Menstrual disorders may present as heavy bleeding with or without pain or bleeding in between periods or infrequent periods.  Sometimes, cycles can become temporarily shorter or longer than usual, or there may be spotting at mid cycle. These disorders are caused either by hormonal imbalance or an abnormality in the womb (uterus).
Clinical examination, blood tests and pelvic ultrasound are often required as workup for a diagnosis.
Menstrual disorders are usually treated by medicines although sometimes surgical treatment may be necessary, if ultrasound shows a fibroid or polyp.
This is done by a procedure called hysteroscopy which involves inserting a small camera within the uterus to see the internal surface and treat if necessary. Usually a small sample of the endometrium (biopsy) is also taken to check for normality.