Violation of the menstrual cycle causes treatment. Violation of the menstrual cycle: causes, treatment, traditional medicine for violations of the MC

Menstrual irregularities are considered abnormalities such as a too long or short menstrual period, the absence of menstruation for 2-3 months, as well as irregular menstruation. In the first few months after puberty, the cycle is usually unstable, and this is completely normal. In addition, the failure of the cycle of menstruation often occurs after the completion of oral contraceptives. In other cases, this is a signal from the body that something is not right with it. Pay attention to the signs listed below.

Signs of failure of menstruation

If your menstrual cycle lasts less than 21 days (from the first day of your period until the next one) or more than 33, this is a cause for concern. Although for some such a deviation may be the norm - a lot depends on heredity. Only a doctor will help to resolve doubts.
A sign of a failure of menstruation may be the absence of a cycle as such. Mark the start days and duration of your period on the calendar to see the pattern and understand how regular they are.
Abnormal duration of menses. Too plentiful or long (more than 5 days) periods are considered a deviation from the norm and, in addition, bring a lot of inconvenience.

Failure of menstruation: causes

If you have a period failure, the reasons can be varied. A consultation with a gynecologist will help resolve this issue. If you've already made an appointment and are thinking about possible reasons, here are a few options:

Diet and excessive exercise. If you have changed your diet drastically or lost a lot of weight, this can affect your menstrual cycle. Often, violations occur in girls who are engaged in bodybuilding, sit on a protein diet, exhaust themselves with exercises and eat a lot of sports nutrition. The body reacts to abnormal loads for it, and menstruation stops. Diets and being underweight often interfere with conception and healthy childbearing.
Hormonal disbalance. Thyroid disorders and other hormonal problems are a very common cause of irregular periods. A blood test for hormones will help you find out the details. In addition, as already mentioned, after stopping the use of hormonal contraceptives, menstruation may be irregular for six months. If the problems don't end after six months, it's time to be wary.
Infections. Cycle disturbances are often a signal that you have a sexually transmitted infection (such as chlamydia). But don't worry: after you complete the course of treatment, everything will return to normal.
Stress. Depression and stress affect the nervous system, which in turn causes menstrual irregularities. In this case, vacations, long walks and a pleasant hobby will save you.
Pregnancy. If the delay occurs for the first time,

Menstruation is a physiological process that is normally repeated in women every month. The duration of the menstrual cycle and the nature of menstruation are individual for each woman, this is due to the structural features of the body, the presence of any diseases of the female reproductive system, genetic characteristics and many other factors.

A healthy woman of childbearing age should have regular periods. The duration of the menstrual cycle (from the beginning of the previous menstruation to the first day of the next menstruation) should be approximately 28 - 35 days.

Why does menstruation occur? Every month, an egg cell matures in the body of a healthy woman. If fertilization does not occur, the egg is released.

A regular cycle of menstruation is the main indicator of the normal functioning of the reproductive function of the body. In other words, a woman whose menstrual cycle is constant is able to conceive and bear a child.

Menstruation is a necessary process for the normal functioning of the female body. However, there are many reasons that can disrupt a woman's menstrual cycle and cause changes in the nature of menstruation. Let's take a closer look at why such violations can occur.

Causes that can cause a failure in the cycle of menstruation and the main clinical forms of disorders

Violation of the menstrual cycle, as a rule, is a consequence of any pathology or occurs as a result of the impact of adverse factors on the reproductive function.

There are three main types of reasons that provoke the failure of the menstrual cycle:

pathological (disruption of the cycle due to the presence of diseases);
physiological (stress, diet, climate change, etc.);
medication (disruption of the cycle is caused by taking or canceling any drugs).

Pathologies that can cause menstrual irregularities:

One of the main and most common causes of menstrual disorders in women is ovarian pathology.
Violation of the hypothalamic-pituitary system.
Pathologies in the work of the adrenal glands.
endometrial polyps.
Endometriosis.
Diseases of the uterus.
Oncological diseases.
Damage to the uterine cavity as a result of curettage or abortion.
Diseases of the liver.
Violations in the work of the blood-clotting system.
Conditions after operations on the organs of the female reproductive system.
genetic reasons.

As mentioned above, one of the types of reasons that can affect the regularity of menstruation are external factors. This is work in hazardous industries, and a change of residence, and strong emotional upheavals, drinking and smoking, unbalanced nutrition, and sudden weight loss.

