Associated with menstrual irregularities. Treatment of disrupted menstrual cycles in adolescence. The reasons for their appearance may be

Menstrual irregularities are considered one of the most common abnormalities in gynecology. Every woman faces this at least once. An accidental failure in this case does not cause concern and is considered normal. An alarming signal is a systematic change in the menstrual schedule.

Many women perceive cycle failure as a banal delay in menstruation. In fact, this is far from the case.

Menstrual dysfunction is considered comprehensively, taking into account duration, intensity, regularity and the presence of concomitant symptoms. Based on this, certain types of failures are identified.

In gynecological practice, the following classification of menstrual disorders is used:

1. – absence of menstruation for more than six months.
2. Metrorrhagia – frequent and prolonged menstruation. The interval between them is irregular.
3. – the interval between menstruation is less than 21 days.
4. Algomenorrhea - critical days are accompanied by severe pain and a general deterioration of the condition.
5. – the interval from one period to another is more than 38 days. The nature of the discharge is scanty.
6. Menorrhagia - no disruptions are observed, but blood loss is more than 250 ml per menstruation.
7. Dysmenorrhea – menstruation may appear earlier or later than expected.

Main symptoms

Menstrual dysfunction can have different symptoms. There are several signs of failure:

• a fickle cycle that changes every month. The next menstruation may be delayed, despite the fact that the previous one was ahead of schedule;
• short periods of menstruation. Monthly periods of critical days are only 1–2 days;
• menstrual irregularities (excessively short or long);
• heavy or scanty discharge;
• changes in the menstrual cycle and absence of discharge for a long period;
• duration of menstruation more than 7 days;
• excessive pain.

Any symptoms indicating a cyclical disorder cannot be ignored. Unstable, scanty, abundant or - this is a reason to visit a gynecologist.

Such changes may indicate serious health problems. If left untreated, they can lead to unwanted complications. Among the most dangerous are infertility.

Why does my menstrual cycle go wrong?

Failure of reproductive function is possible for various reasons, which are divided into the following groups:

• functional – caused by external factors;
• organic – a consequence of the development of a number of pathologies;
• Iatrogenic - the result of taking medications or carrying out therapeutic or surgical measures.

Functional reasons

External factors may explain why the menstrual cycle has gone wrong. Under their influence, improper functioning of the ovaries and changes in hormone levels are possible, and as a result, menstrual dysfunction.

During the same period, there is a change in the activity of the pituitary gland, which also provokes a disruption of the menstrual cycle.

The causes of reproductive dysfunction in this case are due to etiological factors affecting the cerebral cortex. The intensity, duration of discharge and the interval between them may vary. To solve the problem, it is enough to eliminate the influence of the external factor.

When figuring out why the menstrual cycle fails, it is necessary to consider several points. Such changes occur against the backdrop of sudden climate change and stressful situations. Failure of the menstrual cycle is possible if you follow a strict diet and excessive physical or mental fatigue. Smoking and drinking alcohol have a negative impact on reproductive function.

In addition, cycle disruption with previously normal periods is possible in women working in hazardous industries.

Organic causes

If a woman’s cycle is disrupted, the reasons may lie in various ailments. The most common of these is considered to be ovarian pathology. This may be an oncological disease or a violation of the relationship between the organ and the pituitary gland.

Menstrual irregularities are often caused by overly active or insufficient production of gonadotropic hormones. Brain or pituitary tumors and necrosis are also causes.

The development of endometriosis also leads to disruption of the menstrual schedule. Such changes are caused by hormonal imbalance. Diseases of the liver, gall bladder and diseases of the endocrine system affect the reproductive function.

Sometimes the cause of menstruation failure is disturbances in the development of the uterus, polyps on the mucous membrane and cancerous formations. Similar changes are possible with problems with blood clotting and genetic pathologies.

Failure of the menstrual cycle can cause sexually transmitted infections that have a negative effect on the ovaries. Even infectious diseases suffered in early childhood can provoke irregular periods.

Endometritis, chromosomal abnormalities, arterial hypertension, hypovitaminosis and vitamin deficiency affect the duration of the cycle.

In any case, if the cycle has gone astray, you need to conduct a full examination. Only in this way will it be possible to identify the cause of violations and eliminate it.

