Failure of the menstrual cycle treatment. Violation of the menstrual cycle: causes, treatment, traditional medicine for violations of the MC

Violations of the normal menstrual cycle can happen in the life of every woman. Not always such a situation, for example, a delay in menstruation, is a harbinger of pathology, since in most cases it signals the onset of pregnancy. A physiological cycle is considered to be 21-35 days long. That is, 21, and 28, and even 31 days of cycle duration is the norm, it all depends on the individual characteristics of the woman's body.

A violation of the menstrual cycle is considered to be a delay lasting more than 10 days, as well as a reduction in duration (from 5 days or more), which are systematic. There are women who have a genetically determined long cycle, which is not a pathology, that is, there have already been similar cases in the family. The same applies to bloody discharge during the period observed 2 weeks before the onset of menstruation.

Causes of menstrual irregularities

The female menstrual cycle is a very complex system that includes many important biochemical processes. In particular, the cerebral cortex, endocrine glands (adrenal glands, thyroid gland, ovaries), subcortical centers take part in the regulation of the process. This means that any disruption in the functioning of these systems can cause disruptions in the female cycle. But sometimes this reason can also lie in serious pathologies of various organs (tumor,).

Such pathologies of the endocrine organs can lead to cycle disorders, such as:

  • inflammatory process in the ovaries;
  • deficit;
  • untimely release of a mature follicle;
  • ovarian hypoplasia;
  • pathology of the uterus of inflammatory origin;
  • polycystic ovaries.

Causes of menstrual disorders from the cerebral cortex:

  • change of time zone;
  • in a woman in the early morning hours, when hormones-regulators of the cycle are actively secreted;
  • very strong stress shock.

Causes of violations of the MC from the subcortical centers (hypothalamus, pituitary gland):

  • pituitary adenoma;
  • neuroinfections of viral origin;
  • other tumors.

Causes of failure of the menstrual cycle from other organs and systems:

  • thyroid pathology;
  • problems in the work of the adrenal glands;
  • taking certain medications.

Symptoms of menstrual disorders

Violations of the monthly cycle can be manifested by a set of a wide variety of symptoms. In this case, the duration of menstruation, the nature of the discharge, pain, etc., change.

The main symptoms of disorders in various diseases:

  • Hyperpolymenorrhea- a state when very abundant discharges are observed during menstruation, but the cycle itself does not change.
  • Amenorrhea- absence of menstruation for 6 months or more. It can be primary and secondary, the first is characterized by a violation of the cycle from the moment of menarche, and the second after normal menstruation. There is also physiological amenorrhea, which is observed in healthy women during pregnancy and lactation. In all other cases, you should definitely visit a doctor.
  • Opsomenorrhea- a cycle in which there is very little spotting and menstruation lasts 1 or 2 days.
  • Oligoamenorrhea- A woman's period occurs 1 time in 3 or 4 months, that is, rarely. This can be a pretty serious symptom that indicates the presence of polycystic ovaries. Especially if such additional signs are observed as enlarged ovaries (during a bimanual examination), hirsutism (excessive body hair).
  • . In this case, there is an unstable menstrual cycle, when menstruation is delayed or comes ahead of schedule. Usually observed in those who often change time zones and climate (stewardesses, for example). Acclimatization in this case will bring everything back to normal.
  • Menorrhagia. This violation is characterized by a rather long and abundant course of menstruation - 10 days or more.
  • . This is a fairly common problem faced by many girls and women. The main symptoms with such a violation of the menstrual cycle is a cycle failure, accompanied by pain in the lower abdomen, often of a aching nature. In this case, there are problems in the work of the intestines,. Such a symptom complex can be observed from the age of 14 and disturb the patient all her life. Sometimes it disappears after the onset of sexual activity or childbirth, but not always. In some cases, this condition is a sign or.
  • Proyomenorrhea- menstruation occurs earlier than after 21 days (the shortest physiological cycle).
  • metrorrhagia- the appearance of spotting, both during menstruation and in the middle of the cycle.
  • Algomenorrhea- a condition in which a woman suffers from very painful and heavy menstruation, because of which she cannot work normally, as her general well-being is disturbed. The regularity of the cycle is not violated.

Each of the above conditions requires a visit to the gynecologist, examination, passing the necessary tests to establish and clarify the diagnosis. Therefore, if you experience the above symptoms, you should not postpone the appointment with a specialist.

In what cases should you seek medical help

In no case should you postpone contacting a specialist if:

  • there is a regular violation of the cycle, that is, it becomes shorter or longer by 5-7 days;
  • there is no menarche in a girl aged 15 years;
  • there are profuse periods, reminiscent of bleeding. Normally, no more than 250 ml of blood should be lost during the period of one menstruation. Anything more is a symptom of a hormonal imbalance that requires drug therapy;
  • a year or two after the start of menstruation, the cycle was not established;
  • there is a presence of spotting in the period before and after the menstruation itself. Often such a symptom indicates;
  • have pain during ovulation. This condition is dangerous with the possibility of rupture of the ovary and is easily stopped by medications that the doctor selects.

Treatment of menstrual irregularities

Therapy in this case depends on the age of the patient, since there are a number of causes of cycle disorders that are characteristic of a particular age group.

Treatment of menstrual disorders in women of reproductive age

In this category of patients, bleeding is often observed: in the period between menstruation, profuse, painful, etc. At the same time, diagnostic curettage is necessarily carried out in order to stop the bleeding and determine the cause of the condition (the resulting material is sent for histological examination).


