NMC test during the childbearing period. See what "NMC" is in other dictionaries. How to extend a woman's reproductive age

The menstrual cycle is a natural process that is subordinate to the reproductive function. But, like any mechanism in the human body, it can deviate from normal course. Disorder menstrual cycle wears different character depending on external and internal factors, but the most common type is hyperpolymenorrhea.

Hyperpolymenorrhea: description of the problem and its features

Hyperpolymenorrhea refers to menstrual disorders, characterized increased bleeding and increased duration menstruation In this case, most often, patients experience preservation of the periodicity of critical days.

A violation is determined when the daily volume of menstrual flow exceeds 150 ml, and the duration of bleeding is up to 7 days. If a woman notices a decrease in the period between menstruation and an increase in the intensity of discharge, then, most likely, proyomenorrhea has joined hyperpolymenorrhea.

After emotional stress, sudden change climatic conditions and under the influence of other external factors, a woman may begin to have heavy and prolonged menstruation. It is isolated in nature and will occur in the next cycle according to the usual scenario.

In adolescence, hyperpolymenorrhea is associated with the physiological development of ovarian function and hormonal fluctuations. Start menopause also causes disruption due to the natural decline of reproductive function.

TO pathological reasons hyperpolymenorrhea refers to the presence of neoplasms in the uterus - polyps, fibroids, adenomyosis. They interfere with the rejection of the endometrium in the second phase of the menstrual cycle and interfere with the contractile function of the uterine wall. Under such conditions, a woman experiences prolonged and heavy bleeding. The presence of ovarian dysfunction, hyperestrogenism or endometriosis leads to pathological growth endometrium, which leads to hyperpolymenorrhea.

Important! Hyperpolymenorrhea also develops with liver diseases that inhibit the utilization of estrogen. Hormonal imbalance in this case affects the menstrual cycle.

To others reasons hyperpolymenorrhea includes:

1. genetic predisposition ;
2. ectopic pregnancy;
3. taking hormonal contraceptives;
4. presence of an intrauterine device;
5. bleeding disorder;
6. chronic diseases.

According to statistics, hyperpolymenorrhea is diagnosed in 50% of women with uterine fibroids, and up to 10% of patients using intrauterine contraceptives.

Signs of hyperpolymenorrhea complicated by additional disorders in the body are:

1. menstrual bleeding more than 7 days;
2. increased volume of secretions- blood loss is up to 250 ml;
3. gain painful sensations in the abdomen and lower back;
4. weakness and dizziness;
5. increased fatigue;
6. sudden weight loss;
7. fainting;
8. pale skin.

Most symptoms are due to anemia, which develops due to large blood loss.

When visiting a gynecological office, the doctor will interview the patient to study the characteristics of the menstrual cycle and the nature of its changes. More detailed information will follow diagnostics:

• Gynecological examination will determine the possible presence inflammatory processes in the genitals.
• Ultrasound of the pelvic organs will allow you to assess the condition of the mucous membranes of the uterus and ovaries.
• Smear collection and their further microscopic and bacteriological examination will determine the infectious origin of hyperpolymenorrhea.
• Clinical blood test will show the degree of iron deficiency anemia.

In addition, in severe cases, the gynecologist may decide to perform a diagnostic curettage. This is necessary for the endometrium in case of heavy bleeding.

Many women with long and heavy menstruation try to independently eliminate the symptoms of hyperpolymenorrhea. They stop bleeding with drugs such as Vikasol, Tranescam, and pain syndrome filming No-shpoy.

But menstrual irregularities require elimination of the causes and more in-depth treatment. Symptomatic treatment consists of taking medications:

A drug	Release form	Action	Reception scheme
Dicynone	injections, tablets	strengthens capillary walls, increases blood clotting	from the 5th day of menstruation, 250 mg. Course of treatment - 10 days
Vikasol	pills	increased prothrombin synthesis, blood thickening	2 pcs. per day, no more than 3 days
Askorutin	pills	strengthens blood vessels, reduces blood loss	3-4 days before the start of menstruation, 1-2 pcs. 3 times a day
Ibuprofen	effervescent tablets	reduces pain, relieves inflammation	daily dose - 4−6 pcs. dosing interval: 6 hours, dissolve in 200 ml of cold water
Tranexam	solution, tablets	hemostatic	1 PC. 3 times a day, do not use more than 3 cycles in a row
Fenyuls	syrup, tablets, capsules	eliminates iron deficiency, normalizes hemoglobin concentration	1 piece 1 time per day for a month

IMPORTANT! Independent choice of drugs for the treatment of hyperpolymenorrhea can aggravate a woman’s condition. Therefore, you should adhere to the dosage regimen prescribed by the gynecologist.

