Menstrual disorders are problems with the timing, amount or comfort of periods: heavy bleeding, painful periods, irregular or absent periods, bleeding between periods and severe PMS. A typical adult cycle is 21–35 days with bleeding for up to about 7 days. Causes include hormonal changes, PCOS, thyroid disease, fibroids, polyps and endometriosis; most are diagnosed with history, ultrasound and blood tests.
- Normal cycle
- Every 21–35 days
- Normal bleeding
- Up to about 7 days
- Common causes
- Hormones, fibroids, polyps, PCOS
- First tests
- Ultrasound, pregnancy and blood tests
- Treatment
- Medication, IUD, procedures
- Cost guide
- Consult ₩50,000–100,000
What counts as a menstrual disorder?
| Type | What it means | Learn more |
|---|---|---|
| Heavy menstrual bleeding | Bleeding that soaks pads hourly, lasts over 7 days or brings large clots | Heavy menstrual bleeding |
| Painful periods (dysmenorrhea) | Cramps that limit daily life or need more than usual painkillers | Painful periods |
| Irregular periods | Cycle length varies a lot or is shorter than 21 / longer than 35 days | Irregular periods |
| Amenorrhea | No period for 3 months (or 6 if cycles were irregular) | Amenorrhea |
| Intermenstrual bleeding | Spotting between periods or after sex | Vaginal bleeding |
| PMS / PMDD | Mood and physical symptoms before each period | Premenstrual syndrome |
What causes period problems?
Doctors often group causes of abnormal uterine bleeding as structural(something in the uterus) or non-structural(hormones, clotting or medication):
- Structural — endometrial polyps, uterine fibroids, adenomyosis and, rarely, precancer or cancer of the lining.
- Ovulation problems — PCOS, thyroid disease, high prolactin, stress, weight change, and the first years after menarche or before menopause.
- Other — bleeding disorders, blood thinners, hormonal contraception, IUDs, infection and pregnancy-related bleeding.
How menstrual disorders are diagnosed
- Cycle history Bring a period diary or app record: dates, flow, pain and spotting. The consultation is in English.
- Pregnancy test Pregnancy is ruled out first for any change in bleeding.
- Pelvic ultrasound A same-day ultrasound checks lining thickness, polyps, fibroids and ovaries.
- Blood tests Blood count for anemia, and thyroid or reproductive hormones when the pattern suggests it.
- Further tests if needed A Pap smear if due, an endometrial biopsy, or hysteroscopy for persistent abnormal bleeding.
A thickened or irregular lining, sometimes with a polyp, can cause heavy, prolonged or irregular bleeding.
After hormonal treatment or removal of the cause, the lining is thinner and more regular.
Treatment options
| Option | Often used for | Notes |
|---|---|---|
| NSAIDs or tranexamic acid | Heavy or painful periods | Taken during the period only; non-hormonal |
| Combined pill or progestin | Irregular, heavy or painful periods; PCOS | Also contraception for most |
| Hormonal IUD | Heavy and painful periods | Lasts several years; see IUD insertion |
| Treating the cause | Thyroid disease, prolactin, anemia | Iron replacement when needed |
| Procedures | Polyps, fibroids, persistent bleeding | Polypectomy, myomectomy or endometrial ablation |
Your doctor will discuss pregnancy plans first, since some treatments are contraceptive and ablation is not suitable if you may want a future pregnancy.
When to seek care
At Yoonho Women’s Hospital in Apgujeong, Seoul, most period problems are assessed in a single visit with an English-speaking gynecologist. Book a check-up if your periods have clearly changed, are affecting work or sleep, or you feel tired and breathless (possible anemia).
Cost and insurance
As a general guide, a consultation is about ₩50,000–100,000, with ultrasound and blood tests added as needed; a written estimate is given after consultation. Read about health insurance for foreigners, or request English receipts and a diagnosis for travel insurance claims.
Why international patients choose Yoonho
Frequently asked questions
How do I know if my period is abnormal?
Signs include cycles shorter than 21 or longer than 35 days, bleeding longer than 7 days, soaking a pad or tampon every hour, large clots, or pain that stops normal activities. A sudden change from your usual pattern also deserves a check.
Can stress or travel change my period?
Yes. Stress, jet lag, illness and weight change can delay or alter a cycle. If irregular periods continue for more than a few months, get checked.
Do I need an ultrasound for period problems?
Often, yes. A transvaginal ultrasound is the main test for polyps, fibroids and lining thickness. An abdominal scan is used if a vaginal scan is not suitable.
Can I be seen while I am bleeding?
Yes. Bleeding does not prevent an ultrasound or consultation, and seeing the bleeding pattern can be helpful.
Is my contraceptive causing my bleeding changes?
Pills, implants, injections and IUDs can all change bleeding, especially in the first months. Other causes should still be ruled out if bleeding persists.
OB-GYN Specialist · Director of OB-GYN
M.D., Ewha Womans University College of Medicine · Former Clinical Instructor, Ewha Womans University Mokdong Hospital · Member, Korean Society of Menopause
Last reviewed: . This page is for general information and does not replace an in-person consultation.
Talk to an English-speaking gynecologist
Yoonho Hospital · 304 Apgujeong-ro, Gangnam-gu, Seoul · Mon–Fri 9:00–18:00, Sat 9:00–13:00 · Walk-ins welcome.