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Symptoms of menstrual disorders

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There are quite a lot of pathologies of the female reproductive system, the main symptom of which is a violation of menstruation. Such a pathology should disturb any woman, especially the one who is planning a pregnancy. This article will describe all the basic facts that you need to know about the violation of menstruation.

Violation of the menstrual cycle of women: what does it mean, what does it threaten and what consequences can it have?

Before talking about the violation of menstruation, you need to touch on the concept of its norms. Normal menstrual cycles are considered regular menstrual bleeding, which take place at intervals of 24 to 28 days. Also the norm is considered a shortened cycle equal to 21 days, or extended - 33–35 days. But at the same time in each successive month, menstruation should come at the same interval — either normal, or elongated, or shortened. On average, menstruation lasts 3–5 days.

Accordingly, if a woman’s menstruation does not occur in due time, it may indicate a violation of the cycle or that a pregnancy has occurred. In this regard, the first thing that every woman of reproductive age should do in the absence of menstruation is a pregnancy test. Make it necessary before going to the gynecologist.

Violation of the cycle can be expressed not only in the absence or delay of menstruation, but also in the atypical nature of blood discharge - excessively abundant or scarce, short-term or prolonged.

Cycle violation is not a case that should be ignored, since the absence of treatment can lead to negative consequences for women's health:

  • Increased fatigue up to complete loss of working ability.
  • Infertility (lack of pregnancy during the year of regular unprotected sex, including using “interrupted” intercourse).
  • The development of inflammatory diseases of the female reproductive system.
  • The development of endocrine disorders.

How menstrual irregularity manifests itself: the main signs and symptoms

The first signs of menstrual irregularities can be delays (perhaps minor - 3-5 days), intermenstrual bleeding, as well as heavy, prolonged and painful periods. If such signs occur, the woman should urgently consult a gynecologist.

Menstruation can manifest itself in different ways:

  • Amenorrhea - the absence of menstruation from six months or more.
  • The onset of monthly once a year (oligomenorrhea).
  • Scanty periods that last no more than 1–2 days (opsomenorrhea).
  • Hyperpolymenorrhea - abundant bleeding during normal cycle times.
  • Promenorrhea - the duration of the menstrual cycle of less than three weeks (that is, too frequent monthly).
  • Menstruation, accompanied by severe abdominal pain, which can even lead to disability - algomenorrhea.

All of the above is not an independent diagnosis. These are symptoms that may indicate the presence of certain diseases.

Why there are failures in menstruation and what they are connected with: causes of disturbances in the normal menstrual cycle

Violations of the menstrual cycle can occur against the background of stress, due to hormonal failure, rapid weight loss or weight gain, taking hormonal contraceptives, due to chronic diseases of internal organs (stomach, liver, etc.), increased physical exertion, etc.

There are other, more serious causes of cycle failure.:

Often a cycle violation can occur in women after an abortion, during which mechanical curettage of the uterus was performed. This procedure has a negative effect on the female genital organs, and first of all it affects the menstrual cycle.

It is worth noting that in some cases a violation of the cycle is not considered an alarming symptom. Minor menstruation delays can occur in women during recovery from pregnancy and lactation. Also, often do not differ in the constancy of the monthly in very young girls - the cycle can be established for 1-2 years.

Diagnosis of menstrual disorders and its treatment: how to treat and restore the cycle and ovulation in various diseases

The main factor in the successful treatment of a violation of the cycle is the timeliness of the pathology. That is why each woman is recommended to visit a gynecologist at least once a year, and if there is any deviation from the usual course of the cycle, it is not worth waiting for the expiration of the prescribed time between visits. It is best to contact a modern specialized center where highly qualified specialists of various profiles work. In St. Petersburg, it is the reproduction center "Genesis".

When the menstrual cycle is disturbed, the doctor will prescribe some tests for further correct treatment (ultrasound, colposcopy, etc.), and also say which hormones should be tested.

Treatment aimed at restoring the cycle may be different and depends on the nature of the disease.:

  • Acceptance of hormonal drugs - in identifying hormonal failure.
  • In case of violation of the luteal phase (or phase of the corpus luteum) cycle, the doctor prescribes drugs containing progesterone.
  • If the bleeding is too heavy, special saline solutions can be prescribed to minimize the effects of blood loss.
  • If a cycle failure is associated with anemia, high iron supplements are indicated.
  • It is possible to restore menstruation, disturbed by improper nutrition, by adjusting the diet.

In no case should women self-medicate - only a doctor is able to determine the cause of the pathology and prescribe the correct therapy. A woman will need patience, the observance of a normal mode of sleep and rest, proper healthy nutrition, a stable psycho-emotional state.

Disruption of the menstrual cycle and infertility: is pregnancy possible with such a diagnosis and how does the absence of menstruation affect conception?

Since menstrual irregularity is one of the first markers of the pathology of the reproductive system, a relevant question arises for women: is it possible to get pregnant and how can menstruation come with a delay?

If delays in the cycle are episodic in nature, for example, menstruation did not occur in one of the months, but the next one passed as expected, then pregnancy is quite possible (provided regular sex life and the absence of reproductive system pathologies among partners).

If the cycle violations are permanent, then the probability of pregnancy is small. In such cases, before planning a child, you need to restore the cycle and hormones.

If menstrual disorders are associated with an unhealthy diet of a woman, anorexia, then pregnancy is possible in principle, although there is a big “but” here. It lies in the fact that since the woman’s body is deficient in nutrients, the fetus will have exactly the same state, so its development is unlikely to be successful.

Physiology of the female body

Before diving into diseases and their manifestations, it is necessary to understand how the female body functions. The most important task of the functioning of the body of a woman is childbearing. Therefore, the most significant is the reproductive system.

Sex organs are divided into:

  • internal (vagina, ovaries, uterus),
  • external (genital slit, large and small labia, clitoris).

The main task of the reproductive system is to continue the race. Therefore, all its components direct their action on the maintenance of reproductive function. It is important that the female sex hormones are produced in sufficient quantities. They contribute to the restoration of the mucous membrane after menstruation. Progesterone helps to gain a foothold in the uterus of the ovum after ovulation. Sex hormones provide regular menstruation. Therefore, violations of the monthly discharge entail serious consequences in the work of the reproductive system, and sometimes even sterility.