In addition, irregular periods are observed in women undergoing drug treatment with hormone therapy drugs, antidepressants, anticoagulants, and others. That is why the appointment of medications and control over the patient's condition in the course of treatment should be carried out only by a doctor.

The main clinical forms of menstrual cycle disorders are:

1. Cyclic changes in menstruation:

hypermenorrhea - an increase in the volume of menstrual flow with a normal duration of menstruation;
hypomenorrhea - scanty menstruation;
polymenorrhea - normal in terms of the volume of secretions, monthly lasting more than a week;
menorrhagia - a significant increase in the volume of menstrual flow, the duration of menstruation is more than 12 days;
oligomenorrhea - short menstruation (1-2 days);
opsomenorrhea - rare periods, the interval between which can reach 3 months;
proyomenorrhea - a menstrual cycle of less than 21 days.

2. Amenorrhea - the absence of menstruation for more than 3 months.

3. Metrorrhagia (uterine bleeding):

occurring in the middle of the cycle (anovulatory);
dysfunctional (independent of the process of ovulation).

4. Painful menstruation (algomenorrhea).

Diagnosis

In order to regulate the menstrual cycle and restore it, it is first necessary to understand what caused the violations. For this, it is necessary to undergo a comprehensive examination, according to the results of which the specialist will be able to choose the necessary treatment.

Diagnostics includes several stages:

History taking - it is necessary to tell the doctor about all diseases, the number of births and abortions, medications taken, external factors that could affect the constancy of menstruation.
Gynecological examination and delivery of smears.
Blood tests, including for the determination of hormones.
Additional studies prescribed by the doctor.

What can menstrual irregularities lead to?

Irregular menstrual cycles are not considered by many women to be a big problem. However, such violations can lead to infertility. Intermenstrual bleeding, for example, can cause apathy, fatigue, and reduced immunity.

How to deal with irregular periods

After the diagnosis, the doctor decides on the need for one or another method of therapy, it can be either conservative drug treatment or elimination of the causes of the cycle disorder with the help of surgical intervention. Often these two methods are combined in the treatment process.

To normalize the cycle of menstruation, it is necessary to eliminate exactly the cause that caused the failure of the cycle, so anti-inflammatory drugs, hormonal contraceptives, and hemostatic drugs can be prescribed.

Restoration of the menstrual cycle after childbirth

Separately, I would like to talk about the restoration of the cycle of menstruation in women in the postpartum period. It is worth considering that menstruation resumed only after the onset of the first menstruation. But even here you should not hope that the cycle will immediately become regular.

Changes that have occurred in the female body in connection with pregnancy and childbirth, including hormonal ones, can affect the stability, nature, and pain of menstruation. Irregular periods are acceptable during the first 2-3 months from the moment they start to resume.

It is worth worrying for women whose periods do not come 2 months after childbirth, provided that the child is bottle-fed. If your baby is on a mixed diet, then menstruation may be absent for up to six months. Young mothers who are breastfeeding a baby may not wait for menstruation during the entire first year.

It takes time to restore the menstrual cycle. Often, disruptions in the menstrual cycle occur precisely because of the influence of external factors: try to avoid conflicts, stress, emotional experiences, eat right and have a good rest in the postpartum period.

If menstruation after childbirth has become more abundant or scarce, long and short-term, more painful, you should immediately consult a gynecologist for advice.

Particular attention should be paid to the process of restoring menstruation to those women who gave birth by caesarean section. To avoid complications or to identify them at the very beginning, it is necessary to constantly visit a gynecologist.

In conclusion, I would like to emphasize that the detection of pathologies that caused menstrual irregularities in the early stages significantly increases the chance of getting rid of them. Do not self-medicate - this can only aggravate the situation. The prescription of medications should be carried out only by a doctor, taking into account the diagnosis and anamnesis of the patient.

Answers

Starting from the age of 11-12, every woman in her life facing menstruation. It is a sign that the body is mature and physically ready to bear offspring. This phrase may scare you - few people can imagine a future mother who herself still plays with dolls.

But the fact remains - if menstruation has come, the girl becomes a girl. Her body begins to produce female sex hormones responsible for possibility of conception and bearing a child.

