Your period is late, too early, or never at all. It lasts 2 days or 10. You bleed between periods. It hurts so much you can't get out of bed. Your cycle is like a roller coaster, and you never know when the next one will arrive. Welcome to the wonderful world of menstrual disorders.
The problem is, no one really explains to you what's "normal" and what isn't. The bottom line is, you either endure it for years thinking it's like that for everyone, or you panic over something benign. This article lists the most common menstrual disorders, in human language, with one goal: to help you understand what's going on in your body and know when you should really worry.
⚡ What you will learn
What is a "Menstrual Disorder"?
A "normal" menstrual cycle is theoretically between 21 and 35 days, with periods lasting 2 to 7 days, and moderate bleeding (no need to change your protection every hour, not just a few drops either). Anything significantly different from this pattern can be considered a menstrual disorder.
⚠️ Be careful with the word "disorder"
A disorder doesn't automatically mean "serious" or "illness." It means "different from the statistical norm." Some disorders are benign and resolve on their own, while others require medical attention. The goal of this article is to help you differentiate.
🔍 Quiz: What Menstrual Disorder Do You Have?
Answer 12 questions to identify the disorder(s) that best match your symptoms
⚠️ Important Warning
This quiz is a informational tool only. It is in no way a substitute for a professional medical diagnosis. Only a doctor can make a reliable diagnosis after a clinical examination and additional tests. If you have symptoms that worry you, consult a gynecologist.
Summary Table: All the Disorders at a Glance
To help you quickly find your way around, here is a table that summarizes all menstrual disorders, their key symptoms, their severity and the action to take.
Category 1: When Your Cycle Goes Wrong 🔄
These problems concern the rhythm, duration, or abundance of your periods. Your cycle is too long, too short, nonexistent, or your bleeding is irregular. This category includes seven problems.
1. Amenorrhea: When Your Period Doesn't Come (Or No Longer)
💡 What is it really?
Complete absence of periods. Amenorrhea primary, this is when periods never started at age 16. Amenorrhea secondary, this is when your periods stop for at least 3 consecutive months when they were regular before.
🔍 How do you recognize him?
No period for more than 3 months (and you are not pregnant, breastfeeding, or menopausal). Sometimes accompanied by weight gain/loss, acne, excessive hair growth, or vision problems depending on the cause.
🧬 Why does this happen?
Pregnancy (obviously), breastfeeding, intense stress, significant weight loss, extreme sports, PCOS, premature ovarian failure, thyroid disorders, hyperprolactinemia, or anatomical malformations (uterus/vagina).
⚠️ Is it serious?
It depends on the cause. Stress- or exercise-related amenorrhea can be resolved by rebalancing your lifestyle. Primary amenorrhea or amenorrhea related to a hormonal problem requires a complete medical assessment. Never ignore prolonged absence of periods.
✅ What are you doing? Test for pregnancy first. If negative, consult a gynecologist for a hormonal assessment (FSH, LH, prolactin, thyroid hormones). Treatment will depend on the cause identified.
2. Oligomenorrhea: Periods That Become Rare
💡 What is it really?
Very spaced cycles, which regularly exceed 35 days. You have your period, but every 40-60 days instead of every 28.
🔍 How do you recognize him?
You count more than 35 days between the first day of one cycle and the first day of the next. Not just once, but repeatedly.
🧬 Why does this happen?
PCOS (most common), thyroid disorders, chronic stress, weight loss, premenopause, hyperprolactinemia, or simply a normal physiological variation in some women.
⚠️ Is it serious?
Rarely serious in itself. But if you want to get pregnant, it can complicate things (fewer ovulations = fewer fertility windows). Watch out if accompanied by other symptoms (acne, hair growth, weight gain).
✅ What are you doing? Keep a cycle diary for 3 months. If it's consistent and bothers you (or if you're planning a baby), get checked out. Often, the pill or ovulation-inducing medications are enough.
3. Polymenorrhea: Periods That Come Back Too Quickly
💡 What is it really?
