Why do menstruation fail? Prevention of menstruation disorders

Normally, the menstrual cycle (menstruation) is regular, lasting 3-4 days.
The cessation of menstruation in mature women during the generative period is called secondary too frequent - polymenorrhea, rare- Oligomenorrhea. The rhythm of menstruation can be regular or irregular.

Menstrual irregularities with scanty flow are called hypomenorrhea, with copious discharge hypermenorrhea. Too much and frequent menstruation is called menorrhagia, occurring with autonomic disorders (headaches, vomiting, nausea) -, with abdominal pain -
Symptom complex in the form of deterioration in health, headaches, swelling and pain in the mammary glands before menstruation - called

Etiology.

Disruption of regular cycles is a complex pathophysiological process in various parts of the gonadal system of the female body and is clinically expressed in a variety of ways.
The cause of menstrual disorders can be hormonal and anatomical disorders of the genital area, mental neuro-regulatory disorders, various types of intoxication, and debilitating diseases.

Hormonal disorders leading to menstrual irregularities may be hyper- and hypoestrogenic, hyper- and hypoluteal. The above is the direct cause of menstrual disorders, however, these phenomena can be caused by various disorders in the neuroendocrine system, namely diencephalic-pituitary regulation, pathology of the pituitary gland itself, the thyroid gland, the adrenal glands, and the ovaries themselves. An important place in menstrual disorders can be occupied by pathological changes occurring in the uterus itself.

Types of menstrual irregularities, based on causes.

Menstrual Disorders of hypothalamic origin occur due to functional disorders in the subthalamus of the hypothalamus due to infectious-toxic damage, mental trauma, skull injuries, etc.
At the same time, the daily allocation Tretyakov Gallery(gonadotropic hormones) may remain normal, but LH(luteinizing hormone) decreases as its excretion is regulated by the hypothalamus. This reduces the reactivity of the uterus to hormones that regulate the menstrual cycle. Similar reaction tion of the uterus is explained by a violation of its neurotrophic regulation on the part of the hypothalamus due to damage to the latter (the centers of the autonomic nerves that innervate the genitals are located in the hypothalamus) and menstrual disorders manifest themselves as secondary
Patients often exhibit symptoms of damage to the diencephalic region: obesity, sweating. Kept estrogen FSH(follicle-stimulating hormone), 17 -KS in daily urine is usually within normal limits. Vaginal smears indicate atrophic changes in the genital organs.

Local treatment for dysfunction of the genital organs is ineffective, since the neurotrophic apparatus of the uterus can be dramatically altered.
Recommended treatment of diencephalic pathology short-wave diathermy, novocaine blockade upper cervical sympathetic nodes, psychotherapy, if ill This disorder developed as a result of mental trauma. Hormonal therapy is inappropriate, since the neurotrophic apparatus of the endometrium is atrophied.

Menstrual Disorders of pituitary origin occurs as a result of decreased secretion Tretyakov Gallery(gonadotropic hormones) of primary pituitary or secondary hypothalamic origin.

The first mainly occurs during pregnancy and childbirth, due to hemorrhage into the parenchyma of the anterior pituitary gland and the formation of blood clots in the pituitary vessels. Reduced Selection Tretyakov Gallery leads to secondary atrophy of the ovaries: hair loss, and the external genitalia atrophy.
Menstrual irregularities occur gradually, first in the form of oligo- and hypomenorrhea, and then Menstrual irregularities of pituitary origin also occur in cases of hyperplasia or neoplasms of basophilic cells of the pituitary gland; with acromegaly - hyperplasia or neoplasm arising from eosinophilic and chromophobe cells.

True, chromophobe tumors do not secrete hormones, but they compress the secretory cells of the pituitary gland and suppress the gonadal function of the latter. The same thing happens with acromegaly. With illness, excretion increases ACTH(adrenocorticotropic hormone), the adrenal glands are stimulated and the secretion of hydrocortisone and adrenal androgens is enhanced. The latter delay the release of gonadotropic hormones by the pituitary gland. As a result, the ovaries and genitals atrophy, hypomenorrhea, oligomenorrhea occurs, then

Menstrual Disorders of ovarian origin can be:

Hyperhormonal and
Hypohormonal.

Each of these forms, in turn, is divided into:

Hyperestrogenic and hyperprogesterone;
Hypoestrogenic and hypoprogesterogenic.

Hyperestrogenic form of Menstrual Disorders develops with persistent follicle, follicular cyst, small cystic ovarian degeneration.

Follicular cyst is formed as a result of further development of the persistent follicle. The follicle may grow to the size of an orange. The hormonal activity of a follicular cyst depends on the nature of the lining epithelium. Most often, under the pressure of cystic fluid, the cells of the granular membrane atrophy and do not function. Less frequently, they function and secrete estrogens—hyperestrogenism, which causes premenstrual tension and uterine bleeding.
Small cystic ovarian degeneration.
At the same time, several follicles mature. They come in different developmental ages and sizes. Many of them function by secreting estrogens and causing the clinical picture of hyperestrogenism.

Hypoestrogenic form of Menstrual Disorders mainly occurs in mature women, often due to chronic purulence, as a result of which the tunica albuginea of the ovaries hardens, the ovaries themselves become scarred and their blood supply and innervation are disrupted. In such conditions, the follicles do not develop fully and undergo early atresia and scarring. The latter leads to hypoestrogenism, often to obesity, hypomenorrhea, and amenorrhea.

Menstrual disorders due to excessive secretion of progesterone (hyperluteinism) .
This form occurs with persistent corpus luteum or in the presence of luteal cysts. Persistent corpus luteum is rare. The likely cause is considered to be excessive secretion by the pituitary gland. LTG(luteinotropic hormone, prolactin). At the same time, the corpus luteum, which normally atrophies after 12-14 days of existence, does not undergo reverse development and continues to secrete progesterone. Changes appear in the endometrium that mimic pregnancy, loosening and enlargement of the uterus, and a delay in menstruation is observed, which is often mistakenly regarded as a sign of pregnancy.
In practice, there are cases when the corpus luteum atrophies incompletely and secretes progesterone in moderate quantities, which delays the maturation of new follicles. Under such conditions, the exfoliated endometrium cannot recover, and menorrhagia occurs.