Surgical treatment in the form of hysteroscopy and curettage of the uterine cavity is required for women with inflammatory processes in the organ that cannot be corrected with medications. Also, the endometrium is removed in the presence of tumor-like formations and pathological changes in its structure.

Prevention

A woman should understand that the stability of the menstrual cycle depends on many factors. And therefore, to prevent hyperpolymenorrhea with NMC, you should:

1. exclude casual sexual contacts;
2. avoid unprotected sex;
3. visit a gynecologist every six months;
4. balance your diet;
5. accept vitamin complexes in autumn-winter period;
6. monitor the regularity of menstruation.

When detecting heavy and prolonged periods, a woman should hurry up and go to an appointment with a gynecologist. After all, a timely diagnosis will allow effective treatment and eliminate the cause of hyperpolymenorrhea.

Video: menstrual irregularities (MCI) - what are the causes and what to do?

Menstruation- this is one of the periods of the menstrual cycle, which is important aspect in the life of any woman. Most often, menstruation begins at 10-14 years of age, depending on individual characteristics a woman’s body, genetic predisposition plays a significant role. Over the next 30-40 years, the woman is accompanied by this process. During this time, 70% of women experience various types of menstrual cycle disruptions. Such violations can occur at any age; neither girls nor women are immune from this. Even with external similarities, the causes of such disorders and their symptoms are different.

The physiological changes that occur in the body with the onset of menstruation are a complex chain of interconnected processes. The changes occurring in the body indicate that children's body rearranges and the girl enters reproductive period. But this does not mean that she is ready to conceive a child. The onset of menstruation is only the first stage in the transformation of a girl into a woman. For complete transformation, many processes must go through in the female body before it is ready to conceive and carry a pregnancy to term.

The length of the menstrual cycle is different for everyone, the most optimal period is 28 days. But deviation from this number of days per week will not be considered a violation. Therefore, 21-35 days are considered the norm. As a rule, by the age of 15 this period evens out, but sometimes regularity is established only after the first pregnancy. The duration of the course is controlled by hormones produced by the ovaries and pituitary gland. There are several hormones, but the most authoritative among them are FSH (follicle-stimulating hormone), estradiol, LH and progesterones. Menstruation itself also takes place during different time On average, the entire process takes no more than 7 days. During this period, the woman loses 80-100 ml of blood.

The menstrual cycle consists of the following phases.

• First period called follicular. At this stage, follicles mature. But not all of them mature, only the dominant ones, the rest atrophy. This period lasts 1-3 weeks.
• Second period – ovulation. Shell dominant follicle ruptures and an egg comes out. From the ovary it moves to the uterus; if fertilization does not occur at this stage, the egg is destroyed.
• Third period– luteal. Takes 12-14 days. The remains of the follicle are converted into corpus luteum. Active production of progesterone and estrogens begins. This allows you to prepare the endometrial walls for a possible pregnancy. If conception does not take place, the body dissolves, the content of progesterone and estrogen decreases. As a result, the process of endometrial detachment begins.

The menstrual cycle does not always occur on time; periodically, a woman may experience menstrual cycle disorders (MCI).

What is NMC? NMC is any kind of deviation from the norm of the menstrual cycle.

