Because of what there can be no monthly. The problem of delayed menstruation in girls and women. What are the dangers of constant delays in menstruation

What is the menstrual cycle? How to understand that a delay in menstruation has begun?

Delayed menstruation is one of the most common complaints of patients in the gynecological office. Let's take a closer look at the physiology of a woman and, in accordance with the knowledge gained, we will try to get to the bottom of the cause of this pathology.

The first menstruation (menarche) occurs in girls at the age of 12-14 years, sometimes a little earlier or later. After the onset of menarche for 1-2 years, girls often experience a delay in the onset of menstruation and this is considered the norm, since in adolescence only the normal hormonal background of the body is set. If, after this time, there are still delays in menstruation, then this is already a reason to contact a gynecologist.

The menstrual cycle is the period of time from one menstruation to the next. Normally, these intervals should be the same. A new menstrual cycle should be counted from the first day of menstruation. Normally, its duration is 21-35 days. Most often - 28 days. If the menstrual cycle is lengthened for any reason, then this should be considered a delay in menstruation. At the beginning of the menstrual cycle, there is a physiological increase in the hormone estrogen. There is an increase in the endometrium in the uterine cavity in order to "accept" a fertilized egg. At the same time, the maturation of the egg occurs in the ovary. Around the middle of the menstrual cycle, usually on day 12-14, a mature egg is released from the ovary. Ovulation occurs - the period when the onset of conception is possible. And in place of the egg, the so-called corpus luteum is formed, which is a derivative of progesterone. With a lack of progesterone, miscarriages often occur in early pregnancy. Fertilization of the egg occurs in the fallopian tube, the development of the fetus - in the uterus. If conception has occurred, then the cause of the delay in menstruation is the onset of pregnancy. If conception does not occur, then there is a drop in the level of progesterone and estrogen and the next menstruation occurs. Thus, we can conclude that the delay in menstruation, or rather its causes, most often lie in a violation of the hormonal background of the body (in the absence of pregnancy).

Delayed menstruation during pregnancy and after childbirth.

Fortunately, most often, the delay in menstruation is associated with the onset of pregnancy, and not with serious illnesses. The delay in menstruation is observed throughout the entire period of pregnancy. After childbirth, the reason for the delay in menstruation is an increased level of prolactin (the hormone responsible for lactation). If a woman is not breastfeeding, then the delay in menstruation will be minimal. Usually no more than 6-8 weeks. In the event that a woman is breastfeeding, a delay in menstruation can be observed throughout the entire lactation period, up to 2-3 years. But there are exceptions, when the delay in menstruation, even in a nursing woman, is no more than 1.5-2 months after childbirth. Each organism is individual.

Ovarian dysfunction. Is this the reason for the delay in menstruation?

Many doctors, when they hear that you often have a delay of 5 days or more, immediately diagnose “ovarian dysfunction”. Although, delayed menstruation and ovarian dysfunction are, one might say, synonymous. Ovarian dysfunction is a common condition seen in women with irregular menstrual cycles. But ovarian dysfunction itself can be caused by many reasons. Most often, these are pathologies of the endocrine system or diseases of the thyroid gland. Therefore, if there is a delay in menstruation, and the test is negative, then you should visit an endocrinologist and undergo the examinations recommended by him. Usually this is an ultrasound of the uterus, thyroid gland and adrenal glands, brain tomography.

Some gynecological causes of delayed menstruation.

A delay in menstruation can be caused not only by endocrine, but also by gynecological diseases. Pathologies such as uterine fibroids, inflammatory processes in the internal genital organs of a woman, adenomyosis, endometriosis, cancer of the cervix or uterine body, etc. can have a negative impact on ovarian function. Often delays in menstruation by 5-10 days with a negative pregnancy test are associated with inflammatory processes occurring in the ovaries themselves.

Polycystic ovary syndrome as a cause of delayed menstruation.

One of the most common diagnoses in women who often experience problems with missed periods is polycystic ovary syndrome (PCOS). This diagnosis is made on the basis of an external examination of a woman. That is, a woman suffering from this disease often has overweight, male pattern hair growth (hair growth above the lips, in the groin, on the legs, under the arms in excessive amounts), oily skin and hair. But even these signs can be argued. For example, many Eastern women who do not experience delays in menstruation have “excessive” hair growth. But this is their individual feature, not pathology. In addition to external signs, the main indicator of PCOS is an increase in the male hormone in the blood (testosterone). Due to its excess, a woman’s menstrual cycle is upset, but the worst thing is that this leads to infertility, since there is no ovulation with a high level of testosterone.