Luteal cysts also release progesterone and cause menstrual irregularities.

Hypoluteal cysts associated with insufficient progesterone secretion.
The causes are often: diencephalic-pituitary pathology, mental trauma, which reduces the release of gonadotropic hormone by the pituitary gland. This form is characterized by secondary sexual infantilism, hypomenorrhea, amenorrhea, and decreased libido.

Menstrual disorders due to ovarian failure V can be primary and secondary.
In the latter case, they are caused by insufficient secretion of gonadotropic hormones by the pituitary gland. Secondary failure can also occur as a result of mental trauma (in approximately 25% of cases).
Primary failure is associated with anatomical abnormalities, as well as ovarian unresponsiveness to Tretyakov Gallery
Differentiation between these two forms is quite difficult. In the secondary pituitary form, the administration of gonadotropin has a positive effect, but in cases of primary insufficiency there is no effect.

Menstrual disorders associated with gynecological diseases: endometritis, vesicovaginal fistulas, inflammatory tumors. In this case, amenorrhea, opsomenorrhea (the duration of the cycle lasts more than 35 days) and other abnormalities are mainly observed.

Finally, menstrual irregularities are observed in severe debilitating infectious diseases, anemia, vitamin deficiencies and heavy physical labor with insufficient nutrition.

TREATMENT OF MENSTRUAL DISORDERS.

Treatment is complex and varied, since menstrual disorders are polyetiological and polypathogenetic.

Therapy is carried out based on each specific case:
- General strengthening -- vitamin therapy, therapeutic exercises;
- C edative -- calming the nervous-emotional system,
- Hormonal.

Treatment of amenorrhea, hypomenorrhea, opsomenorrhea of ovarian origin is carried out at the beginning of the cycle estrogens to create the follicular phase and then gestagens - secretory transformation.
For secondary hypothalamic-pituitary disorders, it is recommended gonadotropin at the beginning of the cycle in increasing doses, in the middle - large doses up to 5000 units every three days.
For severe hypoplasia of the ovaries and uterus, estrogens within 2-4 months.
To stimulate the gonadal function of the pituitary gland, it is recommended to use estrogen in small doses.
In case of uterine infantilism, it is recommended physiotherapy in the pelvic area, mud therapy, diathermy.
In stubborn cases it is carried out gynecography to identify anatomical defects.

Menstrual cycle disorders include such deviations as too long or short menstrual periods, absence of menstruation for 2-3 months, as well as irregular menstruation. In the first few months after puberty, your cycle is usually erratic, and this is completely normal. In addition, failure of the menstrual cycle often occurs after stopping oral contraceptives. In other cases, this is a signal from the body that not everything is okay with it. Look out for the signs listed below.

Signs of menstruation failure

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 - much depends on heredity. Only a doctor can help resolve doubts.
A sign of menstruation failure may be the absence of a cycle as such. Mark the start days and duration of your periods on a calendar to see patterns and understand how regular they are.
Abnormal duration of menstruation. Too heavy or long periods (more than 5 days) are considered a deviation from the norm and, in addition, bring a lot of inconvenience.

Menstruation failure: reasons

If your menstrual cycle is interrupted, the reasons may be varied. A consultation with a gynecologist will help resolve this issue. If you have already made an appointment and are thinking about possible reasons, here are some options:

Diet and excessive exercise. If you make drastic changes to your diet or lose a lot of weight, this may affect your menstrual cycle. Often violations occur in girls who engage in bodybuilding, sit on a protein diet, exhaust themselves with exercise and eat a lot of sports nutrition. The body reacts to abnormal loads for it, and menstruation stops. Often, dieting and being underweight interfere with conception and healthy childbearing.
Hormonal disbalance. Thyroid diseases and other hormonal problems are a very common cause of irregular periods. A blood test for hormones will help you find out more. In addition, as already mentioned, after stopping hormonal contraceptives, periods 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 sexually transmitted infections (for example, chlamydia). But don't worry: after you undergo treatment, everything will go back to normal.
Stress. Depression and stress affect the nervous system, which in turn causes irregular menstruation. In this case, vacations, long walks and a pleasant hobby will save you.
Pregnancy. If the delay occurs for the first time,

The menstrual cycle is one of the main factors in the normal functioning of a woman’s reproductive system. If your period “goes like clockwork,” then everything is fine with your health. If it’s the other way around, then your body is giving you a clear signal that your health in the female area needs to be corrected. What is a menstrual cycle failure, for what reasons does it happen and how to improve the situation? More on all this and much more below.

When can the menstrual cycle be considered disrupted?

Menstruation lasts on average from 3 to 7 days. The rest of the time is preparing the reproductive system for a new cycle. And such a process must continue systematically and, most importantly, on time. If the menstrual cycle is disrupted, then the above figures deviate from the norm and in this case it is necessary to stabilize the situation. But first, let's figure it out and find out when menstruation is considered irregular?

For some women, periods last 2-3 days, for others a little longer. But here it is important to observe not only their duration - the accompanying symptoms, the amount of blood released, and general well-being. If menstruation is accompanied by severe pain, poor health and increased irritability, then this picture can be considered a disruption of the reproductive system.

Normal menstruation lasts no less than 3 and no more than 7 days. There should be a break between them of no less than 21 and no more than 35 days. The remaining cases are outside the normal range and are considered a failure.

Also, the menstrual cycle is considered disrupted if discharge is observed for 2 days. This is very little. And more than 7 is a lot. Also considered a failure is too much or too little blood. Scanty or heavy periods indicate incorrect ovarian function.

