Cycle 35 40 days when ovulation. What pathologies can a long monthly period indicate? Treatment of menstrual disorders

Women who are planning a pregnancy are sensitive to their own ovulation and scrupulously calculate its date. But sometimes it happens that the middle of the cycle has already passed, and a couple more days, and the schedule basal temperature has not changed and the ovulation test shows only one line. And only just before your period, the long-awaited signs suddenly appear.

This situation is called late ovulation. It can occur occasionally, for reasons unrelated to disease, but observed every month, this condition indicates pathology. Below we will analyze its main causes, as well as the question of whether it is possible to get pregnant during late ovulation and how to determine that conception has occurred.

Determination of late ovulation

The release of the egg (oocyte) from the follicle must occur at a strictly defined time. Usually this period is considered the middle of the cycle, that is, with a cycle of 25-26 days, “day X” is expected on the 12-13th day, but in fact the calculation is a little more complicated.

The menstrual cycle is divided into two: the period before ovulation (follicular phase) and after it (luteal phase). In the first period there are complex processes. First, the functional layer of the endometrium, which has not accepted the embryo, is rejected within three days, then wound surface begins to heal, and by day 5, the formation of a new endometrium begins to replace the rejected one. The synthesis of the “fresh” functional layer continues for 12-14 days (starting from the 5th day of the cycle).

The duration of this period is not strictly fixed, because the uterus needs not only to “grow” new cells, but also to give them the opportunity to grow to 8 mm, and also to provide them big amount tubular glands.

The duration is strictly defined only for the second phase of the cycle and is 14±1 days (that’s how long a person lives corpus luteum in anticipation of pregnancy). That is, to find out the day of oocyte maturation, you need from the first day of the expected menstrual bleeding subtract 13, maximum 14 days. And if this figure is less than 13 days, ovulation is considered late. That is, late ovulation with a 30-day cycle - when it occurred later than the 17th day from the first day of the expected menstruation. When the cycle is longer, for example, 35 days, then the release of an oocyte that occurred after 21-22 days can be called late.

Many women are interested in the question of when the latest ovulation may occur. The answer is difficult to calculate, because it depends on the duration of the cycle. So, if the cycle is within 30-35 days, then the release of the egg less often occurs later than 10-11 days before menstruation. That is, after the 25th day (if from one period to another - no more than 35 days) you should not wait for it. Most likely, this cycle is anovulatory, and if you are under 35 years old and anovulation occurs 1-2 times a year, this is a normal situation that does not require intervention.

If more than 35 days pass between menstruation, then such a cycle itself is already considered a sign of illness that requires examination, and it is very difficult to predict the release of an egg.

Hormonal support of the menstrual cycle

To understand why a doctor might prescribe a certain hormonal drug To normalize the cycle and eliminate late ovulation, we will consider what mechanisms control the period from one period to another.

Regulation menstrual cycle carried out by a 5-level system:

1. The cerebral cortex and its structures such as the hippocampus, limbic system, and amygdala.
2. Hypothalamus. This is the body that “commanders” the entire endocrine system. He does this with the help of two types of hormones. The first are liberins, which stimulate the production of the necessary “subordinate” hormones (for example, folliberin gives the pituitary gland the command to produce follicle-stimulating hormone, and luliberin gives the “order” to synthesize luteinizing hormone). The second are statins, which inhibit the production of hormones by the underlying endocrine glands.
3. Pituitary. It is he who, at the command of the hypothalamus, produces FSH hormone, which activates the synthesis of estrogen, and luteinizing hormone (LH), which triggers the production of progesterone.
4. Ovaries. Produce progesterone and estrogen. Depending on the balance of these hormones, the production of which is controlled by the hypothalamic-pituitary system, the phase and duration of the menstrual cycle depends.
5. Hormonal balance is also affected by organs that are sensitive to changes in the level of sex hormones. These are mammary glands adipose tissue, bones, hair follicles, as well as the uterus itself, vagina and fallopian tubes.

In the first phase of the cycle, the pituitary gland produces FSH and LH. The latter causes synthesis male hormones in the ovary, and FSH – the growth of follicles, the maturation of the egg in one or more of them. During the same period, the blood contains a small amount of progesterone. There must be a strictly defined amount, because both a decrease and an increase will negatively affect the onset of ovulation.

In addition to its effect on the follicles, FSH causes the conversion of androgens into estrogens. When the amount of estrogen reaches its maximum and because of this the amount of LH increases, after 12-24 hours the oocyte should leave the follicle. But if luteinizing hormone or androgens become higher than normal, ovulation does not occur.

After the oocyte is released into “free swimming,” LH decreases and progesterone levels increase, reaching its peak 6-8 days after the oocyte is released (days 20-22 of the 28-day cycle). These days, estrogen also increases, but not as much as in the first phase.

If the egg leaves the follicle late, on day 18 or later, this may be the result of one of the following situations:

• During the period before ovulation, estrogen “dominates” in the blood, to which the body cannot “oppose” anything. This prevents the uterus from preparing for pregnancy. If a woman wants to get pregnant, she is prescribed progesterone during late ovulation, in a course of 5-10 days from the second half of the cycle (usually from 15-16 to 25 days, but optimally - immediately after determining the release of the follicle, even if it happened late).
• The concentration of LH and androgens increases. In this case, contraceptives with an effect that suppresses androgen production help solve the problem.
• There is a deficiency of estrogen, which can be suspected from the fact that follicle growth during late ovulation is very slow. This is corrected by prescribing estradiol drugs in the first half of the cycle (usually from the 5th day). You cannot plan a pregnancy while taking synthetic estrogens.

Reasons for “late” ovulation

Late release of the egg can be triggered by: prolonged stress, climate and time zone changes, abortion or discontinuation of OK. The reason is also the change hormonal balance in the first year after childbirth, if the woman is breastfeeding. Can cause menstrual irregularities such as late ovulation past illnesses, especially infectious (flu, etc.). Also, a shortening of the second period of the cycle will be characteristic of the upcoming one. Finally, sometimes such a deviation in the functioning reproductive system may be an individual feature of a woman.