You should not be afraid of this. It's completely curable. In mild situations, the gynecologist may recommend taking a course of oral contraceptives (birth control pills). There are special oral contraceptives recommended for women with elevated testosterone levels. They help not only restore their hormonal levels, but also significantly improve their appearance and forget about delays in menstruation. The menstrual cycle, in most cases, becomes regular when taking oral contraceptives.

But if you do not have external signs of polycystic ovary syndrome, or there is no other sign of them - a delay in menstruation and futile attempts to conceive a child for more than a year, then you should not "bother" much on this topic.

Other common causes of missed periods.

Often, a delay in menstruation with a negative pregnancy test is associated with deviations in body weight. In order to find out if your weight is normal, you need to calculate your BMI (body mass index). To do this, divide your body weight in kilograms by your height (in meters) squared. If the result is more than 25, then you are overweight, if less than 18, then you are underweight. If a monthly delay of 5 days, 10 days or more is associated precisely with weight, then after its normalization, the regularity of the menstrual cycle will also be restored.

Often, a delay in menstruation is observed in women engaged in physical work. The reason for the delay in menstruation in this case can be removed only by switching to an easier schedule or type of work.

Quite often, a delay in menstruation is observed in women who often experience nervous stress and are engaged in serious mental work. Delayed periods can occur when traveling to an area with a different climate, taking certain medications and even (in rare cases) oral contraceptives.

What threatens frequent delays in menstruation?

There is no danger in the very delay of menstruation. But the danger may lie in the reason that caused the failure of the menstrual cycle. Therefore, this situation should not be let out of control.

For example, if a delay in menstruation occurs due to an increase in the level of prolactin in the blood, and this, in turn, is associated with the formation of a microadenoma (tumor) in the brain, then this can lead to terrible consequences if treatment is not started on time.

The same applies to inflammatory diseases of the ovaries, uterine fibroids and other gynecological and endocrinological diseases.

Frequent delays in menstruation without the first signs of pregnancy may indicate serious disorders in the body. And if left untreated, it can even lead to infertility.

And, in the end, it is much easier for a woman who is sexually active to live with a regular menstrual cycle. When a delay in menstruation is detected, the first signs of pregnancy can be noticed in time. And in some diseases, early detection of pregnancy plays a huge role.

As you now understand, an irregular menstrual cycle is not some specific, serious disease. But you should still monitor the regularity of your menstruation. A delay in menstruation is almost always an indicator of some kind of trouble in the body.

The normal duration of the menstrual cycle is in the range of 21 to 28 days. If the cycle is longer, it is considered a delay. Why does it arise? Let's try to figure it out.

Every girl should know how to correctly calculate the duration of her cycle. But, for some reason, many do not know how to do this and calculate the cycle from the last day of menstruation to the first. In fact, the calculations are made differently: the duration of the cycle is calculated from the first day of menstruation to the first day of the next menstruation. And if there is a delay in menstruation, it is important to find out why it can be.

In general, the causes of delayed menstruation are divided into natural and pathological.

Delayed periods: causes other than pregnancy

So, you missed your period, but the test came back negative? So pregnancy is excluded. What could be the factor for the development of this condition? As already mentioned above: pathological and natural causes.

Physiological or natural causes of delay include:

1. Puberty. There are no reasons for the delay in menstruation in adolescents, as such. Just during puberty, the delay is an absolutely normal condition and does not require a visit to the doctor. It is observed about 2 years after the first menstruation.
2. Preclimax. This condition occurs after 45 years and is evidence of the approaching menopause.

Pathological causes of delayed menstruation include the following:

1. Diseases from the field of gynecology, as well as pathologies of the endocrine system. For example, PCOS, adnexitis, fibroids, endometritis, cervical cancer, impaired thyroid function, diabetes mellitus, kidney dysfunction, poorly placed IUD, sunburn, ovarian defects, etc.
2. abortion. Artificial termination of pregnancy is a factor due to which hormonal failure occurs. If a large amount of uterine tissue was removed during curettage, she needs to recover. Therefore, in this case There may be a delay of up to three weeks.
3. Cancellation of hormonal drugs. After it, ovarian hyperinhibition is usually observed, as a result of which menstruation is absent for 2-4 months.
4. Taking medicines. In particular, antidepressants, diuretics and cytostatic drugs, antibiotics.
5. Obesity or, conversely, excessive thinness. Both conditions can result in a long delay.
6. Significant physical activity. They deplete the girl's body, so it begins to produce hormones that delay menstruation.
7. Stressful situations, acclimatization, change of scenery. Any stressful situation can negatively affect the body. It disrupts the production of hormones that are responsible for reproductive function, and because of this, menstruation stops.
8. Chronic alcoholism or drug addiction, diseases that destroy the immune system and lead to hormonal imbalance.

