Terminology

Introduction
Terminology
Patterns of Bleeding
Causes of Menstrual Abnormalities
Diagnosis
Treatment
Myths
Summary

Although many of these terms are not often used in actual clinical practice, We thought you might be interested in at least knowing some of the definitions that you may see on some of the reports that we issue so that you have a better understanding of the whole process.

By strict definition, a woman "menstruates" only if ovulation has occurred during that cycle. A woman may bleed because of changing hormone levels even though ovulation has not occurred. Such bleeding is termed withdrawal bleeding and is not, strictly speaking, a menstrual period. However, please understand that the term "menstrual period" is used in a rather generic fashion; but it does have a precise definition.

A woman who has normal regular menstrual cycles is "eumenorrheic". By definition, this means that the menstrual periods are coming every 21 to 35 days, with a flow lasting 3-5 days, and the cycles are regular, uniform, and predictable from one month to the next. Menstrual cycles are counted from the 1st day of the period to the 1st day of the next period.

A woman whose periods come more often than every twenty-one days has polymenorrhea. A woman whose menstrual periods come less often than every thirty-five days has oligomenorrhea.

Amenorrhea is the term used to define the complete absence of bleeding. A woman who has gone for at least six months without a period is amenorrheic.

Another definition of amenorrhea is a woman who goes more than 3 times her usual cycle length without bleeding. This is a more functional definition. What it says is that more attention should be paid to woman with normal cycles who suddenly skips 3 or more months than a woman with very irregular cycles who goes 9 months without bleeding.

We can also divide women who fail to menstruate into two additional categories - those who never have a menstrual period when they reach the age of puberty compared to those women who do establish some menstrual cycles but then stop bleeding at some future date.

A woman who has never menstruated (or bled) on her own is said to have primary amenorrhea. A woman who has had at least one spontaneous menstrual period and then stops subsequent to that has secondary amenorrhea.

A woman whose menstrual flow is very light has hypomenorrhea; a woman whose menstrual flow is very heavy and/or very prolonged has hypermenorrhea.

A term you will commonly see is "DUB". DUB stands for Dysfunctional Uterine Bleeding and, by strict definition, means any abnormality of menstruation or bleeding caused by a hormonal disorder. It means there has been a full evaluation including a vaginal ultrasound (an abdominal ultrasound using a full bladder technique is too inaccurate to be of value), a sonohysterogram, and a hysteroscopy when appropriate, and no organic or anatomic cause for the bleeding such as a fibroid tumor of the uterus, a polyp, or adenomyosis has been discovered. The term DUB, however, has taken on a rather loose definition and is often used to describe any woman with abnormal cycles regardless of cause.

You will sometimes see the terms "menorrhagia", "metrorrhagia" and "meno-metrorrhagia" on reports. These are old terms that should no longer be used. Menorrhagia means very heavy menstrual periods; metrorrhagia means bleeding between periods; and meno-metrorrhagia means totally irregular heavy bleeding. These have largely been replaced by the terms mentioned in the preceding paragraphs.