Treatment of MC failures in adolescent girls

Bleeding that opens in girls in adolescence is called juvenile. Such menstrual irregularities are necessarily subject to treatment, carried out in several stages.

This applies:

  • Hemostasis, that is, stopping bleeding on the basis of hemostatic (Vikasol, Dicinon) and hormonal agents.
  • Scraping- performed in case of blood loss, complicated by dizziness, general weakness, very low hemoglobin (below 70).
  • Reception. They are prescribed for hemoglobin 80 - 100 g / l, while using only hormonal combined preparations with a low dosage of hormones (Novinet, Mercilon, Marvelon).
  • Antianemic treatment. It includes the infusion of erythrocyte mass, rheopolyglucin, blood transfusion, Tardiferon, Sorbifer.
  • vitamin therapy- reception, Pentovita, Aevita.

Hormone treatment lasts at least 3 months, taken until the normalization of hemoglobin.

Treatment of menstrual disorders in women with menopause

With bleeding during menopause, curettage of the uterine cavity is mandatory, because such disorders are often a sign of pathologies of the female genital area (endometrial hyperplasia, adenocarcinoma, adenomyosis). At the same time, a histological examination of the obtained material during scraping is shown. In some cases, if indicated, the uterus can be removed.

A number of problems are treated by taking hormonal drugs, among which are most often prescribed:

  • Gestrinone;
  • 17-OPK;
  • Danazol.

Treatment of menstrual disorders in women at any age should be accompanied by:

  • normalization of sleep and wakefulness,
  • complete nutrition,
  • stabilization of the psycho-emotional state,
  • normalization of weight (this applies to both overweight and excessively thin women).

Traditional medicine for menstrual irregularities

Alternative treatment is selected based on the type of violation.

Recipes for oligomenorrhea

For rare periods, the following medicine is used: half a teaspoon of parsley seeds is ground into powder and taken three times a day, washed down with ½ glass of water with a spoonful of honey.

Traditional medicine for amenorrhea

Pour 1 tbsp of chopped wormwood with 200 ml of boiling water. Soak the broth in a water bath for 15 minutes, let cool, strain. It is taken before meals 1/3 glass 3 times a day.

Remedies for menorrhagia


With excessively heavy periods, a collection is used, which includes such herbs, taken in equal proportions:

  • yarrow;
  • Oak bark;
  • raspberries (leaves);
  • goose cinquefoil;
  • strawberries (leaves).

1 st. l of such a mixture is poured with 200 ml of cold boiling water and infused for 4 hours, after which the infusion should be boiled for 5 minutes and drained. Ready broth is taken during the day in a course of 5-8 days.

Folk recipes for such a violation of the menstrual cycle as algomenorrhea

If a woman is worried about pain during menstruation, then the following collection will help, which includes:

  • buckthorn (bark),
  • birch (leaves),
  • blackberry (leaves)
  • yarrow and mint.

A spoonful of this mixture is poured with a glass of boiling water, infused, filtered and drunk throughout the day.

Traditional medicine for menorrhagia

Horsetail has been used for centuries as a hemostatic agent in the treatment of bleeding women. One spoonful of this herb is poured with 0.5 liters of boiling water, insisted and taken 1 tbsp. l every 2 hours until the bleeding stops. Further for medicinal purposes - 1 liter three times a day.

You can learn more about what tests are needed for menstrual irregularities from the video:

Betsik Julia, obstetrician-gynecologist

Ovarian-menstrual cycle disorders (OMMC) are perhaps the most common reason for visiting a gynecologist. Moreover, such complaints can be made by patients aged from puberty to the premenopausal period - that is, during the entire potentially reproductive phase of life.

What cycle is considered normal?

The external manifestation of the natural ovarian-menstrual cycle is menstruation, which occurs with a frequency characteristic of every woman and most often lasts 3-6 days. At this time, the entire overgrown functional layer of the endometrium (uterine mucosa) is rejected. Together with the blood, its fragments exit through the slightly opening cervical canal into the vagina and then out. Peristaltic contractions of its walls contribute to the natural cleansing of the uterine cavity, which can cause some physical discomfort.

The gaping vessels after tissue rejection quickly close, the resulting total defect of the mucous membrane regenerates. Therefore, normal menstruation is not accompanied by significant blood loss and does not lead to the development of anemia, severe asthenia and disability. The average volume of blood loss is up to 150 ml, while there are no blood clots in the secretions.

But the menstrual cycle is not only the stage of endometrial renewal. Normally, it also includes the follicular phase with the maturation of the egg in the ovary, and the subsequent secretory phase with the growth of the endometrium and its preparation for the potential implantation of the fetal egg. A healthy woman of reproductive age also has anovulatory cycles, which is not considered a pathology. They normally do not lead to a change in the duration or nature of menstruation and do not affect the duration of the intermenstrual interval. In such cycles, a woman is not fertile, that is, she cannot become pregnant.

Menstruation begins at puberty. Their appearance indicates the readiness of the reproductive system for conception. The first menstruation (menarche) is observed at the age of 9-15 years, most often between 12 and 14 years. It depends on many factors, the main of which are heredity, nationality, general health, nutritional adequacy of the girl.

The end of the reproductive period is characterized by the onset - the complete and final cessation of menstruation. This is preceded by menopause, which normally occurs at an average of 46-50 years.

