NMC - what is it? Reproductive age of a woman Treatment of menstruation disorders in adolescents.

Date: 03.10.2020

Nature conceived regular periods: an indicator of a woman's health. Gynecologists believe that by the age of 15, a girl should have a menstrual cycle. This is a complex complex of biochemical processes occurring in the body at regular intervals. The structures of the brain take part in it - the cortex and subcortical formations; organs of the endocrine system - adrenal glands, thyroid gland, ovaries.

The well-coordinated work of the body's systems provides the "gold standard": a 28-day cycle. Its duration of 26-38 days is considered normal. This includes the interval from the first day of your period to the next first day. Delaying or shortening the cycle by five to seven days is considered a normal variant.

Types of menstrual irregularities (MCIs)

Anxiety should be caused by too frequent periods, or, on the contrary, rare. Their absence for several months is a serious cause for concern. Scarcity of secretions, abundance, short-term (one or two days), protracted duration - deviations from the norm. The following types of NMC are most commonly diagnosed in gynecology:

Hyperpolymenorrhea: a short menstrual cycle from 14 to 21 days is accompanied by a long period of heavy bleeding - from 7 to 12 days. It is fraught with blood loss, and this is a great load on the body and subsequently leads to violations of the adaptation mechanism. Such an NMC often indicates serious problems of women's health.
Oligomenorrhea occurs in 3% of cases. The interval between menstruation can last 40-180 days, they themselves proceed in two to three days. It is diagnosed more often in young women. The disease is accompanied by an increase in body weight, problems with conception.
Polymenorrhea is a common disorder. With an undisturbed cycle duration, abundant and prolonged blood loss is observed: more than seven days.
Almost half of women under the age of 50 are diagnosed with algodismenorrhea. It manifests itself as cramping pronounced or muffled pain in the lumbar region, headache, nausea, and malaise. Symptoms can go away after a few hours, sometimes after a day.

Over the course of several years, fluctuations in the duration of the cycle, changes in the amount of discharge in women after forty years of age have been observed. These are signals of the extinction of the activity of the ovaries, which leads to a decrease in the efficiency of their work. In this case, the diagnosis of NMC indicates the onset of premenopause. The condition is considered physiological, natural and continues until the climax enters.

Causes of menstrual irregularities

Some women have a long menstrual cycle due to genetics. Very often, psychophysical factors become the cause of disorders: overwork, moving to another place of residence with a change in time zone, stress, anxiety before an important exam, taking certain medications and even extreme heat in summer.

Systematic lack of sleep has a powerful negative effect: in the pre-morning hours, a woman's body actively synthesizes hormones that regulate monthly cycles. A completely commonplace cause of failure can be a urethrogenital infection: mycoplasma, chlamydia, uroplasma.

Conscientious anti-inflammatory treatment will cure problems. Uncontrolled adherence to diets causes a general distortion of metabolism and entails NMC. The consequences of diabetes mellitus, obesity, thyroid diseases, hypertension, anorexia can be SMC.

Diagnostics

Based on the woman's complaint, the doctor prescribes an examination. In this case, the very violation of the menstrual cycle is only a symptom. Diagnostic activities usually include:

study of the hormonal state of the body;
conducting an ultrasound examination in order to exclude pathologies in the pelvic organs;
laboratory analysis of a vaginal smear.

Treatment of NMC

Adequate measures are chosen by the attending physician, based on the results of the examination. In the arsenal of methods: hormone therapy, physiotherapy, anti-inflammatory drugs, antibacterial. In some cases, surgery is possible. Often, sparing techniques, for example, homeopathic remedies, have a corrective effect.

System of examination of patients with NMC.

1. First analyze complaints, i.e. those circumstances that cause concern for the patient (pain, menstrual irregularities, pathological discharge from the genital tract, etc.).

