8 types of abnormal menstruation

Women of childbearing age typically have a period approximately once a month. While this is a natural and common process, many women have some type of abnormal menstruation. Let's take a look at the 8 types of abnormal menstruation, beginning with how common these issues are.

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How Common is Abnormal Menstruation?

If you are concerned about abnormal menstruation, you should know that these issues are actually quite common. 

Between 14%-25% of women will experience abnormal period cycles, including missed or irregular periods not associated with pregnancy or more frequent periods. About 33% of women will experience abnormal bleeding, with periods being very heavy or light at some point in their reproductive years.

The most common of the 8 types of abnormal menstruation is Dysmenorrhea, or painful periods. Numbers vary greatly based on the study and population, with some studies suggesting that up to 90% of women experience painful periods. Severe dysmenorrhea, meaning periods that are so painful they significantly impact daily activities, occurs in 5% to 10% of women. 

The 8 Types of Abnormal Menstruation 

The eight types of abnormal menstruation include: 

1. Dysmenorrhea (Painful menstrual periods)
2. Amenorrhea (Absence of menstrual periods)
3. Oligomenorrhea (Infrequent menstrual periods)
4. Polymenorrhea (Frequent menstrual periods)
5. Menorrhagia (Abnormally heavy or prolonged menstrual bleeding)
6. Hypomenorrhea (Unusually light menstrual bleeding)
7. Metrorrhagia (Bleeding between periods)
8. Menometrorrhagia (A combination of menorrhagia and metrorrhagia)

1. Dysmenorrhea (painful menstrual periods)

Dysmenorrhea, also known as painful menstrual periods, is a common issue for women. In fact, up to 90% of women experience pain during their periods. The pain occurs because the uterus contracts, causing it to shed the uterine lining. Mild to moderate pain during your period is considered normal. However, severe pain that interferes with your daily activities is not normal. 

Along with pain, you may have other symptoms, including nausea, fatigue, and diarrhea.

Types of Dysmenorrhea

There are two types of dysmenorrhea, or painful menstruation. These are primary dysmenorrhea and secondary dysmenorrhea. 

Primary dysmenorrhea occurs when you experience painful periods without an underlying medical cause.  Secondary dysmenorrhea occurs when the pain is caused by an underlying reproductive health condition, such as endometriosis or fibroids. 

Causes of Dysmenorrhea 

It's thought that primary dysmenorrhea occurs because the body releases too many prostaglandins, which causes the uterus to cramp more than is necessary. 

Secondary dysmenorrhea is caused by a medical condition. Endometriosis is the most common cause. It causes the uterine lining to grow outside your uterus.  Adenomyosis occurs when the uterine tissue grows into the muscle tissue of the uterus, causing it to enlarge. Fibroids and Pelvic Inflammatory Disease (PID) are also potential causes. 

Dysmenorrhea Treatment

NSAIDs and other pain relievers are often the first treatment your doctor will suggest for painful periods. Hormonal birth control, like the pill or ring, can also be helpful. If you have secondary dysmenorrhea, treatment may involve addressing the underlying cause of the issue. 

2. Amenorrhea (absence of menstrual periods)

Amenorrhea occurs when a woman stops getting periods, or in girls who don't have their first period by the age of 15. 

There are two types of Amenorrhea, or absence of menstrual periods, as well. Primary amenorrhea occurs when a girl has not started her period by the age of 15. 

Secondary amenorrhea occurs when a woman who was having regular periods stops getting periods for at least three months.

Causes and Treatment 

If you become pregnant or reach menopause, these are natural causes of amenorrhea, and there’s no cause for concern. Medical conditions that can cause your periods to stop include hormonal issues like PCOS, thyroid disorders, or problems with the pituitary gland.  

Amenorrhea can also be triggered by lifestyle factors. These include intense exercise, low body weight, and stress. Other causes include some birth control options, problems with ovarian function, and certain genetic conditions.  

The treatment for amenorrhea varies widely based on the underlying cause. If your periods have stopped due to pregnancy, birth control medication, or menopause, no treatment is needed. 

For other causes of amenorrhea, your doctor will work with you to correct the underlying cause. Treatments can include lifestyle changes, medication, or surgery in rare cases.

3. Oligomenorrhea (infrequent periods)

Another of the 8 types of abnormal menstruation is oligomenorrhea. Oligomenorrhea occurs when your periods are infrequent or typically longer than 35 days apart. Women with oligomenorrhea typically have 6-8 periods a year. A woman menstruating normally will get about 12 periods a year.

 Causes and Treatment  

Oligomenorrhea can be associated with puberty, because the body's cycles aren't regulated yet. Peri-menopause is another potential cause, which means that you are nearing menopause, and your cycles are becoming less frequent before stopping completely. 