Delayed menstruation after childbirth

After the birth of a child, the delay in menstruation is quite justified. Usually, immediately after childbirth, the mother begins to breastfeed the baby, and during this period, the production of prolactin, a hormone that stops ovulation, is carried out. After the end of feeding, menstruation is completely restored within 1-2 months.

Permanent delays of monthly causes

Why can a girl have a constant delay in menstruation? Usually it occurs due to the use of hormonal drugs that increase the duration of the cycle. The drugs block ovulation and prevent fertilization from happening. After taking the last pill, literally the next day, menstruation should begin. If it does not start within two days, the drug must be changed.

Also, a regular delay can occur due to polycystic ovary syndrome, which prevents the normal production of hormones.

That is, the question of why a girl has a delay in menstruation every month can be answered unequivocally: due to pathological processes in the body. You should consult a doctor.

Reasons for delaying menstruation by a week

A slight delay in menstruation, about 5-7 days, is normal. Therefore, it is not always necessary to look for reasons for a delay in menstruation for a week, especially if it happened once. Such a delay can occur due to stress, excessive exercise, diet or acclimatization. Of course, if you have a large delay in menstruation, or if it occurs regularly, you need to find the causes of this condition. For this, be sure to consult a doctor. He will prescribe an examination and help identify the pathology, if any. Thanks to a timely visit to the doctor, it will be possible to cure the cause of the delay effectively and quickly.

Menstruation, menstruation, or regulation, is a periodic rejection of the endometrium of the uterus, accompanied by bleeding. The absence of menstruation in the first place causes a woman of reproductive age to suspect pregnancy. However, you need to know that, in addition to pregnancy, there are a number of reasons that affect the menstrual cycle.

Menstrual cycle: norm, failures, violations

The menstrual cycle is the periodic changes in a woman's body aimed at the possibility of conception. Its beginning is considered to be the first day of menstruation, the end is the day before the start of a new menstruation.

Menstruation occurs in young women at the age of 10-15 years. After that, it is believed that the body has entered the phase of the ability to conceive and carry a child. Menstruation continues up to 46-52 years. Then there is a decrease in their duration and the amount of blood released during this.

The duration of a normal menstrual cycle is 28 to 35 days. Its duration and the amount of discharge depends on the mental and physical condition of the woman. Failures and irregularities of the menstrual cycle can be caused by many reasons:

• pregnancy (uterine and ectopic) and lactation;
• hormonal fluctuations in adolescence and adulthood or against the background of taking hormonal drugs;
• stress
• disease;
• taking or withdrawing medications.

For reference. A prolonged delay or absence of menstruation is called amenorrhea. It can be secondary (acquired) or primary.

What is considered a delay?

A delay in the menstrual cycle, caused by one reason or another, sometimes happens to most women. Under the delay means deviations from the usual menstrual cycle for 10 days or more.

For reference. Every woman has a slight delay in menstruation 1-2 times a year.

Why is there a delay in menstruation:

As already noted, the delay in menstruation occurs for many reasons. The reasons can be both physiological (diseases, stress) and natural (adolescence, pregnancy, lactation, menopause). Some causes can be combined, causing difficulties in diagnosis. Let's look at the delay factors in more detail.

- pregnancy

During the entire period of bearing a child, a woman usually does not have menstruation. After childbirth, the restoration of the cycle occurs in different ways - it all depends on the individual characteristics of the female body. Elevated levels of the hormone prolactin during breastfeeding can prevent eggs from being released. For this reason, during lactation, a woman does not have menstruation.

Important. The absence of menstruation does not mean that a woman cannot become pregnant.

- ectopic pregnancy

An ectopic pregnancy differs from a uterine pregnancy in that the fertilized egg attaches itself outside the uterus. However, the hormone progesterone, which inhibits the menstrual cycle, is produced in the same way as during normal pregnancy. Therefore, it is extremely important for a woman to monitor the fluctuations of her cycle. At the slightest delay, she needs to exclude the possibility of an ectopic pregnancy, which almost always has an unfavorable outcome.