There are certain signs NMC, by which any woman can guess about the problems that have arisen in the body:

• Scanty or excessively heavy periods. The norm is considered to be 80-100 ml per cycle; pads are changed four times in the first days. If a woman's periods pass too quickly and their volume is too small, this phenomenon is called menorrhagia. The disease may be a consequence of inflammatory processes caused by ovarian dysfunction and neoplasms in them. In adolescence, this phenomenon becomes a consequence of hormonal imbalance. The situation with too heavy periods (more than 150 ml per cycle) is called hypermenorrhea. Bleeding too much, requiring frequent changes of pads. This condition is fraught with anemia, fainting, and dizziness.
• Long periods- polymenorrhea, as a rule, this disease is paired with hypermenorrhea. The duration of menstruation in this case is more than a week.
• Too short period of menstruation– oligomenorrhea, menstruation lasts less than 3 days. Often combined with menorrhagia.
• Menstruation occurs with severe aching pain. Painful sensation as if it encircles the entire lower abdomen. This condition is called algodismenorrhea. In this case, the pain spreads to the lumbar region, sacrum and thigh. The condition appears in a woman on the eve of menstruation or in the first days. It is caused by contractions of the uterus. This is primary dysmenorrhea and is not considered a deviation. The secondary stage of this syndrome develops as a result of uterine fibroids, endometriosis and other severe pathologies.
• Irregular menstruation. If the interval between periods is longer than 40 days, this is a reason to think about it. This deviation is not normal. Sometimes the interval reaches six months. Often this disease is marked by abundant acne on the face and body, and libido decreases. All over the body - on the arms, stomach, legs - abundant vegetation appears - this disorder is associated with an increase in male hormones. This is a consequence of a malfunction of the endocrine system. The reason for this condition may be abortion or anorexia.
• Bleeding not associated with menstruation– metrorrhagia. The blood may appear in clots or slightly noticeable bleeding. Sometimes pain occurs, as during menstruation, but more often this condition is asymptomatic. This phenomenon occurs in adolescents at the onset of menstruation or in women during menopause.
• Absence of menstruation for more than six months– amenorrhea. Most often this condition occurs during pregnancy and breastfeeding, in in this case this is a natural process. If neither one nor the other is present, and menstruation does not come for a long time, an urgent consultation with a gynecologist is required. It is quite possible that the cause was a disease of the reproductive system. There is primary amenorrhea - if a girl has not had her period by the age of 15. Secondary amenorrhea occurs when a sexually mature woman suddenly stops menstruating for more than three months.
• Menstruation is regular, but the interval between them is too long - from 35 days. The main reason - hormonal disbalance or a genetic characteristic of an organism.

The main causes of NMC

NMC itself is not a disease, it is only a consequence of some disease, but symptoms disorders can help in correctly diagnosing the true disease. There may be several reasons for the same illness, so for proper treatment Consultation with a specialist is extremely important.

The reasons for the failure of the menstrual cycle are very different - from psychosomatic to the genetic characteristics of the body of this particular woman. Often violations lie in ovarian disease and uterus.

• Polycystic – hormonal disorder ovaries, may be accompanied by enlargement of the ovaries, the appearance of fluid in them and an increase in estrogen levels.
• Adnexit– inflammation in the fallopian tubes, in chronic form may lead to infertility.
• Fibroids – benign neoplasm in the uterus. May be the result of an unsuccessful abortion.
• Endometriosis– one of the most common diseases of women of reproductive age, characterized by the growth of the endometrium throughout the uterine mucosa.
• Anomalies development– most often are congenital.

Malfunctions in the functioning of the reproductive system can be caused by injuries and unsuccessful operations, in particular abortions. They play an important role general diseases organism - diabetes, diseases of the cardiac system, kidneys, liver and even oncology. But still most often problems with menstruation associated with external factors.

• Deficiency of vitamins and microelements entering the body. Against this background, the body switches to power saving mode, against which background duration of the menstrual cycle is significantly reduced.
• Physical overexertion.
• Overweight and obesity can also cause NMC.
• Stress and mental disorders.
• Changing climatic zones sometimes leads to menstrual irregularities.
• Prolonged hypothermia can cause serious disturbances in the functioning of the reproductive system, and overheating can cause no less harm.
• Radiation exposure is carried out at oncological treatment and can also cause NMC.
• Taking some medications can lead to NMC.