Often the reasons for late ovulation are gynecological diseases, which are characterized by an increase in estrogen in the blood (some types), diseases with increased level male hormones (pathology of the adrenal cortex). Late ovulation with a 28-day cycle may be the only sign of low-grade inflammation of the uterus or fallopian tubes, ovarian cysts, as well as genital tract infections caused by chlamydia, trichomonas, and ureaplasma.

A similar symptom (displacement of the egg release cannot be called a disease) also occurs with various endocrine pathologies pituitary gland, hypothalamus, adrenal glands or ovaries. It also develops with obesity, which is also a disease, because adipose tissue is involved in the metabolism of hormones.

Symptoms

Find out that the release of the oocyte still takes place, albeit later due date, the following signs will tell you:

1. Change in vaginal secretion: it becomes similar in viscosity to chicken protein, there may be streaks of blood in it, and all the mucus may come out colored brown or yellowish color. Implantation bleeding occurs in a similar way, occurring only after ovulation, a week later.
2. A pulling sensation in the lower abdomen, usually below the navel and on one side.
3. Enlargement and extreme sensitivity of the mammary glands: any touch causes discomfort or even pain.
4. Irritability, sudden changes mood, increased emotionality.
5. Increased sexual desire.

Each representative of the fairer sex has an individual menstrual cycle and has its own specific duration. Determining the day of ovulation is especially important for couples who are planning to conceive a child. When does ovulation occur if the cycle is 35 days.

On average, a normal menstrual cycle lasts 28-30 days. Don’t worry if the cycle lasts 35-40 days, we are not talking about pathology, but perhaps it’s just a feature of the body.

Causes

It is important to monitor your regularity on a monthly basis. A woman determines the duration of her menstrual cycle independently; she can keep a special diary or calendar. With the advent of numerous programs, data can be entered into the phone, which is very convenient and will never be lost.

Factors that may influence menstrual irregularities:

• neuroses and stressful situations;
• hormonal disorders;
• gynecological diseases of an infectious or inflammatory nature;
• depression;
• chronic diseases body;
• excess body weight or, conversely, sudden weight loss;
• endocrine pathologies;
• use of antidepressants and hormonal drugs.

A constant cycle of 35 days is not a deviation from the norm. You should worry when a woman notices a delay in menstruation and changes in the duration of menstruation. These signs require contacting a specialist, as they may indicate a malfunction in the female body.

Ovulation

If the cycle is 35 days, when does ovulation occur? Very frequently asked question from women who have experienced the phenomenon of late ovulation.

Most women know that fertilization is possible in the middle of the cycle; it is during this period that the egg is released. Therefore, with a 35-day cycle, ovulation will occur on days 19-22 from the start of the cycle. But these days can also vary depending on the woman’s condition and the presence of certain factors.

The main factors that influence the onset of ovulation:

• the beginning of menopause;
• stressful situations;
• hormonal imbalances;
• the period after the birth of the child.

The following will help determine which day will be more favorable for conception and fertilization:

• Ovulation test. It can be purchased at a pharmacy. It is carried out in the morning when there is greatest number hormone. Instructions for proper implementation The dough is in the package.
• Measuring basal body temperature and maintaining a graph. The temperature rises to 37 degrees, in common days approximately within 36.6. How to measure basal temperature correctly can be found in a separate article or asked a question during a visit to a gynecologist.
• Analysis of urine and saliva for luteinizing hormone, which is determined specifically during the ovulatory period;
• Ultrasound to determine the growth and development of the follicle and the estimated day of its rupture and release of the egg.
• Listen to your body; on the days of ovulation, women notice swelling of the mammary glands, soreness, nagging pain lower abdomen, abundant transparent discharge, increased sexual desire. Based on these signs, one can judge the onset of ovulatory syndrome. For each representative of the fair sex they occur individually.

The days for ultrasound and tests must be agreed upon with the doctor. Ovulation should occur 2 weeks before the start of the next menstruation and if the egg is released in late period, the body does not have time to prepare for pregnancy. Ovulation itself lasts approximately 24 hours and if fertilization does not occur during this period, it dies. Further, conception is possible only in next cycle.

Symptoms that require you to see a doctor:

• anovulation occurred more than 2 times;
• the rise in basal temperature occurs towards the end of the cycle, and not in the middle, as expected;
• temperature fluctuations throughout the cycle;
• after menstruation, the temperature does not decrease, but remains at an elevated level.

Gynecologists have such a definition that a cycle of less than 22 days and more than 40 is considered a deviation from the norm and requires clarification of the cause. Therefore, it is important to monitor the duration of your cycle monthly and, if any deviations or concerns occur, contact a specialist.

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Questions and answers on: 35 day cycle when ovulation

2010-12-11 16:46:16

Natalya asks:

Good afternoon. After the termination of pregnancy, I still have questions that the doctors have not yet given me answers to. My husband and I planned the pregnancy in advance, and used birth control for 6 months after a miscarriage (spontaneous at 5-6 weeks). I got pregnant right away. The first day of the last menstruation is October 12. Cycle 30 days. The pregnancy was confirmed by a test, my changes in my body, and of course, a couple of weeks later, on November 24, I had an ultrasound. Everything is fine - the ultrasound confirmed the pregnancy, it is in the uterus, there is a corpus luteum. The only thing they said on the ultrasound was 3 weeks, the fetus was still not visible. After this we contacted our perinatal center, in order to observe pregnancy there. I passed all the tests - the results are all good (only the results for hormones and infections came later). On December 6, I was sent again for an ultrasound to clarify the date. During the procedure, the ultrasound doctor saw the fetus, set the term at 6 weeks, but did not hear the fetal heartbeat. On the same day, I began to feel a cramp in the right lower abdomen. The next day I went to the doctor and she prescribed me a sick leave, progesterone injections and suppositories. She told me to come again for an ultrasound on the 8th so that another doctor could look at the heartbeat. In general, they never heard him, plus she noticed a detachment (although the previous doctor did not notice it on the 6th). After this, they did an ultrasound on the same day of genetics and the result was the same. On the 10th I had a curettage. BUT I am still tormented by thoughts - what if they were all wrong! Suddenly I became pregnant not on the days when ovulation was according to all calculations, but later and the fetus was simply smaller and the heart was not yet heard. After all, three ultrasounds show that the pregnancy is developing: at the first ultrasound on November 24, the embryo was not visible at all, then on December 6 it was already clearly visible and ovum even in two days it increased in size (ultrasound on December 8). I understand that this is out of despair... but suddenly there is an explanation and it happens that my fetus developed at the beginning a little slower than others.

