Failure of the menstrual cycle causes. Menstrual irregularities. Treatment of menstruation disorders in adolescents

The menstrual cycle is established in adolescence and accompanies a woman throughout her entire childbearing period, up to 40-45 years. Its presence signals that the reproductive system is ready to conceive and bear a child, and also that the body is actively producing female sex hormones.

The causes of menstrual irregularities (as it is sometimes called popularly, the correct name is “menstrual”) are due to a number of factors, among which the following can be noted:

Hormonal disbalance – irregular periods may be due to a disruption in the functioning of a woman’s endocrine system. With a lack of estrogen, the first phase of the cycle is significantly prolonged, and the dominant one is not released from the antral follicles. With an excess of testosterone, the capsule of the dominant follicle thickens.

As a result, the egg is not able to leave it and the follicle turns into a follicular cyst. With a lack of progesterone, the second phase of the cycle becomes too short, which significantly brings the arrival of menstruation closer.

In addition, disruption of hormone production can cause pathological changes in the structure of the endometrium, which not only leads to disruption of the menstrual cycle, but also to intermenstrual bleeding.

PCOS and MFJ – polycystic ovary syndrome and multifollicular ovaries. These two pathologies are associated with disruption of the paired female reproductive glands. They often cause delays and the appearance of cysts.

Women who have been diagnosed with one of these diseases have irregular menstrual cycles that tend to last for varying amounts of time. As a result, the intervals between menstrual bleeding can be up to 60-70 days (more about).

STD – sexually transmitted diseases. Unlike hormonal imbalances, they can only cause menstrual irregularities once and disappear completely after treatment.

The most common infections that cause delays and intermenstrual bleeding are gonococci, as well as exacerbation of ureaplasmosis and mycoplasmosis.

Disruption of the pituitary gland and hypothalamus – these parts of the brain produce luteinizing and follicle-stimulating hormones (LH and FSH), as well as estrogens, progesterone and prolactin. Failures in the functioning of these glands can affect changes in the nature of menstruation, both towards their increase and towards their decrease.

Physiological age-related changes - this category includes menstrual cycle disorders in those women over 40. The supply of eggs by this time ends and the ovarian reserve is depleted. This leads to a noticeable decrease in the level of estradiol and progesterone, which provokes irregular periods.

Different causes of menstrual irregularities can have different effects on the appearance of periods. Therefore, dysfunction of the reproductive system can be divided into two types depending on the frequency and nature of bleeding.

Types of menstrual cycle disorders by frequency:

• Polymenorrhea - involves a short cycle, less than 22 days. It is characterized by frequent absence of ovulation and insufficiency of the corpus luteum, in cases where egg maturation does occur. Polymenorrhea can imply either a single-phase or a two-phase cycle. However, in biphasic, there is usually a deficiency of the first or second phase, or both at once.
• Oligomenorrhea - involves the onset of menstruation at intervals of 40 - 90 days. This is the most common type of menstrual irregularities and is most often caused by. Often before the onset of such menstruation, spotting and spotting is observed for 2-3 days.
• – involves menstrual bleeding that occurs once every 3 months or more. Most often it occurs with increased physical activity, depletion of the ovarian reserve, stress and excess body weight.

Types of menstrual irregularities according to the nature of bleeding:

• – characterized by spotting bloody discharge, the duration of which does not exceed 3 days. Such periods are painless, are not accompanied by general weakness and do not have pronounced premenstrual syndrome.
• Heavy menstruation - characterized by large, strong blood loss (especially a few hours before menstruation and in the first hours after its onset). They often have pronounced premenstrual syndrome and last for at least 6–7 days.
• Intermenstrual bleeding is characterized by spotting blood that appears in the middle of the cycle and lasts 2-3 days. They should not be confused with spotting caused by ovulation. The release of the egg from the follicle can contribute to the appearance of only a few drops of blood, which are expressed in the form of light brown one-day discharge. Intermenstrual bleeding is more abundant and brighter in color.
• Premenstrual bleeding – characterized by the appearance a few days before menstruation. They usually intensify and develop into menstruation. They are a characteristic symptom of endometriosis.
• Postmenstrual bleeding is characterized by the presence of spotting, which occurs for several days after the cessation of menstruation and gradually disappears. They are a sign of chronic disease.

Any of these types of menstrual irregularities can be observed in a woman aged 40–45 years at the onset of menopause. Bleeding sometimes becomes scanty and rare, sometimes it becomes breakthrough and stops only for a short period of time.

