What is the NMC: the reasons causing this problem. Signs and causes of the development of oligomenorrhea, a method of treating Nmc disease decoding

At a certain period of life, cycle violations occurred, probably, in every woman. Violation of menstruation , which many ladies are used to considering as something ordinary, are in fact a signal of problems with women's health.

What is an NMC in gynecology? This is a disturbed menstrual cycle that happens to women at different times in their lives.

Irregular menstruation - delays or a shorter cycle indicate physical or mental state women. The monthly cycle is the body's biological clock. Failure of their rhythm should alert and cause a visit to a doctor so that diseases are identified in a timely manner. Below we will talk about why the menstrual cycle fails, and what a woman should do in such a situation.

What is the menstrual cycle

It is important to clearly know what is the menstrual cycle in women, and what should be the normal menstrual function.

Menarche , that is, the first menstruation, in girls, occurs in the period from 12 to 14 years. At what age girls start their period depends on their residence. The further south a teenager lives, the earlier menarche occurs. It is important for parents to watch when girls start their periods in order to understand whether the body is developing normally.

At the age of 45 to 55, the menstrual period ends. This period is usually called premenopausal.

During the period of menstruation, the functional layer of the uterine mucosa is rejected as a result of a decrease in production in the body. A woman's monthly cycle is divided into three phases.

• 1st phase , follicular, characterized by production, under the influence of which they ripen follicles ... Of all the follicles, a dominant follicle is subsequently released, from which a mature egg later emerges.
• 2nd phase the menstrual cycle is the shortest phase and lasts about 1 day. At this time, the follicle ruptures, and the egg is released from it. It is important to understand, speaking about what distinguishes the second phase of the menstrual cycle, that this is the time when the egg is ready for fertilization. This is the fertile phase when conception can occur.
• 3 phase , luteal - the period when synthesis begins progesterone corpus luteum, which has arisen at the site of the ruptured follicle. Progesterone prepares the endometrium for the subsequent implantation of a fertilized egg. But if there was no conception, a gradual death of the corpus luteum occurs, the production of progesterone decreases, and the endometrium is gradually rejected, that is, menstruation begins.

If there is a deficiency of progesterone, the production of estrogen is again activated, and the cycle repeats again. For ease of perception, a diagram of phases by day is useful, where all phases of the cycle are indicated and how these phases are called.

Thus, the menstrual cycle is a cyclical change that occurs over a period of time. The normal cycle should be between 21 and 35 days. If there is a deviation in a certain direction for 3-5 days, this cannot be considered a pathology. However, if more significant changes are noted, then the woman should be alerted to why the cycle of menstruation is shortened or it becomes longer.

If a woman has a normal menstrual cyclehow many days the period lasts is a purely individual indicator. The norm for the duration of menstruation is from three to seven days. It is important to take into account, paying attention to the duration, that this condition should not be a very difficult period for a woman. After all, an important characteristic is not only the rate of duration, but also the fact that menstruation should not cause very strong discomfort. During this period, a loss of about 100-140 ml of blood occurs. If there is profuse blood loss or a woman notices that the delay rate has been violated, it is important to immediately consult a gynecologist.

The cycle is regulated at 5 levels.

In fact, the reasons for the violation of the menstrual cycle are very diverse, and there are many of them. Conventionally, the reasons provoking a violation of the menstrual cycle can be divided into three groups:

• The first - this external factorsthat affect the normal cycle. That is, etiological factors affect the cerebral cortex. A woman may note that the cycle has decreased or, conversely, it is longer, if she has dramatically changed the climate, was in a state of prolonged stress, "sat down" on a strict diet, etc.
• The second - a consequence of pathological conditions concerning not only the reproductive system, but also the body as a whole. So, the reasons for the failure of the menstrual cycle after 40 years are often associated with the onset climacteric... However, it is possible that the reasons for the failure of the menstrual cycle after 40 years are due to the presence of health problems in a middle-aged woman.
• Third - the influence of medications. Often the answer to the question of why the menstrual cycle fails is treatment with a number of drugs. A delay or other failure is possible both after the start of taking certain medications, and after they are canceled. We are talking about hormonal contraceptives, anticoagulants, antiplatelet agents, glucocorticoids, etc.