Iatrogenic

The reasons for the failure of menstruation may be associated with taking hormonal or antibiotic drugs. As a rule, after their cancellation, reproductive function is quickly restored.

Any surgical intervention, curettage or abortive measures leads to the fact that the integrity of the layers of the uterus is disrupted. For this reason, women note that after such procedures their menstrual cycle is disrupted. In most cases, it can be restored naturally, without medical help, but sometimes it is still impossible to do without drug therapy. That's why If any problems arise, you should consult a gynecologist.

Other reasons

Among the various factors that provoke the appearance of an irregular cycle, there may be natural changes in the body. Such disorders are considered normal during menopause, when hormone levels decrease significantly and ovarian activity gradually ceases. After a while, menstruation disappears and menopause occurs.

We recommend reading in more detail about how it occurs in women in our separate article on the website.

Another explanation why the menstrual cycle may go wrong is pregnancy. During pregnancy, menstruation stops and resumes some time after birth. The absence of discharge during lactation is considered normal. The reason for the disruption of the menstrual cycle in this case is due to the production of prolactin.

The menstrual schedule is established in the first couple of years after menarche. During this period, teenagers often notice that their periods are off. The discharge may not appear for several months and may be scanty or abundant.

As soon as the hormonal changes in the body are over, they will occur at the same interval and in normal quantities.

Diagnosis and treatment

To find out how to improve the regularity of menstrual flow, you need to conduct a full diagnosis. Only after identifying the cause of such changes in the body is it possible to choose adequate treatment. Therapy is carried out comprehensively. The following medications are prescribed:

• hormonal agents;
• vitamin complexes;
• antibiotics.

Depending on what exactly caused the menstruation disorder, other groups of medications can be additionally selected, but they are prescribed only by a doctor.

If the menstruation schedule is out of whack due to external influences, it is enough to take vitamins and eliminate the factor that provokes such changes.

Reproductive dysfunction occurs for various reasons. It is extremely important to identify and eliminate them immediately. Only through timely initiation of therapy can unwanted complications be avoided.

Sometimes it is enough to adjust your diet and change your lifestyle, but if pathology is detected, serious treatment is required. At the same time, compliance with all medical recommendations is the key to restoring reproductive function.

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

But the fact remains that if menstruation comes, 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 common occurrence in a woman’s life and continues until the onset of menopause– a period when hormone production decreases and a woman ceases to be able to bear children. However, not everyone's menstrual cycle runs like clockwork. Cycle failures, too heavy or scanty periods, two periods in one month or a delay not related to pregnancy - every woman can face this.

Why do disruptions occur in the menstrual cycle? What are the consequences of such violations? How to identify them and how to treat them? The answers to all these questions are in this article.

Reasons why woman's menstrual cycle can give a sudden failure, differ in nature. They can be physiological, psychological or caused by taking certain medications. The most common reason why a woman’s menstrual cycle begins to go astray is age factor.

When you reach a certain age, the body stops producing the required amount sex hormones, responsible for the stable functioning of a woman’s reproductive system. Menopause sets in - a difficult emotional and physical condition for a woman. Following menopause, during which menstruation usually continues, menopause occurs. And from this age a woman actually becomes infertile.

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

After childbirth, women also experience 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 several years after the birth of the baby.

Most common reasons for failure in the menstrual cycle:

• severe stress;
• recent abortion or miscarriage;
• taking hormonal medications;
• taking medications 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 antibiotic use;
• birth of a child;
• recent onset of menstruation, adolescence;
• recent onset of sexual activity;
• metabolic disease;
• the beginning of menopause;
• menopause;
• strict 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 consult a doctor.

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

A serious menstrual cycle disorder is considered deviation from the norm. Some women begin to worry when their periods do not come on time, or come several days earlier. Such short-term failures are normal as long as they do not occur too frequently.

• Up to a certain point, my periods came steadily, the cycle was equal in time, but there was a glitch. Has changed cycle length, became unstable, the duration of menstruation changed.
• During menstruation, the discharge became too heavy and painful; or its duration has shortened, and allocations have become scarce. The latter may indicate serious problems with the ovaries(polycystic).
• Menstruation comes several times a month, proceeds as usual (polymenorrhea).
• Menstruation is delayed by more than 2 weeks, but pregnancy not confirmed. (Amenorrhea).
• My period disappeared and did not appear for more than two months.
• Cycle duration is less than 21 days, or more than 34 days.