Causes of menstrual cycle failure

When there is a malfunction in the menstrual cycle, the reasons can lie in a variety of moments. There are quite a lot of them and to determine the exact provocative factor you need to familiarize yourself with them all:

First menstruation. In a young female body that has undergone a menstrual cycle for the first time, the hormonal levels have not yet fully adjusted their functioning. In this case, he needs about a year to stabilize the situation. In the meantime, your menstrual schedule may be disrupted.
Delicate age. In women after 40-55 years, menopause or menopause begins. During this period, your periods may go astray, but this is not a pathology, but a normal phenomenon. But in this case, the body also needs support in the form of taking vitamins or special medications.
Hormonal disorders(and not only the genitals, but also the thyroid or adrenal glands), a lot of excess weight or anorexia, infectious diseases. It is also impossible to exclude the influence of stressful situations - having become nervous or overexcited one day, in the near future this may affect the functioning of hormonal levels and, accordingly, the timely onset of menstruation.
Postpartum period. At this time, a global restructuring of the hormonal levels occurs, because the woman’s body is now preparing to feed the baby. After childbirth, it takes time for the menstrual cycle to return, but sometimes it does not go away on its own. And then be sure to visit your local gynecologist. Although, after childbirth this is already necessary, even if there are no violations.
Taking the “wrong” medications. Often the menstrual cycle is disrupted due to the fact that a woman self-medicates her health. Typically, this situation turns out to be due to taking the wrong hormonal drugs or certain anti-excess weight medications. They can both directly and indirectly negatively affect the production of hormones and the functioning of the reproductive system. But not only this can disrupt the menstrual cycle - abruptly stopping the use of any hormonal drugs also entails side effects. You also need to stop taking any medications correctly.
Frequent spontaneous or forced abortions (miscarriages). Such moments are a serious stress both for the psycho-emotional state of a woman and for her health.
Diseases such as uterine fibroids, scleropolycystic ovarian disease, polyp and/or endometrium also provoke menstruation irregularities. In this case, adequate treatment is simply vital, otherwise the issue may concern not only women’s health, but it in general.
Abrupt climate change. When moving to another city or country, the body reacts sensitively to a different climate. And this can disrupt not only the menstrual cycle.
Physical overload. Playing sports is good, but you need to know in moderation in everything. If you overload the body with exercises, and even with weight, then in this case the picture may not result in weight loss or beautiful body contours, but in serious gynecological disorders.

If your menstrual cycle is interrupted for any of the reasons described above, be sure to visit a gynecologist. Any disruption of one of the body systems is dangerous to health. Self-diagnosis, as well as self-medication, will at best give an unsuccessful result, not to mention the undesirable consequences of incorrectly selected therapy.

What to do if you have menstrual irregularities

So, you already know what it means when your menstrual cycle goes wrong, the reasons for this phenomenon, and now you need to figure out how to eliminate all this. Of course, first of all you need a consultation with a gynecologist and a full examination. Sometimes without them it is simply impossible to accurately and correctly diagnose the cause of menstrual irregularities. After the initial consultation, you may be prescribed the following tests and examinations:

Vaginal smear
Pelvic ultrasound
Blood test for hormone levels
Possibly MRI
Urinalysis and so on.

Remember that the failure of the menstrual cycle itself cannot be treated - in order to stabilize the functioning of the reproductive system, it is necessary to eliminate the pathology that led to it. Sometimes treatment can even be surgical, and not just medication. After receiving the results of the tests, the doctor may prescribe the use of hormonal, homeopathic, hemostatic drugs, antibiotics and other remedies. Antibacterial therapy is also possible.

Note! You should not be immediately skeptical about the use of products based on hubbub. Many women are sure that from them the body will suddenly begin to gain weight and become overgrown with unwanted hair. In fact, such medications do not cause weight gain, but simply increase appetite. In this case, the gynecologist will conduct a detailed consultation about nutrition and everything will be fine with your figure.

It is also worth being aware that phytoestrogens have a more gentle effect on the female body than other options. When taking certain hormonal medications, be sure to pay attention to the active substance and the content of phytoestrogen.

It may also be that the gynecologist will not detect any disturbances in the functioning of the woman’s reproductive system. In this case, it would be advisable to refer to an endocrinologist or immunologist for additional examination, because the reasons for the failure of the menstrual cycle may insidiously be hidden in the incorrect functioning of the thyroid gland or even the adrenal glands.

Self-adjustment of women's health

It is very difficult to cope with the adjustment of menstruation on your own, since treatment is also prescribed based on the woman’s age, the characteristics of her body and test results. Often, treatment for the failure of “these days” can be based simply on a healthy lifestyle. Yes, giving up all sorts of bad habits, getting enough sleep and the same diet, playing sports and having a daily routine can contribute to a quick recovery without any treatment.

Often, failures of Women's Day occur after suffering from influenza and other thematic viral diseases. In this case, the immune system weakens and it should definitely be supported with vitamins and proper nutrition. Everything here is according to the standard: fruits, vegetables, calcium, iron, and so on. You can take a course of vitamins, but only those prescribed by your doctor. And, of course, don’t forget about getting good sleep.

A stable sex life is also an assistant in restoring the menstrual cycle. Yes, this is a kind of medicine that should not be neglected, because intimacy causes contractions of the uterus. And this moment has a positive effect on the functioning of the ovaries and, in turn, improves the irregular menstrual cycle.

You can also resort to folk superstitions to get rid of the “women's days” glitch. In fact, the menstrual cycle often coincides with the lunar calendar. During the lunar night, leave the curtains or curtains uncovered so that the moon will help you in such a delicate matter. Seems like a tall tale. It's hard not to argue, but it helps some.

To ensure that women's days go on time every month, try drinking a decoction of wormwood as a course. Prepare a 200 gram glass of crushed dry herbs, half a liter of vinegar, mix this, leave in a glass container in a dark place for 2 days. You need to drink this tincture in a diluted form - dilute a few tablespoons of the tincture in a glass of boiled water or warm tea and drink this drink 3 times a day before main meals. The treatment period in this way is 30 days.

Important! Before using any traditional method to regulate your menstrual cycle, be sure to consult your doctor. Only he will explain why the menstrual cycle is disrupted and how it can be regulated.