2. Collect anamnesis: clarification of working conditions, the presence of occupational hazards and bad habits that could be the cause of the disease. Pay attention to the possible hereditary predisposition of a possible disease. Information about previous illnesses or surgical interventions is important. It is especially important to take into account the diseases during puberty of the girl. When analyzing the menstrual and reproductive functions, the time of the establishment of the first menstruation, the nature of the formation of the menstrual cycle and its features during a woman's life and when contacting a doctor must be taken into account. Anamnestic assessment of reproductive function takes into account data on pregnancies that ended in abortion, childbirth, and spontaneous miscarriages. Clarify their number, features of the course of pregnancies, features of surgical interventions and the nature of complications that have arisen after them. In chronological order, all past gynecological diseases, surgical interventions on the genitals, diagnostic and therapeutic procedures (cervical biopsy, methods of treating cervical pathology, diagnostic curettage, hysterosalpingography, hydrotubation, etc.) are specified.

3. Clinical examination is no less significant than the survey. Often, the very first examination suggests the presence of a particular disease. Assessment of physique and body size includes indicators of height, body weight, the ratio of the span of the arms to height and the upper half of the body to the lower half. Determination of the proportions of the human skeleton is of diagnostic value. Normally, the ratio of the upper half of the body to the lower half is 1: 1. The span of the arms (the distance between the outstretched arms) in an adult is normally equal to his height.

Body mass index (BMI) is an indicator that most accurately characterizes the deviation from normal body weight. The normal BMI of women of reproductive age is 19-26.

The general appearance of the patient, her physique, the nature of the distribution of adipose tissue, the condition of the skin, the nature of hair growth are important in the diagnosis of various endocrine disorders. Hypertrichosis is excessive hair growth on the limbs, back and head. Hirsutism is a male pattern of excess hair on the face, chest, back, extremities and pubis associated with excess production of androgens in a woman's body.

4. Examination of the mammary glands... The mammary glands, being one of the constituent parts of a single reproductive system, are directly influenced by numerous hormones.

5. Gynecological examination allows you to assess the nature of hair growth (male, female), features of the development of the labia majora and small labia, the size and shape of the clitoris, the color and folding of the vaginal mucosa, the shape and condition of the cervix, the nature and amount of vaginal discharge. In a bimanual study, the size, location and mobility of the uterus, pathological changes in the ovaries and appendages, their size, and soreness are specified. The condition of the retrocline-shaped ligaments and the posterior fornix of the vagina is assessed in order to identify external genital endometriosis, in particular, retrocervical.

Along with clinical research methods, laboratory and instrumental methods are also of great complementary importance.

6. Tests of functional diagnostics are used to assess the hormonal function of the ovaries, determine the nature of the menstrual cycle and confirm ovulation. One of the more readily available methods is basal temperature measurement in the rectum. In the absence of ovulation, the basal temperature curve is below 37 ° C and has a monophasic character.

7. Hormonal research methods are the most reliable and accessible in the assessment of the hypothalamic-pituitary-ovarian and adrenal systems. Currently, enzyme immunoassay (ELISA) or radioimmunoassay (RIA) methods are used to determine hormones in biological fluids. It is known that hormone indicators fluctuate depending on the age of patients, phases of the menstrual cycle, time of day and change during pregnancy. Blood for hormonal research is taken from the cubital vein from 9.00 to 12.00 on an empty stomach. Before taking blood, the patient is not recommended to carry out a gynecological examination, examination and palpation of the mammary glands.

With a regular rhythm of menstruation, blood is taken on the 5-7th day of the menstrual cycle. In this case, prolactin, testosterone, dehydroepiandrosterone, dehydroepiandrosterone sulfate or 17-KS in daily urine are determined. If thyroid dysfunction is suspected, TSH, TK and T4 are determined. In case of menstrual irregularities of the type of oligo- or amenorrhea, blood sampling for hormonal research can be performed on any day of the cycle. It is necessary to determine: prolactin, LH, FSH, TSH, estradiol (E), testosterone, cortisol, DEA-C or 17-KS, TK and T4.

