Gynecology obstetricists often face a complaint «Delay of menstruation». At the same time, the patient has concern and regular issues: «All right? I am not pregnant? Is that others? Healthy Li Ya?» Talk about the causes of this state that may be different.
Content
Menstrual cycle is monthly changes in the female organism that occur under the influence of sex hormones. The main sign of the normal cycle (its duration of 21-35 days) is considered regular menstruation - bleeding from the genital organs, the duration of which is normal to 3-7 days.
Normal blood loss during menstruation does not exceed 50-100 ml.
The menstrual function is adjustable using a joint activity of a complex complex of nerve and humoral structures (brain bark; hypothalamus and pituitary gland in the inner secretion, located in the brain), as well as genital organs (ovaries, uterus).
Since all levels of this system are interrelated, the delay of the next menstruation may be associated with a violation of any of the listed links. Therefore, the reason for the delay of menstruation can be «breaking» On any of the levels of regulation of the menstrual cycle.
Cause of delay number 1. Polycystic ovarian
Menstruation delay can be caused by various gynecological diseases, such as inflammation of the appendages of the uterus (salpingo-phorit), myoma (benign tumor) uterus and others. However, it should be noted that with these diseases, bleeding from the uterus is more often observed.
Periodic menstruation delays are characteristic of such a disease, such as ovarian polycystosis (PCA). Under this concept, a number of painful processes are combined, in which hormone production is broken. At the same time, there is no ovulation in the body (the exit of the egg from the ovary) and infertility occurs.
PCA is observed in violation of the function of various organs: hypothalamus, pituitary glands, adrenal glands, thyroid gland and ovarian themselves. Therefore, the disease can appear in different ways depending on the causes of its occurrence, and to establish a diagnosis is not enough to use any one diagnostic character or method.
In case of ovarian polycstries, the menstrual cycle is most often found (more often - delays from several days to several months), excessive growth of hair on the body, an increase in the size of the ovaries (but not always), half of the patients - obesity.
When measuring basal temperature (in the rectum), it remains approximately constant during the cycle, and does not increase in its second half, as in normal. With the most pronounced (primary) form of the disease, these signs appear already in adolescence after the occurrence of menstruation.
For the treatment of this state, various hormonal drugs are prescribed, funds that reduce the level of male genital hormones (which increases with the disease), regulating metabolic processes in brain structures, etc.
In the presence of obesity, it is absolutely necessary to reduce body weight. When preparing for the planned pregnancy, an important stage of treatment is to stimulate ovulation - the exit of eggs from the ovary.
Drugs are used for this, and during their ineffectiveness, surgical treatment methods use. Currently, it is carried out by laparoscopy: small holes are made in the front abdominal wall, through which optical instruments for inspection of the abdominal cavity and surgical instruments are introduced.
Cause of delay number 2. Abortion
Menstruation delay may also occur after the abortion of pregnancy. The cause is the violation of the hormonal balance, as well as the fact that during the instrumental scraping of the uterus, an excessive amount of tissues can be removed, including that part of the inner cape of the uterus, which normally increases during the menstrual cycle and is released in the form of menstrual blood.
To restore this functional layer, sometimes it takes a few more time than during the normal cycle. That is, after an abortion, menstruation may occur not in 28-32 days, but after 40 days and more. Such a delay is not normal: a woman requires a survey and treatment.
Cause of delay number 3. Reception of oral contraceptives
The reason for the delay of menstruation may be the reception of oral contraceptives. During the drug or after its cancellation, there may be a lack of menstruation for several menstrual cycles: this is the so-called ovarian hyperborement syndrome.
In the development of the syndrome of hyperships of the ovaries, oral contraceptives cancel. As a rule, within 2-3 months, the maximum - within 6 months after the end of their reception, the ovarian function is restored. If the absence of menstruation persists more than a long, assign funds that stimulate the pituitary operation, or drugs that stimulate the ripening of the egg and its output from the ovary. Before restoring a normal menstrual function, it is necessary to use other methods of contraception.
Cause of delay number 4. Stress
Stress - Long-term or strong short-term - is the cause of failure in the work of the central structures (cortex of the brain, hypothalamus), regulating the work of the ovarian and uterine. An example of such disorders can be the so-called amenorrhea of wartime, when menstruation ceased under stress conditions.
Cause of delay number 5. Weight loss
Another reason for a significant latency of menstruation can be a significant and fast weight loss. Doctors have such a thing as a critical menstrual mass - this weight, in the presence of teenagers, menstruants are usually beginning. However, we are more interested in the fact that with a strong desire to lose weight, reaching this critical menstrual mass (45-47 kg), a woman can receive not only the desired result, but also a long delay in menstruation.
Most often, such an effect occurs with nervous anorexia - violation of food behavior characterized by refusal to eat and / or its rejection. This is accompanied by a disorder of such regulatory systems of the body, like nervous and endocrine. Nervous anorexia is characterized by a sharp decrease in the production of pituitary hormones regulating including the operation of the ovaries.
In this case, the violation of the reproductive function should be considered as a protective reaction in the conditions of food deficit and mental loads. Therefore, to restore the age secretion of hormones, the ideal body mass and the elimination of mental stress is required.
Nervous anorexia in 50% of cases may occur with episodes of bulimia (increments), after which the patient has particularly explicit signs of anxiety, repentance and depression, successful attempts to cause vomiting.
For this reason, preparing for pregnancy, do not try to achieve the ideal «90 - 60 - 90». If you plan to lose weight, take this reasonable, and better - contact a nutritionist.
Cause of delay number 6. Pregnancy
Pregnancy is, fortunately, the most frequent and most physiological reason for the latency of menstruation in women of reproductive age. In this case, the delay of menstruation may be accompanied by such signs, as a change in taste and olfactory sensations, flaw, diseases of the mammary glands.
As a rule, a pregnancy test in this case gives a positive result. Menstruation delay occurs during ectopic pregnancy, when the fruit egg is attached in the mother liquor. At the same time, all the subjective sensations characteristic of pregnancy may also be present.
What could doctor?
When disorders of the menstrual cycle, you must immediately consult a doctor. Inspection of the obstetrician-gynecologist will eliminate states that require immediate surgery.