Possible complications

At any age, menstrual irregularities can lead to various complications that can be hazardous to health.

• Anemia - may be caused by too heavy periods. Its risk is especially great when bleeding is frequent, with an interval of 2 to 3 weeks.
• Hematometra is the accumulation of blood and blood clots in the uterus, which for certain reasons cannot completely come out. Instead of normal periods, in this case there is very scanty, but long-lasting bleeding.
• - is not a direct consequence of irregular menstruation, but menstrual irregularities signal that a woman’s endocrine system is not functioning properly. The longer the start of treatment is delayed, the greater the likelihood of infertility.

Depending on the nature of irregular menstruation, the method of treatment will be determined. It provides two directions: drug therapy and surgery.

Moreover, the first option is usually aimed at eliminating the cause of cycle disorders, and the second, which involves surgical assistance, is sometimes aimed at eliminating the consequences of the pathological course of menstruation.

• Conservative treatment

Therapy involves two tasks: regulating hormonal levels and reducing blood loss. Before prescribing medications, the doctor should familiarize himself with the results of the ultrasound.

Oral contraceptives– often contain hormones of both the first and second phases. To regulate the cycle, OCs are prescribed for several months (from 3 to 6). The endocrine glands, under the influence of synthetic analogs of hormones, will begin to function normally and menstruation will begin to come on time.

However, there are a number of difficulties with such treatment. Firstly, there is a category of women who do not tolerate oral contraceptives well. Secondly, treatment with such drugs can only have a temporary effect, and after a few months the menstrual cycle will again become irregular.

Hormonal drugs– unlike oral contraceptives, they contain a synthetic analogue of only one hormone, or contain substances that interfere with the production of a specific hormone.

There, according to the results of a blood test, the doctor can prescribe a separate drug for each hormone that exceeds the permissible norm or has a concentration below the norm.

Hemostatic drugs– are prescribed for menstrual disorders that are characterized by excessive blood loss. Unlike hormonal drugs, the use of hemostatic drugs does not treat the cause of hormonal imbalance, but only its consequence - bleeding.

Disorders of the menstrual cycle in women after 45 years of age require only symptomatic drug treatment, since the body enters menopause and after a certain time, menstruation will stop forever.

• Surgery

Irregular menstruation, caused by hormonal imbalances, can lead to the accumulation of blood clots in the uterine cavity, which for various reasons are not able to completely flow into the vagina.

In order to avoid inflammation and in order to save the patient from constant scanty bleeding, curettage of the uterine body is performed. To undergo treatment, a woman must go to hospital for some time.

The operation is performed under general anesthesia, and the contents of the uterine cavity, which were extracted, are sent for histology. If you do not correct the menstrual cycle with hormonal drugs, the clots may accumulate again after some time and surgical intervention will be required again.

If your periods are irregular, you should pay close attention to this and do not put off visiting a doctor.

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

Cycle

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

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

Cycle calculation

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

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

Symptoms of failure

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

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

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

Adolescence and weight problems

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

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

Acclimatization

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

Hormonal disbalance

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

Stress

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

Diseases and hormonal contraceptives

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

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

Pregnancy, lactation

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

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

Premenopause and abortion

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

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

Other reasons

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

When to see a doctor?

Under no circumstances should you delay visiting a specialist if:

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

Diagnostics

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

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

Treatment

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

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

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

For anemia, women are prescribed iron supplements.

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

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

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

The last resort for severe bleeding is surgery.

Hormonal drugs and antibiotics are also prescribed.

Failure of the monthly cycle. Possible complications

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

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

A little conclusion

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

A lot of women face such a problem as menstrual irregularities. Moreover, this phenomenon does not depend on age; it can be observed both in young girls who have just begun menstruation, and in mature women due to hormonal imbalance, injury, or illness.

Usually, a girl's first period in her life comes at about 12-14 years of age. During the first year, the menstrual cycle is just establishing itself. On average, a girl goes through at least eight cycles in 12 months. If a girl over 14 years of age does not get her period, she should visit a doctor for an examination.

The normal duration of the menstrual cycle is considered to be 21-33 days. The countdown must begin from the first day of the next period until the start of the next one. A regular cycle is an indicator of a woman’s health. Bleeding should last no more than a week, and the volume of lost blood should be no more than 100 milliliters. Menstruation that does not correspond to this norm is a violation.

Regardless of the nature of the menstrual disorder, this can cause problems with the functioning of the reproductive or endocrine system. For this reason, any failure in the cycle should be a reason for an early visit to a gynecologist and undergoing the necessary examinations.