Cycles that are too short, less than 21 days. You've barely finished your period and your next one is already coming.
🔍 How do you recognize him?
Less than 21 days between cycles. You wonder if you're having your period all the time. Exhausting and expensive sanitary protection.
🧬 Why does this happen?
Luteal insufficiency (post-ovulation phase too short), thyroid disorders, stress, perimenopause, fibroids, or simply a physiological variation.
⚠️ Is it serious?
Generally benign, but can lead to anemia if bleeding is frequent and heavy. Monitor if accompanied by extreme fatigue.
✅ What are you doing? Consult to make sure it is not related to the thyroid or luteal insufficiency. Possible treatment with progestins or the pill to regulate the cycle.
4. Spaniomenorrhea: Almost Never Have a Period
💡 What is it really?
Very rare periods, only 1 to 2 times a year. This is between oligomenorrhea and complete amenorrhea.
🔍 How do you recognize him?
You can count on one hand the number of times you get your period in a year. Sometimes 4-6 months pass between cycles.
🧬 Why does this happen?
Often linked to PCOS, thyroid disorders, hyperprolactinemia, intense chronic stress, or high-level sport. Can also be idiopathic (without an identified cause).
⚠️ Is it serious?
Requires investigation. A near-total absence of periods may indicate an underlying hormonal issue that warrants evaluation. This is also problematic if you are planning to become pregnant.
✅ What are you doing? Consult for a complete hormonal assessment (FSH, LH, prolactin, testosterone, thyroid) + pelvic ultrasound. Treatment will depend on the cause identified.
5. Hypomenorrhea: Phantom Periods
💡 What is it really?
Very light periods. A few drops, a few traces, sometimes just a panty liner is enough. Your period may last 2-3 days, but it's very light.
🔍 How do you recognize him?
You use less than one protection per day, or just a few traces on the toilet paper. You wonder if it's really your period or just spotting.
🧬 Why does this happen?
Contraceptive pill (common effect), hormonal IUD, PCOS, thin endometrium, uterine adhesions (Asherman's syndrome), early ovarian failure, or simply a normal variation in some women.
⚠️ Is it serious?
Rarely serious in itself. If it's due to hormonal contraception, it's normal and harmless. If it's not related to contraception and it's recent, it deserves investigation.
✅ What are you doing? If you are on hormonal contraception, this is normal. If you are not on contraception and your periods have recently become very light, consult for a pelvic ultrasound and hormonal assessment if necessary.
6. Menorrhagia: Bleeding periods
💡 What is it really?
Very heavy and/or prolonged periods (more than 7 days). You change your protection every 1-2 hours, you have clots the size of coins, and you soak your sheets at night.
🔍 How do you recognize him?
You lose more than 80 ml of blood per cycle (hard to measure, but roughly: more than one pad/tampon every 2 hours, huge clots, periods that last 8-10 days). Intense fatigue, paleness, shortness of breath.
🧬 Why does this happen?
Uterine fibroids, adenomyosis, polyps, clotting disorders, copper IUD, hormonal imbalances, or sometimes without identifiable cause.
⚠️ Is it serious?
May cause severe anemia if left untreated. It is physically and mentally exhausting. Never trivialize heavy periods.
✅ What are you doing? Consult quickly. Blood test (iron, ferritin) + pelvic ultrasound to identify the cause. Treatments: tranexamic acid, pill, hormonal IUD, or surgery depending on the cause.
7. Metrorrhagia: Bleeding between periods
💡 What is it really?
Bleeding that occurs outside of your normal period. This can be light spotting or heavier bleeding, but it may occur mid-cycle or just before/after your period.
🔍 How do you recognize him?
You're bleeding even though it's not your period. It can be a few drops or more pronounced bleeding. Sometimes accompanied by pelvic pain.
🧬 Why does this happen?
Polyps, fibroids, infections (STDs, cervicitis), incorrectly dosed pill, cancer (rare but should be ruled out), trauma, or ovulation bleeding (benign).
⚠️ Is it serious?