Answers Vengarenko Victoria Anatolevna:

Natalya, ultrasound is only additional method examinations, but the fact that the fetus has begun to be rejected is there, so consult geneticists and calmly plan your pregnancy.

2016-10-31 17:39:50

Oksana asks:

Hello, tell me what to do. My husband and I are planning to have 2 children, he works on a rotational basis and always comes on the day when my period starts, and leaves after 10 days. Is there a possibility that we are not ovulating? I decided to track ovulation with tests in this cycle. I bought an electronic cleara, my cycle is 30-31 days at 16 days, the test smiled at me, called my husband, it was yes. the next day I had shooting pains in my ankles and a tugging in my stomach. I really hoped for a miracle, but yesterday it was 23 days, the remaining tests smiled at me again, I was worried and went for an ultrasound today. Dts-24
Uterus in retroposition
Contour: smooth, clear
Body measurements: length 5.96 cm, size 5.11 cm, width 6.0 cm
The shape is correct
The structure of the myometrium is changed: moderate venous congestion
Nodal images not identified
Endometrium: M-echo is differentiated: 14.6 mm, the structure is not changed. The contours at the border with the inner muscle layer are clear.
The uterine cavity is not dilated
Cavity image no
Neck: determined: length 3.13 cm thickness 2.91 cm
The structure has not been changed
The church canal has not been widened.
The fallopian tubes are not identified.
Ovaries:
Right-located 3.51/2.27/2.52 cm; volume 10.13 cc
The location is typical. The shape is correct, the structure is not changed.
Follicles are located: d-0.64 cm; Corpus luteum - no
No cystic formations
Left is located 2.95/2.29/2.22 cm; volume 7.88 cc
Typically located
The form is correct, the structure is not changed
Follicles are located d-0.58 cm; There is no corpus luteum, no cystic formations
Free fluid is not located in the retrouterine space

CONCLUSION
Ultrasound data of a moderate increase in the linear dimensions of the uterine body, the structure of the myometrium is not changed, moderate venous plethora; The structure of the endometrium corresponds to the phase of the menstrual cycle, thickened more than normal, the uterine cavity is not expanded, there are no cavity formations; Ovaries normal sizes and echostructure, the follicular apparatus is not changed, there are no cystic formations, there is no evidence of the presence of a corpus luteum.

P.S. I asked, it turns out I didn’t ovulate?! To which I received the answer that I didn’t come to him earlier for an ultrasound to look at the DF and the corpus luteum may look the same as the follicle and it doesn’t cost anything to guess.

Tell me how bad is the ultrasound?

Answers Palyga Igor Evgenievich:

Hello, Oksana! The ultrasound conclusion is without any peculiarities, although it is strange how can “the endometrium in structure correspond to the phase of the menstrual cycle,” but at the same time “thicken more than normal”?! It is impossible to draw a conclusion about the occurrence of ovulation, since the corpus luteum is not visualized. It makes no sense at all to undergo an ultrasound scan on the 24th day of the menstrual cycle to confirm ovulation. In your case, I would advise scheduling folliculometry to assess growth dominant follicle and the passage of ovulation from 7-8 days m.c. and plan sexual intercourse during the period of objectively confirmed ovulation. Ovulation tests are quite subjective and do not provide fully accurate information.

2016-08-25 08:28:49

Elena asks:

Good afternoon. I had my period on 07/20/16, the cycle was 30 days, today it’s 37 days. Delay 7 days. At 32 d.c. I did an ultrasound and found a corpus luteum cyst of the left ovary measuring 4.4*4.1. In the middle of the cycle (days 15-17) there were signs of ovulation, discharge similar to egg white, then it stopped, but at 23 days. I also had this discharge for one day. There was a PPA just at 20-25 b.c. I donated blood for hCG at 33 dc - the result is negative. Now it’s 37 dc. The breasts are very sore and engorged and the body temperature stays at 37 for several days, there are no periods. Could there be breast tenderness and temperature with a gastrointestinal cyst? or is it pregnancy? Should the hCG be at 33 d.c. Is there already something to show in the blood or is it too early? What if ovulation was just at 23 d.c. when I saw discharge... but it was also in the middle of the cycle... Please tell me.

Answers Bosyak Yulia Vasilievna:

Hello, Elena! If the analysis is hCG negative, which means pregnancy can be ruled out. If you wish, you can retake the hCG test again, but pregnancy is 99% excluded. I advise you to undergo an ultrasound scan of the pelvic organs to determine the cause of the delay.

2016-04-28 21:29:43

Raisa asks:

Hello!
Please help me understand the ultrasound results!
I went for an ultrasound on April 27, 2016, it was the 16th day of the cycle!
After stopping the contraceptive, I took Regulon for 4 months, for prevention after treatment, the gynecologist prescribed it!
So then my cycle went wrong, it became 32 days!
I wanted to understand when to expect ovulation, according to the calendar it should be April 28, and the doctor didn’t want to explain anything to me; there was no time to see a gynecologist...
I really want to get pregnant!
Here are the results of the ovaries and the conclusion:
Endometrium: 7.4 mm thick, not homogeneous, clear, even contours. The shape is oval!
The uterine cavity is not deformed, the contour is clear and even!
Right ovary: 38-25-29 mm, volume 14.4 cm, usually located.
Follicular apparatus: follicles - several up to 5 mm, located on the periphery and FLUID FORMATION 19 MM with homogeneous contents (it seems like the doctor said that there is a dominant follicle in the right ovary, but not a word more (()
Left ovary: 38-17-31 mm, volume 10.3 cm, usually located.
Follicular apparatus: follicles - several up to 5 mm, located on the periphery and a liquid formation of 16 mm with a thickened dense capsule and diffusely heterogeneous content, blood flow is not visible.

