Retrograde Menstruation: What You Should Know

Though it may sound alarming, retrograde menstruation is quite common and menstruating individuals experience some degree of it during their cycles, often without even realising it. Although you still bleed if you have retrograde menstruation, because some of the menstrual blood is flowing backward into the pelvic cavity instead of out through the vagina, it may feel like you're not bleeding during your period as much as usual. In severe cases, this can also lead to bloating, cramping, or a sensation of fullness in the abdomen.

Symptoms And Causes To Watch For

Many people with retrograde menstruation don’t notice anything out of the ordinary. But for others, the condition may cause symptoms that interfere with daily life. These may include:

• Pelvic or lower abdominal pain, especially during menstruation
• Pain during sex or bowel movements
• Bloating or a sense of heaviness
• Not bleeding during your period or experiencing lighter-than-usual flow

These may also overlap with symptoms of retrograde menstruation associated with endometriosis, making diagnosis more complex.

What Causes Retrograde Menstruation?

The precise retrograde menstruation causes aren’t fully understood, but multiple theories exist. The leading cause is believed to be anatomical or hormonal conditions that prevent menstrual blood from exiting the body efficiently. Other contributing factors include:

• Uterine structural abnormalities
• Cervical blockages
• Hormonal imbalances (especially excess estrogen)
• Immune dysfunction that allows endometrial cells to implant where they shouldn’t

Retrograde menstruation is also associated with increased inflammation in the pelvic region, which may play a role in the development of other reproductive health disorders.

Who’s More Likely To Experience It?

Anyone who menstruates can experience retrograde menstruation, but the condition may be more likely or more impactful in individuals with:

• A family history of endometriosis
• Short menstrual cycles
• A narrow cervix or other uterine abnormalities
• Heavy or prolonged menstrual bleeding

Hormonal imbalances and immune system dysfunction can also increase the risk of retrograde menstrual flow becoming problematic.

Does Retrograde Menstruation Cause Endometriosis?

One of the most significant concerns around this condition is the link between endometriosis and retrograde menstruation. In endometriosis, tissue similar to the uterine lining implants and grows outside the uterus often on the ovaries, fallopian tubes, or pelvic walls.

Retrograde menstrual flow may contribute to endometriosis by transporting endometrial cells into the abdominal cavity, where they may implant and cause inflammation. However, not everyone with retrograde menstruation develops endometriosis, suggesting that additional genetic, hormonal, or immune-related factors are involved.

Treatment Options: When And How To Intervene

While many people live with retrograde menstruation without complications, others may experience recurring pelvic pain, chronic inflammation, or difficulty conceiving. The most well-known complication is its association with endometriosis and retrograde menstruation, which can lead to infertility, organ adhesions, or ovarian cysts.

Retrograde menstruation treatment depends on the severity of symptoms and whether it's linked to other conditions like endometriosis. Mild cases may not require any intervention at all. For others, treatment options include:

• Hormonal therapy: Birth control pills, progestins, or GnRH agonists can regulate or suppress menstruation to reduce backward flow.
• Pain management: NSAIDs like ibuprofen can help relieve cramps and pelvic discomfort.
• Surgical treatment: In severe cases or when associated with endometriosis, laparoscopy may be used to remove misplaced tissue.

Lifestyle strategies like stress management, anti-inflammatory diets, and regular exercise can support overall menstrual health.

Can You Prevent Retrograde Menstruation?

There’s no guaranteed way to prevent retrograde menstruation, but supporting hormonal balance through nutrition and stress management and even medication can help.

Make sure to talk to your healthcare provider if you notice:

• Persistent or severe pelvic pain
• Changes in period flow, such as not bleeding during your period or suddenly lighter menstruation
• Symptoms that interfere with daily life or mental health
• Family history of endometriosis and retrograde menstruation

Early diagnosis and personalised care plans can make a significant difference especially if retrograde menstruation treatment is started before complications arise.