A woman has her own individual menstrual cycle, which lasts on average from 28 to 35 days. Menstruation is only one of the stages of the cycle and begins only if the pregnancy has not occurred.

Symptoms of menstrual disorders

Deviations in the course of the monthly cycle may express themselves in different ways. But in any case, the duration of bleeding is violated, they can change their structure, be accompanied by pain or even disappear.

There are the following symptoms of menstrual disorders:

  • Too much discharge, they do not affect the duration of menstruation.
  • The complete absence of menstruation for six months.
  • Too scanty amount of bleeding and small duration (1-2 days).
  • Monthly occur every 3 months.
  • Irregular cycle.
  • Very long discharge of normal nature, bleeding can last up to two weeks.
  • The lack of stability of the cycle, accompanied by pain in the abdomen.
  • Too frequent periods.
  • Permanent painful and heavy menstruation that affect the general condition of a woman

All of the above signs of violations of the MC require attention. Therefore, having found any symptom in oneself, it is necessary to turn to a gynecologist, since starting the disease one can quickly aggravate the situation.

There are some forms of manifestation of violations of the monthly cycle:

  1. Algomenorrhea. Pain in the abdomen and lower back. The most common type of violation.
  2. Dysmenorrhea. Lack of system monthly. The cycle time is constantly fluctuating.
  3. Oligomenorrhea. Too rare bleeding, accompanied by rapid weight gain, the presence of hair in places where they should not be.
  4. Metrorrhagia. This type of MC disorder is characterized by bleeding between periods.
  5. Amenorrhea. Long absence of menstruation.

The above are perhaps the most frequent manifestations of violations of the cycle. If a woman feels such peculiarities of the menstrual period, or he is completely absent, you should immediately see a specialist.

It is very important to take good care of your health, because you cannot buy it for any money. It is important to know that violations in the female genital system can be the cause of irregular menstruation.

Factors affecting the appearance of problems with MC:

  • Pregnancy. This is the most joyful factor.
  • Functional disorders of the reproductive system (problems with ovarian function, lack of ovulation, menopause, diseases of the organs of the endocrine system, thyroid, pituitary, hormonal disruptions).
  • Health problems that extend to the state of the entire female body (endometriosis, uterine fibroids, endometrial hyperplasia, polyps in the uterus, cancer of the genital organs, neoplasms, malformations of the reproductive system, kidney disease, liver, anemia, anemia, overweight).
  • Acquired as a result of long-term drug treatment (use of hormonal drugs, contraceptives, means to get rid of unwanted pregnancy in the first day after unprotected sex).

It is necessary to monitor the state of your health and seek medical help in time.

Treatment methods

You can get rid of this disease using two methods: medically or surgically.

Drug treatment is:

  • Elimination of violations through disposal of provoking factors.
  • The use of hormone therapy.
  • Appointment of vitamin complexes and macronutrients.
  • Getting rid of anemia, and with it anemia.

If we talk about surgical intervention, it can be:

  1. Cleaning mucous membranes.
  2. Removal of polyps, cysts, uterine fibroids and other formations.

In any case, only a gynecologist prescribes treatment. You can never self-medicate, because you can aggravate the situation with complications.

Folk methods

Grandmother's recipes, of course, do not really inspire confidence, but still are popular:

  1. When oligomenorrhea, you need to prepare a powder of 1 spoon of parsley seeds and take it twice a day, drinking plenty of water.
  2. When there are no monthly periods for a long period, take 1 spoonful of wormwood and pour 200 gr. hot water. It is recommended to drink 50 g three times a day.
  3. With abundant secretions will help herbal infusion of equal parts of oak bark, raspberry leaves and strawberry leaves. All ingredients are mixed, add 2 parts of water and boil for 5 minutes. Next, you need to strain the broth and drink in small sips throughout the day during the week.

What are the causes of menstrual disorders in women? Read in the article about the norm and pathology, the factors causing the failure of the female body, the conduct of diagnosis and treatment.

How to treat menstrual disorders? Details here.

Preventive measures

To prevent violations in the MC, you should follow some recommendations:

  1. Mark monthly in the calendar.
  2. Go to the reception to the gynecologist every 6 months.
  3. Monitor physical activity.
  4. Pay attention to nutrition. It should be as healthy and balanced as possible.
  5. Drink a complex of vitamins every 3-4 months.

By following simple rules, you can protect yourself from unwanted difficulties with your menstrual cycle. A timely identification of the disease, you can prevent a serious disease, the consequences of which may be irreversible.

In the video about the examination in violation of the menstrual cycle

Types of violations

Violation of menstruation is considered a cycle, the duration of which increases by more than a week. Also, if the period between periods is reduced by 5-7 days, and this is repeated systematically, we can talk about the failure of the menstrual function. With the exception of women who have a longer or shorter cycle genetically, for everyone else, this is defined as a disorder and requires examination.

There are several types of violations associated with the menstrual cycle:

  1. Amenorrhea - a condition in which for several cycles of menstruation are absent. There are primary and secondary amenorrhea. In the first case, during puberty, menstruation does not begin until the age of 16, if there are other signs of puberty. In the second case, menstruation stops for a long time.
  2. Oligomenorrhea is a pathology in which menstruation occurs very rarely. More common in those who suffer from overweight. With this pathology, women of reproductive age often have problems with conception.
  3. Dysmenorrhea - deviations in the menstrual schedule in the direction of increasing, and in the direction of reducing the intermenstrual period. With such a violation, women can meet at any age. Physiologically related abnormalities during the onset of menstruation, when the cycle is not yet regulated, and in the postpartum period, when the cycle is restored, are not considered dysmenorrhea.
  4. Opsomenorrhea is a disorder in which the duration of a cycle increases to 35 days or more (but not more than three months), and the menstruation is short and scanty. Often accompanied by infertility. Women may have male traits, a tendency to corpulence. A common symptom is acne.
  5. Hypomenstrual syndrome is a pathology characterized by a decrease in the amount of blood released during menstruation. Scanty periods (blood loss less than 50 ml) usually come with a delay and cause a variety of discomfort - nausea, headache, etc.

Other disorders in the menstrual cycle, such as polymenorrhea, proiomenorrhea, metrorrhagia, etc., are also distinguished. Each of these pathologies may have different causes, so an examination (and not only a gynecologist) is mandatory.