As you can see, cycle disruption Both changes in its duration and the intensity of discharge and sensations during menstruation are considered. The appearance of severe pain, which was not there before, or heavy bleeding is a sufficient reason to seek advice from a doctor.

Causes of failure in adolescents

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 levels are still has not stabilized during puberty.

During the first few years, a teenage girl’s menstrual cycle is just establishing itself. Menstruation may come irregularly, with long 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 can be painful, prolonged and heavy. Sometimes the situation manifests itself in the opposite form: menstruation rarely come, it takes no more than 2-3 days.

There is no need to worry too much about such disruptions, 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 regularly visiting gynecologist. To regulate the menstrual cycle, girls are often prescribed light oral contraceptives, which help normalize hormonal levels. Taking 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 levels. The main cause of this phenomenon is severe stress that affects the functioning of the thyroid gland. This, 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 cause of failure. In a woman with a stable cycle, deviations from the norm that occur more than once are a reason to immediately consult a doctor and conduct a full examination.

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

After childbirth

Disruptions in the menstrual cycle after the birth of a baby are absolutely normal. The first reason is the need to restore organs that were stretched or damaged during childbirth.

More often the uterus suffers, which greatly stretches during the development of the child. While the organs are recovering 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 hormone prolactin affecting ovarian function. This hormone is actively produced during breastfeeding and suppresses ovulation. In the absence of ovulation, menstruation does not come, because standard process during the cycle (menstruation, egg maturation, ovulation, in the absence of conception - menstruation) is suppressed.

The timing of recovery of the cycle after childbirth depends on when it ends breastfeeding period. If a woman constantly breastfeeds her baby “on demand,” wait for the cycle to resume no earlier than the first year after birth. If the baby’s diet is mixed or he is switched to complementary feeding from 6 months, menstruation will be restored six months after birth. If a woman does not breastfeed, the ovulatory cycle will be restored by 13-14 weeks after birth, and soon after it they will begin your period is coming.

After 40 years

The main cause of menstrual irregularities after 40 years is the arrival of menopause. This phase in a woman’s life is a period of regular hormonal changes, and is accompanied by changes in mood, deterioration in well-being, and cycle disruptions.

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. Menstruation may disappear for a long period time.

Don't be afraid of this natural process. Menopause is the stage preceding menopause - the period sexual rest(rest from childbirth). A woman can also enjoy sexual intimacy, but becomes unable to birth of a child.

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

After 50 years

After 50 years in a woman's body menopause occurs. This process is characterized by a disruption of the menstrual cycle, and then its complete absence. The level of hormones in the body decreases, eggs stop maturing, and ovulation is absent.

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

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

Treatment

Depending on the cause of the disruption 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 to restore hormonal levels.

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

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

The basis of women's health is a regular monthly cycle. There are times when he gets confused. The reasons for this phenomenon are varied. We will consider them further. Although it is best to immediately contact a qualified gynecologist if you have problems with your cycle. After all, self-medication can only harm your health.

Cycle

What is the monthly period of time from the onset of menstruation to the next one? The process of release of an egg ready for fertilization into the fallopian tube is called ovulation. It divides the monthly cycle into the follicular and luteal phases. And what is it? The follicular phase is the period when the follicle matures. Luteal period refers to the period of time from ovulation to the onset of menstruation.

For those girls whose cycle lasts 28 days, ovulation usually occurs on the fourteenth day from the beginning. After it, the woman’s estrogen levels drop. But during this period, bleeding has not yet occurred. Since the production of hormones is controlled by the corpus luteum. Strong fluctuations in estrogen in any direction during the period of ovulation can cause uterine bleeding between periods, before or after them.

Cycle calculation

Normally, the cycle length is 21-37 days. As a rule, for most girls it is 28 days. The duration of menstruation itself is approximately three to seven days. If you have missed your period for two or three days, no treatment is required. Since such a phenomenon is not a pathology. But if menstruation does not occur even seven days after the required period, then you need to consult a doctor.