Menstruation becomes a regular occurrence in a woman's life and continues until menopause- the period when the production of hormones decreases and the woman ceases to be able to bear children. However, not everyone's menstrual cycle runs like clockwork. Cycle failures, too plentiful or scanty periods, two periods in one month or a delay not associated with pregnancy - every woman can face this.

Why do menstrual irregularities occur? What are the dangers of such violations? How to identify them and how to treat? All these questions are answered in this article.

The reasons why woman's menstrual cycle can give a sudden failure, differ in nature. They are physiological, psychological and caused by taking certain medications. The most common reason why a woman's menstrual cycle starts to go astray is age factor.

At the onset of a certain age, the body ceases to produce the right amount sex hormones responsible for the stable functioning of the female reproductive system. Menopause is coming - a difficult emotional and physical condition for a woman. Following the menopause, during which menstruation usually continues to go, menopause is coming. And from this age the woman actually becomes infertile.

During this period, there are often cases of prolonged menstrual bleeding, during which develop anemia, significant disruptions in the arrival of menstruation: the time intervals between cycles are either halved or lengthened to several months.

After childbirth, women also have problems with cycle instability. This is due to significant hormonal changes during pregnancy, childbirth and subsequent breastfeeding.

According to statistics, in 30% of women the menstrual cycle is restored to its previous state 3-4 months after childbirth, in 20% the cycle is restored within six months, in the rest - either after the end of breastfeeding, or within a few years after the birth of the baby.

Most common failure reasons in the menstrual cycle:

severe stress;
recent abortion or miscarriage;
taking hormonal drugs;
taking drugs that affect the thyroid gland;
climate change (temporary failure);
chronic depression;
chronic bacterial infections of the pelvic organs;
inflammatory processes of the reproductive system;
oncological diseases;
recent severe colds and antibiotics;
birth of a child;
recent onset of menstruation, adolescence;
recent onset of sexual activity;
metabolic disease;
the beginning of the menopause;
menopause;
rigid diets.

All of these factors can cause a serious disruption in the functioning of the body and the female reproductive system, which leads to the fact that the monthly cycle becomes unstable. If you are concerned about the symptoms described in one of the sections below, this is a reason to see a doctor.

Symptoms: how to determine that the cycle has gone astray?

Failure of the menstrual cycle is considered to be its serious deviation from the norm. Some women begin to worry when their periods do not come on their due date, or they come a few days earlier. Such short-term failures are normal, as long as they do not occur too often.

Until a certain point, menstruation came stably, the cycle was equal in time, but there was a failure. Has changed cycle length, has become unstable, the duration of menstruation has changed.
During menstruation, the discharge became too profuse and painful; or her term was reduced, and the allocations became scarce. The latter may indicate serious ovarian problems(polycystic).
Menstruation comes several times a month, goes as usual (polymenorrhea).
Menstruation delayed by more than 2 weeks, but pregnancy not confirmed. (Amenorrhea).
Periods disappeared, and do not appear for more than two months.
Cycle duration less than 21 days, or more than 34 days.

As you can see cycle disorder both changes in its duration and the intensity of discharge and sensations during menstruation are considered. The appearance of severe pain that was not there before, heavy bleeding is a sufficient reason to seek medical advice.

Causes of failure in teenagers

Most often, problems with the cycle occur in completely young girls. In most cases, gynecologists urge not to see this as a cause for alarm. The young body has just entered the maturation phase, the hormonal background is still not stabilized during puberty.

For the first few years, the menstrual cycle in a teenage girl is just being established. Menstruation can come irregularly, with large intervals between cycles.

Often there are anovulatory cycles, as a result of which menstruation does not occur. The internal reproductive organs continue to form, menstruation is painful, prolonged and plentiful. Sometimes the situation manifests itself in the opposite form: menstruation come rarely, go no more than 2-3 days.

You should not worry too much about such failures, since for most women a stable cycle is established only by the age of 18-20 or after the birth of a child. But it is necessary to monitor the situation by visiting regularly. gynecologist. To regulate the menstrual cycle, girls are often prescribed light oral contraceptives, which allow normalizing hormonal levels. Take pills on your own without consulting a doctor Not recommended so as not to harm the developing organism.