Causes of menstrual disorders

The main cause of failure of the menstrual cycle is hormonal imbalance. This happens in various diseases and conditions. Also, an important role is played by the hereditary factor - if the ancestors of the female line were observed to fail in the cycle or other violations, it is quite possible that this will affect the pattern of menstruation in women in the next generations.

Since the brain and the organs of the endocrine system are involved in the regulation of the menstrual cycle, very often the problem arises due to a violation of the interaction.

Lack of sleep, stress, excessive exercise, psychological fatigue, changing time zone or climatic conditions can lead to a failure of menstruation. Frequent cases of problems with menstruation in those who regularly stay awake at night. Brain tumors and neurovirus infections can also cause menstrual failures.

The hormonal cycle with disturbances is also observed in many diseases. Most often this happens against the background of pathologies of the endocrine and urogenital systems, such as:

  • genetic and hormonal pathologies of the ovaries,
  • inflammation of the uterus and appendages,
  • infectious lesions of the pelvic organs,
  • diabetes,
  • thyroid diseases, adrenal glands,
  • obesity, etc.

Functional disorders of the endocrine system, manifested in the accumulation of estrogen with simultaneous deficiency of progesterone, also cause menstrual failures. The cycle may break due to any infectious and non-infectious diseases, acute or chronic.

Among other factors that can lead to failure of menstruation, the most common:

  • Long-term diets, unbalanced nutrition, lack of certain elements in food.
  • Too low / high body weight.
  • Acute or chronic intoxication (including regular drinking, smoking).
  • Acceptance of some medications.

Thus, the overwhelming majority of women are at risk. But this does not mean that the problem of failure in the menstrual cycle can be ignored, “writing off” violations for chronic stress or lack of sleep. If malfunctions occur, a medical consultation is required to rule out serious diseases.

Violations in the menstrual cycle can be a symptom of dangerous diseases, including cancer.

Diagnosis of disturbed menstruation cycle

Many women who have problems with menstruation postpone a visit to the doctor because they are afraid of prescribing hormone therapy. In fact, hormones are shown only in some cases, and to select an adequate treatment regimen, careful diagnosis is necessary.

In addition to the gynecological examination, smear and general blood and urine tests, it may be prescribed:

  • Ultrasound of the pelvic organs and the thyroid gland,
  • analysis of the study of hormones,
  • hysteroscopy
  • research to identify chromosomal abnormalities,
  • PCR, etc.

What kind of tests are needed, the doctor decides after a detailed questioning, in which he can determine the presence of genetic predisposition, the particular lifestyle of the patient and other nuances that have an effect on the frequency and intensity of menstruation. You may also need the advice of doctors of other specialties (endocrinologist, therapist) and additional studies (computed tomography, skull radiography, etc.).

Treatment in adolescence

The first menstruation in girls occurs at the age of 12-14 years. If this did not happen before the age of 16, there is cause for concern and a visit to the pediatric gynecologist-endocrinologist. It is also necessary to consult a doctor if the cycle is not settled over a year and a half. In adolescence, other disorders are possible:

  • too heavy periods,
  • significant blood loss
  • the appearance of bleeding between menstruation,
  • high soreness

Most often, weight problems, vegetative-vascular dystonia, hypertension, chronic inflammatory diseases, and early onset of sexual activity lead to these disorders.

Girls who exhaust themselves with diets often have an irregular menstrual cycle. The same applies to overly emotional teens with a high level of impulsiveness or aggression.

Drugs for the treatment of adolescent disorders are selected based on age. If therapy with hormones is indicated, the most benign hormone preparations with low doses are selected. If the reason for the irregularity of the cycle is associated with disruptions in the functioning of the thyroid gland, a treatment complex is required to normalize the functioning of the thyroid gland.

In case of severe bleeding, hemostatic preparations are used, and in case of complications (hemoglobin fall, dizziness, general weakness) - curettage. At the same time, antianemic therapy with iron preparations is carried out. In uncomplicated cases, cyclic vitamin therapy is used to stimulate the body. In some cases, the doctor may prescribe sedatives, dietary adjustment, changes in the mode of the day, etc.

Treatment at the reproductive age

Disorders of the menstrual cycle in women of child-bearing age occur both for physiological reasons (pregnancy, the postpartum period), and for many other reasons. Therefore, treatment can be prescribed only after a thorough examination. Medicines doctor selects based on the presence of certain diseases.

  • If the problem is caused by hormonal disorders, it is eliminated with the help of estrogen preparations, thyroid hormones, etc.
  • In the presence of infectious diseases, antibiotic therapy is used.
  • Tumors that cause failures in the menstrual cycle are surgically removed (tumor formation in the organs of the urogenital system, the thyroid gland, the pituitary gland).
  • Surgical intervention may be needed in case of genital pathologies.
  • In the absence of ovulation, means are used to stimulate it.
  • When too heavy menstruation fill the volume of blood lost, carry out scraping, and in the most difficult cases - endometrial ablation or hysterectomy.

It may also be necessary to improve the immune system, supplement food rich in vitamins and microelements. If necessary, additional vitamin and mineral complexes are prescribed. Physiotherapeutic procedures have a beneficial effect. Normalization of the day regimen, increasing stress tolerance - the necessary measures to restore the normal menstrual cycle.

Some menstrual disorders lead to infertility. If a woman plans to have children, treatment should begin as soon as possible. If pregnancy is not planned in the near future, hormonal contraceptives may be prescribed to help regulate the menstrual cycle.

Treatment in menopause

Menopause usually occurs between the ages of 45-50 years, although nowadays there are more and more cases of early menopause after 40 and even after 30 years. Usually, when menstruation becomes irregular in adulthood, and then stop altogether, the woman sets herself a diagnosis of menopause and is not in a hurry to consult a doctor.

This approach is fraught with many unpleasant consequences, ranging from undetected diseases in time, and ending with an unwanted pregnancy (this, although rare, but it also happens). Therefore, even with suspected menopause, it is imperative to be examined. If any problems are identified, the doctor will suggest a complex of medical measures, including:

  • means for normalization of hormonal background (duphaston, etc.),
  • antibiotic therapy in the presence of infections
  • balanced diet with a decrease in calories and the total amount of food.