This phenomenon should be taken very seriously, because if treatment is not carried out in a timely manner, in the future you may be unable to get pregnant and give birth to a healthy child.

Possible reasons

In most cases, menstrual irregularities are explained by changes in hormonal levels. Moreover, it is not a fact that the cause lies precisely in the ovaries: the provoking factor may be a dysfunction of the thyroid gland or adrenal glands.

According to WHO statistics, the most common causes of menstrual irregularities are the following:

• Inflammation or other damage to the hypothalamic-pituitary region.
• Ovarian failure.
• Uterine abnormalities.
• Oncology.
• Increased levels of prolactin in the blood.

In addition, inflammation that affects the pelvic organs can lead to disruption of the menstrual cycle. When the provoking factor is eliminated, the cycle returns to normal. The same applies to diseases that are sexually transmitted.

Such common diseases as rubella or chickenpox have a detrimental effect on the formation of follicles in the ovaries. The result of this can make itself felt several months and sometimes years after recovery.

Menstrual irregularities sometimes indicate the presence of severe pathologies:

• endometriosis;
• adenomyosis;
• polyps;
• uterine fibroids;
• oncology of the pelvic organs.

In addition, the normal menstrual cycle may be disrupted due to unfavorable conditions, which include:

• following strict diets;
• changes in climate zones;
• physical stress;
• psycho-emotional stress;
• excessive passion for alcoholic beverages;
• sexual abstinence for a long time;
• use of certain medications.

It should also be remembered that problems with the stability of the menstrual cycle can be caused by a hereditary factor.

Is it dangerous?

A problem such as a disruption of the menstrual cycle should under no circumstances be left without due attention, as this phenomenon can lead to extremely adverse consequences:

• inability to become pregnant and bear a child;
• the occurrence of iron deficiency anemia;
• changes in hormone levels, which in turn can provoke the development of other pathologies;
• formation of benign and malignant tumors in the uterus.

How to cure and restore a disrupted menstrual cycle

Treatment must be prescribed by a competent specialist. Therapeutic measures will depend on the identified cause of the cycle failure. For an accurate diagnosis, the following activities will be carried out:

1. A survey of a woman, during which it becomes clear what kind of life she leads, what diseases she suffered, etc.
2. Examination by a gynecologist, which also includes an STD test and a flora smear.
3. Ultrasound examination of the pelvic organs and thyroid gland.
4. HSG (hysterosalpingography) is a method of x-ray diagnosis of diseases of the uterus, as well as fallopian tubes, which is based on the introduction of contrast agents into them.
5. Hormonal screening, which determines the level of sex hormones in the patient’s body.
6. X-ray of the head (including the sella turcica), this procedure will help identify hypothalamic-pituitary disorders.

Based on the results obtained during the examination, the doctor will prescribe appropriate treatment, which may include the following:

• lifestyle correction;
• drug therapy using hormonal agents;
• physiotherapeutic procedures;
• phytotherapy;
• taking drugs - uterotonics, which reduce blood loss;
• curettage of the uterus;
• operation.

If you seek medical help in time, the chances that the menstrual cycle will be fully restored, and, therefore, the disease will recede, will be quite high.

It should be noted that even with an irregular menstrual cycle, a woman can conceive and carry a child. Drug treatment using drugs that stimulate ovulation will help you get pregnant.

What to do if a girl has a problem in adolescence

When a teenage girl experiences disruptions in her cycle, accompanied by juvenile bleeding—dysfunctional discharge from the uterus—treatment is carried out in two stages.

First, hormonal agents are used, as well as hemostatic drugs - Dicynon, Vikasol.

If the bleeding is quite strong and long, and the girl is bothered by symptoms such as obvious dizziness, passivity and lethargy, and a decrease in hemoglobin levels, a curettage procedure may be prescribed. Then histology of the scraping is performed.

The doctor can prescribe hormonal medications (Novinet, Mercilon), but only if the hemoglobin level is not lower than 80 g/l.

If necessary, therapy against iron deficiency anemia will be carried out (blood transfusion, red blood cells, rheopolyglucin). Iron-containing medications are prescribed.

In adolescence, the duration of taking hormonal drugs should not exceed three months. Anemia therapy is carried out until hemoglobin values ​​are normalized.

For mild disorders, therapy using vitamins according to the phases of the cycle is used. In this case, the drugs are taken according to the regimen prescribed by the doctor to stimulate the production of hormones in the ovaries. Such treatment involves taking B vitamins in the first phase of the menstrual cycle, and vitamins A, C, E, and folic acid in the second.