Often the cause of untimely menstruation is hormonal imbalances, most often they occur in teenagers. The body has not yet developed its own system of the menstrual cycle and often the frequency of the cycle fluctuates different sides. It is considered normal at this age to fluctuate within a radius of 20-40 days. The volume of blood and the duration of menstruation may vary from cycle to cycle. Not considered normal enough copious discharge, their duration is 3-7 days. But if every cycle ends too heavy menstruation- a reason to contact a gynecologist for advice. Most likely this is associated with a number of deviations in the girl’s health.

The most common disorders in teenage girls are:

Hypothalamic syndrome. This syndrome often becomes the culprit of improper hormonal development, it can serve reason for absence menstruation, cause serious disruption of cardio-vascular system, provoke metabolic disorders in a teenager, cause mental instability. Girls often experience increased fatigue, frequent headaches, and frequent mood swings.

Delayed puberty– a similar diagnosis is given to adolescents with weakly expressed or even unexpressed secondary sexual characteristics. They begin to appear during puberty - the appearance of rounded shapes, breast swelling, the appearance of pubic hair and the menstrual cycle. In terms of menstruation, scanty discharge is most often noted, menstruation or not at all absent, or lasts only 2-3 days. The cause of NMC may be malnutrition as a result of an unbalanced diet. Excessive diet also does not lead to women's health. Excessive involvement in sports can lead to such a failure. Any load at this age should be balanced. Delayed sexual development may be hereditary. Sometimes such delays affect not only sexual development, but also affect the intellect and psyche, accompanied by poor memory, inattention, and apathy.

Juvenile uterine bleeding – menstruation lasts too long, a week or longer. Cause of this disease lies in ovarian dysfunction, which results in increased production of estrogen. More often this symptom passes by age 18. The biggest disadvantage of this condition is that the teenager’s fragile body loses a large volume of blood, which can result in anemia and vitamin deficiency, accompanied by a general loss of strength and health. Against this background, it is often observed headache, loss of appetite.

But if in adolescents the cause of NMC occurs due to instability of the menstrual cycle, then in women aged 45-50 years this is associated with the approach of menopause. The reason for these age-related changes is also a transformation of hormonal levels. Menopause is an inevitability that every woman will have to face sooner or later. With its onset, a woman loses her ability to reproduce. Changes in hormonal levels can occur with varying intensity. The body, entering the process of restructuring, can react differently to this vital cycle, including NMC.

The first thing the doctor does is interview the patient:

• date of last menstruation;
• cycle duration;
• the amount of bleeding also matters;
• How painful are periods and what symptoms are they accompanied by?
• patient's lifestyle;
• It is important to inform your gynecologist about the medications and dosages you are taking; this can help determine true reasons feeling unwell female patients;
• patient's age;
• a psychological condition can also cause the disease, so you should report it to your doctor;
• it's important to know what alarming symptoms and when they occur in the patient;
• the number of pregnancies, abortions, births, miscarriages help in diagnosis;
• previous gynecological surgeries;
• working conditions – the patient is a physical or mental worker;
• knowledge of diseases in close relatives will also help in diagnosis;
• Dietary patterns can also help in making a diagnosis.

The doctor will not get by with just conversations; an obligatory part of the visit is an examination in a gynecological chair. At this moment, the gynecologist collects biomaterial for analysis. This will help identify existing sexually transmitted infections. For further diagnostics Causes of NMC may require additional procedures.

Since many diseases in gynecology are a consequence of hormonal imbalance, and NMC is no exception, a detailed study of the patient’s hormonal background will be required. Blood is drawn from a vein; to obtain a high-quality result, you need to pass the test according to all the rules. Many hormones should be taken on a certain day of the menstrual cycle.

Ultrasound results of organs of the pelvis and abdominal cavity will also provide an expanded picture of the patient’s health status. Analysis of urine, biochemical analysis blood, examination thyroid gland– only a set of studies will help establish an accurate diagnosis gynecological character. Hysteroscopy will help obtain a layer-by-layer image of the pelvic organs. If necessary, a sample of the epidermis is taken from the uterus and obtained by curettage.

Treatment of NMC

Treatment of NMC directly depends on research results.