Factors associated with pathological conditions

• Ovarian pathology - we are talking about a violation of the connection between the ovaries and, oncological diseases ovaries, drug stimulation of ovulation, failure of the second phase of the cycle. Also, irregular periods associated with ovarian pathology can be the result of negative occupational exposures, radiation, vibration, chemical influence. The reasons for an irregular menstrual cycle may be associated with surgical interventions on the ovaries, injuries of the genitourinary organs, etc.
• Impaired interaction between hypothalamus and pituitary gland - an irregular cycle may be associated with too active or insufficient release of gonadotropic hormones and releasing factors. Cycle irregularities are sometimes the result of a pituitary or brain tumor, pituitary hemorrhage, or necrosis.
• - if a woman develops endometriosis, both genital and extragenital, the hormonal nature of this disease leads to an imbalance of hormones.
• Disruption of the blood clotting process - hemophilia, other genetic pathologies.
• Curettage of the uterus - The endometrium is damaged if scraping is performed after termination of pregnancy or for the purpose of treatment. As a result, complications may develop - inflammatory processes of the uterus and appendages. Irregular periods after childbirth are also noted.
• Diseases of the liver and gallbladder .
• The appearance of hormone-dependent tumors - oncological processes in the uterus, adrenal glands, mammary gland, thyroid gland.
• in chronic form - the formation of a full-fledged endometrium does not occur.
• Polyps of the uterine mucosa .
• Sharp "jumps" in body weight - both losing weight and provoking irregular periods in adolescents and adult women, since adipose tissue produces estrogens.
• Infectious diseases - can have a negative effect on the ovaries. Moreover, both infections that were transferred in childhood, (for example, or), and genital infections can provoke a failure of menstruation.
• Presence of uterine abnormalities - septum in the uterus, sexual infantilism, etc.
• Endocrine pathology - the causes of irregular periods after 40 years are often associated with it.
• Pathology of the uterus - tumors, hyperplasia.
• Mental illness - epilepsy, etc.
• Having bad habits .
• , hypovitaminosis .
• Chromosomal abnormalities.

What to do with this or that health problem, and how to normalize the cycle, will tell the gynecologist, whom you must visit if your period is "lost".

How can a violation of the cycle manifest itself?

• Amenorrhea - menstruation is absent for six months or more. At primary amenorrhea violations are noted from the moment when the girls started menstruating; in the case of the secondary, violations manifested themselves after a certain period of normal cycles.
• Oligomenorrhea — menstruation occurs once every few months (3-4). After 45 years, similar manifestations can be associated with.
• Opsomenorrhea - scanty menstruation, lasting no more than 1-2 days.
• Polymenorrhea - prolonged periods (more than 7 days) with a normal cycle.
• Hyperpolymenorrhea - there is abundant discharge, but the cycle is normal.
• Menorrhagia - heavy and prolonged menstruation (more than 10 days).
• Metrorrhagia - an irregular appearance of spotting, sometimes they can appear in the middle of the cycle.
• Promenorrhea - Frequent menstruation, in which the cycle is less than three weeks.
• Algomenorrhea - very painful periods, in which a woman becomes disabled. Algomenorrhea can also be primary and secondary.
• - this is the name for any irregularities in the cycle, in which there is pain during menstruation and unpleasant autonomic disorders: unstable mood, vomiting and nausea, etc.

The reason for frequent menstruation, like other disorders described above, may be associated with the most various pathologies... The woman should be alerted to any violations. For example, very frequent menstruation after 40 years may indicate the development of serious diseases.

Cycle irregularities are often observed in adolescents when menstruation begins. This phenomenon is associated with physiological reasons. In girls, the formation of hormonal levels occurs, and this is associated with both the reasons for the short cycle of menstruation and the reasons for delays. In adolescents, the cycle length can be different each time.

The process of formation can last for 1-2 years. But the girl must clearly know how to count the duration of the menstrual cycle in order to track how many days the cycle lasts and whether its gradual formation occurs. This is important not only for those who are already sexually active, but also for girls who need to know the cycle length for hygiene purposes and to monitor their health. Mom must explain to her daughter how to correctly count the cycle of menstruation. An example of such a calculation is also important for a teenager.

There are the following pathological factors that affect the regularity of menstruation in adolescents:

• infections of the brain and membranes;
• traumatic brain injury;
• frequent colds;
• genital infections;
• sclerocystic ovaries.

The fact that young girls practice strict diets, as a result of which not only excessive weight loss, but also hypovitaminosis, violation of menstruation, is noted negatively on the formation of the monthly cycle.

Interestingly, the character traits of adolescents affect the regularity of menstruation.

Doctors identify several more important factors that can affect the formation of the cycle:

• early onset of sexual activity, promiscuous contacts;
• anomalies in the development of the reproductive system;
• the presence of bad habits.

Due to a disturbed menstrual cycle in a teenage girl, a so-called juvenile uterine bleeding ... This condition is characterized by prolonged periods. As a rule, long and heavy periods last more than a week. This leads to anemia and a serious deterioration in a teenager's condition. As a rule, the causes of prolonged periods are associated either with mental stress or infections.