What should a girl do if the problem appears during childbearing years?

In this situation, the treatment regimen will be similar to the treatment of menstrual disorders in a teenager. Regardless of age, if there is severe bleeding, a curettage procedure is performed. This is done for both diagnostic and treatment purposes.

Then therapy is carried out using hormonal agents. The woman will have to take combined oral contraceptives according to the standard regimen. Directly in case of an incomplete second phase of the cycle, the doctor may prescribe products containing progesterone - Duphaston or Utrozhestan.

Since cycle disorders can cause the impossibility of conceiving, women of reproductive age are sometimes prescribed Pergonal or Choriogonin - medications whose action is aimed at stimulating the formation of active follicles. Clomiphene is prescribed to stimulate ovulation.

How to treat bleeding during menopause

If severe bleeding is observed during menopause, the woman must have the uterine cavity scraped out, since this phenomenon can signal dangerous diseases, including the occurrence of atypical hyperplasia, as well as the development of a cancerous tumor.

In severe cases, the doctor may decide to perform a hysterectomy, a gynecological operation during which the uterus is removed. The procedure is usually performed for a malignant tumor of the uterus, as well as the cervix or ovary.

Folk remedies

Menstrual disorders can be treated using traditional medicine. However, before using them, you should consult your doctor.

The choice of remedy will depend on the type of disorder:

1. For rare menstruation (oligomenorrhea), a remedy is used that is prepared as follows: ½ tsp. Grind parsley seeds to a powder. Drink three times a day with half a mug of clean water to which a little honey has been added.
2. In the absence of menstruation for a long time, for example, during several menstrual cycles (amenorrhea), a product based on wormwood is used, which must be thoroughly crushed. Pour the resulting raw material into one cup of boiling water, and then simply place it in a water bath. After 20 minutes, remove from heat, cool and strain. Drink the prepared decoction 100 ml three times a day before meals.
3. If your periods are long (more than 7 days) and abundant (over 100 ml), you can use this recipe: take the following medicinal plants in equal quantities: raspberry leaves, oak bark, cinquefoil, strawberry leaves, yarrow. Next, you need to pour a tablespoon of the resulting mixture into a glass of cooled boiled water. It remains to infuse the medicine for four hours. Then put on the stove, bring to a boil, after 5-7 minutes remove from heat, let cool and strain. Drink the prepared product throughout the day. The duration of the course of therapy is at least five days.
4. A product made from horsetail will also help normalize a long cycle and reduce blood loss. This plant has been used for medicinal purposes since ancient times due to its hemostatic properties. A spoonful of the raw material should be poured with 500 ml of boiling water, left to infuse and then drink only a tablespoon at an interval of two hours until the bleeding stops. Then, for therapeutic purposes, take a spoonful three times a day.
5. For excessively painful menstruation, a herbal mixture consisting of birch leaves, valerian root, mint, buckthorn bark, blackberry leaves, and yarrow helps. So, pour a tablespoon of the composition into 250 ml of boiling water for at least 20-30 minutes. Infuse, strain well, drink a little throughout the day.

Surgery

Surgery in the treatment of menstrual disorders is used extremely rarely and only in the following cases:

• when there is severe bleeding that cannot be stopped by other means;
• if the patient's age is more than 35 years.
• In this situation, a uterine curettage procedure is performed.

Preventive measures

1. Visit a gynecologist for a preventive examination at least once every six months.
2. Carefully observe the rules of personal hygiene.
3. Follow your daily routine (rest in a timely manner, avoid increased stress, eat a balanced diet).
4. Keep a menstrual calendar - this will allow you to detect a failure in a timely manner.
5. Lead an active lifestyle (exercise, walk more in the fresh air).
6. Treat emerging diseases of other systems and internal organs in a timely manner.

Video: 9 reasons for menstrual cycle disruption

Menstrual irregularities can reduce women's performance for a long time and be accompanied by deterioration of reproductive function (miscarriage, infertility), both immediate (bleeding, anemia, asthenia) and long-term (endometrial, ovarian, breast cancer) consequences and complications.

Causes of menstrual irregularities

Disruption of the menstrual cycle is mainly of a secondary nature, i.e., it is a consequence of genital (damage to the regulatory system and target organs of the reproductive system) and extragenital pathology, the impact of various unfavorable factors on the system of neurohumoral regulation of reproductive function.