How to calculate the cycle? The period of time between the first day of your period and the first day of your next period is the length of your cycle. In order not to make mistakes in the calculations, it is better to use a calendar on which to mark the beginning and end of menstruation.

Symptoms of failure

Let's now look at the signs of menstruation failure:

• absence of menstruation;
• shortening of the cycle (less than twenty days);
• increase in time between periods;
• the appearance of bloody discharge;
• heavy or, conversely, scanty periods.

Another symptom of a malfunction is the duration of menstruation for more than seven days or less than three.

Adolescence and weight problems

Why was there a delay in menstruation or a cycle failure? There can be many reasons. During adolescence, the cycle often fails. This problem is quite common among girls. Since their hormonal levels are just beginning to be established. If more than two years have passed since your first menstruation, and the problems continue, then you should definitely go to a gynecologist.

Another reason for the failure of menstruation is severe weight loss (or, conversely, obesity). The body perceives fasting and extreme dieting as a sign that hard times have come. Therefore, it turns on natural defenses, resulting in a delay in menstruation. Rapid weight gain also negatively affects the body. As a result, the cycle may be disrupted.

Acclimatization

What other known causes of menstruation failure? Acclimatization. The cause of the failure is air travel, moving to another time zone. Stress for the body is a sudden change in climate. Usually the cycle is restored after the body gets used to new living conditions.

Hormonal disbalance

Every girl knows this phenomenon) - this is one of the main signs of problems with hormonal levels. This may be caused by problems in the pituitary gland, as well as the hypothalamus. In this case, you should contact an endocrinologist, he will conduct an examination, prescribe the necessary examinations, based on the results of which he will make a diagnosis.

Stress

A common cause of missed periods is stress. It often leads to cycle disruption. During stress, it produces excessive amounts of prolactin. Excess of it inhibits ovulation, resulting in delay. In this case, doctors recommend getting enough sleep and spending more time in the fresh air. A gynecologist may prescribe a sedative if your period fails due to stress. It can be valerian, Cyclodinone tablets and others.

Diseases and hormonal contraceptives

Diseases of the female organs also lead to disruption of menstruation. Often the cause of this is pathology of the cervix, inflammation of the uterus itself or the appendages. Another reason for the failure of menstruation is cysts and polyps. All such problems can be treated surgically.

Taking hormonal contraceptives or refusing them leads to disruption of the monthly cycle. In this matter, you should consult a doctor. You may need to take a break from taking oral contraceptives.

Pregnancy, lactation

Failure of menstruation after childbirth is also a fairly common occurrence. A similar problem after the baby is born and during breastfeeding is the norm. When lactation stops, the cycle should resume.

If severe pain occurs, consult a doctor immediately. Since the cause of this phenomenon can be an ectopic pregnancy. If it is not detected in time, it can lead to death due to painful shock and large blood loss when the fallopian tubes rupture.

Premenopause and abortion

Missed periods after 40 are not uncommon. A similar phenomenon may be a harbinger of menopause.

Abortions, regardless of whether they are spontaneous or forced, have a bad effect on the condition of the uterus and cause a delay in menstruation. Sometimes they even cause infertility.

Other reasons

Why is there a delay in menstruation? Also, the cause of this phenomenon may be diseases of the adrenal glands, thyroid gland or infectious diseases. In addition, bad habits (using drugs, alcohol, smoking), taking medications, vitamin deficiency and vaginal injuries lead to cycle failure.

When to see a doctor?

Under no circumstances should you delay visiting a specialist if:

• Two years have passed since the beginning of menstruation, and the cycle has not yet established itself;
• there is pain during ovulation. This symptom most likely indicates ovarian rupture;
• There is copious bleeding. Normally, a girl loses no more than 250 ml of blood during menstruation. If it is more, then this is already a sign of hormonal imbalance. It must be treated with drug therapy;
• there are regular cycle irregularities (its duration is less than three days or, conversely, exceeds seven days);
• There is spotting before and after menstruation. This symptom indicates endometriosis.

