The Menstrual Cycle and Menstrual Abnormalities Quiz

• A Infrequent periods, with cycles longer than 35 days or fewer than nine periods a year ✓
• B Intermenstrual bleeding, defined as uterine bleeding occurring between otherwise regular menstrual periods
• C Prolonged menstrual bleeding, defined as bleeding that lasts longer than seven days each cycle
• D Heavy menstrual bleeding, defined as excessive menstrual blood loss at regular intervals that interferes with quality of life
• E Secondary amenorrhoea, defined as absent menstruation for more than six months after previously established cycles

Explanation

Why A is correct

See Menorrhagia. Option A is correct. The prefix oligo- means few, so oligomenorrhoea means few periods: periods that come infrequently. It is usually defined as intervals of more than 35 days between cycles, or fewer than nine periods in a year, whereas a typical cycle is around 28 days. It is different from amenorrhoea (the absence of periods), because bleeding does still occur, just rarely. The usual underlying problem is that ovulation is infrequent or irregular, so the hypothalamic-pituitary-ovarian axis (the hormone chain linking the brain and the ovary) is not working in its normal rhythm. Causes include polycystic ovary syndrome, thyroid disease, raised prolactin, pituitary disease and some contraceptive methods. The names themselves help you to remember the main menstrual patterns:

• oligomenorrhoea, which is few periods
• amenorrhoea, which is no periods
• menorrhagia, which is heavy periods
• intermenstrual bleeding, which is bleeding between periods

• Oligomenorrhoea: the prefix oligo- means few, so periods come infrequently.
• Definition: intervals of more than 35 days, or fewer than nine periods a year.
• Underlying problem: ovulation is infrequent or irregular.

Why the other options are incorrect

• B. Intermenstrual bleeding, defined as uterine bleeding occurring between otherwise regular menstrual periods: Bleeding between otherwise regular periods is intermenstrual bleeding, which is a pattern of timing within cycles rather than infrequent cycles.
• C. Prolonged menstrual bleeding, defined as bleeding that lasts longer than seven days each cycle: Prolonged bleeding is a feature of heavy menstrual bleeding but describes duration rather than frequency; oligomenorrhoea is about how often cycles occur.
• D. Heavy menstrual bleeding, defined as excessive menstrual blood loss at regular intervals that interferes with quality of life: Heavy menstrual bleeding at regular intervals describes excessive blood loss, not infrequent cycles, so it is a different menstrual disorder.
• E. Secondary amenorrhoea, defined as absent menstruation for more than six months after previously established cycles: Complete absence of menstruation for more than six months is secondary amenorrhoea; oligomenorrhoea means periods still occur, but infrequently.

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