It depends on the cause. Ovulation bleeding is benign. Repeated metrorrhagia requires an assessment to rule out more serious conditions (polyps, infection, cancer).
✅ What are you doing? If it's occasional (1-2 times), observe. If it's repeated or abundant, consult quickly. Smear + ultrasound + infectious assessment to identify the cause.
Category 2: When Your Period Ruins Your Life 💥
These disorders are related to pain, physical, or emotional symptoms that accompany (or precede) your period. Your life is put on hold for several days each month. This category includes five disorders.
8. Dysmenorrhea: Periods That Really Hurt
💡 What is it really?
Severe menstrual pain during menstruation. Dysmenorrhea primary has no anatomical cause (just excessive uterine contractions). Dysmenorrhea secondary is linked to a pathology (endometriosis, fibroids, adenomyosis).
🔍 How do you recognize him?
Severe abdominal cramps, lower back pain, nausea, vomiting, diarrhea, headaches. You can't get up, you miss work/classes, you're stuck in bed with a hot water bottle.
🧬 Why does this happen?
Primary : Excessive production of prostaglandins (hormones that contract the uterus). Secondary: Endometriosis (most common), adenomyosis, fibroids, uterine malformations, infections.
⚠️ Is it serious?
Primary dysmenorrhea is benign but disabling. Secondary dysmenorrhea can be a sign of a serious condition (endometriosis) that requires treatment. Never normalize pain that prevents you from living.
✅ What are you doing? NSAIDs (ibuprofen, naproxen) as soon as the pain begins. If that doesn't help, consult a doctor to rule out endometriosis. Treatments: continuous pill, hormonal IUD, or even surgery if endometriosis is confirmed.
9. Premenstrual Syndrome (PMS): Hell Before Your Period
💡 What is it really?
A set of physical and emotional symptoms that appear 5 to 14 days before your period and disappear as soon as it arrives. Breast pain, bloating, irritability, fatigue, food cravings, mild anxiety.
🔍 How do you recognize him?
Every month, 1 week before your period, you become a different person: you cry in front of an ad, you yell at everyone, your breasts are painful, you feel swollen like a balloon.
🧬 Why does this happen?
Natural hormonal fluctuations (drop in serotonin linked to progesterone), individual sensitivity to hormones, magnesium/calcium deficiencies, stress.
⚠️ Is it serious?
Benign but painful. PMS isn't life-threatening, but it can really ruin your daily life. This is distinct from PMDD (severe form), which requires medical treatment.
✅ What are you doing? Calcium (1000-1200mg/day), magnesium + B6, chasteberry, physical activity, salt/caffeine/alcohol reduction. If that's not enough, take the pill continuously.
10. Premenstrual Dysphoric Disorder (PMDD): PMS in Extreme Version
💡 What is it really?
The severe psychiatric version of PMS. Intense depression, major anxiety, explosive anger, and suicidal thoughts, which consistently appear before menstruation and disappear afterward. Recognized as a depressive disorder in the DSM-5.
🔍 How do you recognize him?
You can't function normally for the week before your period. You think about dying, you can't go to work, you ruin your relationships, you have uncontrollable fits of rage. Then your period comes and everything goes back to normal.
🧬 Why does this happen?
Neurobiological cause: abnormal sensitivity of the brain to hormonal fluctuations, dysfunction of the GABAergic system, serotonin deficiency, genetic predisposition.
⚠️ Is it serious?
Yes, it is serious. PMDD can lead to suicide. It is NOT psychological; it is a neurobiological condition that requires serious medical treatment.
✅ What are you doing? See a psychiatrist or gynecologist URGENTLY. SSRIs (antidepressants) work in 60-90% of women within 24-48 hours. Continuous pills, CBT. You're not crazy, you're sick, and it can be treated.
11. Endometriosis: When the Endometrium Goes astray
💡 What is it really?
Tissue similar to the endometrium (uterine lining) grows outside the uterus: on the ovaries, fallopian tubes, peritoneum, intestine, and bladder. This tissue bleeds during menstruation, causing inflammation, adhesions, and excruciating pain.