To the leaders etiological factors Menstrual cycle disorders include:

• disturbances in the restructuring of the hypothalamic-pituitary system during critical periods of development of the female body, especially during puberty;
• diseases of the female genital organs (regulatory, purulent-inflammatory, tumor, trauma, developmental defects);
• extragenital diseases (endocrinopathies, chronic infections, tuberculosis, diseases of the cardiovascular system, hematopoiesis, gastrointestinal tract and liver, metabolic diseases, neuropsychiatric diseases and stress);
• occupational hazards and environmental problems (exposure to chemicals, microwave fields, radioactive radiation, intoxication, sudden climate change, etc.);
• violation of diet and work habits (obesity, starvation, hypovitaminosis, physical fatigue, etc.);
• genetic diseases.

Menstrual irregularities can be caused by other reasons:

• Hormone imbalance. A decrease in progesterone levels in the body is often the cause of hormonal imbalance in the body, which leads to menstrual irregularities.
• Stressful situations. Menstrual irregularities caused by stress are often accompanied by irritability, headaches, and general weakness.
• Genetic predisposition. If your grandmother or mother had problems of this kind, it is quite possible that you inherited such a disorder.
• Lack of vitamins and minerals in the body, exhaustion of the body, painful thinness.
• Climate change.
• Taking any medications may have a side effect in the form of menstrual irregularities.
• Infectious diseases of the genitourinary system.
• Alcohol abuse, smoking.

It should be emphasized that by the time the patient goes to the doctor. The effect of the etiological factor may disappear, but its consequence will remain.

Phases of the menstrual cycle

Follicular phase

The menstrual phase includes the period of menstruation itself, which in total can range from two to six days. The 1st day of menstruation is considered the beginning of the cycle. When the follicular phase begins, menstrual flow stops and hormones of the hypothalamus-pituitary system begin to be actively synthesized. The follicles grow and develop, the ovaries produce estrogens, which stimulate the renewal of the endometrium and prepare the uterus to receive the egg. This period lasts about fourteen days and ends with the release of hormones into the blood that inhibit the activity of follitropins.

Ovulatory phase

During this period, the mature egg leaves the follicle. This is due to a rapid increase in the level of luteotropins. It then penetrates the fallopian tubes, where fertilization directly occurs. If fertilization does not occur, the egg dies within twenty-four hours. On average, the ovulatory period begins on the 14th day of the cycle (if the cycle lasts twenty-eight days). Small deviations are considered normal.

Luteinizing phase

The luteinizing phase is the last phase of MC and usually lasts about sixteen days. During this period, a corpus luteum appears in the follicle, producing progesterone, which promotes the attachment of the fertilized egg to the wall of the uterus. If pregnancy does not occur, the corpus luteum ceases to function, the amount of estrogen and progesterone decreases, which leads to rejection of the epithelial layer, as a result of increased synthesis of prostaglandins. This completes the menstrual cycle.

The processes in the ovary that occur during MC can be presented as follows: menstruation → follicle maturation → ovulation → production of the corpus luteum → completion of the functioning of the corpus luteum.

Regulation of the menstrual cycle

The cerebral cortex, the hypothalamus-pituitary-ovary system, the uterus, vagina, and fallopian tubes take part in the regulation of the menstrual cycle. Before you begin to normalize the MC, you should visit a gynecologist and undergo all the necessary tests. For concomitant inflammatory processes and infectious pathologies, antibiotic treatment and physiotherapy may be prescribed. To strengthen the immune system, it is necessary to take vitamin and mineral complexes, a balanced diet, and giving up bad habits.

Failure of the menstrual cycle

Failure of the menstrual cycle most often occurs in adolescents in the first year or two after the onset of menstruation, in women in the postpartum period (until the end of lactation), and is also one of the main signs of the onset of menopause and the end of fertilization. If the disruption of the menstrual cycle is not associated with any of these reasons, then such a disorder can be triggered by infectious pathologies of the female genital organs, stressful situations, and hormonal problems in the body.

Speaking about the disruption of the menstrual cycle, you should also take into account the duration and intensity of menstrual flow. Thus, excessively abundant discharge may signal the development of a neoplasm in the uterine cavity, or may also be the result of the negative effects of the intrauterine device. A sharp decrease in the contents released during menstruation, as well as a change in the color of the discharge, may indicate the development of a disease such as endometriosis. Any abnormal bleeding from the genital tract may be a sign of an ectopic pregnancy, therefore, if any irregularities occur in the monthly cycle, it is strongly recommended to consult a doctor.

