painful periods is dysmenorrhea. There is a wide spectrum of differences in how women experience menstruation. There are several ways that someone's menstrual cycle can differ from the norm: Extreme psychological stress can also result in periods stopping. More severe symptoms of anxiety or depression may be signs of premenstrual dysphoric disorder (PMDD) with is a depressive disorder. Dysfunctional uterine bleeding is a hormonally caused bleeding abnormality. Dysfunctional uterine bleeding typically occurs in premenopausal women who do not ovulate normally (i.e. are anovulatory). All these bleeding abnormalities need medical attention; they may indicate hormone imbalances, uterine fibroids, or other problems. As pregnant women may bleed, a pregnancy test forms part of the evaluation of abnormal bleeding. Women who had undergone female genital mutilation (particularly type III- infibulation) a practice common in parts of Africa, may experience menstrual problems, such as slow and painful menstruation, that is caused by the near-complete sealing off of the vagina. Dysmenorrhea Menstrual hygiene management Menstrual products (also called "feminine hygiene" products) are made to absorb or catch menstrual blood. A number of different products are available – some are disposable, some are reusable. Where women can afford it, items used to absorb or catch menses are usually commercially manufactured products. Menstruating women manage menstruation primarily by wearing menstrual products such as tampons, napkins or menstrual cups to catch the menstrual blood. The main disposable products (commercially manufactured) include: Sanitary napkins (also called sanitary towels or pads) – Rectangular pieces of material worn attached to the underwear to absorb menstrual flow, often with an adhesive backing to hold the pad in place. Disposable pads may contain wood pulp or gel products, usually with a plastic lining and bleached. Tampons – Disposable cylinders of treated rayon/cotton blends or all-cotton fleece, usually bleached, that are inserted into the vagina to absorb menstrual flow. The main reusable products include: Menstrual cups – A firm, flexible bell-shaped device worn inside the vagina to collect menstrual flow. Reusable cloth pads – Pads that are made of cotton (often organic), terrycloth, or flannel, and may be handsewn (from material or reused old clothes and towels) or storebought. Padded panties or period-proof underwear – Reusable cloth (usually cotton) underwear with extra absorbent layers sewn in to absorb flow. Due to poverty, some women cannot afford commercial feminine hygiene products. Instead, they use materials found in the environment or other improvised materials. "Period poverty"