Menstrual disorders are the actual problem of gynecology, many functions of the female body are associated with it: reproductive, family planning, infertility, inflammatory diseases, contraception and oncopathology. Of all gynecological diseases, menstrual disorders account 20%. What is a normal menstrual cycle? These are cyclical changes in a woman's body that repeat with intervals of 24-38 days and manifest by regular uterine bleeding (menstruation - mensis), which lasts from 4,5 to 8 days. The menstrual cycle (MC) includes the period from the first day of one menstruation to the first day of the next menstruation. Today, any deviation of the menstrual cycle from the norm, including changes in the regularity and frequency of menstruation, the duration of menstrual bleeding or the amount of blood lost is called abnormal uterine bleeding.
What are the signs that will help determine that you really have the disorders of menstrual cycle? There are several symptoms that indicate on pathological changes in the menstrual cycle:
- menstrual bleeding occurs more often than 21 days (proyomenorrhea)
- prolonged menstrual bleeding > 7 days (polymenorrhea)
- heavy menstrual bleeding > 80 ml (hyperpolymenorrhea)
- scanty menstrual bleeding < 30 ml (oligomenorrhea)
- menstrual bleeding occurs less than 45 days (opsomenorrhea)
- painful and irregular menstrual bleeding (dysmenorrhea)
- menstrual bleeding occurs 3 - 7 days before the expected menstruation (premenstrual bleeding)
- bloody discharge between periods (metrorrhagia)
- absence of menstrual bleeding for 6 months (amenorrhea)
The causes of menstrual disorders can be quite different. Scientists identify several factors that can cause irregular menstruation:
- physical or psycho-emotional overload
- sexual dysfunction (congenital pathologies of the female genital organs) and genetic diseases
- chronic or acute infectious diseases (genital or extragenital)
- inflammatory diseases of the genital organs
- complications after abortion or childbirth
- use of certain drugs (antibiotics, hormonal drugs)
- external factors (climate change, long journeys, dietary changes, sleep disorders)
- traumas of the genitourinary system
- bad habits (excessive alcohol consumption, smoking, drug use)
If you have any symptoms that indicate to disorders of the menstrual cycle, you should immediately consult an obstetrician-gynecologist, who will conduct a full clinical and laboratory examination. Diagnostics of menstrual disorders includes:
- assessment of anamnesis, physical and sexual development, assessment of the menstrual calendar, clarification of the psychological characteristics of the patient
- gynecological examination includes examination, bimanual examination, according to the indications - vaginoscopy and colposcopy
- a set of laboratory tests consists of general and biochemical blood tests, test of hormones in the blood (follicle-stimulating and luteinizing hormones, prolactin, estrogen, progesterone, testosterone, cortisol, thyroid-stimulating hormone, free thyroxine), microscopy of vaginal secretions, if necessary - examination for sexually transmitted diseases
- ultrasound of the pelvic organs (assessment of the size and structure of the genitals, endometrial thickness, exclusion of malformations, pregnancy, adenomyosis, polyps or hyperplasia of the endometrium, ovarian cysts, pelvic tumors), and, if necessary, ultrasound diagnostics of the thyroid gland and mammary glands
- consultations with related specialists (geneticist, endocrinologist, generalist, psychiatrist, etc.) who help the gynecologist to identify the cause of menstrual disorders
Treatment of menstrual disorders is prescribed depending of the cause of disorders and symptoms. In each case, treatment is selected individually. Specific treatment may include hemostatic agents (in case of bleeding), hormone therapy to correct endocrine disorders, and anti-inflammatory and antibacterial therapy to treat infectious diseases. Surgical treatment is used for tumor processes, congenital malformations of the female genital organs, these processes are the basis of menstrual irregularities.
You should remember that menstrual irregularities - this is the first bell from our body, which can’t be ignored! It is necessary to immediately consult an obstetrician-gynecologist, who will prescribe the necessary examination and begin the necessary treatment in time. And restoration of normal menstrual function is an important measure to prevent reproductive health problems in the future.
- Андрієць О.А., Рак Л.М. Порушення оваріально-менструального циклу в підлітковому віці.
- Державна програма «Репродуктивне здоров’я нації» // Здоровье женщины. - 2008. - №1 (33).
- Наказ № 353 від 13.04.2016 МОЗ України «Про затвердження та впровадження медико – технологічних документів зі стандартизації медичної допомоги при аномальних маткових кровотечах».
- Герасимова Т.В. Тези до лекцій по гінекологічній ендокринології.