What Are the Signs of a Menstrual Disorder?

Menstrual disorders affect many women in Singapore and can have a significant impact on health, fertility, and quality of life. If left unmanaged, it may lead to serious complications like anaemia, chronic pelvic pain, or increased cancer risk. At Daniel Koh Clinic, our gynaecologist provides thorough assessments and personalised treatments for women experiencing menstrual disorders, from irregular or heavy bleeding to absent periods and mood-related symptoms.

Irregular Menstrual Cycle

An irregular menstrual cycle is characterised by infrequent or unusually spaced menstrual periods. Instead of the typical 21 to 35 days interval, individuals with irregular menstrual cycles may have menstruation that occur more than 35 days apart, or they may experience unpredictable cycles. While occasional irregularities may be benign, consistent irregular menstruation may indicate hormonal imbalances, thyroid issues, or polycystic ovary syndrome (PCOS).

Notably, PCOS affects one in every ten Singaporean women, and is one of the leading causes for infertility. It accounts for up to 75% of cases involving anovulation, where the ovaries do not regularly release eggs. 

If you suspect you may have PCOS, early detection, screening and treatment at an OBGYN such as Daniel Koh Clinic is essential to improve ovulatory function and reproductive outcomes. 

Absence of Menstruation (Amenorrhoea)

Amenorrhea is the absence of menstruation for three months or longer, unrelated to pregnancy. It may result from stress, excessive exercise, significant weight loss and/or hormonal imbalances.

However, persistent amenorrhea should never be ignored, especially if you are of reproductive age, as it may be due to more serious causes such as premature ovarian insufficiency, pituitary (hormone gland) disorders, or thyroid disease.

Heavy Menstrual Bleeding (Menorrhagia)

Menorrhagia refers to abnormally heavy periods. You might have this condition if you are soaking through more than a pad or tampon every hour, passing large clots, or have periods that last longer than seven days (menometorrhagia). 

Heavy bleeding may be due to fibroids, polyps, endometriosis or adenomyosis, this may lead to anaemia.

At Daniel Koh Clinic, heavy bleeding is investigated thoroughly. This may include performing blood tests, pelvic ultrasound and Hysteroscopy, Dilation and Curettage (D&C).

Painful Menstruation (Dysmenorrhea)

Painful menstruation, also known as dysmenorrhea, can be a sign of a menstrual disorder, especially if the pain is intense and/or disrupts your daily life. This pain is often felt in the lower abdomen or lower back.

While some discomfort is expected during menstruation, severe or debilitating pain may suggest an underlying gynaecological condition like endometriosis or fibroids.

Spotting or Bleeding Between Menstruation (Intermenstrual Bleeding)

Intermenstrual bleeding (IMB) may indicate: 

• Hormonal imbalance

• Endometrial or cervical polyps

• Uterine fibroids

• Endometrial hyperplasia

• Uterine, cervical or ovarian cancer

Persistent spotting warrants immediate evaluation to rule out pre-cancerous or cancerous changes. This may involve pelvic ultrasound or diagnostic hysteroscopy to examine the uterine cavity directly.

Persistent or unexplained spotting should be evaluated and may be managed through:

• Hormonal regulation with oral contraceptives

• Surgical removal of polyps or fibroids

• Evaluation for cervical pathology via pap smear, HPV test or colposcopy

Menstrual Cycle-Related Mood Disorders

Mild mood changes before your period are common, but severe mood swings, anxiety, or depressive symptoms that disrupt daily function may signal Premenstrual Dysphoric Disorder (PMDD), or Premenstrual Syndrome (PMS).

How Menstrual Disorders Are Diagnosed

At Daniel Koh Clinic, the diagnostic process for menstrual disorders begins with a detailed consultation and clinical history-taking. Our gynaecologist will ask about your menstrual cycle patterns, duration, bleeding volume, associated symptoms such as pain or mood changes, and any family or medical history that may suggest underlying conditions like PCOS, fibroids, or endometriosis.

A physical examination is often followed by diagnostic tests tailored to your symptoms. These may include:

• Pelvic ultrasound

• Blood tests 

• Pap smear and HPV test

• Hysteroscopy, Dilation and Curettage (D&C)

Accurate diagnosis allows for early intervention and improved symptom control.

Treatment Options for Menstrual Disorders

Treatment depends on the underlying causes and severity of symptoms. Common interventions include:

• Lifestyle Modification

• Non-Hormonal Therapy

• Hormonal Therapy

• Endocrine and Metabolic Therapy

• Minimally Invasive Procedures such as Hysteroscopy, D&C, Diagnostic and Therapeutic Laparoscopy 

Treatment is individualised based on clinical findings, imaging, and laboratory results.

When should I see a doctor?

If you notice any of the above symptoms, it would be a good idea to visit your doctor. Early intervention can improve your quality of life and prevent progression to a more serious condition.

Consult a Gynaecologist at Daniel Koh Clinic

If you are concerned, do not hesitate to consult our gynaecologist. At Daniel Koh Clinic, we provide accurate diagnosis and personalised treatment for menstrual disorders.

Book an appointment now.

Frequently Asked Questions:

Is it normal to have irregular periods as a teenager?

Yes, irregular periods are common in the first 1–2 years after the first menstrual cycle as the body adjusts to hormonal changes. However, if irregularity persists beyond this adjustment period, early evaluation is recommended.

Can birth control help regulate menstruation?

Yes, hormonal contraceptives are often prescribed to regulate menstruation cycles. Our gynaecologists at Daniel Koh Clinic will recommend the most suitable option based on your medical history, lifestyle, and treatment goals.

Do menstrual disorders affect fertility?

Yes, certain menstrual disorders can impact fertility. Early diagnosis and treatment can help preserve fertility, restore regular ovulatory cycles, and improve the chances of conception. If you are planning to conceive, it is important to address any menstrual irregularities early.

Is treatment covered by insurance in Singapore?

Many diagnostic investigations and medical treatments for menstrual disorders may be covered under private health insurance or corporate plans, depending on your provider. We recommend checking with your insurer and speaking with our clinic staff to understand coverage, documentation requirements, and claimable expenses.