Menstrual Cycle Disorders

Rhythmically repetitive, hormone-conditioned processes in the female body, accompanied by menstrual bleeding at certain time intervals, are called the menstrual cycle. During the menstrual cycle, the body undergoes changes aimed at providing the conditions necessary for the occurrence and course of pregnancy: the development and maturation of the egg, its fertilization and attachment to the mucous membrane of the uterine cavity. The formation of menstrual function refers to puberty (puberty) period. As a rule, menarche (the first menstruation) occurs at 11-14 years, after which the regularity of the menstrual cycle is established for 1 -1.5 years.

During the menstrual cycle, the body undergoes changes aimed at providing the conditions necessary for the occurrence and course of pregnancy: the development and maturation of the egg, its fertilization and attachment to the mucous membrane of the uterine cavity.

The formation of menstrual function refers to puberty (puberty) period. As a rule, menarche (the first menstruation) occurs at 11-14 years, after which the regularity of the menstrual cycle is established for 1 -1.5 years. The duration of the cycle is calculated from the first day of this menstruation to the first day of the next. Depending on the individual physiology, the menstrual cycle normally ranges from 21 to 30-35 days, more often 28 days. The extinction of menstrual function occurs in 45-50 years, in the menopausal period.

The regulation of the menstrual cycle occurs under the influence of a complex neurohumoral mechanism carried out by the cerebral cortex, pituitary gland, hypothalamus, ovaries, with the involvement of the vagina, uterus, mammary glands.

Gonadotropic hormones secreted by the hypothalamic-pituitary system – FSH, LH and LTG (follicle-stimulating, luteinizing and luteotropic hormones), cause changes in the ovaries – the ovarian cycle, which includes:

• follicular phase – the process of follicle maturation
• the ovulation phase is the rupture of the mature follicle and the release of the egg
• progesterone (luteal) phase – the process of development of the corpus luteum

At the end of the menstrual cycle, in the absence of completed fertilization of the egg, the yellow body regresses. Sexual homones of the ovaries (estrogens, progestogens) cause a change in tone, blood filling, excitability of the uterus, dynamic processes in the mucous membrane, i.e. the uterine cycle consisting of two phases:

• the phases of proliferation are restoration, healing of the wound surface and further development of the functional layer of the endometrium. This phase occurs simultaneously with the process of follicle maturation.
• the phases of secretion are loosening, thickening and rejection (desquamation) of the functional layer of the uterine mucosa. Rejection of the functional layer is manifested by menstruation. In time, this phase coincides with the development and death of the corpus luteum in the ovary.

Thus, normally the menstrual cycle is two-phase: with the follicular and luteal phases of the ovarian cycle and, corresponding to them, the phases of proliferation and secretion of the uterine cycle. Normally, the cyclical processes listed above are repeated again and again at certain intervals throughout the entire female childbearing age.

Menstrual function can be disrupted as a result of gynecological diseases (fibroids and uterine cancer, inflammation of the appendages and uterus), severe extragenital diseases (diseases of the blood, endocrine organs, liver, central nervous system, heart defects), infections, hypovitaminosis, traumatic damage to the uterus (during instrumental manipulations – abortion, etc.), stress and mental trauma.

Menstrual cycle disorders can manifest themselves in changes in the rhythm and intensity of menstruation: lengthening or shortening the interval between them, increasing or decreasing the amount of blood secreted, in the inconsistency of the rhythm of menstruation. Menstrual cycle disorders occur in the form of:

• amenorrhea – absence of menstruation for more than 6 months
• hypermenstrual syndrome (hyperpolymenorrhea, menorrhagia), including:

1. hypermenorrhea – copious menstrual bleeding;
2. polymenorrhea – menstruation lasting more than 7 days;
3. proiomenorrhea – frequent menstruation with a shortening interval of less than 21 days

• of hypomenstrual syndrome, including:

1. hypomenorrhea – scanty menstrual discharge;
2. oligomenorrhea – shortened menstruation (no more than 1-2 days);
3. opsomenorrhea – excessively rare, with an interval of more than 35 days, menstruation

• algomenorrhea – painful menstruation;
• dysmenorrhea – menstruation accompanied by general disorders (headache, lack of appetite, nausea, vomiting);
• algodismenorrhea – menstruation, combining local soreness and general disorders of well-being
• anovulatory (single-phase) uterine bleeding resulting from disorders of neuroendocrine regulation and characterized by the absence of ovulation and corpus luteum.

Menstrual dysfunction in a single-phase menstrual cycle can be caused by follicle persistence (follicle maturation without ovulation and further development of a follicular cyst) or atresia (degeneration, desolation) of an immature follicle.

To identify the biphasicity of the menstrual cycle in gynecology, the method of regular morning changes in rectal (basal) temperature is used. With a two-phase menstrual cycle in the follicular phase, the temperature in the rectum is less than 37 ° C, and in the luteal phase – more than 37 ° C, with a decrease one or two days before the onset of menstruation. With an anovulatory (single-phase) cycle, the temperature curve differs in readings less than 37 ° C with small fluctuations. Basal temperature measurement is a physiological method of contraception. Also, with a two-phase cycle, characteristic changes are observed in the cytological picture of vaginal discharge smears at different periods: symptoms of “thread”, “pupil”, etc.

Metrorrhagia, that is, acyclic uterine bleeding that is not associated with the menstrual cycle, more often accompany tumor lesions of a woman’s reproductive system. Women suffering from a menstrual cycle disorder must necessarily undergo a gynecologist’s consultation and the necessary examinations to determine the causes of the disorders. Treatment of menstrual dysfunctions should be aimed at eliminating the causes that caused the disorder.

Often, subsequent violations of menstrual function can be caused by improper laying and differentiation of the genital organs of the fetus during intrauterine development. Negative factors causing the underdevelopment of the ovaries in girls can be chemical, medicinal, radiation agents, infectious diseases of the mother. Therefore, prevention of menstrual function disorders should begin from the period of antenatal (intrauterine) fetal development, carrying out pregnancy management. Proper nutrition and lifestyle, taking care of your general and women’s health will help to avoid disorders in menstrual function.