Oligomenorrhea - this increase in range (not more than 35 and not less than 60 - 90 days) between periods.Menstruation at oligomenoree are short and last from several hours to two days.Oligomenorrhea as included in the clinic symptom hypomenstrual syndrome, infertility or other serious hormone-dependent diseases.
Short oligomenorrhea often appears in infancy (puberty) or extinction of menstruation (menopause) due to changes in hormonal regulation.Oligomenorrhea This can be attributed to physiological, it does not require treatment and runs independently.It may also include physiological oligomenorrhea a small number of women with recurrent (regular) long interval (50 days) between periods if they retain the ability to conceive (fertility) and have no concomitant endocrine diseases.
If the original oligomenorrhea adolescents is not transformed into a normal menstrual cycle, it is called primary.Secondary oligomenorrhea occurs in women with normal menstrual functions against
Irregular menstruation is the most common reason for seeking medical attention.The menstrual cycle is a very complex mechanism of interaction of all structures responsible for hormonal, endocrine and central nervous activity of the body.Over a lifetime, the majority (70%) of women occur menstrual disorders of various kinds.Typically, such disorders are temporary.If they are accompanied by more severe symptoms, such as infertility, it is necessary to understand the causes and conduct adequate therapy.It is believed that if the number of menstrual periods each year continues to decline (less than 7 per year), even in the absence of other disturbing symptoms to consult a doctor is needed.
normal menstrual cycle provides cyclic changes in the number of members of the pituitary and ovarian hormones under the control of the central nervous system (hypothalamus).In healthy women, the menstrual cycle is biphasic.In the first phase under the influence of follicle stimulating hormone (FSH) in the ovaries begins to mature follicles - "bubble", which is growing and developing female sex cell (ovum).In turn promotes follicle ripening amount of estrogen (primarily estradiol) and a widening of the inner layer of the uterus (endometrium).By mid-cycle FSH level is reduced to a minimum and take the leading role of luteinizing hormone (LH) and progesterone.The drop in estrogen levels and increase of progestorona lead to the fact that the egg is ripe for an hour leaves the follicle, ie ovulation.If, within two days of the egg is not fertilized, it dies, and in the womb of feedback process begins rejection overgrown endometrium ending menstruation.The degree of hormonal dysfunction in women with oligomenorrhea can range from mild to severe, leading to anovulation and infertility.Oligomenorrhea often precedes amenorrhea - the complete absence of menstruation.
Primary oligomenorrhea in adolescents is associated with violations of due puberty and / or birth defects (malformations) genitals.Prerequisites for the development of primary oligomenorrhea formed during fetal development.
Secondary oligomenorrhea may occur in women with normal menstrual cycle after serious trauma or strenuous exercise.Malnutrition and occupational hazards can also negatively affect the menstrual function.
Among the causes that provoke oligomenorrhea, there are:
- Acute or chronic infection (endometritis, adnexitis, salpingoophoritis and so on);
- violations should function in a system, the hypothalamus-pituitary-related injuries, infectious or mental diseases;
- neginekologicheskie Endocrine pathology of the endocrine glands.Changes of quantitative production of thyroid hormones, adrenal glands or the pancreas leading to a common hormonal imbalance and affect the ovaries;
- Incorrect use of hormonal drugs, including contraceptives;
- Polycystic Ovarian Syndrome.It is characterized by an abnormal increase in the content of androgens (male sex hormones) that compete and displace estrogens;
- underweight.The cause of its decline can be a natural weight loss as a result of severe acquired or congenital diseases and / or malnutrition.Excessive desire of women to reduce weight artificially can also lead to the emergence of oligomenorrhea.
oligomenoree If there is a distortion of the menstrual cycle.The cycle keeps the two-phase, but the length and the ratio of the two phases changes.The probability of ovulation in these changes is small - it only occurs in 20% of patients.
oligomenorrhea physiological reasons are not established.
oligomenorrhea oligomenorrhea is not a disease for which is inherent in the whole complex of symptoms.It itself is only a symptom, the essence of which - a very brief (no more than two days) menstruation.That is why the diagnosis of oligomenorrhea is never final, it just points to the dominant symptom that requires ascertain its causes.Almost always oligomenorrhea combined with another symptom - opsomenoreey indicating infrequent menstruation, so they are often combined and referred to as "oligomenorrhea."The amount of menstrual blood can vary from mild to moderate.If the amount of lost blood is less than 40 ml, it is called gipomenoreey.The combination of oligosaccharides, and opso- gipomenorei is called hypomenstrual syndrome, which is a serious disease.
