Menstrual cycle - reasons for possible disorders

Menstrual irregularities are a symptom of a disorder in the female reproductive system. There are many reasons for irregularities, including stressful situations. When collecting anamnesis, we, of course, take into account all aspects, starting from the establishment of menstrual function, the age at which periods begin, whether they are painful or not, how many days menstrual bleeding lasts, what the menstrual cycle is.

A normal menstrual cycle, on average, ranges from 21-25 to 28-35 days, in rare cases up to 40. If periods take the form of acyclic bleeding, that is, they can come after a different number of days, this is a cycle disorder, and it is necessary to find out the cause of this phenomenon.

Possible cycle disorders

Recently, we have been seeing delays most often. They are associated with anovulation or functional cysts, follicular, corpus luteum. There is a lot of hyperprolactinemia now. You start examining, and often hidden pathologies are revealed. Or menstruation comes and starts to go steadily, then disappears again, then we look at the hormonal background, and another cause of hyperandrogenism is revealed - an increase in the level of male hormones. This phenomenon needs to be differentiated - either it is the ovary or the adrenal glands. Here you need to look at the hormones and look for the cause.

The number of days of menstruation itself is normal for everyone, from scanty to heavy. When the menstrual cycle is being established, in the ideal case, the cycle is 28-30 days. The amount of blood lost, again, is individual. It depends on the higher structures, how they were formed there. According to the amount of blood lost during heavy periods, a woman can lose up to 100 ml. But for some, this is normal. Some people have periods lasting 3-4 days, and the amount of menstrual flow is not heavy. If this is the case initially, then this is a normal variant for a woman. In my practice, there were women with barely noticeable periods, a drop on a pad, and that's it.

Periods can be painful and painless. In girls, when the menstrual function is being established, this is called algomenorrhea, painful periods. They are most often associated with contractions of the uterus, painkillers and antispasmodics are usually used. Another variant is algomenorrhea. Periods can be so painful, usually this happens with inflammatory diseases, endometriosis, up to loss of ability to work. Such periods are long, usually start with "smearing", then they come profusely with clots, then they smear again, and this can last up to 10 days.

But all this can be treated, and a woman, first of all, should consult a gynecologist. You should never self-medicate. If something is wrong, it is better to come to a specialist, and he will find the cause. I am not a supporter of immediately prescribing hormonal drugs, especially in case of menstrual cycle disorders in young girls. They can be prescribed cyclic vitamin therapy, then switch to taking vitamins, an enhanced protein and meat diet. You can recommend taking herbal phytohormones. Of our herbs, I recommend tea with linden, viburnum, raspberry leaves. Naturally, it is necessary to observe proper rest without overexertion.

Causes of menstrual cycle disorders

The reasons begin in childhood. If a very young girl comes to us, we find out the nuances of her life from birth: how her mother's pregnancy went, are there any family problems; if there were any, we find out what the girl was sick with. Diseases suffered in childhood with their complications can affect the higher structures of regulation of the menstrual cycle - the pituitary gland, the hypothalamus.

Then we ask if the girl has suffered any injuries, including birth; if she has had any serious infectious diseases, if she takes any medications.

The next point that needs to be found out is whether there were any intoxications, such as smoking, whether there was drug use, this also leaves an imprint. Again, it turns out whether the girl belongs to the risk group for diabetes. These are the main reasons that can lead to a violation of the menstrual cycle.

Then, of course, we begin to ask when the girl begins to live a regular sexual life. There are also many different factors here. Firstly, early onset of sexual activity can also leave an imprint on the menstrual cycle: sexually transmitted infections lead to inflammation of the appendages, and inflammation of the appendages is still the ovaries, and they are the organs responsible for the menstrual cycle. In principle, everyone determines the moment for the beginning of sexual activity for themselves, but in physiological terms, the optimal age is after 18 years, when the formation of the hormonal system ends.

Let's consider the reasons at the age of reproduction. Firstly, these are stress, inflammation, endocrine disorders. There are also disorders associated with changes in the endometrium polyps, cysts that disrupt the ratio of hormones, for example, insufficiency of the second phase, when there is not enough progesterone in the woman's body. This disrupts the cyclical functioning of the reproductive system, and then bleeding may occur.

This may also be inflammation, this is how ovulation may occur, and these discharges may occur in the form of small bloody discharge, or they will be more abundant, or they will pass like menstruation. Then we examine the woman, do an ultrasound, collect anamnesis and say that this is a normal variant. But if this happens from cycle to cycle, then we recommend treatment. For several months, the intake of drugs-hormones analogous to the second phase of the progesterone cycle is prescribed. As a rule, after taking the drugs, the problem stops.