Disrupted cycle in premenopausal women

Treatment of menstrual disorders in adolescents

If a teenage girl has a disturbed menstrual cycle, and the condition is complicated by juvenile bleeding, two-stage therapy is performed.

With prolonged severe bleeding, when the girl is worried about weakness, dizziness, and at the same time she is lowered (up to 70 g / l), the doctor decides on curettage. Then spend histological examination scraping.

Provided that the hemoglobin index is from 80 to 100 g / l, appoint hormonal pills ( , ).

Also, if necessary, carry out antianemic therapy (blood transfusion, erythrocyte mass, infukol, rheopolyglucin). Iron preparations are also prescribed in the treatment regimen.

Teen is assigned hormonal agents for a period not exceeding three months. Treatment for anemia lasts until the hemoglobin count rises to normal.

Treatment of cycle disorders in women of childbearing age

Treatment of menstrual irregularities in this case is similar to the treatment regimen for such disorders in adolescents. As at the age of twenty, and the treatment of menstrual irregularities at 40 years of age with bleeding is carried out by scraping. It is carried out for both diagnostic and therapeutic purposes.

It is important to replenish the circulating blood volume, for which colloidal solutions are used. Antianemic treatment and symptomatic hemostasis are also practiced. Provided that scraping does not work, the doctor may decide about hysterectomy or ablation (burning out) the endometrium.

It is also important to properly treat those concomitant diseases that could provoke a cycle disorder. So, with hypertension, it is important to take prescribed medications, limit the intake of salty, as well as liquids. With liver pathology, you should adhere to the correct diet, take hepatoprotectors.

Some women also practice treatment folk remedies... However, such methods must be practiced very carefully, since there is a risk of missing a serious pathology without consulting a doctor. And even a violation of the menstrual cycle after 45 years, perceived by a woman as the onset of menopause, is the basis for seeking medical attention.

Since cycle failures can be the cause, women of childbearing age, if necessary, are prescribed Choriogonin and Pergonal - drugs to stimulate the development of active follicles. In order to stimulate ovulation, it should be taken.

Bleeding during menopause

With bleeding during menopause, the patient must be prescribed curettage of the uterine cavity. After all, bleeding can indicate serious pathologies, in particular the development atypical hyperplasia or endometrial adenocarcinoma ... Sometimes the doctor may decide to conduct hysterectomy .

Sometimes the patient is prescribed progestogen drugs during menopause: Depo-Provera , , 17-OPK .

In the course of treatment, antiestrogenic agents can also be prescribed - Danazol , Gestrinone , 17a-ethynyl testosterone .

findings

In case of violation of menstruation, the question of how to restore the cycle of menstruation must be urgently addressed by a woman of any age. Those who are interested in how to restore the menstrual cycle with folk remedies should remember that such manifestations are just a symptom of the underlying disease, which must be treated correctly, according to the scheme prescribed by a specialist.

It is not always necessary to take hormonal pills to restore menstruation to eliminate such problems. Sometimes a woman, for whom the question of how to restore the menstrual cycle without hormones, is even helped by changing the daily regimen and dietary habits. For example, obese women are helped by normalizing their weight. And for those who practice very strict diets, it is enough to increase the calorie content of food and overcome the depletion of the body. In any case, if the cycle is "malfunctioning", it is important for both young girls and women with menopause to consult a gynecologist who will tell you how to proceed.

One of the main indicators women's health - menstrual function of the body. Its disorders can manifest itself in the form of oligomenorrhea, which is one of the types (weakening of menstruation) of the syndrome and occurs in 2-3% of women.

Oligomenorrhea is a violation of the menstrual cycle (MMC) in the form of short, less than 2 days, regular spontaneous menstruation with an interval between them from 36 days to six months. Understanding the causes of this syndrome is impossible without a general understanding of the physiological processes of the regulation of menstrual cycles.

Physiology of the regulation of menstrual cycles

Menstrual cycles are repetitive cyclical changes in the female body, especially in various parts of the reproductive system. Its culminating external manifestation is menstruation, which are repeated at a certain interval throughout the reproductive period, except for periods of pregnancy and lactation. Failure of these processes leads to the development of disorders, including oligomenorrhea. After the first menstruation (menarche), which usually appears at 10-12 years of age, the regularity of the cycles can be established for 1-1.5 years.

The normal course and cyclical nature of these processes, accompanied by changes throughout the body, is provided by a single neurohormonal system, consisting of central (uniting) and peripheral effector (executive) structures, as well as intermediate links. In the mechanism of reproductive regulation, 5 levels are conventionally distinguished, which interact with each other in accordance with the principles of positive and negative direct and feedback.