First, of course, you can try to independently establish the cycle of “these days”: get good sleep, eat right, devote proper time to sports, ignore bad habits, live a full sex life and just expect improvements. If all this together does not solve the problem, then a visit to the doctor and examinations are simply inevitable. There is nothing wrong with this - the doctor will examine you, give you directions for tests, get acquainted with their results and prescribe appropriate therapy. And after following all medical recommendations, your health should definitely improve.

Menstrual irregularities (MCI) are one of the most common reasons for a woman to visit an obstetrician-gynecologist. According to various authors, it manifests itself to one degree or another in 35% of gynecological patients. In addition, more than 70% of women experience certain manifestations throughout their lives (irregularity of the cycle after menstruation, heavier periods than normal during stress, etc.).

Normally, the menstrual cycle is controlled by the release of hormones from the pituitary gland and ovaries. In the first phase, FSH predominates - follicle-stimulating hormone, which promotes the maturation of the follicle, which promotes an increase in the secretion of estrogens (primarily estradiol), which, in turn, contributes to the growth of the endometrium. When the level of estradiol increases, the level of FSH begins to fall (this mechanism is called negative feedback), and decreases as much as possible towards the middle of the cycle. At the same time, under the influence of estrogens, the level of LH, the luteinizing hormone, begins to increase. When LH levels reach their peak, ovulation occurs. Along with the increase in LH levels (a little later), there is an increase in progesterone levels. Estrogen levels decrease after the peak and rise again only when progesterone reaches its maximum level. If fertilization does not occur, the levels of progesterone and estrogen decrease and reach minimum values, endometrial rejection occurs. Afterwards, FSH begins to increase again and the process begins again. Simply it looks like this:

The duration of a woman's monthly cycle averages from 21 to 31 days. As a rule, menstruation is established between the ages of 12 and 14 years and most often becomes regular almost immediately. Less often they become regular after the first pregnancy. Periodic deviations from the norm are possible within a few days/week. So if menstruation in a particular cycle occurs several days earlier or later, then it is not legal to talk about a violation. If the break between menstruation is 40-60 days, or, on the contrary, it is less than 21-25 days, and thus the woman’s menstruation flows for a long time, we can talk about cycle irregularity.

Why is the female monthly cycle accompanied by bleeding? The uterus, as is known, consists of three layers, of which the inner layer is the endometrium, which in turn is also divided into two parts: functional and basal. The first serves as the place where the fertilized egg is implanted and where the pregnancy begins to develop. During each monthly cycle, due to the basal layer, it increases and thickens, preparing the basis for possible implantation. In the case when fertilization of the egg does not occur, the “lush” functional layer “unnecessarily” peels off, under the influence of the cyclically changing concentration of pituitary-ovarian hormones in the blood, causing bleeding. The bleeding is quite profuse, which is primarily due to the rich blood supply to the endometrium. The so-called spiral arteries penetrate the endometrium, which are damaged when the tissue that they actually nourished is detached. Their damage leads to dilatation (expansion) of the spiral arterioles, after which menstrual bleeding begins. At first, the adhesion (clumping) of platelets in the endometrial vessels is suppressed, but then the damaged ends of the vessels are sealed with intravascular thrombi consisting of platelets and fibrin. 20 hours after the onset of menstruation, when most of the endometrium has already been rejected, a pronounced spasm of the spiral arterioles develops, due to which hemostasis is achieved. Regeneration of the endometrium begins 36 hours after the onset of menstruation, despite the fact that endometrial shedding is not yet completely completed.

Causes of mental cycle disorders

What are the causes of menstrual irregularities? In principle, the following can be distinguished:

External (physiological) - in this case there is no direct physiological impact on the process, but there are indirect factors, such as: stress, changes in diet, climate change, etc. Consequently, eliminating the external cause leads to normalization of the process.
Pathological – this can include a huge group of diseases and conditions that will be characterized by a violation of the regularity of the cycle.
Medication - when prescribing or canceling certain drugs

What types of menstrual cycle disorders can be:

Dysfunctional uterine bleeding is pathological uterine bleeding without damage to the genital organs.
Menorrhagia is heavy bleeding (more than 100 ml), occurring with clearly defined frequency.
Metrorrhagia is irregular bleeding without clear time intervals.
Polymenorrhea is bleeding that occurs at intervals of less than 21 days.
Intermenstrual bleeding is bleeding between menstrual periods. The amount of blood lost varies.
Postmenopausal bleeding - bleeding a year (or more) after the onset of menopause;

Pathological conditions in which the menstrual cycle is disrupted:

Pathology of the ovaries - this may include: violations of the functional connection between the pituitary gland and the ovary, damage to ovarian tissue, iatrogenic (drug) effects, oncological degeneration of the ovaries. It is necessary to mention such a pathology as insufficiency of the corpus luteum of the ovary (at the site of the follicle from which the egg “emerges” for fertilization, the corpus luteum normally develops, which is capable of producing progesterone necessary for implantation of the amniotic sac) - an insufficient amount of progesterone is not able to maintain the process at a normal level. This is one of the main causes of menstrual irregularities.
Pathology of the hypothalamic-pituitary system - normal regulation of the cycle is disrupted due to inadequate release of FSH and other hormones; oncological degeneration of tissue.
Pathology of the adrenal glands and other estrogen-secreting tissues - the normal synthesis of estrogen is disrupted, the process “does not start.” This also includes adrenal tumors.
Chronic inflammatory diseases of the uterus - normal growth of the endometrium and its timely maturation do not occur.
Endometriosis (genital and extragenital) is considered separately, due to the fact that the causes of its occurrence are poorly understood.
Oncology - the appearance of pathological hormone-secreting tissue can also lead to irregularities in regularity.
Abortion and curettage of the uterine cavity can be accompanied by both mechanical damage and the possible addition of inflammatory processes.
Operated ovary - after surgery on the ovaries, especially with the use of coagulation, failure of organ function may develop, manifested primarily by irregular menstruation.
Liver diseases - as a rule, cirrhotic degeneration of liver tissue is characterized by a violation of estrogen conjugation. As a result, estrogen levels rise and menstrual bleeding becomes more frequent (and heavier).
Dysfunctional uterine bleeding – without organic damage to organs and systems. In 20% of cases they occur immediately after puberty, in 50% in women over 40 years of age. The diagnosis is made when other pathologies are excluded.
Violation of the blood coagulation system - can cause prolonged bleeding without disrupting the regularity of the cycle.
Other reasons are surgical interventions, long-term illnesses, etc.