🔍 How do you recognize him?
Chronic pelvic pain, severe dysmenorrhea (which gets worse over time), pain during intercourse, pain when defecating/urinating during menstruation, chronic fatigue, infertility.
🧬 Why does this happen?
Causes still poorly understood. Theories: retrograde menstruation, genetic predisposition, immune dysfunction, cellular metaplasia.
⚠️ Is it serious?
Yes. A chronic, debilitating illness that destroys your quality of life. Can lead to infertility, adhesions, ovarian cysts (endometriomas). Average diagnostic time: 7 years (unacceptable).
✅ What are you doing? Consult a gynecologist specializing in endometriosis. Diagnosis by ultrasound/MRI + sometimes laparoscopy. Treatments: continuous pill, GnRH agonists, surgery (excision of lesions). You are not "cozy," you are sick.
12. Adenomyosis: Internal Endometriosis
💡 What is it really?
Endometrial tissue infiltrates the uterine muscle (myometrium) instead of remaining inside the uterine cavity. The uterus becomes thickened, swollen, and painful.
🔍 How do you recognize him?
Severe dysmenorrhea (often after 30-40 years), menorrhagia, feeling of pelvic heaviness, enlarged uterus on ultrasound.
🧬 Why does this happen?
Causes unknown. Often in women over 30 who have already given birth. May coexist with endometriosis.
⚠️ Is it serious?
Disabling but not fatal. Can cause severe anemia, chronic pain, impact on fertility. Often underdiagnosed.
✅ What are you doing? Diagnosis by MRI or expert ultrasound. Treatments: hormonal IUD (Mirena), continuous pill, GnRH agonists, or hysterectomy if parental plans are complete and pain is disabling.
Category 3: When It's Your Hormones That Are Messing Up 🧬
These disorders are linked to a hormonal imbalance that disrupts the menstrual cycle. Your body produces too much or too little of certain hormones, or fails to ovulate properly. This category includes five disorders.
13. Polycystic Ovary Syndrome (PCOS): The Hormonal Mess
💡 What is it really?
A hormonal imbalance that causes irregular or absent cycles, excess male hormones (androgens), and often cysts on the ovaries. The most common hormonal disorder in women of reproductive age.
🔍 How do you recognize him?
Very irregular cycles (oligomenorrhea or amenorrhea), severe acne, excessive hair growth (face, chest, back), weight gain that is difficult to lose, oily skin/hair, brown spots on the skin (acanthosis nigricans), difficulty getting pregnant.
🧬 Why does this happen?
Multiple causes: insulin resistance, genetic predisposition, excess androgens produced by the ovaries. Often linked to being overweight but not always (30% of women with PCOS are thin).
⚠️ Is it serious?
It can become so if left untreated. Long-term risks: type 2 diabetes, cardiovascular disease, endometrial cancer (absence of periods = endometrium not eliminated), infertility. But these can be managed well with appropriate monitoring.
✅ What are you doing? Hormonal assessment (testosterone, LH/FSH, blood sugar, insulin) + ovarian ultrasound. Treatments: anti-androgen pill, metformin (if insulin resistance), weight loss (if overweight), ovulation inducers if pregnancy is desired.
14. Anovulatory Cycles: When Ovulation Does Not Occur
💡 What is it really?
A menstrual cycle in which no egg is released. You still have bleeding that resembles a period (withdrawal bleeding), but it is not a true ovulatory cycle.
🔍 How do you recognize him?
Impossible to detect without basal temperature monitoring or ovulation tests. Indirect signs: no elastic cervical mucus mid-cycle, no temperature rise, very irregular cycles.
🧬 Why does this happen?
Intense stress, rapid weight loss, excessive exercise, PCOS, thyroid disorders, breastfeeding, onset of puberty, premenopause. Sometimes without identifiable cause (1-2 anovulatory cycles per year = normal).
⚠️ Is it serious?