Features: none.
Free fluid behind the uterus - 7 ml.

CONCLUSION: liquid formations ovaries. Free fluid behind the uterus.

Please help me figure it out!
When is ovulation and will it happen at all...
Thank you very much in advance for your attention and answer!

Answers Bosyak Yulia Vasilievna:

Hello, Raisa! Most likely, a dominant follicle was visualized in the right ovary (the ultrasound specialist directly conducting the examination should say exactly this). Ovulation occurs when the follicle reaches 20-21 mm (increases by an average of 1 mm per day). It would be rational for you to undergo a control ultrasound scan after 1-2 days to objectively assess whether ovulation has occurred. You most likely have a cyst in your left ovary if a thickened, dense capsule and heterogeneous contents are visualized. In this case, after completing a month, the ultrasound scan should be repeated and the growth of the cyst should be observed. For what purpose were you prescribed Regulon? How old are you? If you wish, please write in more detail.

2016-03-18 08:08:06

Maria asks:

By the way, I ended yesterday, duration 5 days, my cycle is 24 days
Here are the ultrasound results:

direct ovary: along the rib of the uterus 26*16*17 mm, volume 3.5 cm3, clear, even contours, echostr/ra-follicles 11 mm, 11 mm, 11 mm. The echogenicity of the stroma is normal.
Lev testicle: 25*19*17 mm, volume 4.2 cm3, clear contours. smooth. echo is heterogeneous, with the presence of an anechogenic inclusion of 13 mm with an uneven contour

Question: at 6 days I had an ultrasound, it showed three follicles from the right testicle and one from the left one, what is this and what could it be connected with?

March 18, 2016
Bosyak Yulia Vasilievna answers:
Gynecologist, reproductive specialist
information about the consultant
Hello Maria! What worries you? On ultrasound, antral follicles are visualized, at 24- daily cycle You most likely ovulate, plus or minus, on the 12th day of your pregnancy. Have you ever undergone folliculometry? To assess the growth of the dominant follicle and the passage of ovulation, it is advisable to do this.

The doctor sent me to 14 dc for foleiculometry, what worries me is that they told me that three follicles came out of one, 1 from the other and that this is not normal at 6 dc. They prescribed me clostelbigit, which I tolerate strangely, everything hurts, my vision began to worsen, my stomach hurts, my back hurts, everything hurts.

Answers Bosyak Yulia Vasilievna:

Hello Maria! Have you been taking clostilbegit since what day? At what dose? Did you take blood tests for sex hormones before stimulation? If, against the background of clomiphene, 4 follicles begin to grow, then this is normal. The main thing is that these follicles mature and ovulation occurs. If you feel unwell, you should inform your doctor.

2015-08-12 13:24:24

Oksana asks:

Ultrasound at 15 d.c.
body of the uterus 58*45*50mm
M-echo 14
right ovary 33*24 mm follicle 7-10mm
left ovary 36*31 mm follicle 7-10mm

Cycle 33-38 days
When to expect ovulation

Answers Gumenetsky Igor Evgenievich:

Hello, Oksana! Do you think I'm a medium?! Ovulation occurs when the dominant follicle reaches 20 mm, but when this happens, virtually no one can say for sure. If the menstrual cycle is irregular, then I recommend folliculometry.

2015-05-29 12:21:21

Elena asks:

Hello. Could you please advise on my problem? I have always had polycystic disease based on the LH/FSH ratio. They don’t do an ultrasound scan. The ovaries are not enlarged, there are up to 5 follicles in each ovary. Previously, follicles did not grow larger than 8 mm and the endometrium did not grow larger than 6-7 mm. I went to the doctor, they prescribed Remens + Cyclovita for 3 months to reduce LH due to black cohosh in Remens. From the 2nd cycle I went for an ultrasound and the follicle grew to 20mm by 18 days (the cycle lasted from 28 to 35 days, but sometimes it didn’t last for 2 months). the endometrium has grown to 12mm. tried to get pregnant. after 3 days, the fluid behind the uterus was up to 10mm, the formation was 20mm (either a follicle or a wt). Progesterone on the 8th day after supposed ovulation showed 43.5 (normal 13-56). (in that cycle there was a lot of mucus from 14 to 18 days). Then menstruation 14 days after expected ovulation. In the new cycle (3rd cycle of taking Remens), the dryness ended and a little bit of mucus appeared from 18 d.c. only at 18.19 d.c. after which it did not appear again. ultrasound with 13d.ts follicle 8mm, endom 6mm, at 17d.ts follicle 12.5mm, endometrium 7mm, at 21dts follicle already 19mm with tubercle, endometrium 13mm. There was contact with my husband that evening and the next evening. on the 24th day I came for an ultrasound of the right ovary in which there was a follicle - 29*48*33, there was some kind of formation in it mesh structure up to 30mm. The uzist also talked about some kind of hemorrhage, either in the ovary or in the follicle. uzistka new years 20. She said the follicle probably didn’t burst, but she immediately wrote a corpus luteum cyst... although the corpus luteum only after ovulation. there is no fluid behind the uterus, just one drop said. right side where the cyst hurts when I move. The pain started for the first time on the day of expected ovulation at night, when the follicle was 19mm that day. By nightfall, there was a dull, bursting pain on the right side for several hours, then it went away. There was no mucus that day, but it wasn’t dry either, and it’s still not particularly dry. That same night my chest started to hurt and it still hurts, especially at night and in the morning, it’s severe and painful. I’m still in the second cycle and I can’t figure out whether ovulation is happening and whether it happened in this cycle. and what kind of cyst do I have in this cycle - follicle or corpus luteum. We are planning a pregnancy for cycle 2. I am 30 years old. except for LH before treatment, all hormones were normal. (including estradiol, FSH and testosterones) progesterone before treatment was 1.5, but I understood this because there was no ovulation. Please tell me what do you think, did I ovulate in this cycle or that one? and what kind of cyst do I have, gastric or follicular? and if it’s a follicle, then why didn’t the remens work this month? After all, the follicle and endometrium have grown, albeit very quickly. That month, the endometrium was already 12 mm from 14 dc, and this month it grew sharply from 17 to 21 dc, along with the follicle. and there was very little mucus and it didn’t last long. On the days when ovulation was supposed to happen, it was wet but without mucus. and so far. and will it help to accurately determine again a test for progesterone a week after ovulation (in that cycle it was 43.5 on the 8th day after ovulation, as expected) Thank you.