In women of childbearing age

Often the cycle goes astray in an adult woman with fully formed reproductive organs and stable hormonal background. The main reason for this phenomenon is severe stress that affects the functioning of the thyroid gland. That, in turn, provokes disturbances in the production of hormones, and the female menstrual cycle suffers.

Diets, severe weight loss, taking hormonal contraception without a doctor's prescription, abortion pills, inflammatory processes in the pelvic organs - all this becomes failure cause. In a woman with a stable cycle, abnormalities that occur more than once are a reason for an immediate visit to the doctor and a complete examination.

What women take for a failure in the menstrual cycle may be a pregnancy - normal or ectopic. Therefore, pay special attention to your body during a long delay. If the tests do not show pregnancy, this does not guarantee its absence.

After childbirth

Failures in the menstrual cycle after the birth of a baby is an absolutely normal phenomenon. The first reason is the need to restore organs that have been stretched or damaged during childbirth.

Most often uterus suffers, which greatly stretches during the development of the child. While the organs are repairing and returning to their natural state, the menstrual cycle will either be absent or become irregular.

The second reason for the absence of menstruation after childbirth is the active production of prolactin hormone affecting ovarian function. This hormone is actively produced during breastfeeding, and suppresses ovulation. In the absence of ovulation, menstruation does not come, since standard process during the cycle (menstruation, egg maturation, ovulation, in the absence of conception - menstruation) is suppressed.

The timing of the recovery of the cycle after childbirth depends on when it ends period of breastfeeding. If a woman constantly breastfeeds her baby "on demand" - wait for the restoration of the cycle no earlier than the first year after childbirth. If the baby’s diet is mixed or he is transferred to complementary foods from 6 months old, menstruation will be restored six months after birth. If a woman is not breastfeeding, the ovulatory cycle will be restored by 13-14 weeks after birth, soon after it will begin come menstruation.

After 40 years

The main reason for the failure of the menstrual cycle after 40 years is arrival of menopause. This phase in a woman's life is a period of another hormonal adjustment, and is accompanied by changes in mood, deterioration in well-being, and cycle failures.

The hormones responsible for the maturation of the egg and the arrival of menstruation are produced worse, in smaller quantities, and unstable. The cycle changes accordingly. Periods may disappear a long period time.

Do not be afraid of this natural process. Menopause is the stage preceding menopause - a period sexual dormancy(rest from childbirth). A woman can also enjoy sexual intimacy, but becomes incapable of the birth of a child.

If menopause is severe, you should consult a doctor to prescribe drugs that normalize hormonal levels.

After 50 years

After 50 years in the body of a woman menopause is coming. This process is characterized by the failure of the menstrual cycle, and then its complete absence. The level of hormones in the body decreases, the eggs stop maturing, there is no ovulation.

During this period there may still be changes in the nature of menstruation: for example, an increase in its duration or the appearance of copious discharge. Then the menstruation stops completely.

As mentioned above, menopause occurs in every woman and this is an absolutely natural process. On average, most women have this period for 50-56 years. Menopause does not require being under medical supervision and taking any medication.

Treatment

Depending on the cause of the failure in the menstrual cycle and the age of the patient, gynecologists resort to various measures for his treatment.

Most often, the patient is prescribed hormonal therapy in order to restore hormonal levels.

In the event of failures due to stress, consultations with a psychologist and antidepressants are prescribed. If gynecological diseases have become a factor in the failure, an appropriate course of treatment is carried out.

One thing is important: if you have a disruption of the menstrual cycle, do not self-medicate, this can only harm you. Entrust the solution of the problem to a qualified specialist who will establish both the cause of the failure and prescribe the correct treatment.

I would very much like the body to always work perfectly, everything happened to it strictly according to the schedule, no unrest associated with the next “surprises” on its part hit the nervous system. However, this is not possible, we constantly have to solve some problems: among women, the most common is the delay in the menstrual cycle. And if a few days are not critical, when the count goes to weeks, there are serious concerns for health.

Failure of menstruation: when to start worrying?

Before looking for the reasons for the disappearance of menstruation or a change in the schedule for their beginning and end, you should go through several periods in a woman's life, when this is an absolutely normal phenomenon that does not require any outside intervention: neither the woman herself nor the gynecologist.