- adolescence

A delay in adolescence should not cause concern. It is due to the fact that the hormonal background of a teenage girl is still unstable. Once hormone levels return to normal, the cycle will become more stable.

Important. If 2 years after the first regulation (otherwise they are called "menarche") the cycle has not been established, the teenager needs to see a doctor.

- approaching menopause

Rare intermittent periods after the age of 40 can be harbingers of premenopause (the initial stage of menopause). The main reason for the delay in menstruation during menopause is a change in the hormonal background of a woman. Involutional processes (reverse processes, or aging processes) occurring in the hypothalamus contribute to a gradual decrease in the level of sensitivity of this part of the pituitary gland to estrogenic effects in the body.

- intense sports

Excessive physical activity also does not contribute to the regularity of the menstrual cycle. It is known that professional athletes sometimes experience problems with delayed regulation, and sometimes with childbearing. The same problems haunt women engaged in physically demanding work.

- weight changes

Among the reasons for the delay in regulation, a significant weight loss is noted. In medicine, there is a term "critical menstrual mass". If the weight of a woman trying to lose weight is less than 45 kg, then menstruation stops. The body does not have the resources for the normal functioning of the reproductive system. The same thing happens if the excess weight goes beyond what is permitted, approaching the third degree of obesity. The fat layer in case of excess weight accumulates the hormone estrogen, which negatively affects the regularity of the cycle.

- stress

Stress regardless of duration can cause a delay. Stress includes: constant nervous tension, an upcoming important event, problems in the family and at work, a change in the nature of activity, climate change.

For reference. The tense expectation of the onset of menstruation can cause an even longer delay.

- diseases

Some diseases cause fluctuations in the menstrual cycle. So, disorders of the thyroid gland, pituitary gland, adrenal glands directly affect the production of hormones. Hormonal imbalance leads to ovarian dysfunction. Inflammatory diseases of the genitourinary system, polycystic ovary syndrome, endometriosis also lead to cycle fluctuations. Seemingly harmless colds (for example, influenza or SARS), as well as chronic kidney disease, diabetes, gastritis can cause a delay. Tumors of various etiologies are sometimes detected precisely by the delay in menstruation. It is important that with neoplasms, a pregnancy test can show a false positive result.

- withdrawal of hormonal drugs

Sometimes the female body receives hormones from the outside - when taking hormonal drugs. When they are canceled, the woman is faced with a delay in regulation. This is due to the fact that while taking hormonal agents, the ovaries are in a state of temporary hyperinhibition. It will take 2-3 months to restore a normal cycle, otherwise a gynecologist's consultation is necessary.

The same result should be expected after taking emergency contraceptives (for example, Postinor), which contain a large dose of hormones.

- medicines

In addition to hormonal drugs, antibiotics can cause a delay. Means of an antibacterial series negatively affect the production of hormones by the female body. Therefore, they should be taken after a thorough examination and consultation with a specialist. To reduce the negative impact of drugs on a woman's body, you need to drink a course of vitamins, bifidobacteria and lactobacilli.

- body poisoning

Alcohol, smoking, drugs taken by a woman regularly and for a long time can cause intoxication of the body. Also, intoxication, which causes a delay in menstruation, can also be provoked by work in hazardous industries.

What to do if you have a delay in menstruation?

If a woman is experiencing a delay in regulation, she first needs to take a pregnancy test. After ruling out the suspicion of pregnancy, a woman should consult a specialist. Both gynecologists and endocrinologists deal with the problems of delayed menstruation. Only a doctor can identify the cause or even a combination of causes of delayed menstruation.

The specialist, in addition to collecting an anamnesis, may prescribe the following:

• checking for ovulation;
• tests for STDs;
• blood test for hormones;
• curettage of the inner layer of the uterus and its histological examination;
• Ultrasound of the pelvic organs;
• Ultrasound of the thyroid gland and adrenal glands;
• CT (computed tomography) and MRI (magnetic resonance imaging) of the brain.

Important. Don't put off seeing a doctor if you're not sure exactly what's causing the delay.

Thus, a normal menstrual cycle is an indicator of women's health. Any deviations in it can signal problems in the nervous, endocrine, reproductive and other systems.