Diagnostics

How is a patient with menstrual irregularities diagnosed? First, a survey and gynecological examination are carried out, during which all smears are taken. Also, the patient, if the diagnosis is not made, needs to undergo an ultrasound of the pelvic organs and an MRI. In addition, blood is donated for hormones. To clarify the diagnosis, the patient is prescribed hysteroscopy, as well as blood and urine tests.

Thanks to all these methods, it is possible to determine the reason why the cycle went wrong. Once the diagnosis is made, appropriate therapy is prescribed.

Treatment

First of all, the disease that led to the failure of the monthly cycle is treated. As preventive measures, doctors usually recommend to patients:

• Healthy food;
• eat foods rich in iron and protein three to four times a week;
• sleep at least eight hours a day;
• quit smoking and other bad habits;
• take vitamins.

When teenage girls experience problems with their cycles, doctors often use vitamin therapy. The patient is prescribed to take ascorbic and folic acid.

For anemia, women are prescribed iron supplements.

If, in addition to the fact that a girl’s cycle is disrupted, she is diagnosed with infertility, then drugs such as Pergonal and Choriogonin are prescribed to stimulate the development of follicles.

When a patient has severe bleeding, but a bleeding disorder has been ruled out, doctors may prescribe hemostatic drugs. ε-aminocaproic acid is also prescribed.

Even with heavy bleeding, plasma infusion is performed. Sometimes even an infusion of donor blood is practiced.

The last resort for severe bleeding is surgery.

Hormonal drugs and antibiotics are also prescribed.

Failure of the monthly cycle. Possible complications

Remember that your health depends only on you! Therefore, you should not take lightly the fact that disturbances in the monthly cycle occur. Since such problems can lead to infertility. Frequent ones cause disability and fatigue.

Late detection of the pathology that caused the failure of menstruation can lead to very serious problems and death. Although this could have been avoided if he had consulted a doctor in time. Treatment should be carried out under the supervision of a qualified physician.

A little conclusion

Now you know for what reasons there can be failures in the cycle. As you can see, there are many of them. They can be quite serious. Therefore, if you have problems with your menstrual cycle, immediately contact your gynecologist.

The causes of menstrual irregularities are what about 35% of women try to find out when visiting a doctor.

Heavy or scanty menstruation, frequent delays, too short or long cycles - all this indicates disturbances in the female body.

Diagnosis and treatment

How to treat menstrual irregularities is a question that worries girls and women. To avoid unpleasant consequences, you must immediately make a visit to the doctor if characteristic symptoms are detected.

The examination includes:

• inspection;
• passing general tests;
• determination of hormone levels;
• checking for hidden infections;

The menstrual cycle must be brought back to normal. Therapy is not aimed at eliminating symptoms, but at the immediate cause of the failure:

• in the presence of infection and inflammatory processes, medications and physiotherapy are prescribed;
• hormonal imbalance is treated with hormone therapy;
• When tumors are detected, surgery is performed.

Problems with immunity and general weakness of the body can be solved by normalizing the daily routine, balanced nutrition, taking vitamins, and physical activity.

Video about the problem

Menstrual irregularities (MCI) are a very common reason for visits to the gynecologist. This occurs in 35% of patients, and 70% of patients have experienced NMC at least once in their lives.

Normal regular MC is an indicator of women's health. The cycle accompanies a woman throughout her life - from adolescence to menopause. His violations make any representative of the fair sex worry. A visit to a doctor in these cases is required and encouraged, because serious pathologies may be hidden behind irregularities in the menstrual cycle.

NMCs can also be of an extragenital nature. The main manifestation of NMC is disruptions in the regularity, nature of menstruation, and the volume of blood lost. Bleeding during menstruation can become too heavy, scanty, acyclic, painful, etc. When NMCs are associated only with functional disorders without organic matter, we are talking about dyscirculatory bleeding.

Normal menstrual cycle

The normal cycle is not the same for all women; it can vary from 21 to 35 days. On average, for most it is 28 days. The entire MC is determined by the pituitary-ovarian system and their hormones. Menarche appears at 12-13.5 years; subsequently, within almost 1.5 - 2 years, they can be established, i.e. Regularity does not set in immediately and this is the norm.

But it happens that menstruation can be established immediately - this is individual. Once established, any woman may have fluctuations for several days, but not more than a week. The cycle can be called irregular if within 2-3 months it shortens or lengthens, becoming less than 21 days or lengthening more than 35-40 days.