The highest, or first level

It is represented by the cerebral cortex and some other structures of the latter. They are involved in the perception and the corresponding influence on other parts of the reproductive system, depending on the frequency, severity and duration of exposure to external (severe stress, instability of the psychoemotional sphere, etc.) and internal stimuli. In the latter case, this occurs with the help of specific receptors for estrogens, androgens and progesterone. In response to the action of stimuli in these structures of the brain, they are synthesized, released and undergo biochemical transformations biologically active substancesinfluencing the corresponding function of another brain formation - the hypothalamus.

Second level

The hypothalamus, as a neuroendocrine structure, is the second level of regulation. It has the properties of both neurons, which reproduce electrical impulses, and cells that release the hormonal substances liberins (stimulating) and statins (blocking). The activity of the hypothalamus depends both on the regulating influence of the structures of the first level, and on the content of sex hormones in the blood. The hypothalamic gonadotropic liberins are called gonadotropin-releasing hormone (GnRH). Its secretion is genetically programmed and has a circhoral (pulsating) character. The maximum activity of the hypothalamus lasts several minutes, the intervals of activity are from 1 to 3 hours, which is also influenced by the concentration of estradiol in the blood in the luteal or follicular phase of the menstrual cycle.

Third level

The anterior pituitary gland is the third level of neuroendocrine regulation. This part of the brain secretes hormones:

• FSH (follicle-stimulating), which stimulates the growth and maturation of follicles in the ovaries;
• LH (luteinizing), which together with the former promotes the production of progesterone;
• prolactin, which controls the release of progesterone by the corpus luteum into the blood, and also stimulates the growth of the mammary glands and regulates lactation;
• TSH (thyroid-stimulating), STH (somatotropic) and ACTH (adrenocorticotropic).

Only with a balanced secretion of these hormones is it possible for the reproductive system to function adequately, to establish a regular menstrual cycle and the absence of such disorders as oligomenorrhea, etc.

Fourth level

Consists of peripheral endocrine organs, which include the ovaries, thyroid and adrenal glands. The ovaries, in which the follicles grow and mature, sex hormones are synthesized, the corpus luteum is formed, and play the main role. Hormones synthesized in the ovaries are decisive not only in functional changes in the reproductive system itself, but they also have an active effect on metabolic processes in tissues and organs that have receptors for sex hormones, aminopeptides, insulin and glucagon.

The fifth level

Make up the mucous membrane of the vagina, the uterus, especially its mucous membrane (endometrium), in which the cyclic processes are maximally expressed, the fallopian tubes and mammary glands. Cyclic changes in the endometrium, consisting of cell proliferation, secretion and menstruation itself, depend both on the concentration of sex hormones in the blood, and on the state of the tissue receptor apparatus for sex hormones.

These levels form the hypothalamic-pituitary-ovarian axis. The principles of direct and reverse interaction through specific receptors for hormones at all levels ensure the cyclicity and adequate functioning of the reproductive system.

The "direct" connection means the stimulating effect of the hypothalamic region of the brain on the pituitary gland, followed by the synthesis of sex hormones in the ovaries, under "reverse" - the effect of the level of concentration of sex hormones on the hypothalamus and pituitary gland.

One of the main summary indicators that reflects the interaction different levels the axis of the hypothalamus-pituitary-ovaries and the ability to implement the main function of the body's reproductive system is the menstrual cycle. Its nature makes it possible to clinically determine the level of the state of the reproductive system, due to the correct relationships in the hypothalamus-pituitary-ovary system.

Thus, oligomenorrhea-type nmc, like other types of these disorders, can be triggered by factors that cause disorders in the interaction of parts of the neuroendocrine system at one or more levels.

The reasons for the development of oligomenorrhea

Oligomenorrhea can be physiological and pathological in nature. Physiological oligomenorrhea is a disorder that accompanies physiological conditions. It occurs in adolescence, when the formation of the menstrual cycle occurs, and during premenopause, that is, the extinction of the functions of the reproductive system (what is and when the menopause begins, read). In the latter case, it precedes menopausal amenorrhea.

The pathological syndrome differs as:

1. Primary oligomenorrhea - occurs during the formation of the menstrual cycle. In this case, it is an external sign of the beginning of the development of the process, which in the fertile period determines the violation of the neuroendocrine function of the reproductive system of the body. By the end of adolescence, disorders in the hypothalamus-pituitary-ovary system, which are initially functional in nature, acquire relative stability and retain their main features already in childbearing age.
2. Secondary oligomenorrhea - develops after the established normal regular menstrual cycle.