NOMC Development Mechanism

The ovarian-menstrual cycle in the female body is an endocrine-dependent process. Therefore, the main cause of its violations is dishormonal disorders. They can initially arise at different levels, including with the involvement of seemingly non-reproductive glands of internal secretion. This is the basis for the classification of menstrual disorders. According to her, they distinguish:

  • Central disorders with damage to the higher centers of neuroendocrine regulation of the reproductive system. Cortical-hypothalamic, hypothalamic-pituitary and only pituitary structures can be involved in the pathological process.
  • Violations at the level of peripheral structures, that is, the organs of the reproductive system itself. Can be ovarian and uterine origin.
  • Disorders associated with dysfunction of other endocrine glands (adrenal glands, thyroid gland).
  • Disorders caused by genetic and chromosomal abnormalities with congenital hyper- or hypoplasia of organs, a violation of the secretion of key biologically active substances and a disorder of the so-called feedback between peripheral organs and neuroendocrine structures.

Failures at any level will eventually show up in different types of NOMC. After all, hormonal imbalance leads to a change in the functioning of the ovaries, even if they do not have structural abnormalities. A natural consequence of this is a violation of the secretion of the main sex hormones (estrogen and progesterone). And their main target is the functional layer of the mucous membrane of the uterus, it is he who is rejected with blood at the end of the next cycle. Therefore, any dishormonal changes in the body can lead to a violation of the nature and regularity of menstruation.

Endocrine pathology is the main cause of menstrual dysfunction. Only in a fairly small percentage of cases it is not caused by hormonal disorders. Violations of the menstrual cycle can be caused, for example, by pronounced changes in the endometrium. And sometimes false amenorrhea is diagnosed, when menstrual blood and sloughing endometrium are unable to exit naturally due to vaginal atresia or complete infection of its outlet with the hymen.

Causes of dysfunction

There are many reasons for the appearance of menstrual dysfunction. Moreover, a woman can have several etiological factors simultaneously, leading to functional failures at various levels.

The most likely ones are:

  • Various types of pituitary adenomas (acidophilic, basophilic, chromophobic), which can be hormonally active or lead to compression and atrophy of the adenohypophysis. Disease and Itsenko-Cushing's syndrome.
  • Taking drugs that affect the synthesis and metabolism of dopamine and norepinephrine in brain structures, which leads to dysfunction of the hypothalamic-pituitary system. These include reserpine, MAO inhibitors, typical and atypical antipsychotics, antidepressants of various groups, metoclopramide, phenothiazine derivatives, and a number of other drugs.
  • Adrenal adenomas and other tumors that produce androgens and cortisol. Adrenogenital syndrome due to congenital hyperplasia of the adrenal tissue.
  • Some mental disorders accompanied by a violation of the central neuroendocrine regulation. These can be moderate and severe depressive states of various origins, endogenous diseases (schizophrenia) in the acute stage, anorexia nervosa, reactive disorders, and adaptation disorders during chronic stress.
  • Hypo- or hyperthyroidism of various origins.
  • (Stein-Leventhal).
  • Suppression of ovarian function and impaired feedback between them and the hypothalamic-pituitary system after long-term use of COCs and their abrupt withdrawal.
  • and premature gonadal wasting syndrome. They can also have an iatrogenic genesis, for example, due to the repeated participation of a woman in protocols of assisted reproductive technologies with hyperovulation stimulation.
  • Sharp non-physiological changes in the hormonal background, which can be caused by spontaneous or medical abortion, taking drugs to quickly suppress lactation.
  • Malformations and anomalies in the development of the uterus, including those caused by chromosomal diseases.
  • Consequences of surgical interventions on the ovaries and uterus, radiation and chemotherapy, inflammatory diseases of the reproductive organs. This can be a significant decrease in the volume of functioning ovarian tissue, intrauterine synechia up to the development of atresia of the uterine cavity, removal of the gonads and uterus.
  • . Moreover, not only malignant, but also large benign neoplasms with secondary atrophy of the ovarian tissue can have clinical significance.

Violation of the menstrual cycle after 40 years in most cases due to increasing age-related changes in the reproductive system. Their cause is the natural depletion of the ovarian follicular reserve with an increase in the number of anovulatory cycles, progressive hypoestrogenism and the extinction of reproductive function. These changes become most pronounced in the premenopausal period, when the cycle becomes more and more irregular with a tendency to and the addition of psychovegetative disorders.

Violation of menstruation in girls of puberty is most often due to uneven maturation of the hypothalamic-pituitary and ovarian systems. But do not forget that it is during this period that the clinical manifestations of some congenital syndromes, chromosomal diseases and anomalies in the development of the internal organs of the reproductive system may debut.

In addition, adolescent girls often have eating disorders with the formation of alimentary deficiency of key nutrients and especially fats. This leads to a pronounced decrease in the synthesis of steroid (including sex) hormones, which is most often manifested by secondary amenorrhea.

Possible manifestations of NOMC

According to the presence of a previous period of normal menstruation, all possible violations can be divided into primary and secondary.