A normal cycle consists of 4 phases - follicular, ovulatory, luteal and menstrual phases. In the follicular phase, FSH, the follicle-stimulating hormone, dominates. It causes and accelerates the maturation of follicles in the ovaries, with it the production of estrogens (estradiol) increases, and this already leads to the growth of the endometrium. During this period, the body prepares for fertilization, the functional layer of the endometrium becomes lush, preparing to accept the zygote.

As estradiol increases, the amount of FSH decreases - this is called negative feedback. In the middle of the cycle it is reduced to its maximum. Rising estrogens, in turn, cause an increase in LH - luteinizing hormone. At its peak, ovulation occurs. After this, estrogen levels gradually decrease, while progesterone increases in parallel.

When progesterone reaches its maximum, estrogen will rise again. In the absence of conception, progesterone and estrogen decrease, are minimized, and endometrial rejection occurs. His pomp was not needed and he found himself out of work. Then the pituitary gland starts working again with the release of FSH and the whole process is repeated.

The shedding of the endometrium represents the beginning of menstruation. Uterine bleeding in the first 2-3 days is quite significant, because the endometrium is well supplied with blood. This occurs due to its spiral arteries, which fed the functional layer. When rejected, they are the ones that are damaged.

After 2-3 days of bleeding, platelets and fibrin seal the ends of the vessels; the volume of menstruation becomes scanty, begins to smear and then stops. Hemostasis occurs, by which time most of the endometrium has already been rejected. Its regeneration begins 36 hours after the onset of menstruation. The entire period of menstrual blood takes from 3 to 7 days.

The volume of blood loss does not exceed 80-100 ml. In the first days of menstruation, you may experience slight malaise, pain in the lower abdomen, irritability and slight drowsiness - all this is normal. There should not be other symptoms: such as fever, chills, profuse discharge, color changes, rotten smell, etc.

The nature of cycle disorders and its main symptoms

Violations of the MC may be of the following nature:

• Dysfunctional uterine bleeding - disruption of the menstrual cycle in the form of bleeding from the uterus, but without pathologies of the reproductive system;
• Menorrhagia or hyperpolymenorrhea - an increase in the volume of uterine blood secreted (more than 100 ml), but maintaining the regularity of the cycle itself; bleeding lasts 10 days or more.
• Metrorrhagia - uterine bleeding appears at any time without clear time restrictions - during menstruation and in the middle of the cycle;
• Amenorrhea – no menstruation for 6 months or more; amenorrhea can be primary or secondary. Primary is calculated from the moment of menarche. Secondary occurs after an established normal cycle. There is also physiological amenorrhea - during pregnancy, breastfeeding and menopause. All the rest are pathologies.
• Oligoamenorrhea - the onset of menstruation every 3-4 months; This is often a manifestation of polycystic ovary syndrome. They will be joined by such signs as: enlarged ovaries upon palpation, hirsutism, infertility.
• Opsomenorea – menstruation lasts only 1-2 days.
• Intermenstrual bleeding - disruption of the menstrual cycle in the form of uterine bleeding between cycles; the volume of blood lost varies.
• Dysmenorrhea - the menstrual cycle is unstable - delayed or occurs prematurely. It depends on external reasons. For example, for flight attendants when changing time zones and climate. After acclimatization, everything returns to normal.
• Algodismenorrhea - cycle failure with pain in the lower abdomen, aching pain in the lower back; nausea, headaches. This set of symptoms from the age of 14 can accompany a woman throughout her life; it often disappears after the onset of sexual activity or childbirth. It may be a manifestation of adnexitis or endometriosis.
• Proyomenorrhea - menstruation comes before 21 days, every 20 days.
• Algomenorrhea is very painful and heavy periods, as a result of which a woman’s well-being is so impaired that she cannot work normally. The regularity of menstruation itself is not disrupted.
• Postmenopausal bleeding – may appear more than a year or a year after menopause.

These symptoms of disorders are the main ones for various NMC disorders.