Age 13-15 years, when the hormonal formation of the body occurs, is rather unstable. It is at this moment that the period of a teenage girl should begin and, it is likely that after the first discharge, not 27-29 days will pass before the next, but 2-3 months. At the same time, regularity can fluctuate even during the year. You should be worried if the girl does not have a relatively stable schedule in the 16th year.
Age 40-45 years, after which the climacteric period begins, is also often accompanied by a failure of menstruation, however, this border can shift to 50-55 years, depending on the woman's body. Both short-term and long-term violations are possible here, but in each of the cases, the intervention of a gynecologist is not required, unless there is an imposition of other factors, which will be discussed below.

If you do not fall under the age limits suggested above, but the cycle is still broken, the reasons can be both situational and severe. But in order to understand which category to put the current situation in, it is important to accurately determine the degree of failure.

The classic duration of the menstrual cycle, set as the norm, is 28 days, while there may be a run-up from 21 to 37 days. A situational failure is considered a deviation from the established duration by 3-6 days: it is better not to panic here, it is likely that there are no serious problems with the body. But with a delay of 7 or more days, you will have to start looking for internal causes.

Why does the menstrual cycle fail?

Acclimatization- the most common cause of menstrual cycle failure, which is situational in nature. Inherent in a sensitive organism, it does not need outside intervention, and nothing can be done with it. In its action, it is close to classical stress, but often passes much faster. Here the failure is usually short-term, for 3-5 days.
Transferred viral infections- from a common cold to a severe flu: this kind of violation affects all body systems, especially if accompanied by high fever. In most cases, on the contrary, they cause an earlier onset of menstruation, but strong (up to 7 days) delays are not uncommon. Medical intervention is also not required, the body will recover on its own, and the cycle along with it.
elevated physical loads. For the body, they are considered a kind of mild stress, even if in a positive way. The delay or, conversely, early onset is insignificant, but the discharge can be profuse, accompanied by weakness and pain in the lower abdomen. If the load was situational, the failure will be eliminated quickly, if it is long-term (entering a sports mode), then the body will get used to it for a long time, and over the next 2-3 cycles, the same violations of the schedule are possible.
Stress. It all depends on the degree of horror experienced: slight excitement will only stir up the schedule, but serious experiences, accompanied by constant insomnia, loss of appetite, apathy, reduced concentration, and other disorders, often lead to the fact that the cycle is shifted by 7-14 days, and this accompanied by painful symptoms in the abdomen and head, weakness, nausea. In such a situation, it is necessary to provide enhanced reinforcement to the nervous system, and it is better if this is done by a qualified specialist. As a safe support, you can drink "Glycine" or tinctures of valerian, motherwort, St. John's wort.

Severe causes of menstrual cycle failure

All possible causes of menstrual irregularities listed below must be established and confirmed by a specialist, and the treatment in each of the situations should be prescribed by a doctor.

Changes hormonal background. The most common reason from the category of serious and, at the same time, the most complex. Here, too, there are both situational jumps in hormones, especially those associated with the use of oral contraceptives, which are leveled off by non-drug treatment, and diseases of the pituitary gland or thyroid gland, requiring a visit to an endocrinologist.
Sharp changes masses body. Both rapid weight loss and rapid weight gain lead not only to the lowering of the kidneys and the deterioration of general well-being, especially weight loss to extreme values. In such a situation, the body turns on hidden reserves, adjusting to a life support mode in which it is not able to share its energy and nutrients with a possible fetus. Therefore, all possibilities of ovulation are suppressed, as a result of which menstruation completely disappears.
Diseases reproductive systems. There can be both inflammatory processes of the uterus and appendages, polyps and cysts, or infections of the pelvic organs. Upon confirmation (through a full range of tests and examinations) of the diagnosis and its elimination, the cycle is restored independently.
abortion and miscarriages- violation of the cycle after surgery or unsuccessful pregnancy is the rule rather than the exception. However, if the delay is more than 10-14 days, it is likely that it indicates infertility.

And you can never discount the most pleasant cause of menstrual irregularities - pregnancy, as well as subsequent breastfeeding. The recovery of the body will happen immediately after the end of lactation, however, doctors warn that if a pain syndrome in the lower abdomen is fixed on the days set by the schedule, it is necessary to see a specialist.

Ovarian-menstrual cycle disorders (OMMC) are perhaps the most common reason for visiting a gynecologist. Moreover, such complaints can be made by patients aged from puberty to the premenopausal period - that is, during the entire potentially reproductive phase of life.

