Menstrual disorders, symptoms and related conditions

This topic includes menstrual disorders, some of their underlying causes, and associated symptoms. Menstrual disorders are disruptions to the menstrual cycle. These include abnormal uterine bleeding, such as heavy menstrual bleeding, and painful periods (dysmenorrhea) (Munro et al. 2018). Some menstrual disorders may be due to underlying chronic conditions, such as endometriosis or polyendocrine metabolic ovary syndrome (PMOS, formerly known as polycystic ovary syndrome), or their cause may be unknown. 

People may also have symptoms unrelated to the menstrual cycle phase, such as pelvic pain, which may indicate an underlying menstrual disorder or condition. The scope of this current work program includes heavy menstrual bleeding, iron deficiency and iron deficiency anaemia, dysmenorrhea, endometriosis, adenomyosis, PMOS, uterine fibroids, premenstrual distress (including premenstrual dysphoric disorder) and pelvic pain. Future phases of the work program may be expanded to include other menstrual disorders, symptoms and related conditions.

A review of the literature and stakeholder consultations identified 9 critical data gaps relating to menstrual disorders, symptoms and related conditions in Australia, along with a series of priority areas for data development to start addressing these gaps (Table 3). These gaps and priority areas for data development have directly informed the development of the Data Strategies for the 5 Priority Topics.

Table 3: Menstrual disorders, symptoms and related conditions: critical data gaps and priority areas for data development

Data gap

Priority areas for data development

​​​​1. Comprehensive national data on the prevalence of menstrual disorders, symptoms, conditions and comorbidities over time

  1. Strengthen national estimates for endometriosis, uterine fibroids and heavy menstrual bleeding (particularly among priority populations).
  2. Establish national estimates for adenomyosis, iron deficiency and iron-deficiency anaemia, pelvic pain, dysmenorrhea, PMOS and premenstrual distress (including premenstrual dysphoric disorder).
  3. Improve data on comorbidities of menstrual disorders and related conditions, including the frequency of co-occurring conditions (for example, endometriosis and adenomyosis).​​​​​​

2. Impacts of m​​​​enstrual disorders, symptoms and related conditions on quality of life, mental health and sexual and reproductive health outcomes

  1. Measure and monitor impacts on mental health, relationships, daily activities, attendance and performance at school and work.
  2. Measure and monitor impacts on sexual and reproductive health outcomes (for example, infertility and ability to reach desired family size) and how these outcomes affect mental health and quality of life.

3. Access to and quality of care (for example, where and when individuals seek care; wait times; service availability)

  1. Monitor availability of, and geographic distribution of, services.
  2. Monitor wait times for specialist services, diagnostic tests and procedures.
  3. Collect data on diagnosis and management care pathways. 
  4. Monitor patient’s reported experiences of care.

4. Use and acceptability of therapies for menstrual disorders, symptoms and related conditions 

  1. Capture data on how menstrual disorders, symptoms and related conditions are managed and treated. 
  2. Capture data on patient acceptability of different therapies for menstrual disorders, symptoms and related conditions.

5. Health literacy

  1. Measure and monitor health literacy relating to abnormal menstrual symptoms, particularly among young people, parents and LGBTQIA+ people.
  2. Measure and monitor awareness of, and access to, trustworthy and appropriate sources of information.

6. Time taken to diagnosis and treatment, or management of menstrual disorders and related conditions

Collect data that differentiate between age when symptoms first noticed, age when first seeking care, age when diagnosed, and age when symptoms were treated or managed.

7. Health care provider knowledge, training and confidence

  1. Monitor training provided for general practitioners and other health care providers.
  2. Measure and monitor health care provider confidence in diagnosing and treating menstrual disorders, symptoms and related conditions.
  3. Measure and monitor alignment to care standards and clinical guidelines.

​​8. Costs associated with menstrual disorders, symptoms and related conditions

Identify and monitor costs to individuals for health care services, tests, procedures and medications in relation to menstrual disorders, symptoms and related conditions.​​​​

9. National data standards

Develop national data standards and consistent diagnostic criteria to support consistent data collection.

Additional data development priorities

Developing validated diagnostic tools and using consistent coding are required to improve data quality for menstrual disorders, symptoms and related conditions. These will support more consistent identification of symptoms and conditions in relevant data collections, enabling improved monitoring of this topic. 

Developing validated diagnostic tools and implementing consistent coding approaches are broader system-level activities that are beyond the scope of the current work program and would require collaboration with clinical experts, data custodians and other stakeholders.


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