Amenorrhea

The only symptom of primary amenorrhea is delayed menstruation. In addition to low body weight or excessive exercise, other causes of primary amenorrhea include Turner's syndrome, a birth defect related to the reproductive system, or ovarian problems. In 2003, a group of researchers reported on a new genetic mutation associated with primary amenorrhea. In secondary amenorrhea, the primary symptom is the ceasing of menstruation for at least three months. Causes include pregnancy or breastfeeding, sudden weight loss or gain, intense exercise, stress, endocrine disorders affecting the thyroid, pituitary or adrenal glands, including Cushing's Syndrome and hyperthyroidism, problems with or surgery on the ovaries, including removal of the ovaries, cysts or ovarian tumors.

Amenorrhea in athletes or dancers is frequently associated with two other disorders-osteopenia, or reduced bone mass, and eating disorders. This combination is sometimes called the female athlete triad. Osteopenia is of concern because it can lead to premature osteoporosis.

Dysmenorrhea

Primary dysmenorrhea is related to the production of prostaglandins, natural chemicals the body makes that cause an inflammatory reaction. They also cause the muscles of the uterus to contract, thus helping the uterus shed the lining built up during the first part of a woman's cycle. Women with severe menstrual pain have higher levels of prostaglandin in their menstrual blood than women who do not have such pain. In some women, prostaglandins can cause some of the smooth muscles in the gastrointestinal tract to contract, resulting in the nausea, vomiting and diarrhea some women experience. Prostaglandins also cause the arteries and veins to expand, so that blood collects in them rather than flowing freely through them, causing pain and heaviness. Yet another reason for severe cramps, particularly in women who have not yet had a baby, is that the flow of the blood and clots through the tiny cervical opening is painful. After a woman has a baby, however, the cervix opening is larger.

Secondary dysmenorrhea is more serious and is related to some underlying cause. The pain may feel like regular menstrual cramps, but may last longer than normal and occur throughout the month. It may be stronger on one side of the body than the other. Possible causes include:

A tipped uterus

Endometriosis, a condition in which the same type of tissue found in the lining of the uterus occurs outside the uterus, usually elsewhere in the pelvic cavity

Adenomyosis, a condition in which the endometrial lining grows into the muscle of the uterus

Fibroids

Pelvic inflammatory disease (PID)

An IUD

A uterine, ovarian, bowel or bladder tumor

Uterine polyps

Inflammatory bowel disease

Scarring or adhesions from earlier surgery

Menorrhagia

Heavy bleeding during menstruation is usually related to a hormonal imbalance, although other causes include fibroids, cervical or endometrial polyps, the autoimmune disease lupus, pelvic inflammatory disease (PID), blood platelet disorder, a hereditary blood factor deficiency, or, possibly, some reproductive cancers. Thus, menorrhagia is actually a symptom of an underlying condition rather than a disease itself. It may also be related to the use of an IUD.

Women with menorrhagia experience not only significant inconvenience, but may feel very tired due to the loss of iron-rich blood. It is usually diagnosed when a woman soaks through a tampon or pad every hour for several hours or has a period lasting more than 7 days. Clots are not related to menorrhagia, although women with heavy cycles may pass clots. They are typically a normal part of menstruation, more common when a woman has been sitting or in a stationary position for a while