Having an idea of \u200b\u200bthe levels of physiological regulation of the menstrual cycle, it becomes clear that the cause of oligomenorrhea can be any organic or functional disorder at one of the levels. These reasons can be:

1. Anatomical changes in the brain due to trauma, pituitary and other tumors of different nature, Itsenko-Cushing's disease and syndrome.
2. Chronic negative psychogenic stress or severe stressful conditions.
3. Excessive long physical exercise and an abrupt change in climatic or time zone.
4. Sharp infectious diseasescomplicated by neuroinfection, as well as transferred meningitis or encephalitis.
5. Diseases of the endocrine organs (hypothyroidism, pancreatic disease, adrenal tumor, some forms of menopause and).
6. Familial predisposition to reproductive dysfunctions (read more about female infertility).
7. Congenital anomalies the development of the genitals.
8. Metabolic disorders in obesity, rapid body weight loss, unbalanced diet, body weight deficit for a long time.
9. Long-term use of estrogen-containing opioids, metoclopramide (an antiemetic), hallucinogens and some drugs, long-term or inadequate treatment with hormonal (glucocorticosteroids) drugs.
10. Ovarian diseases (,).
11. The cause of oligomenorrhea can be frequent infectious diseases in childhood and adulthood, including chronic inflammatory processes and post-inflammatory changes in the endometrium, as well as tumors, surgical interventions on the uterus and ovaries, trauma (abortion).
12. Diseases of the liver and cardiovascular system (rare).

IN International classification diseases (ICD-10) also introduced such a category as "unspecified oligomenorrhea." It belongs to the class of diseases of the genitourinary system, the block "Non-inflammatory diseases of the female genital organs." This category includes oligomenorrhea, which can be caused by the syndromes of exhaustion, dysgenesis, ovarian hyperinhibition, or immune disorders, covering the humoral and cellular links of immunity and manifested, possibly, by autoimmune oophoritis or other disorders in the ovaries of an unknown cause.

Symptoms of oligomenorrhea

Changes in the nature of bleeding during menstruation and the interval between them are often accompanied by disorders of fat metabolism in the form of overweight (in 80%), the appearance of acne on the face, on the skin of the front and back surfaces chest, development acne, increased oiliness, porosity and cicatricial changes (striae) skin... In 25% of women with this syndrome, there are phenomena of hirsutism, that is, excessive development of hair in the face, abdomen, mammary glands, chest.

In some women, the development of a male physique and a decrease in libido, headaches and dizziness, deviations from the norms of blood pressure indicators, asymmetric blood pressure indicators, numbness of the fingers of the extremities, autonomic disorders, sleep and appetite disorders, tearfulness, irritability, emotional instability are noted.

Diagnostics

The diagnosis of a disease that causes menstrual irregularities is established on the basis of complaints and anamnesis, general objective and gynecological examinations, as well as an assessment of the state of the psychoemotional sphere and neurological state.

Additional methods for diagnosing oligomenorrhea are the definition basal temperature with the construction of a graph, ultrasound and through a vaginal sensor, magnetic resonance imaging of the skull. In addition, laboratory research the content of pituitary hormones (prolactin, follicle-stimulating and luteinizing hormones) and sex hormones (progesterone, estradiol, testosterone) in the blood serum, as well as glucose and cholesterol, the content of 17-ketosteroids in urine (to assess adrenal function) is determined.

Treatment

Treatment of oligomenorrhea consists in the treatment of diseases and correction of pathological conditions, the consequence of which it is. In order to stimulate ovulation, clomiphene or gonadotropic drugs are prescribed according to certain schemes, oral combined contraceptives, urozhestan, parlodel, etc.

Recommendations are given in the plan proper nutrition, drugs with a sedative and, if necessary, antidepressant effect, physiotherapy are prescribed. If brain tumors, pituitary adenomas, and some ovarian diseases are detected, surgical treatment may be recommended.

Timely correction of functional disorders of neuroendocrine regulation can slow down their development or lead to full recovery... In the case of late diagnosis and treatment, functional disorders become irreversible and lead to organic changes in the reproductive organs.

Is it possible to get pregnant with oligomenorrhea?

This largely depends on the reasons for the development of the syndrome. If, at the same time, hormonal disorders occur, there is no ovulation, disorders of rejection and restoration of the uterine mucosa, then naturally, pregnancy becomes impossible. In cases of infantilism, the possibility of pregnancy depends on the degree of uterine hypoplasia, the degree of hormonal functioning of the ovaries, on the presence of concomitant pathological conditions.

According to the data of the World Health Organization for 1985, among all the causes of infertility, 14.7% are accompanied by this type of pathology. Among all infertile women suffering from any irregularities in the menstrual cycle, the frequency of oligomenorrhea is 41.6%. Spontaneous pregnancy occurs in only about 20% of women with this syndrome.