If changes in the menstrual cycle at this age are physiological in nature, no special treatment is required. However, when a woman suffers a climacteric period, it is advisable to use physiotherapy, fortifying drugs, traditional medicine.

Any bleeding in the postmenopausal period is a reason for seeking medical attention as soon as possible, since in most cases this is one of the symptoms of malignant tumors!

Indications for visiting the doctor in violation of the monthly cycle

For any irregularities in the menstrual cycle, it is advisable to consult a doctor. This will help avoid serious consequences and not worry about your condition, thereby aggravating the situation. But in some cases it is necessary to pass the examination:

  • If the teenage girl did not have menarche until the age of 15-16.
  • A year and a half after the first menstruation passed, and the monthly cycle was never established.
  • Monthly too long and too abundant.
  • The nature of the menstrual flow, their color, smell (this can be a sign of endometrial diseases) has changed.
  • Ovulation is accompanied by painful sensations.
  • Allocation is very scarce, and monthly come with a significant delay.
  • Bleeding concerns between periods (even a single case requires examination).

Even if all these changes do not cause discomfort and do not cause complaints, do not ignore them. Disorders of the menstrual cycle are often a sign of disease, and timely treatment allows you to avoid complications and life-threatening conditions.

How does overweight affect the regularity of menstruation? After watching this small video, you will learn about the connection of menstrual disorders with overweight, as well as other causes of failures in the cycle of menstruation.

What cycle is considered normal?

External manifestation of the natural ovarian-menstrual cycle - menstruation, which arise with the frequency characteristic of each woman and lasts most often 3-6 days. At this time, the entire enlarged functional layer of the endometrium (uterine mucosa) is rejected. Together with the blood, his scraps exit through the opening cervical canal into the vagina and then out. Peristaltic contractions of its walls contribute to the natural cleansing of the uterus, which can cause some physical discomfort.

Vessels gaping after rejection of tissues quickly close, the resulting total defect of the mucous membrane regenerates. Therefore, normal menstruation is not accompanied by significant blood loss and does not lead to the development of anemia, severe asthenia and disability. The average volume of blood loss is up to 150 ml, and there are no blood clots in the discharge.

But the menstrual cycle is not only the stage of updating the endometrium. Normally, it also includes the follicular phase with the maturation of the egg in the ovary, ovulation and the subsequent secretory phase with the growth of the endometrium and its preparation for the potentially possible implantation of the ovum. In a healthy woman of reproductive age, there are also anovulatory cycles, which is not considered pathological. They normally do not lead to a change in the duration or nature of menstruation and do not affect the duration of the intermenstrual period. In such cycles, a woman is not fertile, that is, pregnancy is not possible with her.

Menstruation begins at puberty. Their appearance indicates the readiness of the reproductive system to conceive. The first menstruation (menarche) is noted at the age of 9–15 years, most often in the interval between 12 and 14 years. It depends on many factors, the main of which are heredity, national identity, general health, the adequacy of the girl’s nutrition.

Completion of the reproductive period is characterized by the onset of menopause - the complete and final cessation of menstruation. This is preceded by a climacteric period, which normally occurs on average in 46-50 years.

Development Mechanism NOMC

The ovarian menstrual cycle in the female body is an endocrine-dependent process. Therefore, the main cause of its disorders is dyshormonal disorders. They can primarily occur at different levels, including with the involvement of endocrine glands, which are not related to the reproductive system. Based on this classification of menstrual disorders. According to her, emit:

  • Central disorders with lesions of the higher centers of the neuroendocrine regulation of the reproductive system. Cortic-hypothalamic, hypothalamic-pituitary and only pituitary structures can be involved in the pathological process.
  • Violations at the level of peripheral structures, that is, the organs of the reproductive system itself. There may be ovarian and uterine genesis.
  • Disorders associated with dysfunction of other endocrine glands (adrenal glands, thyroid gland).
  • Disorders caused by genetic and chromosomal abnormalities with congenital hyper- or hypoplasias of organs, impaired secretion of key biologically active substances, and disorder of the so-called feedback between peripheral organs and neuroendocrine structures.

Failures at any level in the end will still be manifested by different types of NOMCs. After all, hormonal imbalance leads to a change in the work of the ovaries, even if they do not have structural abnormalities. The logical consequence of this is a violation of the secretion of the main sex hormones (estrogen and progesterone). And their main target is the functional layer of the mucous membrane of the uterus, it is he who is rejected with blood at the end of the next cycle. Therefore, any dishormonal changes in the body can lead to a violation of the nature and regularity of menstruation.

Endocrine pathology is the main cause of menstrual dysfunction. Only in a fairly small percentage of cases is it not caused by hormonal disorders. Violations of the menstrual cycle can be caused, for example, pronounced changes in the endometrium. And sometimes false amenorrhea is diagnosed, when menstrual blood and rejected endometrium do not have the ability to exit naturally due to vaginal atresia or complete clogging of its output with a virgin chimp.

Causes of dysfunction

The reasons for the appearance of menstrual dysfunction are many. Moreover, a woman can simultaneously identify several etiological factors leading to functional disruptions at various levels.

The most likely ones are:

  • A variety of pituitary adenomas (acidophilic, basophilic, chromophobic), which can be hormonally active or lead to compression and atrophy of the adenohypophysis. Disease and Itsenko-Cushing syndrome.
  • Taking drugs that affect the synthesis and metabolism of dopamine and noradrenaline in brain structures, which leads to dysfunction of the hypothalamic-pituitary system. These include reserpine, MAO inhibitors, typical and atypical antipsychotics, antidepressants of various groups, metoclopramide, phenothiazine derivatives and a number of other drugs.
  • Adrenal adenomas and other tumors that produce androgens and cortisol. Adrenogenital syndrome due to congenital adrenal hyperplasia.
  • Some mental disorders associated with impaired central neuroendocrine regulation. These can be depressive states of moderate and severe degree of various genesis, endogenous diseases (schizophrenia) in the acute stage, anorexia nervosa, reactive disorders, and adaptation disorders during chronic stress.
  • Hypo - or hyperthyroidism of various origins.
  • Syndrome of sclerocystic ovaries (Stein-Leventhal).
  • Suppression of ovarian function and impaired feedback between them and the hypothalamic-pituitary system after prolonged administration of COCs and their abrupt cancellation
  • Resistant ovarian syndrome and gonadal depletion syndrome. They may also have iatrogenic genesis - for example, due to the repeated participation of a woman in protocols of assisted reproductive technologies with stimulation of hyperovulation.
  • Drastic non-physiological changes in hormonal levels, which can be caused by spontaneous or medical abortion, taking drugs to quickly suppress lactation.
  • Defects and malformations of the uterus, including those caused by chromosomal diseases.
  • The consequences of surgery on the ovaries and uterus, radiation and chemotherapy, inflammatory diseases of the reproductive organs. This can be a significant decrease in the volume of functioning ovarian tissue, intrauterine synechia up to the development of uterine cavity atresia, removal of the gonads and the uterus.
  • Tumor lesion of the ovaries. Moreover, not only malignant, but also large benign neoplasms with secondary atrophy of ovarian tissue may have clinical significance.