Answers Gumenetsky Igor Evgenievich:

Hello, Elena! In your case, you need to contact experienced specialist Ultrasound, and not rely on your own subjective feelings and draw conclusions based on them. If on the 24th day m.c. there was a formation of 29-30 mm, then it most likely formed follicular cyst, provoking painful sensations. How long have you been openly sexually active without getting pregnant? I personally believe that for a 30-year-old patient who is planning to conceive, prescribing one remens is not rational and there is no particular hope for its effectiveness. To draw conclusions, it is necessary to see the levels of sex hormones - FSH, LH, prolactin, AMH, free testosterone to date and the conclusions of folliculometry.

2015-05-20 17:13:39

Lilia asks:

Hello! I have low progesterone. In this regard, my doctor prescribed taking duphaston from days 10 to 20 of the cycle, that is, 10 days. According to ultrasound readings, I ovulate on the 10th-11th. My cycle is 30-31 days.
Question 1: why was I prescribed to take duphaston for 10 days with a cycle of 31 days, when everywhere it is written that duphaston should be taken from days 11 to 25 with a cycle of 28 days (that is, it should be taken not 10, but 14 days!!!)
Question 2: how to take duphaston when planning pregnancy? I am very afraid that if I stop drinking, another spontaneous miscarriage will occur!

Answers Gumenetsky Igor Evgenievich:

Hello, Lilia! Let's start from the end. Do you have a history of miscarriages? If yes, for what period? If you wish, please write in more detail. Duphaston is actually prescribed from the 11th to the 25th day, i.e. in the second phase of the cycle. At habitual miscarriage I think that the reason is not only low progesterone.

2014-10-20 05:44:33

Julia asks:

Hello. My chest has been hurting for 4 days now, especially when I put on a bra. I used to ache sometimes, but before I started critical days and even then not so much and one -2 days. what could this be from? Now I’m on day 23 of my cycle, I started getting sick 6-8 days after Ovulation. two days before the onset of chest pain, shooting in the ovaries and the left ovary ached. Now sometimes my lower abdomen feels tight. 8-10 days after Ovulation. I caught ovulation with tests that were bright for 3 days!!!

Answers Bosyak Yulia Vasilievna:

Hello Julia! I think this is how you experience premenstrual syndrome. Is there any discharge when pressing on the nipple? If discharge is present, then on day 2-3 m.c. It is necessary to take a prolactin test. After your period, I advise you to undergo an ultrasound scan of the pelvic organs to visualize the ovaries first. Be healthy!

When does it start ovulatory period, the body becomes completely ready to conceive a baby. Therefore, women who want to get pregnant begin to calculate ovulatory days in order to accurately determine the most favorable day for conception. If, with a standard 28-day cycle, the egg is released in the middle, then what should girls with less or big cycle. If the cycle is 30 days, then when will ovulation occur, how to make error-free calculations and feel the onset of day X if a woman, for example, has late ovulation?

Ovulation is a certain female condition when a mature germ cell, ready for fertilization, emerges from the ovary. In fact, ovulation is the stage of the cycle that follows between the follicle-stimulating and luteinizing phases.

In most women, maturation and exit female cage is regular, systematic, repeating every 20-35 days. And the frequency of ovulatory periods is regulated by follicular and gonadotropic hormonal substances. At the beginning female cycle the birth of many cells occurs, developing in the follicular structures of the ovary. One of them is much ahead in development of the others, acquiring dominant status.

The duration of development and maturation of the egg is about 11-15 days. By the time the dominant follicle finally matures, it ruptures and the cell comes out. All these processes are controlled by the estrogen hormone. But when the cell finally matures, estrogen drops, and instead the level of progesterone rises sharply. It is this hormonal surge that causes the follicle to rupture when ovulation occurs. From this moment until the end of the cycle, progesterone is responsible for all processes associated with the egg.

The ovulatory period lasts about 12-48 hours, which is determined by individual characteristics female body. When ovulation is completed, the next phase of the cycle begins - luteinizing, when conception becomes impossible. There are many ways to calculate the ovulatory phase, some of them are more accurate than others, but each one deserves attention.

How to calculate ovulation for a 30-day cycle

IN in some cases additional examinations are required

When a woman for a long time cannot get pregnant, then she involuntarily begins to calculate favorable days of the cycle for successful conception. In other words, the ovulatory day begins to count. Experts recommend calculating ovulation using a simple formula. From the expected start date next menstruation you need to subtract 14 days, since the duration of the luteinizing phase is normally exactly 2 weeks.

So, we are interested in when the ovulatory period will begin if the cycle is 30 days. From 30 (cycle duration) we subtract 14 (days of the second stage of the cycle). It turns out 16, which means that on day 16 ovulation should occur in a 30-day cycle, but some discrepancy of ±2 days is allowed. It is by this principle that they calculate on what day the egg matures and is released with other indicators.

If a woman’s cycle length is unstable, then calculate the onset of the ovulatory period calendar method will be problematic. In such situations, you can use other methods to calculate the date of release of the female cell, which include ultrasound monitoring, testing with pharmaceutical strips and basal measurements.

Ultrasound monitoring

This method of determining the ovulatory phase is also called phylliculometry. The purpose of this study is to monitor follicular growth and egg release from the ovary.

• With a 30-day cycle, ultrasound monitoring begins on the 10-11th day of the cycle, i.e. approximately 4-5 days before the middle of the monthly cycle.
• Subsequent sessions of ultrasound monitoring of the egg are carried out every two days and last until the egg is released.
• The onset of the ovulatory period is confirmed ultrasound diagnostics, when the day before the size of the follicle was 20-24 mm, and now the growth of the yellow-bodied gland has begun.
• The procedure can be performed through the vagina or through abdominal wall.
• During intravaginal examination, no preliminary preparation is required, the main thing is to empty the bladder.
• During abdominal examination it is carried out traditional examination through the abdominal wall. In order for it to pass without difficulties, three days before monitoring it is necessary to exclude all foods that can cause flatulence or bloating, and on the day of the examination it is necessary not to eat and drink at least a liter of water.

