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Introduction to Menstrual Abnormalities

By JoAnn V. Pinkerton, MD, Professor of Obstetrics and Gynecology and Division Director, Midlife Health Center; Executive Director, University of Virginia Health System; The North American Menopause Society

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(For a description of the menstrual cycle, see Female Reproductive Endocrinology : Menstrual Cycle.)

Menstrual abnormalities include

Irregular or absent menses and nonmenstrual vaginal bleeding have many causes, but in women of reproductive age, pregnancy should always be suspected.

Abnormal vaginal bleeding in nonpregnant women is evaluated differently from vaginal bleeding in pregnant women (see Vaginal Bleeding During Early Pregnancy and Vaginal Bleeding During Late Pregnancy).

Polycystic ovary syndrome can cause some of the same symptoms as menstrual abnormalities.

Pelvic congestion syndrome, a common cause of chronic pelvic pain, is often accompanied by abnormal menstrual bleeding.