Symptoms of menstrual irregularities may include:

  • Change in the length of the intermenstrual period. Possible proyomenorrhea (with a cycle duration of less than 21 days) and opsomenorrhea (its lengthening over 35 days).
  • Delay of the next menstruation in the absence of previous cycle disorders.
  • Lack of menstruation for 6 or more months () in a woman of reproductive age.
  • Change in the volume of menstrual blood loss. Perhaps both its increase (hypermenorrhea) and decrease (). Excessive blood loss is referred to as menometrorrhagia.
  • Change in the duration of the menstruation itself in the direction of shortening () or lengthening (polymenorrhea).
  • The appearance of intermenstrual bleeding, which can be different in intensity - from spotting to profuse. With acyclic profuse uterine bleeding, the term "metrorrhagia" is used.
  • Clinically significant local pain during menstruation, which is called algomenorrhea.
  • The appearance of general extragenital symptoms accompanying menstruation. These include headaches of a different nature, fluctuations in blood pressure, nausea and changes in appetite, and other vegetatively conditioned manifestations. This condition is referred to as, and when it is combined with a pain syndrome, they speak of algomenorrhea.

Hypermenstrual syndrome with polyhypermenorrhea and/or acyclic dysfunctional uterine bleeding is usually the cause of chronic posthemorrhagic iron deficiency anemia. Her symptoms often become a reason to see a doctor. At the same time, the woman is worried about fatigue, palpitations, general weakness, a tendency to lower blood pressure, fainting is possible. The condition of the skin, hair and nails worsens, a decrease in the productivity of mental activity is possible, up to the development of moderate cognitive impairment.

Many women of reproductive age also experience infertility - the absence of natural conception within 1 year of unprotected regular sex. It is due to severe violations of the allocation of the dominant follicle in one of the ovaries, the process of maturation of the egg in it and the absence of spontaneous ovulation.

It is important to understand that in the presence of anovulatory cycles, a woman may not make any special complaints about menstruation disorders on her own, although a targeted survey in most cases reveals various symptoms. In this case, the patient usually considers the lengthening of the menstrual cycle characteristic of her as her individual feature, and not as a pathological symptom.

Features of menstruation disorders in different age groups

Juvenile period

NOMC in adolescents can proceed according to the type or with a tendency to the so-called juvenile (pubertal) bleeding. The nature of the violations depends on the etiology and existing dyshormonal disorders. Perhaps late menarche or development of primary amenorrhea. It is said that menstruation does not begin by the age of 15.

Juvenile bleeding occurs in anovulatory cycles due to hormonal disturbances in follicle atresia. They usually alternate with uneven periods, often combined with hair loss, underweight or overweight. In this case, a neuro-emotional overstrain, a sharp change in the climatic and time zone, a violation of the sleep-wake cycle can act as a provoking factor.

reproductive period

In the reproductive age, cycle disorders can be manifested by a failure of the cycle, a delay in the next menstruation, followed by bleeding. At the same time, physiological changes should be distinguished from pathological ones. Normally, the temporary disappearance of menstruation may be due to the onset of pregnancy, the postpartum period and against the background of breastfeeding. In addition, a change in the cycle and nature of menstrual flow occurs against the background of the use of hormonal contraception and after the installation of intrauterine devices.

The lengthening of the cycle is most often due to the persistence of the follicle. In this case, ovulation of a mature egg does not occur. It dies, and the follicle continues to grow in size with the formation of various sizes. In this case, the hormonal background corresponds to the 1st phase of the cycle with hyperestrogenism, which leads to a progressive growth of the endometrium. In this case, the delay in menstruation can reach 6-8 weeks, after which metrorrhagia occurs. Such uterine bleeding is classified as dysfunctional. Another reason for their development is the insufficiency of the luteal phase. In this case, bleeding occurs during the ovulatory period, they are usually not heavy, but protracted.

Changes in the ovaries during a typical menstrual cycle

There may also be menstrual irregularities after an abortion. It can be spontaneous (with spontaneous termination of pregnancy in the early stages) or medical using various methods of removal of the ovum / embryo. In this case, a lengthening of the subsequent cycle is usually noted, and the restoration of menstrual function is expected within 3 months. If the abortion was accompanied by complications, a protracted rehabilitation period with acyclic bloody discharge, algomenorrhea is not excluded.

Premenopausal period and menopause

Most often, failures of the normal cycle of menstruation occur in premenopausal age. The extinction of the reproductive function is often accompanied by a significant increase in anovulatory cycles, a tendency to delays and bleeding against the background of follicle atresia, loss of cyclic changes and the development of the so-called.

The resumption of uterine bleeding in menopause is an extremely alarming sign. After all, the restoration of reproductive function is no longer possible, and blood smearing and bleeding during this period usually indicate the presence of a malignant tumor.

Possibility of pregnancy

Pregnancy with a violation of the menstrual cycle is possible. But the probability of its occurrence depends on the severity of dyshormonal disorders, the full development of the uterus and many other factors. In many cases, menstrual disorders are accompanied by infertility. And it is not always possible to eliminate it by conservative methods, often the onset of pregnancy is possible only with the help of assisted reproductive technologies. And sometimes a woman cannot conceive and carry a child on her own. In this case, she is offered the services of a surrogate mother and donor programs.

In addition, we should not forget that endocrine disorders often lead to inferiority of the functional layer of the endometrium and thus make it difficult for the normal implantation of the fetal egg. This, coupled with insufficient production of progesterone and hCG, significantly increases the risk of abortion at very early and early stages. At the same time, a woman may not be aware of conception, regarding the onset of a delay in menstruation as another dysfunction.

Prior menstrual dysfunction is considered a potentially complicating factor in pregnancy. Such women require special attention. Often, for the prolongation of pregnancy, they need to take certain hormonal drugs. According to statistics, in a number of women after childbirth, menstrual irregularities are independently corrected (about the timing of menstruation recovery, in our article on). And subsequent pregnancies can occur without much difficulty.

