrual cycle disorders.
Menstrual disorders and menstrual cycle disorders are classified according to the severity, duration and timing of the bleeding.
www.salevent.de, Michael Amarotico, Munich
Menstrual cycle disorders
- Missing menstrual period (amenorrhea): Sometimes internal diseases, genital malformations, delayed puberty or the use of medication, e.g. B. Psychotropic drugs, the cause. Much more often, however, it is caused by physical, psychological or social stress, which then leads to changes in the hormonal control of the cycle.
- For example, prolonged menstrual cycles (oligomenorrhea) often occur after stopping the "pill" before or before the onset of menopause. In addition, insufficient follicular maturation leads to ovulation being delayed or not occurring at all and bleeding to be delayed accordingly.
- Shortened menstrual cycles (polymenorrhea): The cause is usually a hormonal imbalance.
- Spotting (spotting, additional bleeding) is caused by disorders of the hormonal cycle or by inflammation and tumors and should always be clarified by a doctor.
- Intermenstrual bleeding (metrorrhagia, dysfunctional permanent bleeding, acyclic permanent bleeding): Heavy intermenstrual bleeding is often organic and therefore always requires a specialist medical examination. Intermenstrual bleeding is less common as a side effect of an IUD or an intrauterine device.
- Increased menstrual bleeding (hypermenorrhea): In addition to hormonal causes, chronic inflammation and tumors of the uterus as well as coagulation disorders lead to increased menstrual bleeding.
- Reduced menstrual bleeding (hypomenorrhea): Apart from pregnancy, breastfeeding and the period after the menopause, mental and physical stressful situations such as diet, competitive sports, long-distance travel and illnesses such as anorexia or depression are the most common reasons for bleeding disorders. The woman's body "protects" itself against a possible pregnancy that it cannot cope with at the moment. In younger women, inflammation of the uterine lining may result in the mucous membrane building up only slightly and the subsequent bleeding weakened.
- Prolonged menstrual bleeding (menorrhagia): The most common problem is contraction disorders of the smooth muscles of the uterus, which mean that the uterine muscles do not contract properly during menstruation. An intrauterine device also causes menorrhagia. Menorrhagia often occurs in combination with hypermenorrhea.
Primary amenorrhea: During the gynecological examination and a contrast medium ultrasound, the doctor can see whether malformations in the female genital tract prevent the menstrual blood from flowing out. To reveal hormonal dysregulation, a blood test is used to determine the levels of the sex hormones and the control hormone GnRH.
Lengthened or shortened menstrual cycle (Oligomenorrhea or polymenorrhea): The doctor uses blood and urine tests to determine whether there is a hormonal imbalance and whether there is ovulation.
Increased menstrual bleeding (Hypermenorrhea): The doctor looks for fibroids, polyps or tumors in the uterus and other sources of bleeding using ultrasound and uterine specimens. The best time for this examination is in the first half of the cycle. Blood tests are used to diagnose coagulation disorders.
Decreased menstrual period (Hypomenorrhea): With the vaginal ultrasound, the doctor measures the cycle-dependent structure of the uterine lining and determines whether it is sufficient for a fertilized egg to implant. If the menstrual period clearly decreases shortly before the menopause, this is caused by the physiological reduction in hormone production in the ovaries. Treatment is then not necessary.
Your pharmacy recommends
What you can do yourself
Very few women always have exactly the same menstrual cycle. If your menstrual period comes once after 25 and once after 31 days, there is nothing to worry about. Today's lifestyle with irregular working hours and frequent, strenuous (air) travel disrupts the rhythm of many women. Shift and night work, a cured flu-like infection or diets that have been severely reduced in calories disrupt the interplay of hormones, so that the menstrual cycle fluctuates greatly. A less well-known disruptive factor occurs when sexual activity is resumed after a month-long break; sometimes it even triggers ovulation. Many women became unexpectedly pregnant during the last war during their husbands' short leave from the front.
Rhythm of life.