What cycle is considered normal?

The external manifestation of the natural ovarian-menstrual cycle is menstruation, which occurs with a frequency characteristic of every woman and most often lasts 3-6 days. At this time, the entire overgrown functional layer of the endometrium (uterine mucosa) is rejected. Together with the blood, its fragments exit through the slightly opening cervical canal into the vagina and then out. Peristaltic contractions of its walls contribute to the natural cleansing of the uterine cavity, which can cause some physical discomfort.

The gaping vessels after tissue rejection 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, while there are no blood clots in the secretions.

But the menstrual cycle is not only the stage of endometrial renewal. Normally, it also includes the follicular phase with the maturation of the egg in the ovary, and the subsequent secretory phase with the growth of the endometrium and its preparation for the potential implantation of the fetal egg. A healthy woman of reproductive age also has anovulatory cycles, which is not considered a pathology. They normally do not lead to a change in the duration or nature of menstruation and do not affect the duration of the intermenstrual interval. In such cycles, a woman is not fertile, that is, she cannot become pregnant.

Menstruation begins at puberty. Their appearance indicates the readiness of the reproductive system for conception. The first menstruation (menarche) is observed at the age of 9-15 years, most often between 12 and 14 years. It depends on many factors, the main of which are heredity, nationality, general health, nutritional adequacy of the girl.

The end of the reproductive period is characterized by the onset - the complete and final cessation of menstruation. This is preceded by menopause, which normally occurs at an average of 46-50 years.

NOMC Development Mechanism

The ovarian-menstrual cycle in the female body is an endocrine-dependent process. Therefore, the main cause of its violations is dishormonal disorders. They can initially arise at different levels, including with the involvement of seemingly non-reproductive glands of internal secretion. This is the basis for the classification of menstrual disorders. According to her, they distinguish:

Central disorders with damage to the higher centers of neuroendocrine regulation of the reproductive system. Cortical-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. Can be ovarian and uterine origin.
Disorders associated with dysfunction of other endocrine glands (adrenal glands, thyroid gland).
Disorders caused by genetic and chromosomal abnormalities with congenital hyper- or hypoplasia of organs, a violation of the secretion of key biologically active substances and a disorder of the so-called feedback between peripheral organs and neuroendocrine structures.

Failures at any level will eventually show up in different types of NOMC. After all, hormonal imbalance leads to a change in the functioning of the ovaries, even if they do not have structural abnormalities. A natural 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 it is not caused by hormonal disorders. Violations of the menstrual cycle can be caused, for example, by pronounced changes in the endometrium. And sometimes false amenorrhea is diagnosed, when menstrual blood and sloughing endometrium are unable to exit naturally due to vaginal atresia or complete infection of its outlet with the hymen.

Causes of dysfunction

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

The most likely ones are:

Various types of pituitary adenomas (acidophilic, basophilic, chromophobic), which can be hormonally active or lead to compression and atrophy of the adenohypophysis. Disease and Itsenko-Cushing's syndrome.
Taking drugs that affect the synthesis and metabolism of dopamine and norepinephrine 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 hyperplasia of the adrenal tissue.
Some mental disorders accompanied by a violation of the central neuroendocrine regulation. These can be moderate and severe depressive states of various origins, endogenous diseases (schizophrenia) in the acute stage, anorexia nervosa, reactive disorders, and adaptation disorders during chronic stress.
Hypo- or hyperthyroidism of various origins.
(Stein-Leventhal).
Suppression of ovarian function and impaired feedback between them and the hypothalamic-pituitary system after long-term use of COCs and their abrupt withdrawal.
and premature gonadal wasting syndrome. They can also have an iatrogenic genesis, for example, due to the repeated participation of a woman in protocols of assisted reproductive technologies with hyperovulation stimulation.
Sharp non-physiological changes in the hormonal background, which can be caused by spontaneous or medical abortion, taking drugs to quickly suppress lactation.
Malformations and anomalies in the development of the uterus, including those caused by chromosomal diseases.
Consequences of surgical interventions 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 atresia of the uterine cavity, removal of the gonads and uterus.
. Moreover, not only malignant, but also large benign neoplasms with secondary atrophy of the ovarian tissue can have clinical significance.