If the problem is associated with prolonged anovulation, that is, ovulation does not occur, the rupture of the follicle, then under the influence of estrogens, the functional layer of the endometrium grows. Rejection of the endometrium can be uneven, and there may be either heavy bleeding, or they "smear" for a long time, or the woman "bleeds". But if a woman has menstrual bleeding for 10 days, and neither hemostatic nor other drugs help her, she should come to the gynecologist to find out the reason. If it is associated with endometrial hyperplasia, we perform curettage of the uterine cavity and prescribe treatment after histology.

What else can cause a violation of the menstrual cycle in reproductive age? Women come with a delay in menstruation, and here it is necessary to make a differential diagnosis of why this violation occurred. First of all, it is necessary to exclude pregnancy, naturally, ectopic. If we look at the ultrasound, and there is a delay or some changes in the endometrium, then we prescribe the delivery of the hCG hormone and, if the problem is excluded, we treat the patient conservatively, prescribe hemostatic drugs. But there is such a thing as hormonal hemostasis, this is stopping bleeding with hormonal drugs, most often monophasic. This corrects the menstrual cycle.

I have not yet mentioned the juvenile period, when there is no cyclic production of gonadotropin hormones, there is no connection between the pituitary gland and the ovaries, when girls' periods can be acyclic and very heavy. They are called juvenile bleeding. Again, the tactics and approach are different. First, it is determined what this may be associated with: either abnormal hormone production, or girls trying to look beautiful and lose weight, and sudden weight loss sometimes leads to the cessation of menstruation. Girls come, and we warn that a diet is life-threatening. Basically, vitamins, enhanced nutrition, and cyclic vitamin therapy are prescribed. If this does not help, then hormonal hemostasis is used.

And the third period, when there are climacteric disorders. This age is different for everyone. In the modern world, it is considered from 36-38 years to 50-51 years. At this age, the reproductive function of the body gradually fades, and, naturally, the cyclic rhythm of hormone release changes, which leads to the suppression of hormonal function. In this period, premenopause is distinguished; it lasts differently for everyone, for some a year, for others two. And here the cyclic rhythm is disrupted, and menstruation comes every other month, every other month, every other month and a half, chaotically.

Then comes the period of perimenopause. It is characterized by the absence of menstruation, and the woman lives seemingly calmly. At this age, during the pre-perimenopause period, there is also bleeding. They are associated with changes in the endometrium, these are the same polyps, endometrial hyperplasia, which require surgical intervention, and then drug correction. But in menopause itself, bleeding is already a rather formidable symptom of oncological diseases. At this age, cysts can be the cause of bloody discharge. There are many types, including oncological ones.

Avoid diets and stress!

Of course, if your menstrual cycle is disrupted, you need to take your diet into account. All kinds of diets aimed at both weight loss and weight gain are contraindicated. A woman loses or gains weight rapidly, and in order for her periods to go normally, even girls have, so to speak, a weight limit. It is believed that menstruation begins at a weight of 47 kg. Even if a woman loses at least 5 kg, for some it turns out to be critical, and, as a result, there follows a violation of the menstrual cycle or the absence of menstruation at all. Weight gain is also dangerous.

The nature of the violations can be different, it will entail various reasons, up to the formation of cysts and polyps. In obese women, fat cells produce estrogens, they begin hyperestrogenism, the first phase of the menstrual cycle becomes longer, there follows an increased growth of the endometrium of the functional layer, and hence bleeding.

Again, as I have already said, stressful situations are dangerous. With prolonged stress, the body responds by releasing the hormone prolactin, this is the pituitary gland, as an intermediate link between the higher structures of the hypothalamus-pituitary gland, then the ovaries and then the uterus.

If there is a violation at the level of the pituitary gland, it responds to stress by producing prolactin. This can lead to anovulation, the formation of cysts. Naturally, high prolactin will lead a chain, and can lead to infertility, if it was a long process.

If you normalize and relieve stress from a woman, give her a rest, then transient prolactin disappears, and everything is normalized, menstruation is restored without any intervention. Sometimes, of course, it happens that there are some organic lesions of the pituitary gland, this will lead to a chain of menstrual cycle disorders that provoke anovulation, and then infertility may occur. But this happens quite rarely, in the case of late and superficial diagnosis.