Ultrasound monitoring requires certain financial costs, but it is the most precise method determining the date when ovulation occurs. There are also less expensive methods for determining the onset of ovulation.

Basal measurements

Measurements are taken in the morning, immediately after waking up

Correctly measuring basal temperature will help determine whether a patient is ovulating normal, early or late. This is one of the simplest ways to determine auspicious days for conception. To use it, it is necessary to measure rectal temperature daily for several months. This should be done after waking up in the morning, but you cannot get out of bed. I just woke up, and right after the thermometer. All results must be scrupulously noted on a special graph. At the end of the cycle, all points with measurement results are connected into a broken graph. During menstruation, measurements are not taken.

On the days when the chart showed sharp decline, and then a rapid increase in temperature, and ovulation occurs. It is better to use simple mercury thermometers for measurements, although electronic ones will do just fine. The main thing is to make all measurements with the same thermometer, then the results will be as accurate as possible. With the help of such a graph, a woman can easily determine fertile days, as well as the nature of egg maturation (early or late ovulation), etc.

Testing

More in a simple way The use of special pharmaceutical strip strips is considered to determine the ovulatory phase. Such tests are available in any pharmacy outlets. Since we are interested in ovulation in a cycle of 30 days, we need to start taking measurements from about day 13. If ovulation is not observed, then the second stripe will be absent. But the day before or on the 15th day, the test line will be as bright as the control line. This sign indicates that the upcoming ovulatory period is coming, which should be expected in the next 24 hours.

Testing is carried out in a similar way to tests to detect conception. You need to immerse the strip in a container with fresh urine for a few seconds, then place it on a dry surface and after about five minutes read the result. If the test strip appears, but the control strip is missing, then the testing is considered unreliable, since such a test is flawed and cannot show the correct, true result.

Signs of egg release

A woman can determine the onset of ovulation by internal sensations, external signs and various changes in the body. The ovulatory period may not always reveal itself with pronounced manifestations; some women do not have any symptoms. But experts say that if you listen to your inner feelings, you can feel the time when the egg will leave the ovary.

First signs

You can guess the approaching onset of the ovulatory phase by various symptoms.

If a girl has long reached puberty and reproductive age, and there are no signs of ovulation, that is, there is a possibility that anovulation is occurring. In addition, the absence of any ovulatory signs indicates the patient's probable infertility. The main thing is to notice the problem in a timely manner and contact a specialist who will select the medications necessary to correct the cycle.

Symptoms of the onset of the ovulatory period

As mentioned above, with the onset of the ovulatory period changes occur with cervical mucus, which becomes more abundant and liquefies, acquiring the consistency of egg white. It is with these secretions that the body tells a woman that she is ready to conceive. Concerning basal rates temperatures, then before the immediate onset of ovulation they fall, and the very next day they rise sharply. It is after this increase that you need to wait for the release of the egg. Those couple of days when there is a slight increase in temperature are considered the most fertile, when the chances of conception are maximum.

Before the onset of the ovulatory phase, serious hormonal changes occur associated with an increase in the production of luteinizing hormone. By the way, tests for determining ovulation work on the principles of identifying this hormone, or, more precisely, on its reaction with certain chemicals. Also, some malaise, pain in the abdomen and nagging discomfort in the lumbar region indicate that ovulation has begun.

Also, the onset of the ovulatory phase is indicated by such signs as increased libido, swelling of the mammary glands, sudden mood swings and excessive, chronic fatigue, tearfulness and tearfulness.

Early and late ovulation

Ovulatory periods are late or occur later than usual, i.e. early and late ovulation. If, in a 30-day cycle, the cell matures on days 11-12, then such ovulation is considered early, but if it began later than expected, then late ovulation is diagnosed. ovulatory phase. Such shifts can occur against the background of frequent sexual intercourse, a debilitating diet, severe physical activity, hormonal disorders, diseases, etc.

At the same time, the probability of conception remains depending on how many days ovulation lasts. In fact, this action only takes a few minutes while the cell ruptures the follicle and gets out of it. That's it, ovulation actually happened. But in medicine, it is customary to call the ovulatory period not only the time when a female cell is released, but also the period of its existence.

If the egg does not come out

In some cases, ovulation does not occur at all during the cycle, then they speak of anovulation. Even in the healthiest patients, cells are not able to mature in every cycle; approximately a couple of cycles remain without ovulation, which is quite normal. Gradually, there are more and more such cycles as the body ages and follicular reserves are depleted. By the age of 35, almost every second or third cycle is anovulatory. In addition to physiological reasons, this condition can also be provoked by a variety of psycho-emotional experiences, stress, inflammatory pathologies genitals and genitourinary system, dysfunctional disorders of the activity of intraorganic structures, etc.

So, calculating the ovulatory period is not at all difficult, even on your own. If traditional home methods like basal charts or ovulatory pharmacy tests do not give results, then you need to contact specialists who, if necessary, will conduct ultrasound monitoring.

It just so happened that reproductive function is activated in the girl’s body at the moment when she does not care about this function at all. Having just put the dolls aside, the girl is faced with a whole series of little-understood processes occurring in her body, which immediately begin to be heatedly discussed among her peers, with consultations from those who are older. And mothers in this situation do not always rise to the occasion, since they themselves are poorly versed in this topic.

So, let’s figure out once and for all what happens to you every month, dear women, what is considered normal, what should alert you.

Most women answer a question about the length of their menstrual cycle with a similar phrase “about once a month, a couple of days earlier than the previous month”- this one with a fancy phrase the cycle duration is 28 days. This cycle length occurs in most healthy women, but does this mean that shorter or more long cycle Is there a manifestation of pathology? No!

Recognized that a normal menstrual cycle can last from 21 to 35 days, that is, plus or minus a week from the average of 28 days. The duration of menstruation itself can normally range from 2 to 6 days, and the volume of blood lost should be no more than 80 ml. A longer cycle occurs among residents of the northern regions, a shorter cycle among those living in the southern regions, but this is not an absolute pattern.