In addition, it is necessary to highlight irregular periods associated with taking medications. These include: hormone replacement therapy drugs, corticosteroids, anticoagulants, tranquilizers, antidepressants, digitalis, Dilantin and intrauterine devices. Therefore, the prescription of any of the listed drugs should be carried out only by a doctor, as well as their withdrawal. If necessary, consult with the specialist who prescribed the drug.

Diagnosis of menstrual irregularities

Due to the huge number of reasons, the diagnostic search must begin from simple to complex:

Taking an anamnesis - the doctor should find out about the medications the patient is taking, whether she has a history of recent pregnancy (after pregnancy, periods can not only normalize, as mentioned above, but also be disrupted), about all external factors that may contribute to cycle disruption. Pay attention to the patient's mental state.
Examination of a woman - attention is drawn to the exhaustion of the patient, changes in the color of the patient’s skin, mucous membrane and sclera, the presence of manifestations of extragenital pathology (increase in the size of the liver, thyroid gland, the appearance of discharge from the nipple not associated with pregnancy, etc.).
Gynecological examination - pay attention to the appearance of pain during examination, especially during palpation of the cervix, the nature of the discharge and its quantity, the presence of space-occupying formations in the pelvis and infiltrates.
Taking all smears allows you to exclude an infection, the long-term persistence of which can also cause cycle irregularity.
Ultrasound of the pelvis or abdominal cavity - pay attention primarily to the condition of the uterus and ovaries, if there is no pathology in them - ultrasound of all organs and systems, targeted ultrasound of the thyroid gland (for a possible pituitary cause) and liver. When examining the ovaries, attention is paid to their size, the presence of follicles and their size, blood supply to the tissue, etc.
Clinical and biochemical blood tests, coagulogram - necessary for differentiation from pathological conditions of hematopoietic tissue and pathology of blood clotting.
Determining the level of hormones in the blood is an important factor. Standards:
Estradiol - 0.17±0.1 nmol/l - follicular phase, 1.2±0.13 nmol/l-ovulation, 0.57±0.01 nmol/l - luteal phase.
Progesterone - 1.59±0.3 nmol/l – follicular phase, 4.77±0.8 nmol/l – ovulation, 29.6±5.8 nmol/l – luteal phase
LH - follicular phase – 1.1 – 11.6 mIU/l, ovulation 17 – 77 mIU/l, luteal phase 0 -14.7 mIU/l
FSH - follicular phase - 2.8-11.3 mIU/l, ovulation - 5.8 - 21 mIU/l, luteal phase - 1.2 - 9.0 mIU/l
MRI is a method through which a patient can be examined in detail for tumors and pathological changes in tissue. Expensive, rarely used.
Hysteroscopy - allows you to study in detail the condition of the endometrium, the presence or absence of a polyp. Allows you to perform curettage after examination to send the material for histological examination. The disadvantages are the cost and the need to give anesthesia.

The combination of anamnesis data, clinical manifestations and methods of laboratory and instrumental examinations makes it possible to determine the cause of irregular menstrual cycle, pain and pathological bleeding and eliminate them.

Treatment of menstrual irregularities

First of all, it is necessary to include the elimination of all external influence factors. Since the craze of many women for losing weight can be the main cause of menstrual irregularities, it is necessary to choose the right diet for patients and advise them to give up excessive exercise.

In case of heavy bleeding, after excluding pathology of the blood coagulation system, it is necessary to begin symptomatic treatment. This may include:

Hemostatic drugs – vikasol, etamsylate, tronexam. In a hospital setting, they are usually prescribed intramuscularly (Vikasol, Etamzilate) or drip (Tranexam) + in tablet form to enhance the effect (usually 2 tablets 3 times a day - Tronexam, 2 tablets 2 times a day Vicasol and Etamzilate).
ε-Aminocaproic acid – reduces bleeding in 60% of women
In case of heavy bleeding - compensation of blood loss through infusion of plasma, sometimes (in rare cases) blood.
Surgical treatment is a last resort method of treatment, for example, in case of heavy bleeding, over the age of 40 years, in the presence of persistent anemia of the patient, when the cause of the bleeding cannot be reliably established. Maybe:
- Curettage of the uterine cavity.
- Endometrial ablation – burning out the endometrium with a laser.
- Balloon ablation of the endometrium (a balloon with liquid is inserted into the uterine cavity, which is then heated to 87.5 degrees).
- Hysterectomy (removal of the uterus).
A combination with hormonal drugs, primarily oral contraceptives, is required. This not only enhances the hemostatic effect, but can also become the first, and sometimes the main therapy for irregular periods. As a rule, combination drugs are used that contain high doses of estrogen and progesterone.

Duphaston and Utrozhestan remain one of the most popular progesterone drugs in the Russian Federation used in the treatment of menstrual irregularities. As a rule, their prescription depends on the hospital; there is no real evidence of the advantage of one over the other. Prescribed doses depend on the situation, on average: Duphaston - 1 tablet 1-2 times a day from 11 to 25 days of the cycle, Utrozhestan 1 capsule 2-3 times a day.
In addition, hormonal treatment includes the following drugs:
Norethisterone - oral progesterone, 5 mg 3 times a day from the 5th to the 26th day of the cycle.
Medroxyprogesterone acetate – 10 mg per day from days 5 to 26.

In women over 40 years of age, it is permissible to use drugs that completely or partially “turn off” menstruation. These include:

Danazol – 200-400 mg/day. Reduces the volume of blood lost with each menstruation by 87%.
Gestrinone – one capsule 2.5 mg 2 times a week. Leads to endometrial atrophy.
GnRH agonostes cause complete cessation of menstruation and amenorrhea. Treatment should be limited to 6 months to prevent osteoporosis. Rarely used and quite expensive.