Violation of the menstrual cycle after 40 years in most cases due to increasing age-related changes in the reproductive system. Their cause is the natural depletion of the ovarian follicular reserve with an increase in the number of anovulatory cycles, progressive hypoestrogenism and the extinction of reproductive function. These changes become most pronounced in the premenopausal period, when the cycle becomes more and more irregular with a tendency to and the addition of psychovegetative disorders.

Violation of menstruation in girls of puberty is most often due to uneven maturation of the hypothalamic-pituitary and ovarian systems. But do not forget that it is during this period that the clinical manifestations of some congenital syndromes, chromosomal diseases and anomalies in the development of the internal organs of the reproductive system may debut.

In addition, adolescent girls often have eating disorders with the formation of alimentary deficiency of key nutrients and especially fats. This leads to a pronounced 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 a previous period of normal menstruation, all possible violations can be divided into primary and secondary.

Symptoms of menstrual irregularities may include:

Change in the length of the intermenstrual period. Possible proyomenorrhea (with a cycle duration of less than 21 days) and opsomenorrhea (its lengthening over 35 days).
Delay of the next menstruation in the absence of previous cycle disorders.
Lack of menstruation for 6 or more months () in a woman of reproductive age.
Change in the volume of menstrual blood loss. Perhaps both its increase (hypermenorrhea) and decrease (). Excessive blood loss is referred to as menometrorrhagia.
Change in the duration of the menstruation itself in the direction of shortening () or lengthening (polymenorrhea).
The appearance of intermenstrual bleeding, which can be different in intensity - from spotting to profuse. With acyclic profuse uterine bleeding, the term "metrorrhagia" is used.
Clinically significant local pain during menstruation, which is called algomenorrhea.
The appearance of general extragenital symptoms accompanying menstruation. These include headaches of a different nature, fluctuations in blood pressure, nausea and changes in appetite, and other vegetatively conditioned manifestations. This condition is referred to as, and when it is combined with a pain syndrome, they speak of algomenorrhea.

Hypermenstrual syndrome with polyhypermenorrhea and/or acyclic dysfunctional uterine bleeding is usually the cause of chronic posthemorrhagic iron deficiency anemia. Her symptoms often become a reason to see a doctor. At the same time, the woman is worried about fatigue, palpitations, general weakness, a tendency to lower blood pressure, fainting is possible. The condition of the skin, hair and nails worsens, a decrease in the productivity of mental activity is possible, up to the development of moderate cognitive impairment.

Many women of reproductive age also experience infertility - the absence of natural conception within 1 year of unprotected regular sex. It is due to severe violations of the allocation of the dominant follicle in one of the ovaries, the process of maturation of the egg in it and the absence of spontaneous ovulation.

It is important to understand that in the presence of anovulatory cycles, a woman may not make any special complaints about menstruation disorders on her own, although a targeted survey in most cases reveals various symptoms. In this case, the patient usually considers the lengthening of the menstrual cycle characteristic of her as her individual feature, and not as a pathological symptom.

Features of menstruation disorders in different age groups

Juvenile period

NOMC in adolescents can proceed according to the type or with a tendency to the so-called juvenile (pubertal) bleeding. The nature of the violations depends on the etiology and existing dyshormonal disorders. Perhaps late menarche or development of primary amenorrhea. It is said that menstruation does not begin by the age of 15.

Juvenile bleeding occurs in anovulatory cycles due to hormonal disturbances in follicle atresia. They usually alternate with uneven periods, often combined with hair loss, underweight or overweight. In this case, a neuro-emotional overstrain, a sharp change in the climatic and time zone, a violation of the sleep-wake cycle can act as a provoking factor.

reproductive period

In the reproductive age, cycle disorders can be manifested by a failure of the cycle, a delay in the next menstruation, followed by bleeding. At the same time, physiological changes should be distinguished from pathological ones. Normally, the temporary disappearance of menstruation may be due to the onset of pregnancy, the postpartum period and against the background of breastfeeding. In addition, a change in the cycle and nature of menstrual flow occurs against the background of 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. In this case, ovulation of a mature egg does not occur. It dies, and the follicle continues to grow in size with the formation of various sizes. In this case, the hormonal background corresponds to the 1st phase of the cycle with hyperestrogenism, which leads to a progressive growth of the endometrium. In this case, the delay in menstruation can reach 6-8 weeks, after which metrorrhagia occurs. Such uterine bleeding is classified as dysfunctional. Another reason for their development is the insufficiency of the luteal phase. In this case, bleeding occurs during the ovulatory period, they are usually not heavy, but protracted.