Thus, oligomenorrhea is a symptom that may be present in many other diseases, such as fever or headache accompanied by a huge number of ailments.Complaints of patients with oligomenorrhea determined by the underlying disease that caused it.
oligomenorrhea most often as a symptom accompanies:
- Disorders of fat metabolism, which is the outward signs of overweight and acne, fat deposits can be worn by non-physiological in nature;
- hirsutism, hair growth, or "male pattern": under the influence of androgens (male sex hormones) dark hair stem appear in the chest area, upper lip and chin, back and abdomen;
- Men's figure;
- Decreased sexual desire;
- Depletion of the patient.Abuse and starvation diets to reduce weight can lead to menstrual dysfunction.
essence oligomenorrhea diagnosis is to determine its causes.The pelvic examination to determine the state of the uterus and appendages, reveal the presence of inflammatory diseases.Pap smears can detect or rule out the presence of infection.
is impossible to overestimate the importance of hormonal research.Determining the level of sex hormones - FSH, LH, prolactin, estradiol and progesterone - is necessary to determine the nature and degree of hormonal disorders, as well as to select the method of therapy.For the diagnosis of infertility, it is important to establish the absence of ovulation.Hormonal studies are conducted in accordance with the phases of the menstrual cycle.
Ultrasound scanning (US) pelvic determines the size of the uterus and appendages, identifies deviations in their development and diagnose inflammatory processes.Especially the ovaries are closely investigated, namely - the size, condition of blood circulation, tissue density, the presence of follicles, polycystic signs and so on.
not often as necessary, the hysteroscopy.
survey and consultation related professionals help to establish the nature neginekologicheskuyu oligomenorrhea.Endocrinologist, neurologist and internist, if necessary, carry out a survey as part of their profession.
After a full examination oligomenorrhea diagnosis is not correct and gives way to a diagnosis of the underlying disease leading to oligomenorrhea.
primary diagnosis of oligomenorrhea put patients at a young age, if the end of puberty, is not accompanied by the establishment of the normal rhythm of menstruation (period of 21-35 days in duration and 8, but not less than 2 days).
Primary oligomenorrhea often the result of intrauterine growth retardation, accompanied by hypoplasia and / or infantile genitalia.If the size of the uterus is not correlated with the age norm, talk about sexual infantilism.The degree of sexual infantilism is determined by the presence or absence of ovarian failure and the level of underdevelopment of the uterus:
- First degree infantilism is very rare and is related to developmental abnormalities, characterized by the presence of rudimentary uterus.Menstruation is practically absent.Restoring the normal structure of the female reproductive organs when such a structure is not possible.
- Second degree of underdevelopment corresponds to the "child" size of the uterus and is accompanied by oligomenorrhea.Adequate long-term treatment helps to restore the normal anatomic structure of the organ.
- third degree of infantilism - hypoplasia of the uterus.The uterus has a normal structure, but its size does not correlate with the age norm.The reasons can be hypoplasia of severe infections or inflammatory diseases of genitals at puberty.Oligomenorrhea when hypoplasia is temporary and lasts as long as the queen is not "grow up" under the influence of therapy.Hypoplasia of the uterus may disappear on their own due to internal hormonal resources.
Ultrasound examination in the presence of primary oligomenorrhea to determine the presence of abnormalities in the development of sexual organs, and laboratory tests to establish the nature of hormonal disorders.
Secondary oligomenorrhea never accompanies puberty, it is inherent in older women.This is facilitated by a variety of reasons - from the "simple" like fatigue or cold to serious diseases.The emergence of short-term disturbances of the menstrual cycle, followed by a self-recovery - an absolutely normal situation.
oligomenorrhea If there is a long time, accompanied by alarming symptoms such as infertility, hirsutism, obesity, decreased sexual desire, or endocrine disorders, requires an in-depth examination.
oligomenorrhea secondary treatment involves the elimination of the underlying disease.
Treatment of oligomenorrhea
for the successful elimination of oligomenorrhea necessary to establish the cause.Treatment of oligomenorrhea is not carried out:
- when the patient is a young girl with no signs of abnormal development of reproductive organs and endocrine diseases, may be monitored for two years;
- In the waning days of menstrual function (menopause);
- When oligomenorrhea is caused by short-term factors.For example, if the cause of oligomenorrhea is excessive physical exertion or fatigue, oligomenorrhea self-destructs.
presence of endocrine pathology require treatment together with the endocrinologist.The menstrual cycle can lead to normal only after adequate treatment of underlying disease.
After treatment of the underlying disease is successfully completed, proceed to the restoration of the menstrual cycle by hormonal correction.It is possible that the menstrual cycle is restored without any medical intervention.