Regularity is important in the menstrual cycle. That is, if a woman’s cycle is always 35-36 days, then this can be absolutely normal for her, but if it is either 26, then 35, then 21, this is not the norm. Thus, Irregularity can be considered a pathology(when menstruation comes at an uneven period of time), long cycle(more than 36 days) or short cycle(less than 21 days). In general, the menstrual cycle can vary greatly depending on the condition of the woman and the situation in which she finds herself.

However, different women lability of the menstrual cycle depending on external and internal factors can be different. For some, a little stress can already lead to a delay in menstruation, while for others, severe depression is not a reason for menstrual irregularities. One woman's menstrual cycle can match another's if they long time exist together. This is often seen on women's sports teams or when living together in a dorm. It is not entirely clear what explains this fact. All we can say is that menstrual cycle although there is a clear mechanism, but may vary significantly in a normal healthy woman and these changes are a reflection of the body’s reaction to external and internal factors.

The menstrual cycle is not always stable

The most irregular period is the first two years after the start of menstruation and three years before its end (menopause). Violations during these periods are due entirely physiological reasons, which we will talk about below.

Where do these numbers come from and why might they change?

The menstrual cycle is divided into three phases: menstruation, the first phase (follicular) and the second phase (luteal). Menstruation lasts on average 4 days. During this phase, the lining of the uterus (endometrium) is shed due to failure to become pregnant.

First phase lasts from the end of menstruation until ovulation, that is, on average until the 14th day of the cycle with a 28-day cycle (the days of the cycle are counted from the moment the menstruation begins).

This phase is characterized by the following events: several follicles begin to grow in the ovaries (from birth, the ovaries contain a lot of small vesicles (follicles) containing eggs). During their growth, these follicles secrete estrogens (female sexual hormones) into the blood, under the influence of which the mucous membrane (endometrium) grows in the uterus.

Shortly before the 14th day of the cycle, all follicles except one stop growing and regress, and one grows to an average of 20 mm and bursts under the influence of special stimuli. This process is called ovulation. An egg emerges from a ruptured follicle and enters the fallopian tube, where she waits for the sperm. The edges of the ruptured follicle gather (like a flower closing for the night) and this formation is now called the “corpus luteum.”

Starts immediately after ovulation second phase of the cycle. It lasts from the moment of ovulation until the start of menstruation, that is, about 12-14 days. During this phase, the woman's body waits for the pregnancy to begin. In the ovary, the “corpus luteum” begins to flourish - the corpus luteum formed from the burst follicle sprouts vessels and begins to secrete another female sexual hormone (progesterone) into the blood, which prepares the uterine mucosa for the attachment of a fertilized egg and the beginning of pregnancy. If pregnancy does not occur, then a signal is sent to the corpus luteum and it curtails its work.

When the corpus luteum stops secreting progesterone, a signal is sent to the uterus, and it begins to reject the no longer needed endometrium. Menstruation begins.

At of different durations cycle, the duration of the phases is reduced - this means that one woman needs 10 days for the follicle to mature, while another needs 15-16.

Having understood what the menstrual cycle consists of, it is easy to understand what determines its duration normally and in the presence of pathology.

Why is everything often unstable at the very beginning and then, after childbirth, it gets better?

The female reproductive system matures gradually, and being a complex mechanism, requires a setup period. The fact that a girl's first menstruation occurs does not mean that its system is mature and ready to work fully(although for some, the menstrual cycle starts working correctly from the very beginning).

The functioning of the female reproductive system can best be compared to an orchestra, the coordinated play of all the instruments of which creates the unique sound of a piece of music - in our case regular menstrual cycle. Just as instruments in an orchestra require a period of tuning, all components of the reproductive system need to agree with each other to understand and work together harmoniously. Such a rehearsal usually takes about 6 months - for some it is longer, for others it is shorter, and for others it may take longer.

Why do there be delays or do my periods start earlier?

Everything is very simple - if during the first phase of the cycle it is not possible to grow a full-fledged follicle, which could burst in the middle of the cycle (ovulation), then the second phase of the cycle, accordingly, does not begin (no ovulation - there is nothing to form the corpus luteum from). The first phase lasts a long time, until the uterine mucosa (endometrium), which has grown under the influence of estrogen, begins to be rejected on its own (like a pyramid of cubes collapses when it is stood too high). The cycle in this situation can last up to several months.

In this case, in the next cycle, ovulation may occur and the cycle will have a normal length. When such alternation occurs, they speak of an irregular menstrual cycle.

Another reason for delayed menstruation may be too long existence of the corpus luteum. As I noted above, it lives for about 10 days and then begins to curtail its work, since pregnancy has not occurred. But sometimes it happens that despite the fact that pregnancy has not occurred, the corpus luteum continues its work and menstruation does not occur, and occurs only when the corpus luteum finally decides to leave.

More earlier onset of menstruation This is usually due to the fact that the notorious corpus luteum, on the contrary, stops its work too early. This leads to more early start menstruation.

Remember how the orchestra sounds when it tunes its instruments - the same cacophony from the menstrual cycle is often observed at the beginning. The components of the reproductive system negotiate so that they can grow a follicle in 14 days, start the ovulation process, and maintain the functioning of the corpus luteum for at least 10 days. At the beginning, she does not succeed in all stages of this work and this is manifested by an irregular menstrual cycle.

But this adjustment can be seriously interfered with by the person himself. Nothing has such a negative impact on the development of the reproductive system as stress(intensive study, exams, unhappy love), reinforced sports training, extreme weight loss, frequent illnesses, smoking, alcohol and drugs. Against the backdrop of all of the above, quite often periods disappear and then you have to wait a long time for them. And the reason is very simple, I would say there is simple biological expediency in this - in extreme conditions life and when, for health reasons, a woman cannot bear healthy offspring – reproductive function turns off until better times. It’s not for nothing that during the war, most women stopped menstruating; this phenomenon was even given a special term “wartime amenorrhea.”

What to do about it?