• Hormone therapy. It is often used to eliminate NMCs caused by a lack of a particular hormone. Treatment is carried out with drugs based on hormones produced by the ovaries or thyroid gland - it all depends on the test results. IN medicinal purposes Oral may be prescribed hormonal contraceptives. This is especially true when treating an unstable menstrual cycle.
• Painkillers and antispasmodics. This group of drugs is prescribed for painful periods.
• Hemostatic agents and uterotonics. This treatment is carried out when bleeding is too heavy during menstruation. They are also prescribed for poor blood clotting. Aminocaproic acid contained in the preparations helps stop bleeding.
• Homeopathy and physiotherapy. Treatment often comes down to taking medications based on herbs and natural ingredients. The courses are complemented by a complex of physiotherapy procedures.
• Phytotherapy. To improve hormonal levels, eliminate pain during menstruation, heavy bleeding treating the doctor can formulate treatment based on herbs. Teas, infusions, douching based on tansy, shepherd's purse, elecampane, prutnyak, valerian will help eliminate many problems.
• Surgical intervention. Such treatment is highly undesirable for girls, but in the presence of neoplasms and pathologies of various origins it is required surgical intervention doctor At serious illnesses female organs may require partial removal. To carry out these procedures, the patient goes to the department gynecology and is under close surveillance doctor before and after surgery.
• A course of antibiotics and anti-inflammatory drugs. This treatment is a specialist antenatal clinic prescribes upon detection of various types inflammatory diseases reproductive system. The complex in each case is selected according to the situation.

Comprehensive preventive measures will prevent some gynecological diseases. For this there are the following rules:

• Use only high-quality and the right products, vegetables and fruits are very healthy. They provide the body with a rich set of microelements, fiber and vitamins.
• It is important to avoid stressful situations and react to emerging situations without unnecessary emotions.
• Important in the life of every woman physical exercise. A set of special exercises will prevent a number of gynecological problems. But you should understand that the load must be adequate, not exhaust the body, but train and harden. Excessive strength training can lead to an increase in the level of testosterone, the male hormone, which will inevitably affect menstruation.
• Excess weight means extra problems. Obesity often leads to hormonal imbalances, which should not be allowed.
• Under no circumstances should you use strict diets, especially during adolescence. The body loses vitality, which negatively affects the menstrual cycle.
• You should visit a gynecologist regularly. Even if a woman has no complaints and feels great, she should visit a doctor at least once every six months. There are a number of problems that initial stage developments do not cause any discomfort. But if a woman often experiences various types of NMCs, this should be done much more often.

System for examining patients with NMC.

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

2. Carry out anamnesis collection: clarification of working conditions, the presence of occupational hazards and bad habits that could be the cause of the disease. Attention is also paid to a possible hereditary predisposition to a possible disease. Information about previous illnesses or surgical interventions is important. It is especially important to take into account diseases during a girl’s puberty. When analyzing menstrual and reproductive functions, be sure to take into account the time of the first menstruation, the nature of the formation of the menstrual cycle and its features during a woman’s life and when visiting a doctor. When making an anamnestic assessment of reproductive function, data on pregnancies that ended in abortion, childbirth, and spontaneous miscarriages are taken into account. Their number, features of the course of pregnancies, features of surgical interventions and the nature of the complications that arose after them are clarified. 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 in chronological order.

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

Body mass index (BMI) is an indicator that most accurately characterizes 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 excess hair growth on the face, chest, back, limbs and pubis in the male pattern, associated with excess production of androgens in the woman’s body.

4. Breast examination. The mammary glands, being one of the components of a single reproductive system, are under the direct influence of numerous hormones.

5. Gynecological examination allows you to evaluate the nature of hair growth (male, female), features of the development of the labia majora and minora, 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. During a bimanual examination, the size, location and mobility of the uterus are clarified, pathological changes ovaries and appendages, their size, pain. The condition of the retrosphenoid ligaments and the posterior vaginal vault is assessed to identify external genital endometriosis, in particular retrocervical.

Along with clinical research methods, laboratory and instrumental methods also play an important complementary role.

6. Functional diagnostic tests used to assess the hormonal function of the ovaries, determine the nature of the menstrual cycle and confirm ovulation. One of the most accessible methods is measurement basal temperature in the rectum. In the absence of ovulation, the basal temperature curve is below 37°C and is monophasic.