Not serious in itself, but problematic if you want to get pregnant (no ovulation = no fertilization possible). To investigate if it is systematic.
✅ What are you doing? If planning a baby: consult for infertility assessment. Ovulation induction treatments (clomiphene, gonadotropins). If not planning a baby and regular cycles: nothing to do.
15. Luteal Insufficiency: Phase 2 of the Cycle Too Short
💡 What is it really?
The luteal phase (after ovulation) is too short (less than 10 days) or progesterone production is insufficient. The endometrium does not prepare properly for possible implantation.
🔍 How do you recognize him?
Short cycles (less than 21 days), spotting before periods, repeated early miscarriages, basal temperature that does not stay high long enough after ovulation.
🧬 Why does this happen?
Dysfunction of the corpus luteum (structure that produces progesterone after ovulation), thyroid disorders, hyperprolactinemia, stress, age (more common after 35 years).
⚠️ Is it serious?
Problematic especially in the context of fertility. May prevent implantation or cause early miscarriages. Requires evaluation if difficulty conceiving or repeated miscarriages.
✅ What are you doing? Progesterone dosage in the luteal phase. Treatment: progesterone supplementation (Utrogestan, Duphaston) in the second half of the cycle, or ovulation inducers to improve the quality of the corpus luteum.
16. Hyperandrogenism: Too Many Male Hormones
💡 What is it really?
Excess androgen hormones (testosterone, androstenedione) in the blood. Often associated with PCOS, but can exist in isolation.
🔍 How do you recognize him?
Severe acne (face, back, torso), hirsutism (hard, dark hair on the face, chin, upper lip, torso, stomach), androgenic alopecia (hair loss on the top of the head), deep voice, irregular cycles.
🧬 Why does this happen?
PCOS (main cause), ovarian or adrenal tumor (rare), congenital adrenal hyperplasia, certain medications (anabolic).
⚠️ Is it serious?
Psychologically very difficult to live with (impact on self-esteem), but rarely dangerous. Requires investigation to rule out a tumor (rare but should be excluded).
✅ What are you doing? Complete hormonal assessment (total and free testosterone, SDHEA, 17-OH progesterone). Treatments: anti-androgen pill (Diane 35, Jasmine), spironolactone, laser hair removal, treatment of the underlying cause.
17. Uterine Fibroids: Benign But Annoying Tumors
💡 What is it really?
Benign (non-cancerous) tumors that develop in the uterine muscle (myometrium). Can be as small as a pea or as large as an orange. Very common, especially after age 30.
🔍 How do you recognize him?
Often asymptomatic. When they cause symptoms: menorrhagia (very heavy periods), feeling of pelvic heaviness, frequent urge to urinate (bladder compression), pelvic pain, swollen belly.
🧬 Why does this happen?
Causes poorly understood. Excessive sensitivity to estrogen, genetic predisposition. More common in women of African descent.
⚠️ Is it serious?
Benign, never become cancerous. But can cause severe anemia, pain, fertility problems (depending on location). Many women live with it without knowing it.
✅ What are you doing? Diagnosis by ultrasound. If asymptomatic: simple monitoring. If symptomatic: hormonal IUD, pill, uterine artery embolization, surgical removal (myomectomy), or hysterectomy if parental plans are complete.
Red Flags: When to Seek Emergency Medical Care 🚨
Some symptoms require prompt, even urgent, attention. Never ignore them.
Consult without delay
🩸 Hemorrhagic bleeding: You soak a pad/tampon every hour for 2 hours+, or you have huge clots + dizziness/extreme pallor (risk of acute anemia or hemorrhage).
💥 Sudden and severe pelvic pain: Acute pain that does not go away with analgesics, especially if accompanied by fever, vomiting, malaise (risk of ovarian torsion, ectopic pregnancy, appendicitis).
🌡️ Fever + abnormal bleeding: Fever > 38,5°C + bleeding/foul-smelling discharge (risk of serious infection: endometritis, PID).