Disruption of the menstrual cycle after 40 years in most cases due to the increasing age-related changes in the reproductive system. They are caused by the natural depletion of the follicular ovarian reserve with an increase in the number of anovulatory cycles, progressive hypoestrogenic and extinction of the reproductive function. These changes are most pronounced in the pre-menopausal period, when the cycle becomes increasingly irregular with a tendency to dysfunctional uterine bleeding and the addition of psycho-vegetative disorders.

Violation of menstruation in girls of pubertal age is most often caused by uneven maturation of the hypothalamic-pituitary and ovarian systems. But do not forget that during this period clinical manifestations of certain congenital syndromes, chromosomal diseases and abnormalities of the development of the internal organs of the reproductive system can debut.

In addition, adolescent disorders are often found in adolescent girls with the formation of nutritional deficiencies of key nutrients, and especially fats. This leads to a marked decrease in the synthesis of steroid (including sex) hormones, which is most often manifested by secondary amenorrhea.

Possible manifestations of NOMC

According to the presence of the previous period of normal menstruation, all possible irregularities can be divided into primary and secondary.

Symptoms of menstrual disorders may include:

  • Change the duration of the intermenstrual period. Proiomenorrhea is possible (with a cycle duration of less than 21 days) and opsomenorrhea (its lengthening is over 35 days).
  • Delay regular menstruation in the absence of previous violations of the cycle.
  • The absence of menstruation for 6 months or more (amenorrhea) in a woman of reproductive age.
  • The change in the volume of menstrual blood loss. It is possible both its increase (hypermenorrhea) and decrease (hypomenorrhea). When excessive blood loss talk about menometroragii.
  • The change in the duration of the menstruation in the direction of shortening (oligomenorrhea) or lengthening (polymenorrhea).
  • Появление межменструальных кровянистых выделений, которые могут быть различными по интенсивности – от мажущих до профузных. При ациклических обильных маточных кровотечениях используют термин «метроррагия».
  • Клинически значимый локальный болевой синдром в период менструации, что называют альгоменореей.
  • Появление общих экстрагенитальных симптомов, сопровождающих менструацию. These include headaches of a different nature, fluctuations in blood pressure, nausea and changes in appetite, and other autonomic manifestations. This condition is referred to as dysmenorrhea, and when combined with pain syndrome they speak of algomenorrhea.

Hypermenstrual syndrome with polyhypermenorrhea and / or acyclic dysfunctional uterine bleeding is usually the cause of the development of chronic post-hemorrhagic iron deficiency anemia. Her symptoms are often the reason for going to a doctor. In this case, the woman is worried about increased fatigue, palpitations, general weakness, a tendency to lower blood pressure, and fainting is possible. The condition of the skin, hair and nails is worsening, a decrease in the productivity of mental activity up to the development of mild cognitive disorders is possible.

Many women of reproductive age also have infertility - the absence of a natural conception within 1 year of unprotected regular sexual life. It is caused by severe violations of the allocation of a dominant follicle in one of the ovaries, the process of maturation of the egg in it and the lack of spontaneous ovulation.

It is important to understand that in the presence of anovulatory cycles, a woman can independently and not make any special complaints about menstrual irregularities, although with targeted questioning, in most cases, various symptoms appear. In this case, the patient usually considers the characteristic lengthening of the menstrual cycle as her individual feature, and not as a pathological sign.

Features of menstrual disorders in different age groups

Juvenile period

NOMTs in adolescents may be of the hypomenstrual syndrome type or with a tendency to so-called juvenile (pubertal) bleeding. The nature of the disorder depends on the etiology and the existing dyshormonal disorders. Perhaps later menarche or the development of primary amenorrhea. It is said that menstruation does not begin at the age of 15.

Juvenile bleeding occurs in anovulatory cycles due to hormonal imbalance in follicle atresia. They usually alternate with irregular periods of menstruation, often combined with impaired hair growth, insufficiency or excessive body weight. In this case, a neuro-emotional overstrain, an abrupt change in the climatic and temporal belt, a violation of the sleep-wake cycle can act as a provoking factor.

Reproductive period

In the reproductive age, violations of the cycle may be manifested by a failure of cycling, delaying the next menstruation with subsequent bleeding. At the same time, physiological and pathological changes should be distinguished. Normally, the temporary disappearance of menstruation may be due to the onset of pregnancy, the postpartum period and hyperprolactinemia in the background of breastfeeding. In addition, a change in the cycle and nature of menstrual flow occurs during the use of hormonal contraception and after the installation of intrauterine devices.

The lengthening of the cycle is most often due to the persistence of the follicle. At the same time, ovulation of the mature egg cell does not occur. It dies, and the follicle continues to grow in size with the formation of a follicular cyst of various sizes. At the same time, hormonal background corresponds to phase 1 of the cycle with hyperestrogenism, which leads to progressive growth of the endometrium. The delay of menstruation can reach 6-8 weeks, after which metrorrhage occurs. Such uterine bleeding is referred to as dysfunctional. Another reason for their development is the insufficiency of the luteal phase. In this case, bleeding occurs in the ovulatory period, they are usually not abundant, but prolonged.

Changes in the ovaries during a typical menstrual cycle

There may also be menstrual disorders after an abortion. It can be spontaneous (with spontaneous termination of pregnancy in the early stages) or medically using various methods for the removal of the ovum / embryo. In this case, a prolongation of the subsequent cycle is usually noted, and the restoration of menstrual function is expected within 3 months. If abortion was accompanied by complications, a protracted rehabilitation period with acyclic bloody discharges, algomenorrhea is not excluded.