7. Hormonal research methods are the most reliable and accessible in assessing the hypothalamic-pituitary-ovarian and adrenal systems. Currently, enzyme-linked immunosorbent assay (ELISA) or radioimmunoassay (RIA) methods are used for determining hormones in biological fluids. It is known that hormone levels fluctuate depending on the age of patients, phases of the menstrual cycle, time of day and change during pregnancy. Blood for hormonal testing is taken from the ulnar vein from 9.00 to 12.00 on an empty stomach. Before taking blood, the patient is not recommended to undergo 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 are determined in daily urine. If thyroid dysfunction is suspected, TSH, T3 and T4 are determined. In case of menstrual irregularities such as oligo- or amenorrhea, blood collection for hormonal testing can be done on any day of the cycle. It is necessary to determine: prolactin, LH, FSH, TSH, estradiol (E), testosterone, cortisol, DEA-S or 17-CS, T3 and T4.

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

If the progesterone test is negative, a cyclic test with estrogen-gestagen drugs should be performed. The appearance of a natural menstrual-like reaction indicates that the endometrium is sensitive to an adequate level of steroid hormones. A negative test (no bleeding after stopping the administration of drugs) indicates a uterine form of amenorrhea.

8. Functional tests make it possible to clarify the condition, safety and reserve abilities of various levels of the neuroendocrine system, to carry out a differential diagnosis between functional and organic disorders, as well as primary and secondary hypofunction of the peripheral endocrine glands. These tests allow you to determine the hypothalamic or pituitary level of the lesion. Such tests include: tests with thyrotropin-releasing hormone and metoclopramide, a test with bromocriptine (Parlodel), a clomiphene test, a test with gonadoliberin, a test with ACTH, a small or large dexamethasone test.

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

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

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

12. Hysterosalpingography(HSG) is an x-ray method that is carried out in outpatient and inpatient settings and allows you to identify malformations of the uterus, pathological processes of the endometrium, submucosal uterine fibroids, adenomyosis, intrauterine synechiae, the condition of the fallopian tubes and the nature of the adhesive process in the pelvis. It is preferable to perform HSG on the 16-21st day, i.e. in the P phase of the menstrual cycle, which makes it possible to assess with a high degree of reliability the patency of the fallopian tubes, the presence of endometrial hyperplasia or polyps. It is possible to conduct research 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 for the following indications: dysfunctional uterine bleeding; disturbance of the rhythm of menstruation; intrauterine pathology (synechia, polyps and endometrial hyperplasia, adenomyosis, uterine fibroids, congenital intrauterine pathology; suspected endometrial hyperplasia or polyps); infertility; recurrent miscarriage. In phase I of the cycle, hysteroscopy is performed if submucous uterine fibroids and adenomyosis are suspected. If hyperplastic processes of the endometrium are suspected, the procedure is performed on any day of the cycle, and in case of intrauterine adhesions - on the eve of menstruation. In case of infertility of “unexplained” origin or defective luteal phase of the cycle, hysteroscopy is indicated on the 6th - 7th day of rising basal temperature.

Laparoscopy- a method that allows one to accurately identify various pathologies pelvic organs, part of which causes disturbances not only of menstrual but also reproductive function (external genital endometriosis, ovarian cysts, tumors of the uterus and appendages, tubo-peritoneal pathology). Laparoscopy allows you to significantly reduce the examination time and perform a low-traumatic correction of the identified pathology. Indications for laparoscopy are: all types of infertility; pelvic pain syndrome; suspicion of the presence of organic pathology of the genitals; suspected 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 expected pathology, is carried out in phase I or II of the cycle.

Menstruation is an integral aspect of the lives of all women and girls. The menstrual cycle begins at about 10 years of age and continues for 30-40 years. During this time, 70% of women experience some kind of disturbance in the functioning of this system. But few people know why menstrual irregularities occur. What are the symptoms of the pathology, and what is the prevention and treatment of NMC?

Menstruation: norm and pathology

The menstrual cycle consists of three phases:

This process allows a woman to conceive a child. The cycle is controlled by the pituitary gland, ovaries, uterus and nervous system. The duration of the cycle is from 28 to 35 days. Deviations from this period by several days or even a week are possible. Most often this is the norm.