💭 Suicidal thoughts: If you are thinking about harming yourself, immediately contact 3114 (the national suicide prevention number) or the psychiatric emergency room.
🤰 Late period + pain + bleeding: Risk of ectopic pregnancy (EP) - life-threatening emergency. Take a pregnancy test and seek medical help immediately.
🩺 Postmenopausal bleeding: Any bleeding after menopause should be investigated promptly (risk of endometrial cancer).
How to Talk to Your Doctor About Your Conditions
Many women struggle to describe their symptoms to their doctor or feel unregarded. Here's how to maximize your chances of being heard and diagnosed.
✅ Prepare your consultation
📝 Keep a cycle journal for 2-3 months
Note: start date of period, duration, abundance (number of protections/day), pain (intensity 1-10), emotional symptoms, spotting. This gives objective information to the doctor.
💬 Use precise terms
- Instead of "heavy periods" → "I change my pad every hour for 2 days"
- Instead of "very bad" → "I can't get up, I threw up 3 times, I missed 2 days of work"
- Instead of "irregular cycles" → "I had my period on January 5, February 18, April 2"
🎯 Describe the impact on your life
"I miss work two days a month," "I can no longer have sex," "I have suicidal thoughts before my period." Functional impact is an important medical criterion.
⚡ Insist if you are not taken seriously
"I'd like to rule out endometriosis/PCOS," "Can you note in my file that you refuse to do further tests?", "I'd like a second opinion." You have the right to be heard.
Rules That Are Making Your Life a Misery?
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Your Period Is Not Inevitable
Menstrual disorders affect most women at some point in their lives. Some are benign and temporary, while others require serious medical attention. The key is knowing the difference between a normal change in mood and a real health problem.
If your period is preventing you from living a normal life, if you're in so much pain that you miss work, if you're bleeding like a fountain, if you have suicidal thoughts before your period, it's NOT normal and it's NOT in your head. You deserve to be taken seriously, you deserve further testing, and you deserve treatment that works. Menstrual disorders are not inevitable, and you are not doomed to suffer in silence.
Sources & Scientific References
This article is based on medical publications and recommendations from learned societies in gynecology.
Official recommendations
- American College of Obstetricians and Gynecologists (ACOG). Menstrual Disorders and Related Problems. Practice Bulletin.
- CNGOF (National College of French Gynecologists and Obstetricians). Recommendations for clinical practice - Menstrual cycle disorders.
- World Health Organisation. Menstrual health and rights. Information sheet, 2021.
Studies on specific menstrual disorders
- Zondervan KT, Becker CM, Missmer SA. (2020). Endometriosis. New England Journal of Medicine. DOI: 10.1056/NEJMra1810764
- Teede HJ, Misso ML, Costello MF, et al. (2018). Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome. Human Reproduction. DOI: 10.1093/humrep/dey256
- Yonkers KA, O'Brien PMS, Eriksson E. (2008). Premenstrual syndrome. The Lancet. DOI: 10.1016/S0140-6736(08)60527-9
- Munro MG, Critchley HOD, Fraser IS. (2018). The two FIGO systems for normal and abnormal uterine bleeding symptoms and classification of causes of abnormal uterine bleeding. International Journal of Gynecology & Obstetrics. DOI: 10.1002/ijgo.12666
- Petraglia F, Hornung D, Seitz C, et al. (2015). Reducing the burden of menorrhagia in Europe. Health Economics Review. PMC4371495
Premenstrual dysphoric disorder
- American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Section on Premenstrual Dysphoric Disorder.
- Hantsoo L, Epperson CN. (2015). Premenstrual Dysphoric Disorder: Epidemiology and Treatment. Current Psychiatry Reports. DOI: 10.1007/s11920-015-0628-3
Note: The information in this article is based on current medical literature and recommendations from learned societies. It is not a substitute for personalized medical consultation.
Medical Warning: This article is for informational purposes only and is not a substitute for medical advice. If you experience worrying symptoms, severe pain, or any other menstrual disorder that affects your quality of life, consult a gynecologist, midwife, or general practitioner.