Delayed menstrual cycle

If menstruation does not occur within five days from the date of the expected period, this is considered to be a delay in the menstrual cycle. One of the reasons why menstruation does not occur is pregnancy, so a pregnancy test is the first thing to do if your period is late. If the test turns out to be negative, you should look for the cause in diseases that may have affected the MC and caused its delay. Among them are diseases of a gynecological nature, as well as endocrine and cardiovascular diseases, neurological disorders, infectious pathologies, hormonal changes, lack of vitamins, injuries, stress, overexertion, etc. In adolescence, a delay in the menstrual cycle in the first year or two from the onset of Menstruation is a very common phenomenon, since hormonal levels at this age are not yet stable enough.

Symptoms of menstrual irregularities

Hypomenaprual syndrome is a disorder of the menstrual cycle, which is characterized by a decrease in the volume and duration of menstruation until it stops. It occurs in both preserved and disrupted cycles.

The following forms of hypomenstrual syndrome are distinguished:

• Hypomenorrhea - scanty and short periods.
• Oligomenorrhea - delay of menstruation from 2 to 4 months.
• Opsomenorea - delay of menstruation from 4 to 6 months.
• Amenorrhea is an extreme form of hypomenstrual syndrome, which is the absence of menstruation for 6 months. and more during the reproductive period.

Physiological amenorrhea occurs in girls before puberty, in pregnant and breastfeeding mothers, and in postmenopausal women.

Pathological amenorrhea is divided into primary, when menstruation does not appear in women over 16 years of age, and secondary, when MC does not recover within 6 months. in a previously menstruating woman.

Different types of amenorrhea differ in the reasons that caused them and the level of damage in the reproductive system.

Primary amenorrhea

Menstrual irregularity, which is a lack of factors and mechanisms that ensure the launch of menstrual function. 16-year-old (and possibly 14-year-old) girls who do not have breast development by this age need examination. In girls with normal MC, the mammary gland should have an unchanged structure, regulatory mechanisms (hypothalamic-pituitary axis) should not be impaired.

Secondary amenorrhea

The diagnosis is made in the absence of menstruation for more than 6 months (except pregnancy). As a rule, this condition is caused by disturbances in the activity of the hypothalamic-pituitary axis; the ovaries and endometrium are rarely affected.

Oligomenorrhea

This menstrual cycle disorder occurs in women with irregular sex life, when regular ovulation does not occur. During the reproductive period of life, the most common cause is polycystic ovary syndrome.

Menorrhagia

Heavy blood loss.

Dysmenorrhea

Painful menstruation. 50% of women in the UK report painful periods, 12% very painful ones.

Primary dysmenorrhea- painful menstruation in the absence of an organic cause. This menstrual disorder occurs after the onset of the ovarian cycle shortly after menarche; the pain is cramping in nature, radiating to the lower back and groin, maximum severity in the first 1-2 days of the cycle. Excessive production of prostaglandins stimulates excessive contraction of the uterus, which is accompanied by ischemic pain. A decrease in the production of prostaglandins and, as a consequence, pain is caused by taking prostaglandin inhibitors, for example mefenamic acid, at a dose of 500 mg every 8 hours orally. The pain can be relieved by suppressing ovulation by taking combined contraceptives (dysmenorrhea may be a reason for prescribing contraceptives). The pain decreases somewhat after childbirth when the cervical canal is stretched, but surgical stretching can cause cervical incompetence and is not currently used as a treatment.

Secondary dysmenorrhea caused by pathology of the pelvic organs, for example endometriosis, chronic sepsis; occurs at a late age. It is more constant, observed throughout the entire period and is often combined with deep dyspareuia. The best treatment is to treat the underlying disease. When using intrauterine contraceptives (IUDs), dysmenorrhea intensifies.

Intermenstrual bleeding

Menstrual irregularities that occur in response to the production of estrogen in the middle of the cycle. Other causes: cervical polyp, ectropion, carcinoma; vaginitis; hormonal contraceptives (topically); Navy; complications of pregnancy.

Bleeding after coitus

Causes: cervical trauma, polyps, cervical cancer; vaginitis of various etiologies.

Bleeding after menopause

Menstrual irregularities that occur 6 months after the last menstruation. The cause, until proven otherwise, is considered to be endometrial carcinoma. Other causes: vaginitis (often atrophic); foreign bodies, such as pessaries; cervical or vulvar cancer; endometrial or cervical polyps; withdrawal of estrogen (with hormone replacement therapy for ovarian tumors). The patient may confuse bleeding from the vagina and rectum.