Specially for- Elena Kichak

In reproductive age, the onset of monthly menstruation will allow a woman to leave thoughts of illness and unplanned conception. There is a generally accepted opinion: menstruation has begun - so you can relax. A delay in the menstrual cycle is a dangerous phenomenon for any age, since it may indicate the course of the pathological process.

Why is there a delay in menstruation during pregnancy

The first sign of the “interesting position” of a woman is the absence of menstruation. Normal delay in menstruation testifies that the representative of the weaker sex in 9 months will experience the joy of motherhood. In such a clinical picture, the arrival of planned bleeding is not expected in the near future, and the first menstruation will remind of itself a few months after childbirth.

If you are interested in what happens in the female body during pregnancy, and where the planned menstruation disappears, it is worth clarifying. Physiologically, such bleeding is provoked by progesterone, the level of which in a pregnant woman is unstable. So:

1. With the fertilization of the egg and its attachment in the thickness of the uterus, the hormone index increases - for this reason, menstruation is absent.
2. A negative pregnancy test results in a drop in progesterone, resulting in menstruation.

Why can there be a delay in menstruation

A pregnant woman does not have a period - this is the norm. If the representative of the weaker sex is not in an "interesting position", the risk of exposure to physiological and pathological factors increases. It is important to know in detail what can cause a delay in menstruation to respond in a timely manner to a progressive health problem. There can be many reasons, but it is important to highlight the most common among those.

For stress and fatigue

Even in healthy women, the menstrual cycle can be disturbed. For example, due to emotional overwork and nervous exhaustion, after suffering shock or stress, in the case of chronic fatigue, abnormal processes associated with dysfunction of the reproductive system predominate in the female body. The patient may not be aware what can cause a delay in menstruation, but everything is clear to the doctor - the causes of "malfunctions" in the work of the nervous system. What is the relationship?

Increased nervousness negatively affects the functions of the central nervous system, as a result of which the activity of the uterine muscles is disrupted. Separate muscle structures receive an insufficient amount of blood, the contraction and relaxation of blood vessels is disturbed. Under the negative influence of such abnormal phenomena, the patient experiences an unexpected delay in menstruation for several days. It happens that bleeding for these reasons, on the contrary, occurs ahead of schedule.

With excess and deficiency of body weight

A possible reason for the lack of planned bleeding in a woman of reproductive age is impaired weight. There are standards established by WHO standards that ensure the smooth operation of the endocrine system. So, the weight of a woman should not be less than 45 kg at the age of 18 years and older. For the BMI indicator, there are also certain limitations:

1. If the BMI is less than 18 units, there are serious violations of the endocrine system. When the body is depleted, the “death” of estrogen is observed, and, as a result, a violation of the hormonal background.
2. When the BMI is more than 25 units, signs of hormonal imbalance and a delay in the menstrual cycle are obvious. With obesity, estrogens are produced in subcutaneous fat, and their "production" by the ovaries blocks the pituitary gland.

Since the endocrine system does not cope with its functions with abnormal weight, hormonal imbalance progresses. Increasing estrogen deficiency what causes delays in menstruation. Until conservative methods manage to stabilize the level of the female hormone in the blood, the menstrual cycle, for obvious reasons, will not be regular.

When changing residence and time zones

The biological clock is an important indicator of women's health. If there are failures of the menstrual cycle, the reasons may be hiding in a violation of the usual rhythm of life. This often happens when changing jobs or places of residence, regular lack of sleep, as well as long-distance travel, in a new climate and time zones. Delayed menstruation is not a pathology, and the cycle will soon normalize without medical intervention.

Causes of delayed menstruation in adolescents

In the pubertal period (girls 14-16 years old), the first menstruation occurs, which indicates that the body has reached reproductive age. The representatives of the weaker sex already feel like girls, but they often ask the question why there is no menstruation if they have already come before. Reasons why do teenagers miss their period observed, several, the most relevant in puberty are described below:

1. Physiological: the formation of a hormonal background, nervous shocks, rapid bone growth, overwork at school, a change of residence or time zone.
2. Pathological: one of the stages of obesity, pathologically low weight, hormonal imbalance against the background of excess prolactin, past infectious diseases, thrush.

Failures of menstruation with inflammation

When there is no period, the first thing a woman buys is a pregnancy test. It is possible that she is expecting a child. It so happens that delay without pregnancy comes, indicates serious pathologies in a feminine way. Such a clinical picture is especially common in inflammatory gynecological diseases that require urgent medical treatment.