Premenopausal and Menopause

The most common malfunction of the menstrual cycle occurs in premenopausal age. The extinction of reproductive function is often accompanied by a significant increase in anovulatory cycles, a tendency to delay and bleeding against the background of atresia of the follicle, loss of cyclical changes and the development of the so-called menopausal syndrome.

The resumption of uterine bleeding in menopause is an extremely alarming sign. After all, the restoration of reproductive function is no longer possible, and the bleeding and bleeding during this period usually indicate the presence of a malignant tumor.

Possibility of pregnancy

Pregnancy in violation of the menstrual cycle is possible. But the probability of its occurrence depends on the severity of dyshormonal disorders, the usefulness of the development of the uterus and many other factors. In many cases, menstrual disorders are accompanied by infertility. And it is not always possible to eliminate it by conservative methods, often the onset of pregnancy is possible only with the help of assisted reproductive technologies. And sometimes a woman can not conceive and independently carry out the child. In this case, she is offered the services of a surrogate mother and donor programs.

In addition, we should not forget that endocrine disorders often lead to the inferiority of the functional layer of the endometrium and thus impede the normal implantation of the ovum. This, coupled with insufficient production of progesterone and hCG, significantly increases the risk of abortion at very early and early stages. In this case, a woman may not be aware of conception, regarding the delay in menstruation as another dysfunction.

Prior menstrual dysfunctions are considered a factor potentially complicating pregnancy. Such women require special attention. Often, for the prolongation of pregnancy they need to take certain hormonal drugs. According to statistics, in a number of women after childbirth, menstrual irregularity is independently corrected (for periods of menstruation, in our article by reference). And subsequent pregnancies they can occur already without much difficulty.

Survey

In most cases NOMCs have a favorable prognosis, as they are caused by changes that are not life-threatening for a woman. But we should not forget that up to 10% of cases are due to oncologic diseases of various localization. Therefore, the diagnosis of such a condition requires careful examination to establish the true cause of menstrual dysfunction, to determine the nature and severity of existing changes. It is this tactic that will allow you to choose the optimal corrective therapy or carry out a radical treatment in a timely manner.

Basic examination should include:

  • Careful collection of obstetric and gynecological anamnesis with clarification of the time of appearance of complaints, possible connection with any factors, the fact of previous violations of menstruation, age of menarche (first menstruation), the probability of conception. Be sure to find out the transferred diseases and operations, the number and prescription of abortions and childbirth, the course and outcome of previous pregnancies. Also important is the fact of taking any drugs, the nature of the contraception used.
  • Gynecological examination of the vagina and cervix in the mirrors, bimanual palpation of the pelvic organs. At the same time, structural changes in the visible mucous membrane (defects, overgrowth, deformation, discoloration, swelling), varicose transformation of the superficial veins, change of contours, size, position and texture of the uterus and appendages can be detected. The nature of vaginal discharge and the cervical canal is also evaluated.
  • Taking smears from the vaginal walls, sponges of the cervical canal, urethra on the main urogenital infections (STDs), the degree of purity.
  • A smear on oncocytology from the cervix, which is especially important in the presence of pathological foci on it.
  • Exception of pregnancy. To do this, conduct a urinary rapid test or determine the level of hCG in the blood.
  • Determination of endocrine status. It is necessary to assess the level of the main hormones that regulate the work of the ovaries and the menstrual cycle. These include estrogen, progesterone, pituitary hormones - LH (luteinizing), FSH (follicle-stimulating), prolactin. In many cases, it is also advisable to determine the performance of the thyroid gland and adrenal glands, because violations of the functioning of these glands affect the work of the ovaries.
  • Ultrasound of the pelvic organs. Transvaginal and abdominal sensors are most commonly used. This is sufficient for a full examination of the uterus and its cervix, appendages, parametric fiber, blood vessels and regional lymph nodes. With a preserved hymen, a rectal sensor is used instead of the vaginal if necessary. Ultrasound is the most accessible and yet quite informative method of visualization of internal organs.
  • Histological examination of the endometrium, obtained by separate diagnostic curettage of the cervix and uterine cavity. This is shown mainly in hypermenstrual syndrome and metrorrhages.

If there is evidence at stage 2 of the survey, high-tech diagnostic techniques are used (CT, MRI, PET, and others). Most often they are prescribed for suspected oncogynecological pathology.

Principles of treatment

Treatment of menstrual disorders includes several areas:

  • Stopping bleeding. For this purpose, hormonal preparations, agents that affect blood clotting and contractility of the uterus, and sometimes curettage can be used.
  • Correction of existing hormonal disorders, which is the prevention of recurrent menstrual disorders. The treatment regimen is selected individually, based on the patient's endocrine profile.
  • The decision on the feasibility of surgical treatment for the elimination of the main causative factor or the correction of existing developmental anomalies.
  • If necessary - measures aimed at stimulating the development of the uterus and activation of the ovaries. Various physiotherapeutic methods, cyclic vitamin therapy, phytotherapy are widely used.
  • Correction of associated disorders (psycho-vegetative disorders, anemic syndrome, etc.).
  • Correction of the resulting therapy for the underlying disease. For example, when taking psychotropic drugs can be recommended to replace them with more modern, narrowly targeted drugs. Of course, the final decision on the correction of therapy is not made by the gynecologist, but by the attending physician (for example, a psychiatrist, a neurologist).
  • If desired, conception - complex treatment of infertility using conservative and, if necessary, surgical (endoscopic) techniques, timely decision making about the feasibility of using assisted reproductive technologies.

Disruption of the menstrual cycle is a very common problem. And its relevance is not reduced, despite the achievements of modern medicine. Fortunately, quite a few forms of such disorders are amenable to correction. And with the timely treatment of a woman to the doctor, it is often possible to avoid complications, to keep patients with a high quality of life and even to cope with concomitant infertility.

Treatment of menstrual disorders

Allot conservativeand surgerymenstrual disorders.

Conservative (non-surgical) treatment menstrual disorders.

