Menstrual problems – what a mess and pain at times

Irregular and erratic troublesome menstruation is normally due to anovulatory menstrual cycles i.e when there is a lack of ovulation where the ovary does not release an egg each month, and can result in both heavy and prolonged menstrual bleeding when menstruation does eventually occur. Irregular vaginal bleeding is also a well-recognized consequence of Poly Cystic Ovarian Syndrome (PCOS) in particular in women in their reproductive age. Rarely, irregular bleeding can be due to uterine cancer or pre-cancer. Nearly 10% of women on HRT will experience unscheduled irregular bleeding.

Inter Menstrual Bleeding (IMB) is bleeding between two regular periods and Post Coital Bleeding (PCB) is bleeding after sexual intercourse. The two problems usually coexist and may be due to a common cause. Most cases are due to benign disease of the female genital tract where no major problem can be found. Bleeding that occurs in the mid-cycle is usually physiological and normal and should not be a cause for concern. More often, the use of the contraceptive pill or female hormones containing progesterone can cause unscheduled sporadic bleeding. Chlamydiae infection or the clap, a sexually transmitted infection, may present with IMB and PCB. Polyps in the cervix (neck of womb) and endometrium (lining of womb) can cause IMB and PCB. Rarely, cervical cancer can present in this manner.