The onset of female puberty is marked by the onset of menstruation. As a rule, in the early years the cycle is unstable, but at the end of the transitional age, it should normally improve. The diagnosis of NMC in gynecology is made quite often, and the reasons for it are various. Violation of the menstrual cycle cannot be ignored, since it reflects the functioning of not only the reproductive system, but also the entire female body.

How do deviations manifest?

The well-coordinated work of the cerebral cortex and the endocrine system ensures the regularity of the cycle, the beginning of which is considered the first day of menstruation. Any failure is not a disease in itself, it only signals a problem. You should not sound the alarm about a one-time minor failure, but the obvious symptoms of NMC should be noted:

• the duration of the cycle goes beyond 21-35 days;
• severe pain before and during menstruation, extending to the lower back, back, hips;
• the total volume of discharge is less than 25 or more than 150 ml;
• the duration of your period is less than 3 or more than 7 days;
• irregular cycle;
• frequent delays with a regular cycle;
• spotting in the middle of the cycle;
• complete cessation of menstruation outside of menopause, pregnancy or lactation.

Often a woman turns to a doctor with a complaint about several problems at once: scanty menstruation, a short cycle, there is no pain or menstruation for six months, but occasionally blood appears. Not always the NMC speaks of any disease, perhaps this is a variant of the norm for a certain woman. But even the most harmless, seemingly, deviation from the norm (especially if the body used to work like a clock) can be a sign of serious problems.

What caused the violations?

One-time delays or other atypical phenomena in menstruation can be caused by:

• stress;
• a long trip with a change in time and climatic zones;
• colds.

If after a month or two the parameters of the cycle do not recover or a different schedule is established, this already speaks of changes in the body that need to be studied.

Among the factors leading to the absence of menstruation (amenorrhea) are:

• a strong decrease in body weight (with a body weight of less than 45 kg, menstruation stops);
• hormonal imbalance due to natural causes;
• hormonal imbalance caused by medication;
• ovarian dysfunction;
• outrageous physical activity;
• nutritional features;
• poisoning, intoxication with poisonous substances;
• genital infections.

Modeless profuse bleeding most often indicates serious diseases, including:

• oncological processes;
• uterine fibroids;
• the appearance of polyps and other neoplasms in the uterus;
• ovarian cysts;
• trauma to the pelvic organs;
• a blood clotting disorder;
• complications after childbirth or termination of pregnancy.

Using an IUD can also increase blood volume.

Diagnostic methods

Since NMC is just a concept that unites many symptoms in gynecology, only a comprehensive examination will help establish the cause:

1. A vaginal swab that will show the presence of pathogenic microorganisms.
2. Bacteriological culture from the cervical canal.
3. A smear for oncocytology.
4. Screening for STIs.
5. Gynecological examination and bimanual examination.
6. Endocrinological examination for detecting malfunctions of the ovaries, thyroid gland, pituitary gland and hypothalamus.
7. Donating blood for hormones.
8. Ultrasound of the pelvic organs.
9. A conversation with the patient, from which the attending physician learns the important moments of her life: the age of the first menstruation, nutrition, physical activity, field of activity, sex life, medication, stress factors.

Danger of NMC

Very often, infertility and cycle disorders are directly related. Disruptions signal health problems. Disorder of the hormonal system interferes with the maturation of eggs, pregnancy does not occur or ends in miscarriage or fading. Sometimes a woman does not pay attention to weakly expressed signs: scanty periods, fluctuating cycle length. This going beyond the norm can also be a consequence of the pathology of the reproductive system.

A timely examination can prevent the development of a serious illness (fibroids, cysts, tumors), detecting it on early stage... Lost time can lead to death or disability.

Hormonal imbalance isn't just about pregnancy problems. A deficiency or excess of a hormone disrupts the work of the whole body, which can lead to weight gain, a decrease in libido, a deterioration in the condition of the skin and hair, an increased growth of body hair, a general loss of strength and depression.

If there is no NMC

Quite often, a woman cannot get pregnant with an ideal cycle. In this case, we are talking about anovulatory menstrual cycle, when the egg does not mature and does not go out into abdominal cavity... Over the years, these cycles become more and more, so the chance of getting pregnant decreases. With suspicion of pathology, the patient is sent for the same examinations as with the NMC, adding the diagnosis of the ovaries for tumors, polycystic, endometriosis, exhaustion.

A decrease in the ovarian reserve can be caused by genetic problems, diseases and operations, intoxication, vaginal dysbiosis, hormonal drugs.