However, the main thing in the treatment of menstrual irregularities is the cure of the underlying disease.

Without eliminating the main focus, it is impossible to achieve a complete cure. So, for example, if an endometrial polyp is detected, it is necessary to perform a diagnostic curettage of the uterine cavity; in case of a chronic inflammatory process, antibiotics should be prescribed, etc. Let us repeat once again - in most cases, menstrual irregularities are only a symptom of some underlying pathological process, and its treatment should be prevalent. Only after eliminating the main focus and the most acute clinical manifestations can one begin to restore the disrupted cycle.

Complications of menstrual irregularities

Irregular cycles may be accompanied by persistent anovulation, hence leading to infertility

Frequent intermenstrual bleeding can cause serious complications - from fatigue to complete loss of ability to work.

Late diagnosis of many pathologies, the first symptom of which is menstrual irregularity, can lead to death from a pathology that could have been cured with timely consultation with a doctor.

Self-medication is acceptable, but only under the supervision of an experienced specialist. Obligatory observation by a gynecologist. Severe endocrine pathologies may be the cause of irregular periods; consultation with an endocrinologist may be necessary. In case of extragenital pathology, consultation with a specialist is necessary.

For women with menstrual irregularities, it is very important to choose the right diet. It is necessary to include as much as possible in the diet foods rich in iron and protein, primarily meat. Exhaustive diets and workouts are extremely contraindicated. Be sure to consult a nutritionist.

Gynecologist-endocrinologist Kupatadze D.D.

Doctors say that every representative of the fair sex has at least once in her life encountered a problem - failure of menstruation. Problems with the frequency and duration of the menstrual cycle are the most common problems with which women go to the gynecologist. The problem does not always mean pathology, but for many it is an early symptom of infertility. Therefore, if the cycle fails, it is imperative to find out the reason.

Appointment with a gynecologist - 1000 rubles. Comprehensive pelvic ultrasound - 1000 rubles. Consultation on diagnostic results (optional) - 500 rubles.

Normal periods are like: norms for healthy women

The main characteristics of a stable menstrual cycle:

cyclicity - three phases of the menstrual cycle must replace each other;
duration of the cycle and menstruation itself within normal limits (21 – 35 days);
the total blood loss during one period of menstruation should be 50 – 150 ml;
absence of severe pain and discomfort.

Violation of at least one of these conditions indicates disruption of the menstrual cycle.

What should be the duration of the menstrual cycle?

The frequency, duration and volume of blood released are the main attributes of the menstrual cycle.

The menstrual cycle is the period between the first days of the previous and current menstruation. Its normal duration should be from 20 to 45 days. The standard period is considered to be 28 days, although it is present in only 15% of women.

The duration of menstruation largely depends on age, which is explained by hormonal characteristics. Each age category has norms regarding cycle duration:

In teenage girls, the cycle usually fluctuates and can be up to 45 days. Gradually, after a year or more, it is established. Occasionally, complete recovery is observed only after the first birth.
The most regular cycle of 21–35 days is present in women of childbearing age. The presence of cycle disorders during this period usually indicates pathology, for example, inflammation in the uterus, hormonal imbalance, etc.
During perimenopause, the cycle shortens, and menstruation itself becomes unpredictable and longer. This occurs due to a decrease in the level of the hormone estrogen in the blood and the physiological decline of reproductive function.

It is not considered a cycle disorder if menstruation occurs a few days earlier or later. If there is a break between menstruation of more than 40–60 days or, conversely, less than 20–25 days, a serious pathology can be stated. In this case, failure of menstruation may be associated with pregnancy - normal or , , , hormonal diseases and even .

Norms of menstrual flow

Normally, menstruation should last from 3 to 7 days. The nature of this period is individual for each woman, as it depends on many factors. Normal filling of a pad or tampon should occur within 3 to 4 hours on days of heaviest discharge. The alarming signal is that they fill in 1 – 2 hours and the impossibility of spending the night with one night pad.

In this case we can assume , this state will end during menstruation.

Should your stomach hurt before your period: signs of menstruation

Common signs of the imminent onset of menstruation are considered natural: breast enlargement and tenderness, a slight increase in temperature and blood pressure, nagging pain in the lower abdomen and lower back, etc. A woman may experience all of these symptoms, but they should be relatively comfortable.

When strong, or when , you need to immediately contact a gynecologist.

Menstrual cycle: how it happens in phases

With changes in hormonal levels in the female body, there is a change in periods of the menstrual cycle: menstrual, follicular, ovulation and luteal (premenstrual).

The menstrual phase is the time of critical days

The first phase is menstrual. Is the most painful of all. At this stage, the layer lining the uterus (endometrium) begins to peel off and come out along with the unfertilized egg, resulting in bloody vaginal discharge. Typically, the heaviest bleeding is observed on days 2–3 of the cycle, but for some, the highest peak may occur on day 1 or on days 2 and 4 - this parameter is quite individual.

The first phase is manifested by the following symptoms:

spasmodic pain in the lower abdomen, lumbar region and pelvis;
cramps in the limbs;
general malaise.

Spasms can be of varying degrees. They appear because the body helps the endometrium shed through uterine contractions.

Follicular phase

The second phase is follicular. Characterized by the cessation of discharge. During this period, hormones of the pituitary gland and hypothalamus are intensively synthesized, thereby affecting the ovaries. Follicle-stimulating hormone is the main one. It stimulates increased growth and development of follicles.

The ovaries produce the sex hormone estrogen, which starts the process of growing new endometrium in preparation for pregnancy. This stage of the cycle lasts about two weeks.

Fertile window, ovulation - days of conception

5 days of the follicular phase + 1 day of ovulation is called the fertile window - the period during which there is the highest probability of conception. It is not easy to determine it on your own; only special diagnostic methods can help with this, for example, .

Ovulation is the period during which a mature egg is released from the follicle. The process itself resembles a kind of explosion and occurs very quickly, within a few minutes. If within 24 hours the egg meets the sperm, it passes through the fallopian tube into the uterus - pregnancy occurs.