Pain syndrome with a preserved cycle

Pain syndrome with a preserved cycle - cyclic pain observed during ovulation, the luteal phase of MC and at the beginning of menstruation, can be caused by a number of pathological conditions.

Ovarian hyperstimulation syndrome is a pain syndrome that occurs during hormonal drug stimulation of the ovaries, which in some cases requires emergency care.

Types of menstrual dysfunction

The degree of menstrual cycle disturbance is determined by the level and depth of disturbances in the neurohormonal regulation of the MC, as well as changes in the target organs of the reproductive system.

There are various classifications of menstrual cycle disorders: according to the level of damage to the reproductive system (CNS - hypothalamus - pituitary gland - ovaries - target organs), according to etiological factors, according to the clinical picture.

Menstrual cycle disorders are divided into the following groups:

• Algodysmenorrhea, or painful periods, is more common than other disorders, can occur at any age and is observed in approximately half of women. With algodismenorrhea, pain during menstruation is combined with headache, general weakness, nausea, and sometimes vomiting. The pain syndrome usually lasts from several hours to two days.
• Dysmenorrhea. This disorder is characterized by instability of the circulatory system - menstruation can either be significantly delayed or begin earlier than expected.
• Oligomenorrhea is a disorder of the menstrual cycle, which is characterized by a reduction in the duration of menstruation to two or less days. Menstrual flow is usually scanty; the duration of the intermenstrual period can be over thirty-five days.
• Amenorrhea is the absence of menstruation for several cycles.

Treatment of menstrual disorders

Treatment for menstrual irregularities is varied. It can be conservative, surgical or mixed. Often the surgical stage is followed by treatment with sex hormones, which plays a secondary, corrective role. This treatment can be either radical, pathogenetic in nature, completely restoring the menstrual and reproductive functions of the body, or play a palliative, replacement role, creating an artificial illusion of cyclical changes in the body.

Correction of organic disorders of the target organs of the reproductive system is usually achieved surgically. Hormonal therapy is used here only as an adjuvant, for example, after removing synechiae of the uterine cavity. In these patients, oral contraceptives (OCs) are most often used in the form of cyclic courses for 3-4 months.

Surgical removal of gonads containing male germ cells is mandatory in patients with gonadal dysgenesis with karyotype 46XY due to the risk of malignancy. Further treatment is carried out jointly with an endocrinologist.

Hormone replacement therapy (HRT) with sex hormones is prescribed after the end of the patient’s growth (closure of bone growth zones) at the first stage only with estrogens: ethinyl estradiol (microfollin) 1 tablet/day - 20 days with a break of 10 days, or estradiol dipropionate 0.1% solution 1 ml intramuscularly - 1 time every 3 days - 7 injections. After the appearance of menstrual-like discharge, they switch to combined therapy with estrogens and gestagens: microfotlin 1 tablet/day - 18 days, then norethisterone (Norkolut), duphaston, lutenil 2-3 tablets/day - 7 days. Since this therapy is carried out for a long time, for years, breaks of 2-3 months are allowed. after 3-4 cycles of treatment. Similar treatment can be carried out with OCs with a high level of estrogen component - 0.05 mg of ethinyl estradiol (non-ovlon), or with HRT drugs for menopausal disorders (femoston, cycloproginova, divina).

Tumors of the pituitary-hypothalamic region (sellar and suprasellar) are subject to surgical removal, or undergo radiation (proton) therapy, followed by replacement therapy with sex hormones or dopamine analogues.

Hormone replacement therapy is indicated for patients with hyperplasia and tumors of the ovaries and adrenal glands with increased production of sex steroids of various origins, alone or as a postoperative stage of treatment, as well as for post-variectomy syndrome.

The greatest difficulty in the treatment of various forms of amenorrhea is the primary lesion of the ovaries (ovarian amenorrhea). Therapy for the genetic form (premature ovarian failure syndrome) is exclusively palliative (cyclic HRT with sex hormones). Until recently, a similar scheme was proposed for ovarian amenorrhea of ​​autoimmune origin (ovarian resistance syndrome). The frequency of autoimmune oophoritis, according to various authors, ranges from 18 to 70%. In this case, antibodies to ovarian tissue are detected not only in hypergonadotropic amenorrhea, but also in 30% of patients with normogonadotropic amenorrhea. Currently, to relieve the autoimmune block, the use of corticosteroids is recommended: prednisolone 80-100 mg/day (dexamethasone 8-10 mg/day) - 3 days, then 20 mg/day (2 mg/day) - 2 months.

