Menstrual Disorder Treatment in Singapore
Dr. Chang T.C.
Obstetrician & Gynaecologist Singapore
MBBS London, MD London, FRCS Glasgow, FRCOG UK, FAMS
For many women, period problems become so familiar they stop feeling like problems at all. But heavy bleeding that disrupts daily life, pain that keeps you from work, or cycles that are persistently irregular are not simply inconveniences to manage around. They are signs that something in your reproductive system may need attention.
Menstrual disorder treatment in Singapore helps identify what is causing your symptoms and sets out a clear plan for managing them.
When Are Periods Considered Abnormal?
There is natural variation in what a normal period looks like.
Most cycles fall between 21 and 35 days, last up to eight days, and involve a manageable amount of bleeding.
A period may be considered abnormal if:
- It is consistently heavier than usual
- It is significantly more painful than expected
- You are experiencing irregular periods or cycles that have stopped altogether
Bleeding between periods or after the menopause also warrants investigation. If your periods are regularly interfering with your daily activities, work, or sleep, that is a reasonable basis to seek an assessment.
Common Types of Menstrual Disorders
| Type | What it looks like |
| Heavy periods (menorrhagia) | Blood loss exceeding 80 mL per cycle; soaking through protection every hour for several consecutive hours; periods lasting longer than seven days |
| Painful periods (dysmenorrhoea) | Cramping that is severe, worsening over time, or unresponsive to standard pain relief; may indicate endometriosis or adenomyosis. Adenomyosis symptoms tend to worsen over time, and endometriosis is the most common cause of secondary dysmenorrhoea |
| Irregular or absent periods | Cycles that vary significantly in length, or periods that stop altogether (amenorrhoea); may reflect hormonal imbalances, thyroid dysfunction, or polycystic ovary syndrome (PCOS) |
| Bleeding between periods or after menopause | Intermenstrual bleeding, or any bleeding 12 months or more after periods have stopped; always warrants prompt assessment |
What Can Cause Menstrual Disorders?
Menstrual disorders have a wide range of causes, and more than one may be present at the same time.
Common causes include:
- Uterine fibroids (non-cancerous growths in or around the uterine wall)
- Endometrial polyps (small, benign growths on the lining of the uterus)
- Endometriosis or adenomyosis
- Hormonal imbalances, including thyroid disorders
- Polycystic ovary syndrome (PCOS)
- Bleeding or clotting disorders
- Intrauterine devices (IUDs) as a contributing factor in some cases
- Endometrial (uterine lining) abnormalities
How Are Menstrual Disorders Assessed?
A thorough assessment for abnormal uterine bleeding typically begins with a detailed medical history and discussion of your symptoms.
This is usually followed by:
- A pelvic examination
- Blood tests to check hormone levels, thyroid function, and signs of anaemia (low iron from heavy blood loss)
- An ultrasound scan to assess the uterus, ovaries, and any structural abnormalities
Where the cause remains unclear, further investigation may include a hysteroscopy (a thin camera to view the inside of the uterus) or endometrial sampling (a small tissue sample from the uterine lining for laboratory analysis).
Treatment Options for Menstrual Disorders
| Treatment | What it involves |
| Hormonal treatments | The combined oral contraceptive pill, progesterone therapy, or a hormonal intrauterine system to regulate or reduce bleeding |
| Non-hormonal medications | Tranexamic acid or anti-inflammatory pain relief for dysmenorrhoea |
| Surgical options | Fibroid removal (myomectomy) or the removal of endometrial polyps (polypectomy) for structural causes |
| Laparoscopic surgery | Minimally invasive surgery for conditions such as endometriosis or adenomyosis |
| Hysterectomy | Surgical removal of the uterus, considered where symptoms are severe and other treatments have not been effective |
Many menstrual disorders can be managed effectively without surgery. Your doctor will discuss all applicable options with you before any decisions are made.
When May Hysteroscopy or D&C Be Recommended?
A hysteroscopy is a procedure performed to look directly inside the uterine cavity using a thin, lighted instrument passed through the cervix.
It is used both to diagnose and, in many cases, to treat conditions such as endometrial polyps, submucosal fibroids (fibroids within the uterine cavity), and abnormalities of the uterine lining.
Dr Chang performs hysteroscopy as part of his general gynaecological surgery services.
A dilatation and curettage (d&c) procedure is a gynaecological procedure that involves gently opening the cervix and scraping or suctioning away the lining of the uterus. It may be recommended to obtain a tissue sample for diagnosis, to manage abnormal uterine bleeding, or following a miscarriage.
Both procedures are typically performed under general or local anaesthetic and are usually completed as day surgery. Recovery is generally straightforward, with most women returning to normal activities within a few days.
When Should You See a Gynaecologist?
You should consider seeking an assessment if:
- Your periods are consistently heavier, more painful, or more irregular than they used to be
- You are soaking through sanitary protection every hour for several consecutive hours on a regular basis
- You experience bleeding between periods or after sexual intercourse
- You have any bleeding after the menopause
- Your symptoms are affecting your sleep, work, or daily activities
- You have been trying to conceive and are concerned that a menstrual disorder may be a factor
Menstrual Disorder Care with Dr TC Chang
Dr TC Chang is a Consultant Obstetrician and Gynaecologist with over 31 years of specialist experience. He is the Head of the Fetal Assessment Unit at Thomson Medical Centre, and his gynaecological services cover the assessment and management of menstrual disorders, including surgical treatment for conditions such as fibroids, endometriosis, adenomyosis, and endometrial polyps.
If your periods are causing concern, book a consultation with Dr TC Chang.
Frequently Asked Questions
What causes heavy or prolonged periods?
Heavy periods have a range of causes, including uterine fibroids, endometrial polyps, hormonal imbalances, adenomyosis, and bleeding disorders. In some cases, no structural cause is found, and the condition is described as dysfunctional uterine bleeding. An assessment will help identify the most likely cause and guide treatment decisions.
Are painful periods always normal?
What tests may be needed for menstrual disorders?
Assessment typically includes a medical history review, pelvic examination, blood tests, and an ultrasound scan. Where the cause remains unclear, a hysteroscopy or endometrial biopsy may be recommended.
Can menstrual disorders be treated without surgery?
When may hysteroscopy be recommended for abnormal bleeding?
When may a D&C procedure be needed?
A d&c procedure may be recommended to obtain an endometrial tissue sample for diagnosis, to manage ongoing abnormal uterine bleeding, or in the management of a miscarriage. Your doctor will explain what the procedure involves before you make any decision.
Can menstrual disorders affect fertility?
Some menstrual disorders, such as PCOS, endometriosis, fibroids, and polyps, can affect fertility. If you are trying to conceive and have irregular periods, heavy periods, or painful periods, it is worth raising this with a gynaecologist. Dr Chang offers fertility screening for couples looking to understand their reproductive health in more detail.
There is no obligation at a first consultation. It is simply an opportunity to discuss your symptoms, understand what may be causing them, and explore your options.