Menstrual irregularities in gynecology are characterized by:

• delay of menstruation by more than 10 days;
• too short a cycle (less than 21 days);
• heavy bleeding for more than 7 days;
• cycle irregularity;
• soreness.

If you have one of these symptoms, it is important to seek help from a doctor to determine the causes of the deviation and begin treatment on time.

Some of the diseases that cause disruption in women monthly cycle, can lead to infertility or even the development of cancer.

Types of NMC

There is such a classification of menstrual cycle disorders:

Features of NMC at a young age

Menstruation begins in girls aged 10-14 years. A constant menstrual cycle is established within about a year. In adolescents it ranges from 20 to 40 days. Menstruation at this time is not heavy and lasts 3-7 days. Excessive bleeding during menstruation should be a concern. strong pain, absence of menstruation for more than six months. With such symptoms, you should consult a doctor.

These disorders occur in girls during puberty, since the reproductive system during this period is especially sensitive to the influence of unfavorable factors. The most common causes of NMC in adolescents are:

• poor nutrition;
• stress;
• bulimia and anorexia;
• infectious and colds.

Types of NMCs found in girls:

• Oligomenorrhea.
• Metrorrhagia.
• Menorrhagia.

Diseases that cause irregularities in the monthly cycle in teenage girls:

Causes of disorders and diagnostic methods

The functioning of the menstrual system can be affected by the following factors:

Menstrual irregularities can be a symptom of many diseases, including:

These are quite serious diseases, so when NMC appears, you need to consult a gynecologist to establish a diagnosis.

To determine the cause of NMC, the doctor first collects medical history data from the patient. All the details are important here:

After interviewing the patient, a gynecological examination is performed to identify abnormalities in the internal and external genital organs. The doctor also examines the chest and checks whether the liver and thyroid gland are enlarged.

Tests that may be prescribed include:

• General and biochemical analysis of blood and urine;
• vaginal smear;
• analysis of hormone levels in the blood;
• coagulogram (blood clotting test).

To establish an accurate diagnosis, functional diagnostic methods are used:

• radiography;
• Ultrasound of the pelvic organs or other organs (depending on the specific case);
• hysteroscopy;
• computed tomogram;
• MRI.

Based on all this data, the doctor will make a diagnosis and prescribe treatment. If the causes of NMC are not gynecological, then consultation with other specialists, for example: an endocrinologist, psychiatrist or therapist, will be required.

The onset of female puberty is marked by the beginning of menstruation. As a rule, in the first years the cycle is unstable, but after adolescence, it should normally improve. The diagnosis of NMC in gynecology is made quite often, and its reasons are varied. Menstrual irregularities cannot be ignored, since they reflect the functioning of not only the reproductive system, but the entire female body.

How do deviations manifest themselves?

The 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 you should note the obvious symptoms of NMC:

• the duration of the cycle goes beyond 21-35 days;
• severe pain before and during menstruation, spreading to the lower back, back, hips;
• the total volume of discharge is less than 25 or more than 150 ml;
• duration of menstruation is less than 3 or more than 7 days;
• irregular cycle;
• frequent delays in a regular cycle;
• spotting in the middle of the cycle;
• complete cessation of menstruation outside menopause, pregnancy or lactation.

Often a woman goes to the doctor with a complaint about several problems at once: scanty menstruation, a short cycle, no pain or menstruation for six months, but occasionally blood appears. NMC does not always indicate any disease; perhaps this is a variant of the norm for a certain woman. But even the most harmless deviation from the norm (especially if the body previously worked 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;
• long travel with changes in time and climate zones;
• colds.

If after a month or two the cycle parameters are not restored or a different schedule is established, this already indicates changes in the body that need to be studied.

Among the factors leading to the absence of menstruation (amenorrhea) are:

• severe loss of body weight (with body weight less than 45 kg, menstruation stops);
• hormonal imbalance due to natural causes;
• hormonal imbalance caused by taking medications;
• ovarian dysfunction;
• extreme physical activity;
• nutritional features;
• poisoning, intoxication with toxic substances;
• sexual infections.