Other causes of oligomenorrhea are similar to those that cause your period to stop completely, and include thyroid disorders, intense exercise, stress, and certain medications. 

Oligomenorrhea can be treated with hormonal birth control, which helps to regulate your periods. You may find your periods are more regular and predictable, particularly with hormonal birth control pills. 

Other treatments involve addressing the underlying cause of your infrequent periods. 

4. Polymenorrhea (more frequent periods)

If you have polymenorrhea, this means you have more frequent menstrual periods. You meet the polymenorrhea definition if your cycles are less than 21 days apart. You may have a period more often than once a month, and will have more than 12 periods in a year.

Causes and Treatment 

Surprisingly, some causes related to infrequent or absent periods, including perimenopause, puberty, and hormonal disorders can also cause your periods to be more frequent. 

Like other conditions involving an abnormal cycle, birth control pills are often the first treatment your doctor will recommend to regulate your periods.  Other causes involve addressing the underlying issue causing your frequent periods. 

5. Menorrhagia (heavy period bleeding)

Heavier than normal periods are called menorrhagia. If you soak through a pad or tampon every hour for several hours or need to get up to change your period product overnight, you likely have menorrhagia. Periods that last longer than seven days are also considered menorrhagia. Excessively heavy periods are sometimes called hypermenorrhea. 

Causes and Treatment  

Menorrhagia can be caused by conditions like endometriosis, hormone imbalances, PCOS, and certain medications. Rarely, heavy menstrual bleeding can be caused by a bleeding disorder, like von Willebrand disease.

Treatment can involve hormonal treatments like birth control pills, medications designed to reduce bleeding, NSAIDs, and surgical treatment for severe cases.

6. Hypomenorrhea (light periods)

Hypomenorrhea is on the other end of the spectrum. This is unusually light bleeding. You may also have shorter periods. Women with hypomenorrhea often have periods that last two days or less.

Causes and Treatment 

Hypomenorrhea can occur during pregnancy or breastfeeding. It's also common during perimenopause or puberty. Other common causes include hormonal contraceptives, hormonal imbalances caused by PCOS or thyroid issues, and structural abnormalities. Lifestyle factors like changes in your weight or stress can also trigger hypomenorrhea. 

Hypomenorrhea treatments are not necessary for causes like breastfeeding, perimenopause, puberty, or light periods caused by birth control. Other treatments will focus on addressing the underlying cause, and may involve medication, lifestyle changes, or birth control pills. 

7. Metrorrhagia (bleeding between periods)

Bleeding between periods, often called spotting or intermenstrual bleeding, is known as metrorrhagia. This type of bleeding is typically irregular and may vary in amount. Metrorrhagia also includes bleeding during pregnancy. 

Causes and Treatment

If metrorrhagia occurs during pregnancy, it can indicate complications or miscarriage. However, it can also occur due to implantation or as part of a normal pregnancy. 

Like many of the 8 types of abnormal menstruation, it can occur during puberty or peri-menopause. PCOS, uterine fibroids, some medications, and bleeding disorders are also potential causes. 

8. Menometrorrhagia (heavy periods and bleeding between periods)

Menometrorrhagia is another type of unusual bleeding. Menometrorrhagia is a combination of menorrhagia, or heavy periods, and metrorrhagia, or bleeding between periods. This means your periods are excessively heavy or long, and don’t follow a predictable pattern.

Symptoms of menometrorrhagia include: 

• Heavy period bleeding
• Bleeding that lasts longer than 7 days
• Bleeding between periods
• Irregular menstrual cycles

Causes of Menometrorrhagia

Like the other 8 types of abnormal menstruation, menometrorrhagia can have many potential causes. 

These can include perimenopause, ectopic pregnancy, miscarriage, PCOS, and thyroid issues. If you've recently stopped or started hormonal birth control, this can also be the cause. Uterine, ovarian, or cervical cancer can also cause menometrorrhagia. 

When to See Your Doctor

Once you begin having regular periods, you should check with your doctor if you have any major changes to your period. This includes changes in the frequency of your period, significant changes in flow, or your periods becoming more painful. 

While abnormal menstruation can have many causes that are nothing to worry about, including pregnancy, menopause, and puberty, it can also indicate an issue that needs to be addressed. 

FAQs 

What's the Difference Between Amenorrhea vs Dysmenorrhea?

Amenorrhea means that your periods have stopped. Dysmenorrhea means that your periods are painful.

Is It Common to Have More Than One Type of Abnormal Menstruation?

Yes. Many women will have more than one type of abnormal menstruation. For example, you may experience Oligomenorrhea, or infrequent periods, along with hypomenorrhea, or unusually light menstrual bleeding. It's also common to experience different types of abnormal periods at different times in your life.

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