If this does not happen, then with the onset of menstruation the egg is removed from the body. It is extremely rare that ovulation can occur twice a month with an interval of 1 to 2 days. Without it, pregnancy is impossible.

During ovulation, the following symptoms may be observed:

minor discharge of blood (spotting);
nagging pain in the lower abdomen;
general malaise - weakness, fatigue;
feeling of discomfort.

Luteal phase: premenstrual period

The third phase is the luteal phase. The final period of the menstrual cycle, called premenstrual, lasts up to 16 days. It is characterized by the formation of the corpus luteum - a special temporary gland at the site of the follicle that the egg left. Progesterone is produced, which is necessary to increase the sensitivity of the endometrium so that the fertilized egg can more easily penetrate the uterine wall.

If implantation of the fertilized egg does not occur, the gland regresses, leading to a sharp drop in progesterone levels. This becomes a provocation for destruction and subsequent rejection of the endometrium. The cycle is closed.

The premenstrual period is manifested by the following symptoms:

nervousness, short temper, irritability;
spasmodic pain in the lower abdomen and lower back;
mood swings;
tearfulness;
aching muscle and joint pain;
the appearance of acne on the skin;
swelling and tenderness of the mammary glands;
increased nipple sensitivity;
heaviness in the abdomen, bloating;
stool disorders;
weight gain;
general malaise – fatigue, weakness, slight chills;
headaches and dizziness, nausea, fainting (in the last days of the cycle).

Failure of menstruation is a dangerous condition.

Menstrual cycle disorders: all diseases associated with changes in menstrual periods

Cycle disorders occur due to a disruption in the frequency and duration of menstruation, as well as due to changes in their course. These violations were divided into appropriate groups:

The first group of violations includes:

Polymenorrhea - increased frequency of menstruation with an interval of less than 21 days with heavy prolonged blood loss;
Oligomenorrhea - the duration of menstruation is no more than 2 days, and the interval between them is about 40 days;
Amenorrhea is the complete cessation of menstruation. This condition guarantees .

The second group of violations includes:

Hypermenorrhea (mennorrhagia) – increased bleeding during menstruation without disruption of the cycle;
Hypomenorrhea - scanty bleeding during menstruation (less than 50 ml in total), while its duration may be normal or shorter;
Algodismenorrhea – excessively painful menstruation;
Metrorrhagia – menstruation occurs several times per cycle;
Menstruation after menopause - the appearance of bloody discharge in the postmenopausal period (from a year after menopause). At this time the woman .

Reasons for the “jumping” cycle: menstruation failure is dangerous

An irregular menstrual cycle often indicates that there is a problem in a woman’s body. The main reason for its occurrence is hormonal imbalance, which can be triggered by a number of factors. It is customary to distinguish between physiological, drug and pathological causes of a disrupted cycle.

Physiological causes of menstrual irregularities

Physiological causes are the least dangerous and are easier to eliminate than others. These include:

stress and nervous tension, lack of sleep, chronic fatigue;
severe physical overload;
body weight disorders (obesity and wasting);
sudden climate change;
activation or lack of sexual activity;
strict diets, consumption of alcohol, tobacco, drugs, excessive caffeine consumption;
postpartum period and lactation period;
various cleanings, ;
radiation and poisoning.

All of these factors lead to a state of shock in the body. A stress hormone (adrenaline, prolactin or cortisol) is released. It blocks the ovaries, i.e. interferes with the production of female sex hormones, and thereby disrupts the menstrual cycle.

Violation of body weight can lead not only to cycle failure, but even to its temporary absence. This occurs due to the production of the male hormone androgen in adipose tissue, and the more this tissue, the more hormone is released.

Pathological causes of problems with menstruation: urgently see a gynecologist!

Pathological causes are more dangerous and can lead to serious complications if not diagnosed and treated in a timely manner. These include the following main diseases:

tumor and , various "ohms" - for example, that disrupt the proper functioning of the reproductive system;
ovarian pathologies (cyst, polycystic disease, dysfunction);
infectious and inflammatory processes in the genital area;
endometrial hyperplasia;
thyroid diseases;
other diseases of the “non-sexual” area that cause hormonal imbalance (blood diseases, diabetes, etc.);
hereditary predisposition.

The range of such provoking diseases is wide: from mild colds of the genital organs to oncology. This can also include frozen pregnancy, miscarriage and complications after an abortion. Often the pathology is asymptomatic, the general condition is satisfactory, but the menstrual cycle is irregular. In this case, a special examination will be required to confirm or refute the presence of pathology.

Medicinal causes of menstrual irregularities

Medicinal causes include taking medications. Almost any medicine that enters the body affects all organs and systems, especially the reproductive one. The following drugs can disrupt the cycle:

Antidepressants – cause a delay in menstruation and reduce the amount of discharge;
Anticoagulants and blood thinners – increase the intensity of bleeding;
oral contraceptives - long-term use of hormonal drugs shortens the duration of menstruation and makes them scanty, and the wrong choice can radically change the cycle. Cancellation of oral contraceptives often also leads to disruption of the cycle, but this does not pose a danger to the body. Full recovery in such cases occurs after 2–3 months of the cycle;
Hemostatic drugs – reduce the amount of discharge;
Antiulcer drugs – cause a delay in menstruation;
Intrauterine spiral - the body perceives its installation as a stressful situation, so even if it is performed correctly, minor malfunctions occur cycle.

Incorrect placement of the intrauterine device or illiterate installation often provokes uterine bleeding or serious cycle disorders. His Stabilization should normally occur within 3–4 cycles.

Examination of a patient with an irregular menstrual cycle

Irregular menstrual cycle - a compelling argument immediately . The cause may be serious pathologies that you may not even suspect. Therefore, it is important not to self-medicate, only aggravating the situation.