Changes in the ovaries during a typical menstrual cycle

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

Premenopausal period and menopause

Most often, failures of the normal cycle of menstruation occur in premenopausal age. The extinction of the reproductive function is often accompanied by a significant increase in anovulatory cycles, a tendency to delays and bleeding against the background of follicle atresia, loss of cyclic changes and the development of the so-called.

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

Possibility of pregnancy

Pregnancy with a violation of the menstrual cycle is possible. But the probability of its occurrence depends on the severity of dyshormonal disorders, the full 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 cannot conceive and carry a child on her own. 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 inferiority of the functional layer of the endometrium and thus make it difficult for the normal implantation of the fetal egg. This, coupled with insufficient production of progesterone and hCG, significantly increases the risk of abortion at very early and early stages. At the same time, a woman may not be aware of conception, regarding the onset of a delay in menstruation as another dysfunction.

Prior menstrual dysfunction is considered a potentially complicating factor in 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 irregularities are independently corrected (about the timing of menstruation recovery, in our article on). And subsequent pregnancies can occur 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 oncogynecological diseases of various localization. Therefore, the diagnosis of such a condition requires a thorough examination to establish the true cause of menstrual dysfunction, to determine the nature and severity of the existing changes. It is this tactic that will allow you to choose the optimal corrective therapy or timely conduct radical treatment.

The baseline examination should include:

Careful collection of an obstetric and gynecological history, specifying the time of appearance of complaints, a possible connection with any factors, the fact of pre-existing menstrual disorders, the age of menarche (first menstruation) and the likelihood of conception. Be sure to find out past diseases and operations, the number and duration of abortions and childbirth, the course and outcome of previous pregnancies. Also important is the fact of taking any drugs, the nature.
Gynecological examination of the vagina and cervix in the mirrors, bimanual palpation of the pelvic organs. In this case, structural changes in the visible mucous membrane (defects, growths, deformations, discoloration, swelling), varicose transformation of superficial veins, changes in the contours, size, position and consistency of the uterus and appendages can be detected. The nature of the discharge from the vagina and from the cervical canal is also assessed.
Taking smears from the walls of the vagina, sponges of the cervical canal, urethra for major urogenital infections (STDs), degree of purity.
A smear for oncocytology from the cervix, which is especially important if there are pathological foci on it.
Exclusion of pregnancy. To do this, conduct a urinary express 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 functioning 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 are also reflected in the work of the ovaries.
Ultrasound of the pelvic organs. Most often, transvaginal and abdominal sensors are used. This is enough 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 a vaginal one, if necessary. Ultrasound is the most accessible and at the same time 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 metrorrhagia.

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

Principles of treatment

Treatment of menstrual disorders includes several areas:

Stop bleeding. For this purpose, hormonal drugs, agents that affect blood coagulation and uterine contractility, and sometimes curettage can be used.
Correction of existing hormonal disorders, which is the prevention of repeated menstrual disorders. The treatment regimen is selected individually, based on the endocrine profile of the patient.
Deciding on the advisability of surgical treatment to eliminate the main causative factor or correct existing developmental anomalies.
If necessary, measures aimed at stimulating the development of the uterus and activating the work of the ovaries. Various physiotherapeutic methods, cyclic vitamin therapy, herbal medicine are widely used.
Correction of concomitant disorders (psychovegetative disorders, anemic syndrome, etc.).
Correction of received therapy for the underlying disease. For example, when taking psychotropic drugs, it may be recommended to replace them with more modern, narrowly targeted drugs. Of course, the final decision on the correction of therapy is made not by the gynecologist, but by the attending physician (for example, a psychiatrist, a neurologist).
If you want to conceive - a comprehensive treatment of infertility using conservative and, if necessary, surgical (endoscopic) techniques, timely decision-making on the advisability of using assisted reproductive technologies.

Menstrual irregularities are a very common problem. And its relevance is not decreasing, despite the achievements of modern medicine. Fortunately, many forms of such disorders can be corrected. And with timely treatment of a woman to a doctor, it is often possible to avoid complications, maintain a high quality of life for patients, and even cope with concomitant diseases.