Let me make it clear right away that I don’t take into account various diseases, I'm talking about some common menstrual cycle adjustment problems. Such cycle disorders are solved by taking hormonal contraception. Here we need to return again to the comparison with the orchestra. If the orchestra starts to go out of tune, you must stop playing completely, give the musicians a rest and start again. Hormonal contraception does just that. She turns off the reproductive system and “rests” the entire time she takes contraception. Then, after its cancellation, the system begins to work again and, as a rule, the cycle failures disappear.

Why does the cycle quite often become stable after childbirth, and sexuality flourishes?

The orchestra can rehearse as much as it wants, but it is finally played only when it performs its first concert from beginning to end. Pregnancy is the only purpose for which the reproductive system is designed in the body. Only after the first full pregnancy, which ends in childbirth and the period of breastfeeding, the reproductive system matures completely, since during this period all the functions provided by nature are realized. After pregnancy, a woman finally matures and all the not fully “unpacked” properties of the body finally begin to work in full force.

The reproductive system must be used for its intended purpose - this is important; menstruation is not a function of the reproductive system, but a monthly reminder that it exists at all and is still working.

Let's step beyond 30...

Time passes, the reproductive system, which on average is allotted to exist in working order for 38 years (from 13 to 51), instead of performing its function is limited only to regular menstruation.

For reference: on average, a woman experiences about 400 menstruation during her life (with 2 births) and loses about 32 liters of blood, while during reproductive behavior (pregnancy, childbirth, 3 years of breastfeeding, and only then 1-2 menstruation and pregnancy again ) there are about 40 menstruation periods.

In addition, as a woman ages, her history of various gynecological and common diseases , and all this begins to affect the state of the reproductive system and, therefore, is reflected in menstrual irregularities. Inflammation, abortion, gynecological operations, overweight or underweight, and common chronic diseases can cause problems.

Menstrual irregularities in the form of delays or earlier onset of menstruation a couple of times a year can occur even in the absence of any pathology.

As a rule, this is due to climate change or other stresses on the body (illness, hard work, personal problems, etc.). All nervous professions can lead to either delays in menstruation, their earlier onset or complete cessation.

Every woman is different, so everyone's cycle will change differently depending on the type of stress response and the phase of the cycle in which it occurs. For most women nervous work have no effect on their menstrual cycle at all. Cycle disorders, especially if it was stable before, often make a woman think that something is wrong with her. Not in all cases you need to panic.

If you can clearly remember any negative events in the recent past that greatly shocked you, then most likely this is a one-time cycle disruption and there is nothing wrong with it. If there is no menstruation for a very long time (and the pregnancy test is negative), then you need to consult a doctor. If menstruation came earlier and does not end, this is also a reason to rush to see a gynecologist.

Sometimes Cyclic disorders can manifest as very frequent menstruation(several times a month). And there is no need to delay it - see a doctor immediately.
But if the regularity of the cycle disappears completely– this is also a reason to see a doctor.

Regularity– the main indicator of the normal functioning of the reproductive system. Sometimes it happens that a cycle had one duration and suddenly becomes shorter while maintaining its regularity. As a rule, this is due to the fact that the second phase of the cycle becomes shorter, as the corpus luteum begins to work less. Such changes are more often observed closer to 40 years. This is not a reason to panic, but simply a reflection that your reproductive system will change as you age, just like you.

Early menopause

This is one of the very common fears of women. In fact, this fear is exaggerated, since early menopause quite rare. It is mainly due to rare congenital diseases, rare systemic diseases, a consequence of treatment (chemotherapy, radiation therapy at oncological diseases) and others rare conditions. There are situations when, due to surgical intervention A woman's ovary or part of it is removed. Then menopause may occur earlier due to the fact that there is little tissue left in the ovaries that could support normal operation reproductive system.

Early menopause As a rule, it is manifested by the cessation of menstruation and the appearance of symptoms of insufficiency of female sex hormones (hot flashes, irritability, tearfulness, insomnia, etc.). There is no prevention of this disease.

Painful periods and PMS

For some reason it is generally accepted that bad feeling This is normal during menstruation. Presence of pain, nausea, migraines during menstruation is not normal. This condition painful menstruation called dysmenorrhea and requires treatment. Even if these phenomena are expressed insignificantly, they can and should be corrected.

Dysmenorrhea it happens like primary(most often in at a young age), when it is most likely due to simply the immaturity of the reproductive system and secondary– when it is a reflection of a number of serious gynecological diseases.

The same applies to premenstrual syndrome. In general, the widespread popularization of this syndrome allows women to attribute their sometimes not entirely adequate actions and behavior to manifestations of this syndrome. However, PMS is not a woman’s personality trait., which everyone has to put up with. PMS is a disease, which has incompletely understood causes, whole list symptoms and specific therapeutic measures. Manifestations of PMS can and should be corrected. Take monthly illness for granted in modern conditions wrong. If you have such problems, consult a doctor.

How it all ends

Decline of the reproductive system usually occurs in the same way as its formation. Menstruation becomes irregular and there is a tendency to be delayed. This is due to the same reasons as in the beginning.

The ovaries respond less well to stimuli from the brain. It is not possible to grow follicles that could reach ovulation - accordingly, the cycle is delayed. If ovulation occurs periodically, the resulting corpus luteum does not work well. What causes menstruation to either start earlier or, on the contrary, to be delayed? long term. Eventually your periods will stop, and if you haven't had them for more than 6 months, you should see a doctor. Based hormonal tests and ultrasound can suggest the onset of menopause.

Sometimes there are cases when menstruation stops for a long time, and according to tests and ultrasound, the onset of menopause is expected. This can be especially frightening for young women. However, this may only be a temporary period, and menstruation may resume on its own, for example, after proper rest.

Thus, the myth that 28 days is the norm and everything that differs from this figure is pathology has been debunked. The main thing in the menstrual cycle is its regularity, and the duration of the cycle can fluctuate over a wide range.

And yet, there is a simple rule, if you regularly go through preventive examination see a gynecologist (at least once a year), if any disorders appear, do not put off an “unpleasant” trip to the gynecologist - then you will almost never have serious gynecological problems.