  • Treatment of the underlying disease that caused menstrual disorders.
  • Regulation of the menstrual cycle with the help of hormonal preparations containing:
    • estrogen (female sex hormone that contributes to the growth of the endometrium (uterine lining)),
    • progesterone (a female sex hormone that helps sustain pregnancy).
  • Restorative therapy (prescription of vitamin complexes, diets rich in animal proteins (meat products), etc.).
  • Reducing physical activity, creating comfortable working conditions.
  • Treatment of anemia (anemia) with iron preparations.

Surgery in the form of scraping (scraping, removal of the endometrium with the help of a special tool inserted into the uterus through the vagina) the uterine mucosa shows:
  • with heavy uncontrolled bleeding,
  • women over 35 years old.

Complications and consequences

  • Infertility (inability to conceive a child with regular unprotected sex during the year).
  • Endometrial cancer (malignant formation of the mucous membrane of the uterus).
  • Ovarian cancer (female genital glands).
  • Mastopathy (benign breast tissue change with a predominance of connective tissue and the presence of cysts (abdominal masses filled with fluid)).
  • Mammary cancer.
  • Ovarian dysfunction (ovarian dysfunction).
  • Hyperplasia (growth) of the endometrium (mucous membrane of the uterus).
  • Uterine polyps (benign endometrial neoplasms).
  • Uterine fibroids (benign neoplasm of the muscular layer of the uterine wall).
  • Miscarriage of pregnancy (spontaneous abortion prior to the period of 37 weeks).
  • Anemia (anemia).
  • The decline in the quality of life of a woman, the deterioration of her psychological health.

Prevention of menstrual disorders

  • maintaining the menstrual calendar (for early and self-revealing by the woman of menstrual disorders),
  • regular visits to the gynecologist (2 times a year),
  • timely detection and treatment of gynecological diseases,
  • timely detection and treatment of endocrine (hormone producing) gland diseases,
  • timely detection and treatment of chronic diseases of internal organs,
  • observance of a balanced diet (with a moderate content of carbohydrates and fats (excluding fatty and fried foods, flour, sweets) and sufficient protein content (meat and dairy products, legumes))
  • regular exercise, sports,
  • exclusion of intense physical and psycho-emotional stress.

  • "Guidelines for outpatient care in obstetrics and gynecology", edited by V.I. Kulakov. - M .: "GEOTAR-Media", 2007
  • "Emergency care in obstetrics and gynecology: a brief guide" ed. V.N. Serov. - M: “GEOTAR-Media”, 2011.
  • “Obstetrics: national leadership” ed. E.K. Aylamazyan. - M .: "GEOTAR-Media", 2013.

Causes of menstrual disorders

The menstrual female cycle is a very complex system that includes many important biochemical processes. In particular, the cerebral cortex, endocrine glands (adrenal glands, thyroid gland, ovaries), subcortical centers participate in the regulation of the process. This means that any malfunction in these systems can cause disruptions to the female cycle. But sometimes this reason may lie in the serious pathologies of various organs (tumor, tuberculosis, ectopic pregnancy).

Endocrine organ pathologies such as:

  • inflammation in the ovaries,
  • progesterone deficiency,
  • untimely release of ripe follicle,
  • excess estrogen
  • ovarian hypoplasia,
  • pathology of the uterus of inflammatory origin,
  • polycystic ovary.

Causes of violations of the menstrual cycle of the cerebral cortex:

  • time zone change,
  • lack of sleep in a woman during the early morning hours, when hormones-regulators of the cycle are actively secreted,
  • regular lack of sleep
  • stress,
  • very strong stressful shock.

Causes of MC disorders from the subcortical centers (hypothalamus, pituitary):

  • pituitary adenoma,
  • neuroinfection of viral genesis,
  • other tumors.

Causes of failure of the menstrual cycle by other organs and systems:

Symptoms of menstrual disorders

Violations of the monthly cycle can manifest a set of various symptoms. When this occurs, the duration of menstruation, the nature of the discharge, pain, etc., changes.

The main symptoms of disorders in various diseases:

  • Hyperpolymenorrhea - a state where there is a very abundant discharge during menstruation, but the cycle itself does not change.
  • Amenorrhea - absence of menstruation for 6 months or more. It can be primary and secondary, the first is characterized by a violation of the cycle from the time of menarche, and the second after normal menses. There is also a physiological amenorrhea, which is observed in healthy women during pregnancy, menopause, lactation. In all other cases, be sure to visit a doctor.
  • Opsomenorea - a cycle in which there is very little bleeding and menstruation last 1 or 2 days.
  • Oligomenorrhea - Monthly women come 1 time in 3 or 4 months, that is, rarely. This can be a rather serious symptom that indicates the presence of polycystic ovary. Особенно если наблюдаются такие дополнительные признаки как бесплодие, увеличенные в размерах яичники (при бимануальном осмотре), гирсутизм (чрезмерное оволосение на теле).
  • Dysmenorrhea. In this case, there is an unstable menstrual cycle, when menstruation is delayed or premature. Usually observed in those who often change time zones and climate (flight attendants, for example). Acclimatization in this case will bring everything back to normal.
  • Menorrhagia. This violation has a rather long and abundant course of menstruation - 10 days or more.
  • Algomenorrhea. This is a fairly common problem that many girls and women face. The main symptoms of such a violation of the menstrual cycle - cycle failure, accompanied by pain in the abdomen, lower back, often whining character. In this case there is nausea, problems in the bowels, headaches. Such a symptom complex can be observed already at the age of 14 and disturb the patient throughout her life. Sometimes it disappears after the onset of sexual activity or childbirth, but not always. In some cases, this condition is a sign of adnexitis or endometriosis.
  • Promenorrhea - monthly come earlier than after 21 days (the shortest physiological cycle).
  • Metrorrhagia - the appearance of bleeding, both during menstruation and in the middle of the cycle.
  • Algomenorea - a condition in which a woman suffers from very painful and heavy menstruation, because of which she cannot work normally, as her state of health in general is disturbed. The regularity of the cycle is not violated.

Each of these conditions requires a visit to the gynecologist, examination, passing the necessary tests for the formulation and clarification of the diagnosis. Therefore, in the event of the above symptoms should not postpone the appointment with a specialist.

When should I seek medical help?