Survey

In most cases, NOMCs have a favorable prognosis, as they are caused by changes that are not life-threatening for a woman. But we should not forget that up to 10% of cases are oncogynecological diseases of various localization. Therefore, the diagnosis of such a condition requires a thorough examination to establish the true cause of menstrual dysfunction, to determine the nature and severity of the existing changes. It is this tactic that will allow you to choose the optimal corrective therapy or timely conduct radical treatment.

The baseline examination should include:

  • Careful collection of an obstetric and gynecological history, specifying the time of the appearance of complaints, a possible connection with any factors, the fact of pre-existing menstrual disorders, the age of menarche (first menstruation) and the likelihood of conception. Be sure to find out past diseases and operations, the number and duration of abortions and childbirth, the course and outcome of previous pregnancies. Also important is the fact of taking any drugs, the nature.
  • Gynecological examination of the vagina and cervix in the mirrors, bimanual palpation of the pelvic organs. At the same time, structural changes in the visible mucous membrane (defects, growths, deformations, discoloration, swelling), varicose transformation of superficial veins, changes in the contours, size, position and consistency of the uterus and appendages can be detected. The nature of the discharge from the vagina and from the cervical canal is also assessed.
  • Taking smears from the walls of the vagina, sponges of the cervical canal, urethra for major urogenital infections (STDs), degree of purity.
  • A smear for oncocytology from the cervix, which is especially important if there are pathological foci on it.
  • Exclusion of pregnancy. To do this, conduct a urinary express test or determine the level of hCG in the blood.
  • Determination of endocrine status. It is necessary to assess the level of the main hormones that regulate the functioning of the ovaries and the menstrual cycle. These include estrogen, progesterone, pituitary hormones - LH (luteinizing), FSH (follicle-stimulating), prolactin. In many cases, it is also advisable to determine the performance of the thyroid gland and adrenal glands, because violations of the functioning of these glands are also reflected in the work of the ovaries.
  • Ultrasound of the pelvic organs. Most often, transvaginal and abdominal sensors are used. This is enough for a complete examination of the uterus and its cervix, appendages, parametric fiber, blood vessels and regional lymph nodes. With a preserved hymen, a rectal sensor is used instead of a vaginal one, if necessary. Ultrasound is the most accessible and at the same time quite informative method of visualization of internal organs.
  • Histological examination of the endometrium obtained by separate diagnostic curettage of the cervix and uterine cavity. This is shown mainly in hypermenstrual syndrome and metrorrhagia.

If there are indications, at the 2nd stage of the examination, high-tech diagnostic techniques (CT, MRI, PET, and others) are used. Most often they are prescribed for suspected oncogynecological pathology.

Principles of treatment

Treatment of menstrual disorders includes several areas:

  • Stop bleeding. For this purpose, hormonal drugs, drugs that affect blood coagulation and uterine contractility, and sometimes curettage can be used.
  • Correction of existing hormonal disorders, which is the prevention of repeated menstrual disorders. The treatment regimen is selected individually, based on the endocrine profile of the patient.
  • Deciding on the appropriateness of surgical treatment to eliminate the main causative factor or correct existing developmental anomalies.
  • If necessary, measures aimed at stimulating the development of the uterus and activating the work of the ovaries. Various physiotherapeutic methods, cyclic vitamin therapy, herbal medicine are widely used.
  • Correction of concomitant disorders (psychovegetative disorders, anemic syndrome, etc.).
  • Correction of received therapy for the underlying disease. For example, when taking psychotropic drugs, it may be recommended to replace them with more modern, narrowly targeted drugs. Of course, the final decision on the correction of therapy is made not by the gynecologist, but by the attending physician (for example, a psychiatrist, a neurologist).
  • If you want to conceive - a comprehensive treatment of infertility using conservative and, if necessary, surgical (endoscopic) techniques, timely decision-making on the advisability of using assisted reproductive technologies.

Menstrual irregularities are a very common problem. And its relevance is not decreasing, despite the achievements of modern medicine. Fortunately, many forms of such disorders can be corrected. And with timely treatment of a woman to a doctor, it is often possible to avoid complications, maintain a high quality of life for patients, and even cope with concomitant diseases.

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

The causes of the violation of the menstrual cycle (as it is sometimes called by the people, the correct name is "menstrual") due to a number of factors, among which the following can be noted:

Hormonal disbalance - Irregular periods may be due to a violation of the functioning of the endocrine system of a woman. With a lack of estrogens, the first phase of the cycle is significantly lengthened, 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, a violation of the production of hormones 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 gonads. They often cause delays and 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 on).

STD - Sexually transmitted diseases. Unlike hormonal disruptions, they can only once cause a violation of the menstrual cycle and completely disappear after treatment.

Most often, infections due to which delays and intermenstrual bleeding occur are gonococci, as well as exacerbation of ureaplasmosis and mycoplasmosis.

Disruption of the pituitary 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 work of these glands can affect the change in the nature of menstruation, both in the direction of their increase and in the direction of decrease.

Physiological age-related changes - this category includes menstrual irregularities in those women who are over 40. The reserve 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 the irregularity of menstruation.

Different causes of menstrual irregularities can affect the appearance of menstruation in different ways. Therefore, dysfunction of the reproductive system can be divided into two types depending on the frequency and nature of bleeding.