In some cases, different types of research are used. hormonal tests... The progesterone test allows you to determine the level of estrogen saturation and assess the degree of adequacy of the response of the endometrium to the administration of progesterone. The reaction is regarded as positive if, 3-7 days after taking gestagens, a menstrual-like reaction occurs. The absence of a reaction indicates a pronounced hypoestrogenism, the absence of proliferative processes in the endometrium or its absence in the uterine cavity.

With a negative progesterone test, a cyclic test with estrogen-progestogen drugs should be performed. The appearance of a regular menstrual-like reaction indicates that the endometrium is sensitive to adequate levels of steroid hormones. A negative test (absence of bloody discharge after stopping the administration of drugs) indicates a uterine form of amenorrhea.

8. Functional tests allow to clarify the state, safety and reserve capacity of various levels of the neuroendocrine system, to carry out differential diagnostics between functional and organic disorders, as well as primary and secondary hypofunction of peripheral endocrine glands. These tests allow you to determine the hypothalamic or pituitary level of the lesion. Such tests include: tests with thyroliberin and metoclopramide, test with bromocriptine (parlodel), clomiphene test, test with gonadoliberin, test with ACTH, small or large dexamethasone tests.

9. Colposcopy is a mandatory method for the initial examination of patients and allows you to identify signs of colpitis, cervicitis, endocervicitis and cervical erosion, which are a sign of chronic inflammatory diseases of the genitals, dyshormonal disorders and are the cause of menstrual irregularities and infertility. An additional research method is micro-colphysteroscopy, which allows for an intravital examination of the vaginal part of the cervix and cervical canal, which are treated with 0.1% hematoxylin solution before the procedure.

10. Ultrasound examination(Ultrasound) is advisable to use in all cases with menstrual or reproductive disorders. The method allows detecting tumors of the uterus and ovaries, makes it possible to accurately characterize the number, size, structure and location of the formations. It is especially important to conduct a study in patients before prescribing hormonal treatment methods to identify small formations that are not diagnosed during gynecological examination, especially in obese patients. With the help of ultrasound, it is possible to dynamically monitor the growth of the follicle in the normal cycle and the cycle stimulated by hormonal drugs, when clarifying the diagnosis in case of suspicion of an ectopic pregnancy.

11. For all patients with menstrual irregularities, it is mandatoryX-ray examination skull and sella turcica - a craniogram in the sagittal and frontal projection, which is important in the diagnosis of pituitary tumors. More accurate and modern is CT scan(CT) Turkish saddle.

12. Hysterosalpingography(GHA) is an X-ray method that is carried out on an outpatient and inpatient basis and allows you to identify malformations of the uterus, pathological processes of the endometrium, submucous uterine myoma, adenomyosis, intrauterine synechia, the state of the fallopian tubes and the nature of the adhesions in the small pelvis. It is preferable to produce the GHA on the 16-21st day, i.e. during the P phase of the menstrual cycle, which allows to assess with a high degree of certainty the patency of the fallopian tubes, the presence of endometrial hyperplasia or polyps. It is possible to conduct a study in the first phase of the cycle, in order to identify internal endometriosis of the uterus.

13. Endoscopic methods examinations include hysteroscopy and therapeutic and diagnostic laparoscopy. Hysteroscopy carried out according to the following indications: dysfunctional uterine bleeding; violation of the rhythm of menstruation; intrauterine pathology (synechiae, polyps and endometrial hyperplasia, adenomyosis, uterine myoma, congenital intrauterine pathology; suspected endometrial hyperplasia or polyps); infertility; habitual miscarriage. In the first phase of the cycle, hysteroscopy is performed with suspicion of submucous uterine myoma and adenomyosis. If you suspect endometrial hyperplastic processes, the procedure is performed on any day of the cycle, and with intrauterine adhesions - on the eve of menstruation. With infertility of "unclear" genesis or defective luteal phase of the cycle, hysteroscopy is indicated on the 6-7th day of the rise in basal temperature.