It should be borne in mind that every woman has her own genetically inherent ovarian reserve. Ideally, a woman's ability to conceive persists for 40 years - from puberty to menopause, but many factors can significantly shorten the childbearing period, and menopause occurs 10-20 years earlier than normal.

Treatment of NMC

It is possible to establish a cycle and ovulation only after finding and eliminating the root cause. If examinations of health problems have not shown, then it is possible that the reason for the failure of menstruation lies only in the lifestyle, therefore, treatment is not prescribed. It is enough to change the diet, reduce emotional stress, correct physical activity, proper sleep and rest. In addition, the doctor may prescribe vitamins. If, after the measures taken, the problem is not solved, you will again have to go to the gynecologist for a treatment course.

In case of serious endocrine disorders, there is a need for hormonal treatment, but it can be avoided with minor deviations from the norm. In this case, medicine offers phytotherapy, which gently restores hormonal levels without side effects.

Menstrual pain (in the absence of disease as a cause) is well relieved by breathing techniques, acupuncture and other unconventional methods. Since medication these days is aimed at relieving cramps, alternative ways good because the effect of them lasts a long time. Sometimes psychotherapy sessions help. Positive results are achieved and folk methods, but only after discussion with the gynecologist.

Oral contraceptives as a method of correction of NMC are prescribed by a gynecologist-endocrinologist strictly according to indications, are selected individually, the treatment process is controlled. To prevent weight gain, the doctor prescribes a diet for the period of taking OK.

For the treatment of genital infections, antibiotics and drugs that restore the vaginal microflora are prescribed. In some cases, you will need surgical intervention or complex therapy in a hospital.

We should also say about working with anovulatory cycles. The number of eggs in the body cannot be increased, and artificial stimulation will only lead to early depletion, so this method is used only when infertility is diagnosed.

findings

NMC is possible throughout the entire reproductive period. it wide range symptoms indicating a malfunction of the female body. It's believed that modern women are increasingly faced with problems such as infertility and hormonal disruption due to the deterioration of the environment and the quality of food, the emergence of electronic technology, medication and reduced physical activity.

Prevention of NMC is based on two rules:

1. Avoiding anything that can compromise health.
2. Regular visits to the gynecologist and tests.

Life is stressful. Therefore, the problem of NMC is often solved after eliminating the harmful factor from life. The body begins to work in full force, given to it by nature. You must accept the fact that you may need medication or surgical careand the sooner the better.

Menstrual irregularities can occur at any age. The reproductive period of a woman is no exception. Violation of the menstrual cycle in the reproductive period is caused by various factors. Even if a woman in adolescence did not have any problems with menstrual function, then in the reproductive period she should definitely consult a doctor in order to eliminate the cause that led to the failure of the menstrual cycle and restore fertility. The main cycle disorder in reproductive age, as in all other ages, is dysfunctional uterine bleeding.

What is the reproductive period

The reproductive period, or puberty, is a woman's age between 18 and 45. It is at this time that a woman is considered functionally mature and possesses fertility (that is, the ability to bear children). In addition, during the reproductive period, the menstrual cycle is regular and steady.

Causes of menstrual irregularities in the reproductive period

Cause of violation menstrual function in the reproductive period are disorders in the hypothalamic-pituitary-ovarian system, which leads to anovulation. The factors causing these disorders can be hormonal homeostasis disorders (abortion), diseases of the endocrine glands (adrenal glands, thyroid and others), neuroendocrine diseases (Itsenko-Cushing's disease, postpartum obesity), emotional and mental stress, infections, intoxication, intake drugs (for example, antipsychotics).

Mechanism of violation

Dysfunctional menstrual irregularities uterine bleeding in reproductive age is most often associated with persistence of follicles in the ovaries and excess production of estrogen. Since ovulation does not occur and the corpus luteum does not form, a progesterone deficiency state is formed. As a result, there is absolute hyperestrogenism. As a result, the proliferation time of the endometrium and its intensity are lengthened. Ultimately, hyperplastic processes (endometrial hyperplasia) develop in the uterine mucosa. During uterine bleeding, areas of hyperplastic endometrium with foci of necrosis are rejected, which is the result of vasodilation, thrombosis and internal hemorrhages.

Clinical picture

Dysfunctional uterine bleeding in the reproductive period is irregular (acyclic) and begins after a delay in menstruation from one and a half to six months. Bleeding is usually very intense and prolonged. As a result of such bleeding, a woman develops weakness, headaches, fatigue, and decreases blood pressure and the heartbeat increases. In addition, the patient develops anemia.