Types of menstrual irregularities by frequency:

  • Polymenorrhea - involves a short cycle, less than 22 days. It is characterized by the frequent absence of ovulation and insufficiency of the corpus luteum, in cases where the maturation of the egg does occur. Polymenorrhea can mean both a single-phase and a two-phase cycle. However, in a biphasic, there is usually a failure of the first or second phase, or both at once.
  • Oligomenorrhea - involves the onset of menstruation at intervals of 40 to 90 days. This is the most common type of menstrual irregularity, it most often becomes its cause. Often, before the start of such menstruation, spotting is observed for 2-3 days.
  • - suggests menstrual bleeding, which occurs at intervals of once every 3 or more months. Most often occurs with increased physical exertion, depletion of the ovarian reserve, stress and overweight.

Types of menstrual disorders according to the nature of bleeding:

  • - characterized by spotting spotting, the duration of which does not exceed 3 days. Such periods are painless, not accompanied by general weakness and do not have a pronounced premenstrual syndrome.
  • Abundant menstruation - characterized by large blood loss, strong (especially a few hours before menstruation and in the first hours after they start). They often have a pronounced premenstrual syndrome and a duration of at least 6 to 7 days.
  • Intermenstrual bleeding - characterized by spotting bleeding that appears in the middle of the cycle and lasts 2-3 days. Do not confuse them with spotting, provoked by ovulation. The release of the egg from the follicle may contribute to the appearance of only a few drops of blood, which are expressed in the form of mild light brown one-day discharge. Intermenstrual bleeding is more abundant and has a bright color.
  • Premenstrual bleeding - characterized by the appearance a few days before menstruation. Usually they intensify and develop into menstruation. They are a characteristic symptom of endometriosis.
  • Postmenstrual bleeding - characterized by the presence of spotting spotting, which are observed for several days after the cessation of menstruation and gradually disappear. They are a sign of chronic.

Any of these types of menstrual irregularities can occur in a woman aged 40 to 45 years with the onset of menopause. Bleeding sometimes becomes scarce 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 will be dangerous to health.

  • Anemia - may be due to too heavy periods. Its risk is especially high in the case when bleeding is frequent, with an interval of 2 to 3 weeks.
  • Hematometra is an accumulation of blood and blood clots in the uterus, which for some reason cannot completely go outside. Instead of normal menstruation, in this case, there are very meager, but long-term spotting.
  • - is not a direct consequence of irregular menstruation, however, menstrual irregularities signal that the 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 the irregular menstruation, the method of treatment will be determined. It provides for two directions: drug therapy and surgery.

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

  • Conservative treatment

Therapy involves two tasks: the regulation of hormonal levels and the reduction of blood loss. Before prescribing medication, 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, OK is prescribed for several months (from 3 to 6). Endocrine glands under the influence of synthetic analogues of hormones will begin to function normally and menstruation will begin to come on time.

However, there are some difficulties with this treatment. Firstly, there is a category of women who do not tolerate oral contraceptives. 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 they contain substances that prevent the production of a certain hormone.

There, the doctor, based on the results of a blood test, 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 such violations of menstruation, which are characterized by excessive blood loss. Unlike hormonal drugs, the use of hemostatic drugs does not treat the cause of hormonal failure, but only its consequence - bleeding.

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

  • Surgery

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

In order to avoid inflammation and in order to save the patient from constant scanty bleeding, the body of the uterus is scraped. For treatment, a woman must lie down for a while in a hospital.

The operation is performed under general anesthesia, and the contents of the uterine cavity, which was taken out, is sent for histology. If you do not correct the menstrual cycle with hormonal drugs, then the clots may accumulate again after some time and surgery will be required again.

If menstruation is irregular, you should pay close attention to this and do not postpone a visit to the doctor.

The interval between periods should be 21-35 days. On the day of bleeding, a woman loses 30-80 ml of blood. Any deviations in these terms and volumes mean a violation of the menstrual cycle of a hormonal nature.

It is associated, as a rule, with ovarian dysfunction. The exceptions are during pregnancy, breastfeeding and menopause.

Loop failure features

Delays and early periods for many women seem to be a common occurrence. They can alternate with the normal cycle, completely disappear and reappear. If physical discomfort in the form of pain and abnormal discharge does not manifest itself, the woman is in no hurry to get checked out by a gynecologist.

However, a violation of the menstrual cycle can be the result of inflammation, as well as a sign of developing pathologies of the reproductive, endocrine or nervous system. Regardless of the cause, permanent change requires diagnosis and treatment. It should be noted that all deviations from the norm associated with menstruation are included in the concept: dysfunctional uterine bleeding.

A delay of a couple of days, which manifested itself once, does not require a trip to the doctor, a diagnosis. Here the reason may be in the usual stress or other everyday, psychological factor. However, if the symptom recurs, it is necessary to seek advice from a gynecologist-endocrinologist.

Varieties of violations of the intermenstrual period

Cycle disorders are divided into several groups. Some of them are associated with changes in the duration of menstruation, others - in the frequency, and others - in the amount of blood released.

Change duration

By duration, all cycle disorders are divided into the following diseases:

- polymenorrhea - an increase in the menstrual period; the same as the delay of menstruation, when the period between periods is more than 35 days;

- oligomenorrhea - reduction in the number of menstrual days;

- amenorrhea - the complete disappearance of menstruation for a period of 6 months.

abnormal periodicity

According to the frequency, menstruation is divided into 2 types:

- rare (bleeding 1 time in 1.5-3 months);

- frequent (metrorrhagia; bleeding 2 times a month).

