Polymenorrhagia (epimenorrhoea)

Polymenorrhoea also refers to menstruation periods that occur at shorter intervals than usual (14-21 days), but they are frequent and regular.

• Hormonal imbalances : Fluctuations in oestrogen and progesterone levels can disrupt the normal menstrual cycle and result in more frequent periods.
• Thyroid disorders : Overactive thyroid (hyperthyroidism) or underactive thyroid (hypothyroidism) can affect hormone production and menstrual regularity.
• Polycystic ovary syndrome (PCOS): This condition is characterized by hormonal imbalances, enlarged ovaries with cysts, and irregular menstrual cycles.
• Uterine abnormalities : Conditions such as uterine fibroids, polyps, or adenomyosis can cause abnormal bleeding and frequent periods.
• Stress and lifestyle factors : Chronic stress, excessive exercise, drastic weight changes, and poor nutrition can disrupt the hormonal balance and contribute to polymenorrhea.

• Menstrual Cycles Shorter than 21 Days : Defined by the duration between the onset of one period and the beginning of the next, with cycles constantly falling below the normal 21-days.
• Frequent Menstrual Periods : Menstrual bleeding occurring every two weeks or at intervals of less than 14 days, indicating increased frequency compared to the standard monthly cycle.
• Altered Bleeding Patterns : Variations in blood flow, with episodes of lighter or heavier bleeding than what is considered for the individual.
• Increased Menstrual Discomfort : Discomfort or pain associated with menstruation, more than the discomfort experienced during a regular menstrual cycle.
• Fatigue or Tiredness : Resulting from more frequent blood loss due to polymenorrhea, leading to a decrease in energy levels and an increased sense of tiredness.
• Emotional and Psychological Impact : Potential emotional consequences, including anxiety or mood swings, from the physical and hormonal changes associated with more frequent menstrual cycles.

• Medical history and physical examination : A thorough evaluation of the menstrual patterns, symptoms, and any underlying medical conditions is conducted. A pelvic examination may be performed to assess the reproductive organs.
• Hormone level assessment: Blood tests may be done to measure hormone levels, including oestrogen, progesterone, thyroid hormones, and other relevant hormones.
• Pelvic ultrasound: This imaging test can provide visual information about the ovaries, uterus, and any structural abnormalities.
• Endometrial biopsy : A sample of the uterine lining may be obtained and examined to rule out any abnormalities or cancer.

• Hormonal therapy : Depending on the underlying cause, hormonal medications, such as oral contraceptives or hormone-regulating medications, may be prescribed to regulate the menstrual cycle and reduce the frequency of periods.
• Treatment of underlying conditions : If polymenorrhea is caused by conditions such as PCOS or uterine abnormalities, appropriate treatment strategies will be implemented to address the specific cause. Carry out dilatation and curettage (D&C) to remove retained products if its the cause.
• Lifestyle modifications : Stress reduction techniques, maintaining a balanced diet, regular exercise, and adequate sleep can help regulate hormonal balance and promote overall well-being.
• Supportive care : Nursing management focuses on providing emotional support, educating patients about menstrual hygiene, symptom management, and lifestyle modifications.
• Monitoring and follow-up : Monitoring patients’ response to treatment, assessing the effectiveness of interventions, and ensuring appropriate follow-up care should be put into considerations.