In no case should not postpone the appeal to a specialist if:

  • there is a regular violation of the cycle, that is, it becomes shorter or longer by 5-7 days,
  • there is no menarche in a girl at the age of 15,
  • abundant periods, resembling bleeding. Normally, no more than 250 ml of blood should be lost during a single menstruation period. All that more is a symptom of hormonal imbalance, which requires drug therapy,
  • a year or two after the beginning of the monthly cycle was not established,
  • there is a presence of spotting in the period before and after the menstruation itself. Often this symptom indicates endometriosis,
  • There is pain during ovulation. This condition is dangerous for the probability of ovarian rupture and is easily stopped by medicines that the doctor selects.

Treatment of menstrual disorders in women of reproductive age

In this category of patients bleeding is often observed: in the period between menstruation, copious, painful, etc. At the same time, diagnostic curettage is required to stop the bleeding and determine the cause of the condition (the resulting material is sent for histological examination).

Next is the treatment of menstrual disorders, including:

  • Hormone therapy, which is usually the purpose of oral combination contraceptives.
  • If the problem is in the luteal phase of the cycle, then progesterone drugs are shown (Utrogestan, Norkolut, Dyuhoston).
  • To compensate for blood loss, intravenous fluids are prescribed special solutions.
  • Anemia shows iron.
  • If violations of the cycle are accompanied by infertility, then Horiogonin and Pergonal are used to stimulate the development of follicles.
  • If the cause of failures in extragenital pathology, then first of all they are engaged in its treatment. Power correction is carried out, if necessary, refuse from mono-diet, heavy physical exertion.

Treatment of malfunction of the MC in adolescent girls

Bleeding that occurs in girls during adolescence is called juvenile. Such violations of the menstrual cycle must be treated, carried out in several stages.

It applies:

  • Hemostasis, that is, to stop bleeding on the basis of hemostatic (Vikasol, Ditsinon) and hormonal agents.
  • Scraping - is performed in case of blood loss, complicated by dizziness, general weakness, very low hemoglobin (below 70).
  • Contraceptive use. They are prescribed for hemoglobin of 80 - 100 g / l, while using only hormonal combination drugs with low dosage of hormones (Novinet, Mersilon, Marvelon).
  • Antianemic treatment. It includes erythrocyte mass infusion, reopolyglukine, blood transfusion, Tardiferon, Sorbifer.
  • Vitamin therapy - receiving folic acid, Pentovit, ascorbic acid, Aevita.

Treatment with hormones lasts no less than 3 months, anti-anemia drugs are taken until normalization of hemoglobin parameters.

Treatment of menstrual disorders in women with menopause

When bleeding during menopause, curettage of the uterus is necessary, because such violations are often a sign of pathologies of the female genitalia (endometrial hyperplasia, adenocarcinoma, myoma, adenomyosis). At the same time, histological examination of the material obtained during curettage is shown. In some cases, if indicated, the uterus can be removed.

A number of problems are treated with hormonal drugs, among which the most commonly prescribed:

Treatment of menstrual disorders in women of any age should be accompanied by:

  • normalization of sleep and wakefulness,
  • good nutrition
  • stabilization of the psycho-emotional state
  • normalization of weight (this applies to both full and overly thin women).

Menorrhagia remedies

When excessively heavy monthly use of the collection, which includes such herbs, taken in equal proportions:

  • yarrow,
  • Oak bark,
  • raspberry (leaves),
  • silverweed goose,
  • strawberries (leaves).

1 tbsp. l of this mixture is poured 200 ml of cold boiling water and infused for 4 hours, after the infusion should be boiled for 5 minutes and strain. Ready broth is accepted during the day by a course of 5-8 days.

Traditional medicine for menorrhagia

Horsetail for many centuries has been used as a hemostatic agent in the treatment of women with bleeding. One spoon of this herb is poured with 0.5 l of boiling water, insist and take 1 tbsp. l every 2 hours until the bleeding stops. Further, for therapeutic purposes - 1 l three times a day.

For more information on what analysis is needed for menstrual disorders, you can learn from the video:

Betsik Julia, obstetrician-gynecologist

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Violation of the menstrual cycle. First about the norm

The reproductive period in the life of a woman is accompanied by menstruation - periodic bloody discharge from the genital tract. This is a natural process by which the body regains its readiness for pregnancy. It is cyclical, the duration of the cycle and its regularity are a mirror of the intimate health of a woman. Violation of the menstrual cycle is an alarm, and in no case can not be ignored.

Menstruation usually begins at the age of 12-14 years. Within a year after the first menstruation there is no clear periodicity, the cycle is only being established.

The menstrual cycle is counted from the first day of one menstruation to the first day of the next. On average, it is 28 days, but there may be individual deviations. The normal duration is from 21 to 35 days. The duration of the discharge itself is usually 3-5 days. Menstruation is often preceded by the so-called premenstrual syndrome - a period of poor health. There may be pain in the lower abdomen, swelling of the chest, increased swelling, headache.

No menstruation during pregnancy. After birth, the menstrual cycle is restored. The earliest it can occur 6 weeks after delivery. When breastfeeding a child, menstruation returns much later, how much later it depends on the individual characteristics of the female body.

In anticipation of menopause, the menstrual cycle may become unstable, and the intervals between menstruation increase. Such disorders between the ages of 45-55 are not pathological.

Scanty menstruation

Insufficient development of the mucous membrane of the uterus - the main cause of poor menstruation. However, hypomenstrual syndrome can be a genetic feature of women. Change of menstruation in the direction of reduction is considered normal if:

  • the girl's cycle has not yet been fully established (puberty).
  • In a woman aged 45 and older, scanty periods indicate that menopause is approaching.

It should be remembered that taking birth control pills significantly reduces the amount of menstruation.

The list of possible causes is not exhausted. In order to establish the cause requires a medical examination, and in some cases - a comprehensive examination.

When any violations of the menstrual cycle is necessary to consult a doctor?

Any violation of the menstrual cycle is a good reason to consult a gynecologist. The absence of a clearly defined cycle means impaired reproductive function, which can affect the ability to get pregnant and bear the child. And most importantly - this is a possible sign of a serious illness.

Be sure to visit the doctor if:

  • a girl in 15 years did not start menstruation,
  • discharge observed during pregnancy
  • menstruation is extremely painful, accompanied by pain in the lower abdomen (this can be a sign of ectopic pregnancy)
  • there is abundant bleeding (this can occur during ectopic pregnancy, spontaneous abortion, malignant tumors of the uterus).

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