Uncontrolled heavy bleeding most often indicates serious diseases, including:

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

Using an intrauterine device 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 determine the cause:

1. A vaginal smear that will show the presence of pathogenic microorganisms.
2. Bacteriological culture from the cervical canal.
3. Smear for oncocytology.
4. Screening for STIs.
5. Gynecological examination and bimanual examination.
6. Endocrinological examination to identify malfunctions of the ovaries, thyroid gland, pituitary gland and hypothalamus.
7. Donating blood for hormones.
8. Ultrasound of the pelvic organs.
9. A conversation with the patient, from which the attending physician learns important points her life: age of first menstruation, nutrition, physical activity, field of activity, sex life, taking medications, stress factors.

Danger of NMC

Very often, infertility and cycle disorders are directly related. Failures signal health problems. A disorder of the hormonal system interferes with the maturation of eggs, pregnancy does not occur or ends in miscarriage or death. Sometimes a woman does not pay attention to weak pronounced signs: scanty periods, fluctuating cycle length. This deviation from normal limits can also be a consequence of pathology of the reproductive system.

A timely examination can prevent the development of a serious disease (fibroids, cysts, tumors) by detecting it on early stage. Lost time can lead to death or disability.

Hormonal imbalance is not only problems with pregnancy. A deficiency or excess of any hormone disrupts the functioning of the entire body, which can lead to weight gain, decreased libido, deterioration of skin and hair, increased body hair growth, and 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 an anovulatory menstrual cycle, when the egg does not mature and is not released into abdominal cavity. Over the years, there are more and more such cycles, so the chance of getting pregnant decreases. With suspected pathology, the patient is sent for the same examinations as for NMC, adding diagnostics of the ovaries for tumors, polycystic disease, endometriosis, and exhaustion.

A decrease in ovarian reserve can be caused by genetic problems, diseases and surgeries, intoxication, vaginal dysbiosis, and taking hormonal medications.

It should be borne in mind that every woman has her own genetically determined ovarian reserve. Ideally, a woman’s ability to conceive remains 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

You can adjust your cycle and ovulation only after finding and eliminating the root cause. If examinations do not show any health problems, then it is possible that the reason for the failure of menstruation lies only in lifestyle, and therefore treatment is not prescribed. It is enough to change the diet, reduce emotional stress, make corrections physical activity, good sleep and rest. Additionally, the doctor may prescribe vitamins. If after measures taken the problem will not be solved, you will have to contact the gynecologist again for a course of treatment.

For 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 herbal medicine, which gently restores hormonal levels without side effects.

Menstrual pain (in the absence of illness as a cause) is well relieved breathing techniques, acupuncture and others unconventional methods. Since taking medications these days is aimed at relieving spasms, alternative ways The good thing is that their effect lasts for a long time. Sometimes psychotherapy sessions help. Positive results are achieved and traditional methods, but only after discussion with a gynecologist.

Oral contraceptives as a method of correcting NMC are prescribed by a gynecologist-endocrinologist strictly according to indications, selected individually, and the treatment process is monitored. To prevent weight gain, the doctor prescribes a diet for the period of taking OK.

To treat genital infections, antibiotics and drugs that restore the vaginal microflora are prescribed. IN in some cases will require surgery or complex therapy in the hospital.

It is worth mentioning separately about working with anovulatory cycles. It is impossible to increase the number of eggs in the body, and artificial stimulation will only lead to rapid depletion, so this method is used only for the diagnosis of infertility.

conclusions

NMC is possible throughout reproductive period. This wide range symptoms indicating malfunctions in the female body. It is believed that modern women People are increasingly faced with problems such as infertility and hormonal imbalance due to the deterioration of the environment and food quality, the advent of electronic technology, medication use and a decrease in physical activity.

Prevention of NMC is based on two rules:

1. Avoiding everything that can affect your health.
2. Regular visits to the gynecologist and testing.

Life is full of stress. Therefore, the NMC problem is often solved after eliminating harmful factor from life. The body begins to work at full strength given to it by nature. It is necessary to accept the fact that medical or surgical help may be needed, and the sooner the better.