Laparoscopy- a method that allows you to accurately identify various pathologies of the pelvic organs, part of which is the cause of not only menstrual, but also reproductive function (external genital endometriosis, ovarian cysts, tumors of the uterus and appendages, tuboperitoneal pathology). Laparoscopy can significantly shorten the examination time and carry out a low-traumatic correction of the revealed pathology. Indications for laparoscopy are: all types of infertility; pelvic pain syndrome; suspicion of the presence of organic pathology of the genitals; suspicion of an ectopic pregnancy; suspicion of uterine perforation; torsion or rupture of an ovarian cyst; suspicion of ovarian apoplexy; acute inflammatory processes of the pelvic organs .. The operation, depending on the alleged pathology, is carried out in the I or II phase of the cycle.

The main sign of a normal menstrual cycle is regular menstruation - spotting from the genital tract. They appear every 21-35 days and last for 3-7 days.

How to recognize violations?

Everything is very simple and logical: if menstruation is normal, then everything is in order, if not, the menstrual cycle is disrupted. The most pronounced form of cycle disorders is amenorrhea: the complete absence of menstruation for more than six months. In addition, too scanty or, conversely, too abundant periods, as well as their irregularity (very frequent or rare), are considered suspicious. A woman should be concerned about bleeding that lasts only 1-2 days or more than a week.

Causes

Menstrual irregularities are not a disease, but just a sign that some kind of malfunction has occurred in the work of the internal genital organs. Defects in the hormonal system are usually at the origin of the cycle disorders. Moreover, it is not at all necessary that these defects relate specifically to sex hormones. Thyroid hormones, adrenal hormones and even the pituitary gland (an important part of the brain) can easily be the culprit. There can be several reasons for such hormonal disruptions:

constant stress or damage to the nervous system;
infectious and non-infectious diseases of the internal genital organs;
serious diseases of other internal organs and systems (liver, kidneys, lungs, blood);
severe infectious diseases;
hereditary predisposition;
taking certain medications;
abrupt change of place of residence (for example, moving from Syktyvkar to Murmansk);
radiation and poisoning;
irrational nutrition (weight loss or vitamin deficiency or, on the contrary, obesity).

At the same time, hygiene tampons, contrary to some misconceptions, do not have a negative effect on the menstrual cycle (although they can lead to other problems).

Why is it dangerous?

Sometimes very serious diseases can be behind a minor violation of the menstrual cycle: ectopic pregnancy, benign and malignant tumors of the ovaries or uterus, tuberculosis, brain tumors.

Diagnostics

Noticing that menstruation suddenly became not the same as usual, a woman should immediately go to an appointment with a gynecologist. The sooner the cause of menstrual irregularities is identified, the better. First of all, the doctor will prescribe a study of the patient's hormonal profile. It is also necessary to do an ultrasound scan to find out if there are any diseases or damage to internal organs. Another necessary study is to check for infections: a regular vaginal smear or more complex PCR diagnostics. Depending on what the hormone analysis showed, the patient may need to consult a specialist endocrinologist.

Treatment

The disturbed menstrual cycle must be made normal. At the same time, it is not the violation of the cycle itself that is treated, but the reasons that led to it are removed:

infectious and inflammatory processes are treated with special pills and physiotherapy;
with initial hormonal disorders, hormone therapy is prescribed;
in the case of tumors, surgery may be required;
physical education, balanced nutrition, vitamins will help support a weakened body.

At a certain period of life, cycle violations occurred, probably, in every woman. Violation of menstruation , which many ladies are accustomed to consider 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 a violation of the physical or mental state of the woman. The monthly cycle is a kind of biological clock of the body. 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 the menstrual cycle is 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 begin their period depends on their residence. The farther south a teenager lives, the earlier menarche occurs. It is important for parents to monitor when girls start their periods in order to understand whether the body is developing normally.

Between the ages of 45 and 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.
Phase 2 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 conception did not take place, 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 the 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 cycle, how many days her periods last 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.