Diseases may not affect the reproductive system, for example, a classic cold or cystitis causes a delay in the menstrual cycle. If a woman begins to get very sick, all the forces of the body are aimed at fighting the pathogenic virus, and the arrival of menstruation recedes into the background. After recovery, the immune system needs time to recover, after which menstruation occurs.

Delayed period due to medication

After a long period of drug treatment, the reason for the absence of menstruation is obvious, especially if the patient was taking hormonal drugs, such as oral contraceptives. Doctors report that this is an indicator of the norm, but recommend that women additionally do a pregnancy test. If the result is negative, the reason for the delay is in birth control pills. There are other medications that can delay your period. It:

• emergency contraception;
• antidepressants;
• chemotherapy drugs;
• corticosteroid hormones;
• antibiotics.

Delayed menstruation with thyroid pathologies

If there is a malfunction in the thyroid gland, it will not be possible to normalize the menstrual cycle until the underlying disease is treated. Only after the normalization of the hormonal background, you can expect that the next planned menstruation will come in a timely manner. It is important to note that thyroid hormones are responsible for metabolism, so the disturbed concentration causes a menstrual cycle to fail.

What causes a delay in polycystic ovaries

If breastfeeding delays the arrival of menstruation, this is a perfectly acceptable process in the female body. If the lactation period has nothing to do with it, and menstruation does not go astray for the first month, female problems are not excluded. They equally occur in spring, winter and summer, suggest serious diseases of the reproductive system. It can be endometriosis, fibroids or other neoplasm of the uterus, polycystic ovaries. In the latter case, we are talking about a hormonal disorder, which not only disrupts the menstrual cycle, but also leads to diagnosed infertility.

If polycystic ovaries begin, effective treatment may take several weeks. If you miss the first symptoms of a characteristic ailment, the disease becomes chronic, incurable, radically disrupts the hormonal background of a woman. It is recommended to pay attention to symptoms such as facial hair, skin type changes, a growing belly, and a jump in body weight.

Why there is a delay in premenopause

A constant violation of the menstrual cycle, a change in the abundance of monthly bleeding (scanty or, conversely, intense), the appearance of premenstrual syndrome after 45 years are signs of an approaching menopause, when radical hormonal changes resume in the female body. This problem does not last for one week, and in some patients, anxiety symptoms can last for even one year.

A pregnancy test will definitely be negative, and a delay in menstruation for a week or more is due to a reduced concentration of estrogen in the blood. A woman after 45 years of age will have to put up with such innovations in her general condition, but it is better to contact a local gynecologist in a timely manner, to determine an individual hormone therapy regimen.

Video

When consulting women, an obstetrician-gynecologist often encounters a complaint about "delayed menstruation." In this case, the patient has anxiety and legitimate questions: "Is everything all right? What if I'm pregnant? Does this happen to others? Am I healthy?" Let's talk about the causes of this condition, which may be different.

A bit of physiology

The menstrual cycle is the monthly changes in the female body that occur under the influence of sex hormones. The main sign of a normal cycle (its duration is 21-35 days) is regular menstruation - spotting from the genitals, the duration of which is normally 3-7 days. Normal blood loss during menstruation does not exceed 50-100 ml.

Menstrual function is regulated by the joint activity of a complex complex of nervous and humoral structures (cerebral cortex; hypothalamus and pituitary glands - endocrine glands located in the brain), as well as genital organs (ovaries, uterus). Since all levels of this system are interconnected, the delay in the next menstruation may be associated with a malfunction of any of the listed links. Therefore, the cause of a delay in menstruation can be a "breakdown" at any of the levels of regulation of the menstrual cycle.

Causes of delayed menstruation

Delayed periods can be caused various gynecological diseases, such as inflammation of the uterine appendages (salpingoophoritis), uterine fibroids (benign tumor of the uterus) and others. However, it should be noted that with these diseases, bleeding from the uterus is more common.

Periodic delays in menstruation are characteristic of a disease such as polycystic ovaries (PCOS). Under this concept, they combine a number of pathological processes in which the production of hormones is impaired. In this case, ovulation does not occur in the body (the release of an egg from the ovary) and infertility occurs.

PCOS is observed when the function of various organs is impaired: the hypothalamus, pituitary gland, adrenal glands, thyroid gland and the ovaries themselves. Therefore, the disease can manifest itself in different ways depending on the causes of its occurrence, and it is not enough to use any one diagnostic feature or method to establish a diagnosis.

