Chart — Maternal-Newborn
Menstrual Disorders Comparison Chart
The common menstrual complaints, sorted into the buckets the exam tests: absent (amenorrhea), painful (dysmenorrhea), heavy/irregular (abnormal uterine bleeding), and cyclic mood/physical symptoms (PMS/PMDD) — with the “primary vs secondary” distinction that matters.
Educational use only. Evaluation and treatment of menstrual disorders are provider-directed. This chart is educational background for nursing care. This material supports nursing education and exam review. It is not medical advice and is not a substitute for clinical judgment, institutional policy, or medical direction. Always follow facility protocols and current provider orders.
Side by Side
| Disorder | Definition | Typical cause | Management |
|---|---|---|---|
| Primary amenorrhea | No menarche by age 15 (with normal growth/secondary sex characteristics) | Genetic/anatomic or endocrine (e.g., gonadal dysgenesis, outflow obstruction) | Evaluate cause; treat underlying condition |
| Secondary amenorrhea | No menses for ≥3 cycles / 6 months after previously menstruating | Pregnancy (rule out FIRST!), excessive exercise/low body weight, stress, PCOS, thyroid/prolactin | Confirm not pregnant; correct underlying cause |
| Primary dysmenorrhea | Painful periods with NO pelvic pathology | Prostaglandin-driven uterine cramping | NSAIDs (best started before/at onset), heat, hormonal contraceptives, exercise |
| Secondary dysmenorrhea | Painful periods caused by pelvic pathology | Endometriosis, fibroids, PID, adenomyosis | Treat the underlying disorder |
| Abnormal uterine bleeding / menorrhagia | Heavy, prolonged, or irregular bleeding | Anovulation, fibroids, polyps, coagulopathy, hormonal imbalance | Hormonal therapy/IUD, treat cause; watch for anemia |
| PMS vs PMDD | Cyclic luteal-phase symptoms; PMDD is the severe form with marked mood impairment | Cyclic hormone sensitivity affecting mood/physical symptoms | Lifestyle, NSAIDs; SSRIs and OCPs for PMDD |
Exam Traps
- ✦Secondary amenorrhea: rule out PREGNANCY first — it's the most common cause.
- ✦Primary dysmenorrhea = no pathology (prostaglandins) → NSAIDs work best started before or at the onset of pain.
- ✦Secondary dysmenorrhea has a cause (endometriosis, fibroids, PID) — treat the underlying disorder.
- ✦Heavy/prolonged bleeding (menorrhagia) → watch for iron-deficiency anemia.
- ✦PMDD is the severe, mood-predominant form of PMS — SSRIs and OCPs are used.
- ✦Any postmenopausal bleeding is NOT a menstrual disorder — it's abnormal and needs evaluation.
Related Resources
Standards & sources
Fact-checked Jun 20, 2026This page is written to align with American College of Obstetricians and Gynecologists (ACOG) · AWHONN · American Academy of Pediatrics (AAP) — newborn. It is an educational summary, not a citation of any single document — always verify specific doses, values, and protocols against current guidelines and your facility policy. How we source content →