Antigonadotropic drugs (gonadotropin-releasing hormone agonists), prescribed for up to 8 months, can also perform the same role. In the future, if there is an interest in pregnancy, ovulation stimulants (clostilbegit) are prescribed. In patients with hypergonadotropic amenorrhea, the effectiveness of such therapy is extremely low. To prevent estrogen deficiency syndrome, they are advised to use HRT drugs for menopausal disorders (femoston, cycloproginova, divina, trisequence, etc.).

Diseases of the most important endocrine glands of the body, secondary to sexual dysfunction, require treatment primarily from an endocrinologist. Sex hormone therapy is often not required or is of an auxiliary nature. At the same time, in some cases, their parallel administration makes it possible to achieve faster and more stable compensation for the underlying disease (diabetes mellitus). On the other hand, the use of ovarian TPD allows, at the appropriate stage of treatment, to select the optimal dose of the drug for pathogenetic effects both to restore menstrual and reproductive function and to compensate for the underlying disease.

Therapy for stages of hypomenstrual syndrome that are milder than amenorrhea is closely related to the degree of hormonal deficiency of MC. For conservative hormonal therapy of menstrual dysfunction, the following groups of drugs are used.

Menstrual irregularities: treatment

For menstrual irregularities, which are associated with hormonal imbalance and progesterone deficiency, the drug cyclodinone is used. The drug is taken once a day in the morning - one tablet or forty drops at a time, without chewing and washed down with water. The general course of treatment is 3 months. In the treatment of various menstrual disorders, such as algodismenorrhea, amenorrhea, dysmenorrhea, as well as menopause, the drug remens is used. It promotes the normal functioning of the hypothalamus-pituitary-ovarian system and balances hormonal balance. On the first and second days, the drug is taken 10 drops or one tablet eight times a day, and starting from the third day - 10 drops or one tablet three times a day. The duration of treatment is three months.

Modern drugs for drug correction of menstrual dysfunction

In patients with endocrine infertility, additional use of ovulation stimulants is indicated.

As the first stage of treatment for patients with infertility, it is possible to prescribe combined OCs (non-ovlon, triquilar, etc.) in order to achieve a rebound effect (withdrawal syndrome). OCs are used according to the usual contraceptive regimen for 2-3 months. If there is no effect, you should move on to direct ovulation stimulants.

• Antiestrogens - the mechanism of action of AE is based on the temporary blockade of LH-RH receptors of gonadotrophs, the accumulation of LH and FSH in the pituitary gland with the subsequent release of their increased amount into the blood with stimulation of the growth of the dominant follicle.

In the absence of effect from treatment with clostilbegit, stimulation of ovulation with gonadotropins is possible.

• Gonadotropins have a direct stimulating effect on the growth of follicles, their production of estrogens and egg maturation.

Menstrual irregularities cannot be treated with gonadotropins in the following cases:

• hypersensitivity to the drug;
• ovarian cysts;
• uterine fibroids and developmental abnormalities of the genital organs incompatible with pregnancy;
• dysfunctional bleeding;
• oncological diseases;
• pituitary tumors;
• hyperprolactinemia.
• Gn-RH analogues - zoladex, buserelin, etc. - are used to imitate the natural pulse secretion of LH-RH in the body.

It should be remembered that when an artificially induced pregnancy occurs against the background of the use of ovulation stimulants, the mandatory prescription of preserving hormonal therapy at its early, pre-placental stage (progesterone, uterozhestan, duphaston, turinal) is required.

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

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

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

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

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

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

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

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

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

Most common reasons for failure in the menstrual cycle:

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

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

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

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

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

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

Causes of failure in adolescents

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

During the first few years, a teenage girl’s menstrual cycle is just establishing itself. Menstruation may come irregularly, with long intervals between cycles.

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

There is no need to worry too much about such disruptions, since for most women a stable cycle is established only by the age of 18-20 or after the birth of a child. But it is necessary to monitor the situation by regularly visiting gynecologist. To regulate the menstrual cycle, girls are often prescribed light oral contraceptives, which help normalize hormonal levels. Taking pills on your own without consulting a doctor Not recommended so as not to harm the developing organism.

In women of childbearing age

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

Diets, severe weight loss, taking hormonal contraception without a doctor's prescription, abortion pills, inflammatory processes in the pelvic organs - all this becomes cause of failure. In a woman with a stable cycle, deviations from the norm that occur more than once are a reason to immediately consult a doctor and conduct a full examination.

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

After childbirth

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

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

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

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

After 40 years

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

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

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

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

After 50 years

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

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

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

Treatment

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

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

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

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