The first level is the cerebral cortex	If the cycle of menstruation is out of order, the reasons may be associated with emotions, stress, worries.
Second level - hypothalamus	It is a synthesis of releasing factors affecting the third level.
The third level is the pituitary gland	It produces follicle-stimulating and luteinizing hormones or gonadotropic hormones that affect the fourth level.
Fourth level - ovaries	Under the influence of pituitary hormones, the synthesis of estrogen or progesterone occurs, depending on the phase of the cycle.
Fifth level - female genital organs	There are changes in the endometrium in the uterus, the epithelium in the vagina is renewed, peristalsis in the fallopian tubes is noted, which contributes to the meeting of sperm and egg.

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

The first Are external factors that 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 affecting 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 of menopause. 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.
The 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 of the 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 exposure, 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 due to a tumor of the pituitary gland or brain, hemorrhage in the pituitary gland, 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 curettage 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, the gynecologist, whom you must visit, will tell you if your period is "out of order."

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 periods, 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.
Proyomenorrhea - 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, can be associated with a wide variety of pathologies. A woman should be alerted to any violations. For example, very frequent menstruation after 40 years may indicate the development of serious illnesses.

Cycle irregularities are often observed in adolescents when menstruation occurs. 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 the delays. In adolescents, the cycle length can be different each time.

The formation process 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 takes place. 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 regularity of menstruation is influenced by the character traits of adolescents.

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 an irregular menstrual cycle in a teenage girl, a so-called juvenile uterine bleeding ... This condition is characterized by prolonged periods. As a rule, prolonged and at the same time abundant periods last more than a week. This leads to anemia and a serious deterioration in a teenager's condition. As a rule, the reasons for prolonged periods are associated either with mental stress, or with infections.

Disrupted cycle in premenopausal women

Treatment of menstrual disorders in adolescents

If a teenage girl has an irregular 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 to carry out curettage. Next, a histological examination of the scraping is carried out.

Provided that the hemoglobin index is from 80 to 100 g / l, hormonal tablets (,) are prescribed.

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

A teenager is prescribed hormonal drugs for a period of no more than three months. Treatment for anemia lasts until the hemoglobin counts rise 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, the treatment of menstrual irregularities at the age of 40 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 the scraping did 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 folk remedies. However, such methods must be practiced very carefully, since without consulting a doctor, there is a risk of missing a serious pathology. 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 carry out 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 .

conclusions

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 the diet 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.

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 themselves?

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 the presence of 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 ml or more than 150 ml;
the duration of menstruation is less than 3 days 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. The NMC does not always speak 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 journey with a change in the time and climatic zone;
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 illnesses, including:

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

Using an IUD can also increase blood volume.

Diagnostic methods

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

A vaginal swab that will show the presence of pathogenic microorganisms.
Bacteriological culture from the cervical canal.
A smear for oncocytology.
Screening for STIs.
Gynecological examination and bimanual examination.
Endocrinological examination to detect malfunctions of the ovaries, thyroid gland, pituitary gland and hypothalamus.
Donating blood for hormones.
Ultrasound of the pelvic organs.
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 disease (fibroids, cysts, tumors), detecting it at an early stage. Lost time can lead to death or disability.

Hormonal disruption 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 enter the 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, and hormonal drugs.

It should be borne in mind that every woman has her own genetically built 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, adequate sleep and rest. In addition, the doctor may prescribe vitamins. If, after the measures taken, the problem is not resolved, you will again have to go to the gynecologist for a treatment course.

With 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 taking medications these days is aimed at relieving cramps, alternative methods are good because the effect from them lasts a long time. Sometimes psychotherapy sessions help. Positive results are also achieved with folk methods, but only after discussion with a 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, surgical intervention or complex therapy in a hospital will be required.

Separately, it should be said about working with anovulatory cycles. It is impossible to increase the number of eggs in the body, and artificial stimulation will only lead to an early depletion, so this method is used only when infertility is diagnosed.

conclusions

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

Prevention of NMC is based on two rules:

Avoiding anything that can compromise health.
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. It is necessary to accept the fact that medical or surgical care may be needed, and the sooner the better.