To determine the cause of the failure, the doctor will conduct an examination of the woman, which will include:

visual and internal examination of the genital organs;
And ;
hysteroscopy – examination of the uterine cavity and its cervix using a special device – a hysteroscope, inserted into the cervical channel. Using the method, you can not only assess the condition of the organ under a large magnification, but also to take aim biopsy.

It is also necessary to undergo an examination by a hematologist, including:

– blood test for homeostasis (blood clotting);
clinical and (to determine serum iron, bilirubin, liver enzymes, platelet count);
determination of progesterone levels and others .

To clarify the diagnosis, doctors may also need information about the duration and abundance of menstruation since adolescence, the regularity of bleeding from the nose and gums, how often bruises appear on the body, etc.

Why treat menstruation failure: what will happen with an irregular menstrual cycle

An irregular menstrual cycle is considered normal in adolescence, the postpartum period, and in women over 50 years of age. In these cases, the cycle stabilizes without outside help and does not require treatment.

An irregular cycle as an independent deviation does not pose a health hazard. But in women outside the above list, it is often a sign of hormonal imbalance, which can be caused by various reasons, including serious pathologies of the genital organs (uterine cancer, endometriosis, polycystic disease, endometrial hyperplasia, etc.).

That is why it is extremely important not to ignore cycle disorders, but to undergo the necessary examinations in the clinic. Timely diagnosis and treatment will allow you to successfully get rid of the problem.

Irregular periods are an obstacle to the normal onset of ovulation. This means that conceiving a child will cause significant difficulties for a woman. In some cases, a disrupted cycle can lead to a serious complication - infertility. Therefore, the doctor should recommend to the woman.

Treatment of irregular menstrual cycles

A “jumping” menstrual cycle is not a pathological process, but only a symptom of various disorders. That is why methods of its treatment can differ radically depending on the provoking cause.

Problematic menstruation can be stabilized with:

changes in lifestyle and habits;
diagnosis and treatment of underlying pathology;
taking hormonal medications ( );
changing the method of contraception.

Changing lifestyle and habits

If the disruption of the cycle is associated with a woman’s lifestyle and her bad habits, then to stabilize it you just need to change it: give up excessive consumption of caffeine, get rid of bad habits, do not overload the body physically, get enough sleep, protect yourself from nervous stress, eat right etc.

Detection and treatment of underlying pathology

Treatment can be carried out medicinally using the following symptomatic drugs:

analgesic and antispasmodic - to relieve pain;
hemostatic;
anti-inflammatory drugs;
hormonal (oral contraception) - to normalize the activity of the endocrine system.

Vitamin therapy and physiotherapy are also often prescribed for polycystic disease.

If drug treatment is unsuccessful, then curettage of the uterine cavity is prescribed. It is also possible to eliminate the problem through surgery, for example, if a tumor, polycystic disease or thyroid disease is detected.

Prescribing hormonal drugs

A widespread way to stabilize a disrupted menstrual cycle is combined oral contraceptives. They apply even to those who are not sexually active, or, conversely, . Hormone therapy lasting six months stabilizes the cycle. After its cessation, the likelihood of pregnancy increases significantly.

Changing your contraceptive method

The body's reaction to a particular method of contraception may be unpredictable due to the characteristics of the body itself. If, for example, as a result of taking contraceptives, a sharp disturbance in the menstrual cycle is observed, then it is recommended to change the drug to another with a higher dosage or composition. It is necessary for the doctor to assess the situation and adjust the contraception.

If the reason for the failure of menstruation is the intrauterine device, and menstruation does not normalize within the allowable period, then the only solution is to remove the device and choose another .

Treatment with medicinal herbs

Restoring the cycle is possible if traditional methods of treating menstruation failure are added to the main methods. It is possible that medicinal plants, if used incorrectly, can cause harm to the body, so before use, you must always consult a doctor and identify the main cause of the disorders.

Medications for heavy menstruation:

You will need: horsetail (100 g), pepper knotweed (20 g), chamomile (150 g), shepherd's bag (50 g), yarrow (150 g), lungwort (50 g), acorn (50 g). Decoction for one dose it is prepared as follows: 1 tsp. collection is boiled in 200 ml of water. Drink once a day before bedtime. Course duration – from 3 weeks;
You will need: shepherd's bag (1 d.l.), yarrow (1 tbsp.), oak bark (1 d.l.). Pour the collection with 0.5 liters of boiling water and leave for 30 minutes under the lid. After straining, drink in 2 doses (in the morning and before bed).

Medicinal herbs for painful periods:

Peppery knotweed. Pour 1 tbsp. crushed plant 200 ml of boiling water and leave for 30 minutes. Take the decoction 3 times a day, 1 tablespoon;
Chamomile, mint and valerian root (3:3:4). Brew 1 tbsp each collection in 200 ml of boiling water. Take during menstruation several times a day;
Leaves raspberries Pour 1.5 tbsp. raw materials 200 ml of boiling water and let it brew for 15 minutes. Take several doses of infusion per day in small quantities.

Medicinal herbs to stabilize the cycle:

Flowers cornflower. Pour 1 tbsp. plants 200 ml boiling water and let it brew for 60 - 80 minutes. Drink the decoction 3 times a day, 1/3 cup. The course of therapy is at least 3 weeks;
Seeds parsley Pour 1 tsp. crushed raw materials 0.5 liters of warm water for 8 hours. Drink the infusion 4 times a day, half a glass without straining;
Sagebrush. Pour 1 tbsp. herbs 300 ml of boiling water and let it brew in a warm place for 4 - 5 hours, then strain. Drink the infusion 3 – 4 times a day, a quarter glass.

Where to go for menstrual irregularities in St. Petersburg, prices

The main specialization of the clinic. We treat irregular periods and any menstrual irregularities. In our medical center you can undergo an ultrasound using one of the best expert ultrasound machines, take hormone tests, undergo a gynecological examination with colposcopy, etc.

The cost of treating period disorder depends on the root cause of the condition, but in any case it is inexpensive. For example. a comprehensive ultrasound of the pelvic organs, including examination of the uterus, costs 1000 rubles, a consultation with a gynecologist based on the diagnostic results costs only 500 rubles.