Diagnosis of menstrual irregularities

The diagnosis of dysfunctional uterine bleeding at reproductive age is not difficult. After a thorough collection of complaints and anamnesis, a possible gynecological pathology (remains of the ovum, uterine fibroids, ectopic pregnancy And so on). Then a gynecological examination and diagnostic curettage are performed the uterine cavity under the control of hysteroscopy. Repeated hysteroscopy is performed five to six days after the surgical procedure. The role of ultrasound of the pelvic organs is no less important in the diagnosis of bleeding. ... Ultrasound of the genitals allows you to identify myomatous nodes, assess the thickness and structure of the endometrium, and determine the foci of adenomyosis.

Opsomenorrhea is a violation of the menstrual cycle, characterized by its lengthening up to 36 days or more.

To avoid dangerous complications, it is very important to diagnose pathology in a timely manner and undergo a course of treatment. You can make an appointment with a doctor by calling the phone number listed on the website or using the appointment button.

NMC (menstrual irregularities) of the type of opsomenorrhea often occurs in girls after the onset of menarche, as well as in women in the premenopausal period.

Menstruation with opsomenorrhea can be both regular and irregular. In this case, the volume of discharge can be either normal or less or more in volume. Lean menstruation, lasting no more than 2 days, along with an increase in the duration of the menstrual cycle, are signs of hypomenstrual syndrome. Abundant rare menstruation may indicate follicle persistence.

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Causes of opsomenorrhea

Opsomenorrhea-type NMC can develop for various reasons.

• Genital infantilism
• Chronic infectious diseases (mainly pathological processes in genitourinary system)
• Severe cardiovascular disease
• Severe diseases of the hematopoietic system
• Disruption of the hypothalamic-pituitary system
• Autoimmune processes
• Volumetric formations in the brain
• Sheehan's syndrome
• Injuries to the organs of the reproductive system, surgical interventions in the uterus and ovaries, artificial termination of pregnancy

NMC by the type of opsomenorrhea in a two-phase and monophasic cycle

Long periods of honey with menstruation can occur both with a normal biphasic and with a single-phase menstrual cycle:

• Biphasic menstrual cycle with lengthening of the follicular phase with the normal duration of the luteal phase. With insufficient secretion of FSH by the pituitary gland, follicles need more time for growth and development, and the release of a mature egg from the ovary is carried out on the 17-30th day, while on average ovulation occurs on the 14th day.
• Biphasic menstrual cycle with lengthening of the follicular and shortening of the luteal phase of the cycle. As in the first case, ovulation occurs later than usual due to insufficient production of follicle-stimulating hormone. In addition, in the second phase of the cycle, the corpus luteum hypofunction ( endocrine gland, developing at the site of a ruptured follicle, which secretes progesterone and estrogens within 2 weeks after ovulation in the event that fertilization has not occurred), that is, luteal insufficiency develops.
• Monophasic menstrual cycle. In this case, the persistence of the follicle can become the cause of opsomenorrhea. If normally the dominant follicle ruptures and a mature egg comes out of it, then in this case it continues to exist for some time. Thus, the ovaries can simultaneously contain several follicles that actively produce estrogens. Prolonged high concentration of estrogens causes excessive growth of the functional layer of the uterine mucosa. After the follicles begin to undergo a reverse development, and the level of estrogen falls, the rejection of the hyperplastic endometrium begins. In addition, congenital underdevelopment of the reproductive system can become the cause of opsomenorrhea in a monophasic cycle.

Diagnosis of opsomenorrhea

Rare menstruation is a serious reason for contacting a specialist, since it cannot be ruled out in the future that they completely stop and that infertility develops. The following methods can be used to identify the causes of opsomenorrhea:

• Taking anamnesis
• Examination by an obstetrician-gynecologist (including a bimanual examination to detect the presence of anomalies in the development of reproductive organs)
• Ultrasound of the pelvic organs
• Tests for hormones (sex hormones, thyroid hormones)
• STI tests
• Consultation with an endocrinologist and other related specialists

The scope of research, if necessary, can be expanded for each patient on an individual basis.

Opsomenorrhea treatment

Treatment of NMC by the type of opsomenorrhea depends on the reasons for its development and is based on the results of the examination. So, opsomenorrhea is often detected in patients with polycystic ovary disease and, accordingly, PCOS treatment will be required. The presence of tumors in the brain is an indication for surgical intervention... If sexual infantilism is detected, therapy for the underdevelopment of the organs of the reproductive system will be required, which depends on the severity of the pathology.

Opsomenorrhea and infertility

Since a significant increase in the duration of the menstrual cycle, as a rule, indicates a malfunction in the functioning of the reproductive system, it is necessary to consult a specialist in a timely manner and undergo a complete examination.

If you have any questions related to opsomenorrhea, you can ask the doctors of Nova Clinic. You can make an appointment with a doctor by calling the phone number listed on the website or using the appointment button.

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