With polycystic ovaries, the most common are menstrual irregularities (more often - delays from several days to several months), excessive growth of body hair, an increase in the size of the ovaries (but not always), in half of the patients - obesity. When measuring basal temperature (in the rectum), it remains approximately constant during the cycle, and does not increase in the second half, as is normal. With the most pronounced (primary) form of the disease, these signs appear already in adolescence after the onset of menstruation.

To treat this condition, various hormonal drugs are prescribed, drugs are used that reduce the level of male sex hormones (the formation of which increases with this disease), regulate metabolic processes in brain structures, etc. In the presence of obesity, weight loss is absolutely necessary. In preparation for a planned pregnancy, an important stage of treatment is to stimulate ovulation - the release of an egg from the ovary. For this, drugs are used, and if they are ineffective, surgical methods of treatment are used. Currently, it is performed by laparoscopy: small holes are made in the anterior abdominal wall, through which optical devices for examining the abdominal cavity and surgical instruments are inserted.

Delayed menstruation may also occur after abortion. The reason is a violation of the hormonal balance, as well as the fact that during the instrumental curettage of the uterus, an excessive amount of tissue can be removed, including that part of the inner lining of the uterus, which normally grows during the menstrual cycle and is excreted in the form of menstrual blood. To restore this functional layer, sometimes it takes a little more time than during a normal cycle. That is, after an abortion, menstruation may occur not after 28-32 days, but after 40 days or more. Such a delay is not normal: the woman needs examination and treatment.

The cause of delayed menstruation may be taking oral contraceptives. In the course of taking the drug or after its withdrawal for several menstrual cycles, the absence of menstruation may be observed: this is the so-called ovarian hyperinhibition syndrome.

With the development of ovarian hyperinhibition syndrome, oral contraceptives are canceled. As a rule, within 2-3 months, maximum - within 6 months after the end of their intake, ovarian function is spontaneously restored. If the absence of menstruation persists for a longer time, drugs that stimulate the pituitary gland (CLOMIFENE) or drugs that stimulate the maturation of the egg and its release from the ovary (PERGONAL, CHORIONIC GONADOTROPIN) are prescribed. Until the restoration of normal menstrual function, it is necessary to use other methods of contraception.

Stress- long-term or strong short-term - is the cause of a malfunction of the central structures (cerebral cortex, hypothalamus) that regulate the functioning of the ovaries and uterus. An example of such disorders is the so-called wartime amenorrhea, when menstruation stopped in conditions of stress in women.

Another reason for a significant delay in menstruation can be significant and rapid weight loss. So, doctors have such a thing as a critical menstrual mass - this is the weight at which teenage girls, as a rule, begin menstruation. However, we are more interested in the fact that with a strong desire to lose weight, reaching this critical menstrual mass (45-47 kg), a woman can get not only the desired result, but also a long delay in menstruation.

Most often, this effect occurs when anorexia nervosa- an eating disorder characterized by refusal to eat and / or its rejection. This is accompanied by a breakdown in the work of such regulatory systems of the body as the nervous and endocrine. Anorexia nervosa is characterized by a sharp decrease in the production of pituitary hormones that regulate, among other things, the work of the ovaries. At the same time, the violation of the reproductive function should be considered as a protective reaction in conditions of nutritional deficiency and mental stress. Therefore, in order to restore age-related secretion of hormones, it is necessary to achieve an ideal body weight and eliminate mental stress.

Anorexia nervosa in 50% of cases can occur with episodes bulimia(gluttony), after which the patient shows especially clear signs of anxiety, remorse and depression, successful attempts to induce vomiting.

For this reason, when preparing for pregnancy, do not try to reach the ideal of "90 - 60 - 90". If you are planning to lose weight, be smart about it, or better yet, consult a nutritionist.

Pregnancy- this, fortunately, is the most common and most physiological reason for delayed menstruation in women of reproductive age. In this case, a delay in menstruation may be accompanied by such signs as a change in taste and olfactory sensations, engorgement, soreness of the mammary glands. As a rule, a pregnancy test in this case gives a positive result. A delay in menstruation also occurs during an ectopic pregnancy, when the fetal egg is attached to the fallopian tube. In this case, all subjective sensations characteristic of pregnancy may also be present.

What can a doctor do?