Changes in blood volumes

According to the volume of released blood, changes in the menstrual period are divided into the following varieties:

hypomenorrhea - scant bleeding

- menorrhagia, hypermenorrhea - too much blood loss.

Algodysmenorrhea: severe pain should not be

A separate type of menstrual disorder is algomenorrhea - a condition when menstruation is accompanied by too much pain in the lower abdomen. Sometimes they spread to the hips, lower back. This pathology can be primary (observed during the formation of a regular cycle) and secondary (in women over 30 years old; it is a consequence of endometriosis, inflammation of the uterine appendages).

Symptoms of menstrual disorders

In addition to changes in the duration and frequency of bleeding, menstrual disorders are manifested by secondary symptoms. By themselves, they do not indicate this pathology, but accompany the main symptoms, causing discomfort to the woman, and often real suffering.

These symptoms include:

- pain in the lower abdomen of a pulling nature, observed in any phase of the cycle

- drowsiness, headaches, dizziness, "goosebumps" in the eyes when standing up

weakness, diarrhea, vomiting, migraine.

Causes of the disorder of the intermenstrual period

Almost always, failure occurs due to disturbances in the work of the pituitary gland and ovaries. It is they who produce hormones that regulate the frequency and volume of menstruation. At the same time, in each phase, its own set of hormones is secreted, and their ratio is constantly changing. If the menstrual cycle fails, then the pituitary gland produces the wrong amount of hormones. Either he stopped producing them altogether, or their ratio is abnormal.

Against this background, ovarian dysfunction occurs, which is explained by the following reasons (may not be associated with the pituitary gland):

- an acute inflammatory process has formed in the appendage or a chronic, sluggish stage is observed

- various disorders in the endocrine system (dysfunction of the thyroid gland or adrenal cortex)

- pathology of the genital organs: endometriosis, uterine fibroids, benign or malignant tumor

– treatment with chemotherapeutic drugs, radiation therapy for the treatment of oncology of another organ

- a sharp change in weight (exhaustion or obesity)

- in adolescent girls: underdeveloped myometrium (the muscular layer of the uterus)

- circulatory disorders due to varicose veins

- mental illness, nervous exhaustion.

Consequences: infertility and various pathologies

Most often, the failure of the menstrual cycle is dangerous by the inability to become pregnant. If the birth of a child is not planned, the woman is in no hurry to be treated (in cases where bleeding is less frequent, and not more often than normal). However, untreated disorders of this nature can lead to complications not only in the genital organs, but also in the hormonal and endocrine systems. Also, the result is: osteoporosis, anemia.

In this case, you can expect the appearance of many other diseases that lead to failure throughout the body, since the cardiovascular system is also affected. The consequences can develop over the years, and a woman will not associate them with violations in the menstruation schedule.

Severe consequences can be avoided by taking timely measures to treat disorders of the menstrual schedule. It should be noted that self-medication and treatment with folk methods should be used carefully. Such methods can lead to a false recovery, when the symptoms disappear only for a while, but not completely. So a sluggish stage appears, getting rid of which becomes extremely problematic.

Diagnostic methods

Changes in the intermenstrual period lead either to a delay or to an increased occurrence of menstruation. If a woman of childbearing age has a delay in menstruation, pregnancy and a tumor process should be excluded. With the appearance of acute pain in the lower abdomen, an urgent examination of the fallopian tubes is carried out to make sure that there is no ectopic conception.

Identification of the causes of pathology includes the following types of diagnostics:

– examination by a gynecologist with the help of mirrors

- laboratory examination of smears from the vagina, cervix, body of the uterus

– diagnostic laparoscopy, endometrial biopsy, hysteroscopy

– study of hormonal levels: progesterone, estrogen, LH, FSH, PRL

- a study of blood, urine for the amount of hormones of the adrenal glands, thyroid gland

– examination of the brain using MRI, CT.

This set of examinations allows you to find out the causes of delayed menstruation and the consequences of this pathology. Also, too much bleeding. It should be noted that primary disorders are always associated with genetic changes, while secondary ones are acquired as the consequences of pathological processes. At the same time, cycle disorders themselves are the root causes of other diseases that develop against their background.

Who is affected by menstrual cycle changes?

In addition to adolescent girls and premenopausal women, women of childbearing age are susceptible to this pathology. If congenital causes are excluded, some risk factors must be observed for the development of a malfunction in the hormonal system. These include, first of all, socio-psychological and sanitary-hygienic conditions. As well as behavioral factors: intimate relationships, caring for one's own health, disease prevention or ignoring it.

The risk group with a high probability of cycle disorders includes women:

- who smoke more than 10 cigarettes a day, abuse alcohol

- having promiscuous intimate relationships or an affair with an unscrupulous man

- those who do not observe personal hygiene, namely: the cleanliness of the genitals

- ignoring the symptoms of inflammatory and other pathological processes in the genitals, throughout the body

- in the anamnesis of which there are abortions, frequent childbirth, as well as gynecological operations, diagnostic manipulations with punctures of the abdominal wall

- in the anamnesis of which there is a delay in the development of the reproductive system, malformations of the genital organs, chromosomal failure.