Many women want the same interval between menstrual periods as possible. The best "medicine" for such an even cycle is a regular life - without holidays, without changing jobs or partners, etc. But unfortunately, life usually doesn't work that way. It is also not at all important whether your days come "on time". It is important that you know the factors that influence the arrival of your menstruation. Important: If you have an irregular menstrual cycle but symptom-free menstruation, you should bear in mind that natural contraception methods are problematic.
Keep a cycle and menstrual calendar. An annual calendar the size of a credit card is sufficient. In many medical practices, such small cycle calendars are available to take away. It also serves as preparation for the consultation with the doctor.
If the bleeding is weakened, a daily increasing footbath in the week before the expected menstruation often helps. To do this, place both feet in a tub filled with warm water (around 33 ° C) and pour hot water over and over again for the next 15 minutes - the temperature should not exceed 40 ° C.
The therapeutic efficacy of monk's pepper extract (club mud) for the treatment of menstrual disorders has not been sufficiently proven. The corresponding preparations are therefore assessed as "not very suitable". So they might be worth a try, but don't expect too much.
A tea made from dead nettle (Lamium album) helps v. a. with irregular menstrual cycles. Mixtures of teas made from St. John's wort (Hypericum perforatorum) and lady's mantle (Alchemilla vulgaris) are also said to have a bleeding effect. Yarrow (Achillea millefolia) is said to help in particular with increased or prolonged menstruation.
Relaxation methods such as progressive muscle relaxation according to Jacobson, autogenic training or yoga are not only suitable for reducing stress, but also have a positive effect on the endocrine system. It is important to do the exercises regularly. However, it takes 2-3 months for such a relaxation technique to work.
V. a. Acupuncture has proven its worth in a shortened or lengthened menstrual cycle.
The same applies to homeopathy, which recommends an individually tailored constitutional treatment.
Primary amenorrhea. A cure and thus the restoration of fertility is not always possible, but it is often possible by taking hormones or control hormones.
Secondary amenorrhea. Treatment depends on the underlying disease. If you miss menstruation because of depression or anorexia, doctors often prescribe hormones. Studies have shown that the affected women feel better again with the onset of menstruation and that the therapy is accelerated.
Extended menstrual cycle. Extended cycles are only treated if the woman feels impaired by the irregular cycle - with the "pill". A rhythm is imposed on the body through the 21-day intake cycle and the subsequent 7-day break.
Shortened menstrual cycle. If the bleeding is too frequent or irregular, polyps and other tumors in the uterus must be excluded. A scraping may also be necessary for this.
Decreased menstrual period. In principle, it only requires treatment if there is an unfulfilled desire to have children.
Increased menstrual bleeding. Removal of the uterine lining (thermal ablation of the uterine mucosa, abrasion, myomectomy) or the uterus (hysterectomy) is recommended for women who suffer from heavy and long periods or who have anemia as a result. The combination of the endoscopy with a scraping makes it possible to remove any polyps or fibroids discovered in the reflection immediately. However, surgical procedures should only be considered if drug treatment does not sufficiently relieve the symptoms.
- Unfortunately, useful and balanced information on menstruation, menstrual cramps and menstrual problems is scarce on the Internet. We couldn't make a recommendation.
- For book tips see also the general women's health books
- T. Kreitman et al .: Trouble-free through the days. What girls want to know about their periods. Ueberreuther, 2002. Youth guide with many self-help tips for menstrual cramps. Not just for teenagers.
- J. Becket (Ed.): Ruby Red Time - Beginning of Menstruation. Diametric, 2006. Women from four generations talk about the beginning of their menstrual period. No medical specialist information, but insights into a rapidly changing self-image.
AuthorsDr. med. Astrid Waskowiak, Dr. med. Arne Schäffler in: Gesundheit heute, edited by Dr. med. Arne Schäffler. Trias, Stuttgart, 3rd edition (2014). Revision and update of the sections "Symptoms and complaints", "When to see the gynecologist", "The disease", "Confirmation of diagnosis", "Your pharmacy recommends" and "Medical treatment": Dagmar Fernholz | last changed on at 10:59
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