In case of menstrual irregularities, you should immediately consult a doctor. Examination by an obstetrician-gynecologist will exclude conditions that require immediate surgical intervention. It can be an ectopic pregnancy, miscarriage, tumor diseases, etc.

To understand the cause of menstrual irregularities, the doctor may prescribe additional examinations:

• measurement of basal temperature and drawing up a graph of its change- these measurements, along with other methods, make it possible to judge the presence or absence of such an event as ovulation - the release of an egg from the ovary;
• Ultrasound of the pelvic organs- uterus, ovaries;
• blood test for hormones- with its help determine the level of hormones of the pituitary gland, ovaries, and, if necessary, other endocrine glands;
• computed or magnetic resonance imaging- methods that can be used to obtain layered images of brain structures to exclude a pituitary tumor.

In the presence of concomitant endocrine diseases, the gynecologist will prescribe a consultation with other doctors - an endocrinologist, a psychotherapist, a nutritionist.

Ildar Zainullin
obstetrician-gynecologist, Ufa

Discussion

I have a delay of 8 days, pains in the lower abdomen, as if they will begin soon, but they are not (
Strong white discharge
There are no signs of pregnancy, no nausea, no taste changes, the chest does not hurt, there is nothing, what could it be?

Hello. I'm already 7 days late and why is it or pregnancy.

Good article, thanks. I've dealt with stress in my life. And not just once. The most important thing in this situation is not to be nervous. And, since I myself can’t counterattack it, I took and take courses of Theanine from Evalar, a good drug helps with stress, calm down, relax.

my sister had a month delay due to a hormonal imbalance and there was still dysbacteriosis - she was injected with progesterone then and was prescribed a drug to restore microflora, after that there were no problems

For me, the article is also quite tolerable, some points and subtleties may not be disclosed, but in general it is well written.
By the way, I didn’t attach any importance to this cycle before, until I thought about the baby, and then it started, then you need to take into account one moment, then treat it here, correct it there (They also prescribed a time factor to stabilize the cycle. I have a problem only after a floor years I decided, and now I'm almost a mommy.

I do not agree that the article is weak. Everything is very well described. I like it. I also had a problem with the cycle, at first I didn’t go to the doctor, it didn’t really interfere with my life. And then, when I decided to give birth, it was not there. I couldn't get pregnant right away. Until the doctor prescribed me treatment, the cycle did not even out, I did not become pregnant. Three months Time factor spent on drink and voila)))) My baby is already with me, we will soon have a month!!!

give internet ****

May 30, 2005 06:11:42 PM, Listik

extremely weak article ...:(((((

Comment on the article "Delayed menstruation - why does it happen?"

There were no periods for 2 months before the exams. In general, it all depends on nutrition. There are functional ovarian cysts that lead to delays.

Delayed menstruation - why does it happen? Causes of delayed menstruation. A delay in menstruation can be caused by various things. Menstruation has become much more abundant.

Discussion

I have such a phenomenon happens after a sharp climate change, physical activity and diets. Surely only a gynecologist can tell.

I don't want to upset you, but it looks like it. Perhaps for a long time there will be such an indefinite period

Delayed menstruation - why does it happen? Causes of delayed menstruation. A delay in menstruation can be caused by various gynecological diseases, such More often ...

Discussion

"Novinet" took the fate, after the first months came from 10 days late on the 12th of spring, there are no others (
They prescribed DUFASTON and SPIRONOLACTONE. Ultrasound did not clearly write "echo signs of PCOS, paraovarian cyst?" under a question mark
I don’t understand, but it’s read from the prison that ПЯ 36 * 29mm, and LA 48 * 30mm

It is necessary to examine not only a gynecologist, but also an endocrinologist. Duphaston is an excellent tool for solving such problems, but maybe the doctor will also advise you to connect OK.

Delayed menstruation - why does it happen? Causes of delayed menstruation. A delay in menstruation can be caused by various gynecological diseases ...

Discussion

Oh, Nastenka, of course, I hope for a miracle, so I'm waiting for the test result, and it must be repeated in a couple of days, even if tomorrow it's negative. Did your chest hurt before you canceled duphaston? In general, I heard that after the cancellation, you can wait a week for months.

You can wait 10 days, in general there is a cyst of the corpus luteum on dufaston, you can do an ultrasound and see if there is one. If there is - it's not at all scary and even good - it means that the ovaries are working, just because of the cyst there may be a delay.