Reasons for the absence of menstruation

The main reasons for the lack of menstruation are polycystic ovaries, sudden weight loss after excessively large body weight, adherence to strict diets for weight loss. Also, the cause can be almost a mechanical factor, when adhesions prevent the menstrual blood from leaving the uterus, which led to the gluing of the walls of the organ.

Reasons for frequent bleeding

Unlike polymenorrhea, the main cause of metrorrhagia (frequent menstruation, that is, 2 times a month) is the insufficiency of the 2nd phase of the menstrual cycle. The condition means the short life of the corpus luteum, which in this case is less than 10 days. The second option: the corpus luteum does not form at all, and the consequence of this is a single-phase cycle that ends with bleeding in the middle of the graph.

Treatment methods for menstrual irregularity

So, a cycle failure can be caused in a woman by serious pathologies or completely harmless reasons. Often, for recovery, it is enough to take simple actions: bring weight back to normal, cut adhesions (gynecological surgery) or stimulate ovulation with drugs. Also, sometimes it is enough to remove polyps, cure endometriosis or a blood disease if it is not of a genetic nature.

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

Cycle

What is the monthly period from the onset of menstruation to the next. 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. By luteal is meant 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 start. After her, the level of estrogen drops in a woman. But during this period, bleeding does not yet occur. Since the production of hormones is controlled by the corpus luteum. Strong fluctuations in estrogen in any direction during ovulation can cause uterine bleeding between periods, before or after them.

Cycle calculation

The normal cycle length is 21-37 days. As a rule, most girls have 28 days. The duration of the menstruation itself is approximately three to seven days. If you have had a two-day or three-day failure of menstruation, treatment is not required here. Since such a phenomenon is not a pathology. But if menstruation has not come even seven days after the required period, then you need to contact the doctor for a consultation.

How to calculate cycle? The period of time between the first day of menstruation and the first day of the next is the length of the 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.

Failure symptoms

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

  • lack of menstruation;
  • shortening of the cycle (less than twenty days);
  • increase in time between periods;
  • the appearance of bleeding;
  • plentiful or, on the contrary, meager periods.

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

Adolescence and weight problems

Why did the delay of menstruation occur or did the cycle fail? There can be many reasons. During adolescence, cycle failure often occurs. This problem is quite common among girls. Since their hormonal background is just beginning to be established. If more than two years have passed since the first menstruation, and the failures continue, then you should definitely go to the gynecologist.

Another reason for the failure of menstruation is a strong weight loss (or, conversely, obesity). Starvation and extreme dieting are perceived by the body as hard times. Therefore, it includes natural protection, resulting in a delay in menstruation. Rapid weight gain also has a negative effect on the body. As a result, the cycle may be disrupted.

Acclimatization

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

Hormonal disbalance

A similar phenomenon is known to every girl) - this is one of the main signs of problems with the hormonal background. This can be caused by problems in the pituitary gland, as well as the hypothalamus. In this case, it is worth contacting 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 menstruation failure is stress. It often breaks the cycle. During stress, it produces an excessive amount of prolactin. An excess of it inhibits ovulation, resulting in a delay. In this case, doctors recommend getting enough sleep, spending more time outdoors. A gynecologist may prescribe a sedative drug if menstruation fails due to stress. It can be like valerian, and Cyclodinone tablets and others.

Diseases and hormonal contraceptives

Diseases of the female organs also lead to the fact that menstruation fails. Often the cause of this is the 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 are treated surgically.

Taking hormonal contraceptives or refusing them leads to a failure of the monthly cycle. In this matter, it is worth consulting 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 appearance of the baby and during the period of breastfeeding is the norm. When lactation stops, the cycle should be restored.

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

Premenopause and abortion

Failure of menstruation after 40 is 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, causing a delay in menstruation. Sometimes they even cause infertility.

Other reasons

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

When to see a doctor?

In no case should you postpone a visit to a specialist if:

  • two years have passed since the beginning of menstruation, and the cycle has not yet been established;
  • pain during ovulation. Such a symptom most likely indicates rupture of the ovary;
  • profuse bleeding is observed. Normally, a girl loses no more than 250 ml of blood during the period of menstruation. If more, then this is already a sign of hormonal imbalance. It needs to be treated with drug therapy;
  • there are regular violations of the cycle (its duration is less than three days or, conversely, exceeds seven days);
  • there is spotting before and after menstruation. This symptom is indicative of endometriosis.

Diagnostics

How is a patient diagnosed with a menstrual cycle disorder? First, a survey and a gynecological examination are conducted, during which all smears are taken. Also, the patient, if the diagnosis is not made, you need to undergo an ultrasound of the pelvic organs and MRI. In addition, blood is given for hormones. To clarify the diagnosis, the patient is prescribed hysteroscopy, as well as a blood and urine test.

Thanks to all these methods, you can determine the reason why the cycle has gone astray. After the diagnosis is made, appropriate therapy is prescribed.

Treatment

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

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

When teenage girls experience irregular cycles, doctors often use vitamin therapy. The patient is prescribed ascorbic and folic acid.

With anemia, women are prescribed iron supplements.

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

When a patient is bleeding heavily, but bleeding disorders are excluded, doctors may prescribe hemostatic drugs. ε-aminocaproic acid is also prescribed.

Even with heavy bleeding, an infusion of plasma is performed. Sometimes donated blood is even 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, do not take lightly the fact that there are violations of the monthly cycle. Since such problems can lead to infertility. Frequent cause disability and fatigue.

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

A small conclusion

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