Menstrual Disorders

Living with a menstrual disorder can disrupt your daily activities and be very frustrating when you are experiencing symptoms and you are not sure what is causing them. Often, women put off visiting their gynaecologist for menstrual disorders as they pass off their symptoms as just having an irregular period.

What are menstrual disorders?

Menstrual disorders can be defined as symptoms that disrupt the menstrual cycle, often accompanied by physical and/or emotional symptoms just before and during menstruation.

These symptoms may include:

  • A heavy flow or irregular flow
  • Sleep disruptions and fatigue
  • Low mood and depression
  • Debilitating stomach cramps
  • Bloating and fullness in the lower abdomen
  • Feeling emotionally distressed


Premenstrual syndrome (PMS) has a wide variety of emotional and physical symptoms that occur before a woman’s cycle. PMS is very common, with most women having at least some of these symptoms before and during their cycle. These symptoms can level in intensity from mild to severe. For some women, these symptoms can disrupt their daily lives.

Symptoms of PMS include:

  • Feeling tense and anxious
  • Depressed mood
  • Feeling tearful or crying
  • Mood swings
  • Appetite changes and food cravings
  • Fatigue
  • Fluid retention related to weight gain
  • Abdominal bloating
  • Breast tenderness
  • Acne
  • Constipation or diarrhoea

In a small number of cases, these symptoms can be debilitating, where women are unable to continue with daily activities and disrupting their lives. This is known as Premenstrual Dysphoric Disorder (PMDD).

Untreated PMDD can be extremely emotionally distressing and, if left untreated, can lead to depression and suicide. The cause of PMDD is not known, but some experts believe that it is caused by the fluctuating serotonin levels in the brain.

You may be more prone to PMDD if you have

  • A history of anxiety or depression
  • A family history of PMDD
  • A family history of mood disorders

Treatment options for PMDD

PMDD can be managed with hormonal birth control pills and, sometimes, antidepressants.

Stress management, regular exercise and making dietary changes can also have a positive effect on PMDD symptoms. If you suspect you may have PMDD, book a consultation with Dr Tshimanga for a diagnosis and to discuss treatment options.


Polycystic ovary syndrome (PCOS) is a common hormonal imbalance that occurs in women in their reproductive years. It causes ovaries to create excess hormones called androgens. PCOS is one of the most common reasons why women struggle with infertility.

Symptoms of PCOS include

  • Irregular periods - on average, menstrual cycles come every 28 days; if you are missing periods or regularly have late periods, it is considered irregular
  • Abnormal hair growth on the face, chest, arms and abdomen due to high androgen levels
  • Acne on your face, chest and back
  • Obesity - up to 80% of people with PCOS struggle to maintain a healthy weight
  • Darkening of the skin in the folds of the skin, such as armpits and groin
  • Infertility as a result of not ovulating

Treatment options for PCOS

Dr Tshimanga will determine the right treatment for your situation, but most of the time, PCOS can be treated with hormonal birth control, Insulin-sensitising medicine and medications to block androgens. You may also be advised to make some lifestyle changes that can include exercising and having a healthy diet to maintain a healthy weight.


Endometriosis is a common and painful disorder where the endometrium tissue (the tissue that lines the uterus) grows outside of your uterus in places like the fallopian tubes, ovaries, and vagina, causing the surrounding tissue to become inflamed during your menstrual cycle.

Symptoms of endometriosis include

  • Experiencing very painful cramps in the lower back and abdomen during menstrual periods
  • Experiencing pain and discomfort during and after sex
  • Heavy flow during the menstrual period and spotting in between periods
  • Difficulty falling pregnant
  • Painful bowel movements, especially during menstrual periods

Treatment options for endometriosis

Dr Tshimanga will determine the right course of treatment for your particular situation. He will consider how severe the condition is, your plans for future pregnancy, your age and the severity of your symptoms.

Endometriosis can, in most cases, be managed with hormonal birth control, pain relief medication and hormone-releasing medication. Surgery, also known as a Laparoscopy, might be suggested to remove lesions.