When you need to see a doctor urgently:

1. If causeless irregularity is repeated several cycles in a row;
2. The appearance of unbearable pain during menstruation;
3. Abundance of discharge, when the pad has to be changed hourly or every 2 hours; Normally, no more than 4 gaskets are required.
4. The usual duration of bleeding suddenly decreased - from 5-7 days it suddenly became 1-3;
5. Additional symptoms appeared that were not there before.

Causes of MC violation

All causes of menstrual irregularities are divided into pathological and physiological, as well as medicinal:

1. Physiological factors include factors that act not directly, but indirectly: nervous overload and stress; change of time zones and climate; strict diets, fasting, disturbances in the habitual diet; intensive training. If these causes are eliminated, the MC will normalize on its own.
2. Pathological – everything that is associated with diseases.
3. Medication is a separate group, since there are no gynecological pathologies. These NMCs appear when taking or stopping various drugs. The MC is most disrupted when treated with hormones. But antidepressants, digitalis drugs, anticoagulants, corticosteroids, benzodiazepines, and Dilantin can also have an effect. The cycle may be disrupted both at the beginning of appointments and during cancellation.

Possible pathologies and their symptoms

MC disruption may be associated with the following pathologies:

1. Ovarian diseases are the most common etiology of disorders. Diseases of the ovaries include violations of their connections with the pituitary gland; corpus luteum deficiency, when progesterone production is disrupted; inflammation of the ovaries and tubes; damage to ovarian tissue; performing operations on the ovaries (especially if they were performed using cauterization (coagulation), the functioning of the ovaries is disrupted); taking drugs; inflammations, cysts, polycystic diseases, tumors.
2. Failure in the hypothalamic-pituitary system, since it generally controls the functions of all endocrine glands; here tumors can arise and congenital anomalies and pathologies can occur.
3. Diseases of the adrenal glands (tumors). In this case, the synthesis of estrogen is disrupted and the MC process does not start.
4. Diseases of the uterus itself: endometrial polyposis - benign processes in the endometrium can lead to intermenstrual bleeding in the form of spotting, but if menstruation corresponds to the cycle, it is abundant. - endometriosis (genital and extragenital - adenomyosis) - with it the endometrium grows and menstruation becomes abundant, painful; endometritis; with chronic endometritis there is no normal growth of the endometrium, and, as a consequence, its timely maturation; tumors.
5. Poor-quality abortions and diagnostic or therapeutic curettages; In this case, damage to the endometrium and secondary infection may occur.
6. Liver disease because estrogen levels are abnormally increased. This is due to a violation of its detoxic functions. Your periods are frequent and intense.
7. Blood clotting disorders - they are characterized by menorrhagia.
8. Recent pregnancy and childbirth; after them, recovery of the cycle may not occur immediately, for several months.
9. Dysfunctional uterine bleeding is always caused by hormonal changes, although the organs themselves are not changed. When menstruation is delayed, hormones continue to work, but more slowly than usual. In the uterus, under their influence, a new layer of endometrium grows, which comes out during menstruation. In every fifth patient, dysfunctions appear after puberty, and in half of women - after 40 years.
10. Infections of the pelvic organs are the most common and common cause of disrupted cycles. To cycle disorders are added symptoms in the form of changes in color, smell, fever, pain in the lower abdomen and lower back, etc. A gynecologist needs to be examined for the pathogen and undergo anti-inflammatory therapy.
11. The appearance of pathological hormone-secreting tissue in oncology; the regularity of the cycle is disrupted.
12. The installation of an IUD often changes the MC for a long time.
13. Thyroid disorders and other endocrinopathies (DM, obesity).
14. Frequent colds in girls under 12 years of age are called a high infectious index.
15. If a girl has had rubella and chickenpox, they disrupt ovulation in adolescents from the first cycle, but often adolescents do not attach importance to this and diagnosis is delayed.

Diagnostic measures

Diagnosis of NMC:

1. Collecting anamnesis - information about recent pregnancy, medications, external factors.
2. Visual examination of the woman; At the same time, attention is paid to symptoms such as exhaustion, decreased skin turgor and changes in its color; the severity of secondary sexual characteristics, etc.
3. Gynecological examination - the presence of tenderness of the uterus, appendages and cervix during palpation and bimanual examination;
4. Vaginal smear for analysis;
5. Ultrasound of the uterus and appendages;
6. Ultrasound of the thyroid gland and liver.
7. Blood biochemistry and coagulogram;
8. Conducting hormonal screening; this is an important indicator. The levels of estradiol, progesterone, LH, FSH are determined. An insulin test is also necessary - this is important when choosing treatment.
9. MRI - the method is used quite rarely due to its high cost;
10. Hysteroscopy is a detailed examination of the endometrium using a hysteroscope.

At the time of examination, it is possible to carry out diagnostic curettage to take material for histology. The disadvantages include the provision of anesthesia and the high price. It is not necessary to assign all methods at once; Often one or two are enough to make a diagnosis.

Treatment of NMC

To begin with, it is logical that if there are external factors, you need to eliminate them. This includes all kinds of diets and intense exercise. In addition, if a woman takes drugs that have a bad effect on the circulatory system, they must be replaced with others. An important point is to normalize your psychological state. Treatment of menstrual irregularities can be conservative or surgical.

Drug therapy

In the presence of abundant uterine hemorrhages with concomitant disorders of the blood coagulation system, symptomatic treatment is carried out: Dicynon, Tronexam, Vikasol, Etamzilat are used for hemostasis. They can be prescribed by injection, in the form of droppers or tablets. All prescriptions of regimens and doses are made only by a doctor.

Also during this period, aminocaproic acid is prescribed; in 60% it reduces the intensity of bleeding. Compensation for blood loss in case of excessive bleeding is compensated by the appointment of plasma transfusions. Hemostatics should always be combined with OK; the hemostatic effect is enhanced.

Treatment with hormones

Symptomatic treatment is meaningless without hormonal therapy. They are the main part of the treatment. But this should not be done by you by choice, but by a specialist. You don’t have to wait 1-2 days for the effect to appear; the treatment is quite long, lasting 9-10 months.

Delays in menstruation for 2-3, or even six months, always indicate a hormonal imbalance and it is impossible to do without correcting it. But the issue with hormones is always resolved individually; there is no general treatment template.

If cycle disturbances are minor, and there are only minor delays of up to 10 days, or there is impaired functioning of the ovaries, the doctor in these cases may prescribe treatment in the form of a complex of vitamins and homeopathic remedies. It is also possible to use physical therapy.

It is often necessary to consult a medical psychologist, since polycystic ovary syndrome includes symptoms such as male-pattern hair growth; acne on the face; greasiness of skin and hair; weight gain; changes in voice timbre; increased facial and body hair (hirsutism). Of course, this does not add attractiveness, which is always important for girls. Often such girls also have uterine infantilism. An insulin test will always show the doctor whether a given patient has insulin resistance.

If it is present, there is always the possibility of weight gain with hormonal treatment. But we can also solve this issue, because weight gain is associated with an increase in appetite. Prescribing a hypocaloric diet completely solves this problem. When treating with hormones, COCs are usually prescribed - containing significant doses of progesterone and estrogens.

The most frequently prescribed progesterone drugs in Russia are Duphaston (from 11 to 25 days of the cycle) and Utrozhestan. Duphaston is a synthetic analogue of progesterone; causes thickening of the endometrium and causes menstruation when it is delayed. It is prescribed, of course, in the absence of pregnancy. Utrozhestan - prescribed from 16 to 26 days of the cycle; helps with MC failures. In addition to them, the following are less commonly prescribed: tablet progesterone Norethisterone; Medroxyprogesterone acetate - they are prescribed from 5 to 26 days of MC.

In the period after 40 years, medications are often prescribed that can completely or partially stop the onset of menstruation. Among them are Danazol (has the ability to reduce the volume of menstrual blood by 87% with each cycle); Gestrinone (leads to endometrial atrophy), used twice a week. Danazol reduces the production of FSH.

GnRH agonists completely stop menstruation and cause amenorrhea; they block the hypothalamic-pituitary system and prevent the production of hormones. They are used for no more than six months so as not to cause osteoporosis. These drugs are rarely used due to their high cost. These include Goselerin, Decapeptyl, Buselerin.

Surgical methods

Used when other methods are ineffective; if persistent anemia persists, and the cause of the pathology remains unclear; and more often surgical methods are resorted to after 40 years.