Many women are interested in the issue of the opsomenorrhea, what it is, because of what it develops and how to treat it. The average duration of the menstrual cycle is from 21 to 35 days. Changes in its duration in the direction of increasing for any reason, has the name opsomenorei. This violation is a companion of the pathological process and can carry a threat to the life of a woman. This is especially reflected in reproductive function. The duration of the cycle with opsomenorae can reach 4 months, and also the intensity of bleeding changes in the direction of reduction.
Factors of occurrence
The menstrual cycle is completely regulated by hormones, therefore, the occurrence of opsymenorrhea during puberty or menopause is not a pathology. In the first case, this is due to the rate of puberty, and in the second - with hormonal regression. The menstrual cycle has two phases. During the first, there is growth and an increase in the inner layer of the uterus, in the second - endometrial rejection and its exit beyond the uterus. In the normal course of this process, a new egg has time to grow and mature, and the old one leaves the body with menstrual flow. And if the cycle is broken by the type of opsomonorrhea, then the probability of conception is sharply reduced.
You should know that this pathology preserves the two-phase nature of the menstrual cycle, but the timing changes. Hormonal imbalance provokes a violation of the length of the phases of the cycle, while the process of ovulation is not completed or completely absent.
Depending on the reasons for the occurrence of osmenorrhea is
- Primary occurs in the pathology of the female reproductive system or its underdevelopment and manifests itself initially in the form of a long first menstruation,
- secondary is a consequence of pathological processes that disrupt the brain, or the presence of changes in the uterus and appendages.
The reasons for the appearance of the first are abnormalities in the development of reproductive organs, their hypoplasia or infantilism, the presence of asthenia in the period of early sexual development. Secondary occurs due to many reasons, namely:
- lack of nutrition
- diseases of the cardiovascular system
- inflammatory processes with spread to the genital and urinary systems,
- the effects on the body of chemicals
- trauma to the uterus or ovaries, including abortion,
- brain neoplasms,
- parasitic damage to the body,
- autoimmune pathology,
- hormone disruption,
- psycho-emotional trauma.
Symptoms of pathology
It is believed that the disease has no symptoms of its own, but only accompanies other diseases. However, there are signs of this pathology that characterize the obssenorrhea. Given that this pathology disrupts the duration of the phases of the menstrual cycle, the full maturation of the follicle does not occur, therefore, the ovulation process remains inadequate. This leads to a sharp decrease in the chances of a woman to become pregnant. When this occurs, the transformation of the menstruation itself, the volume of which is significantly reduced and they take the form of "traces" or "smears".
Opsomenorrhea is often accompanied by infertility and ovarian pathology in the form of polycystic. Long-existing or untreated opsenorrhea can transform into amenorrhea. Following the violation of the menstrual cycle, there is an increase in the weight of the woman, as well as the appearance of acne on the face and chest. The emergence of secondary male-female sexual characteristics in the form of noticeable hair on the lips, hands and back, or a change in the muscles towards an increase, can also be a sign of osomenorei. It is worth noting the decrease in sexual desire and the appearance of dissatisfaction with sexual intercourse. Gynecological examination can reveal abnormalities of the genital organs or detect the inflammatory process.
The diagnosis is carried out using a range of studies. In any case, complaints and anamnesis are first taken into account. It is necessary to focus the attention of the patient on what infectious diseases she suffered, whether there were injuries or abdominal operations. Data on genetic pathology and hereditary diseases are also important.
After that, the patient is examined, in which anomalies of the congenital and acquired organs of the reproductive system are excluded. In addition, blood is taken for a full examination, namely:
- general blood and urine analysis
- detailed biochemical profile,
- testing for HIV, hepatitis and genital diseases,
- analysis of the hormonal background of the woman.
Blood is taken and discharge from the cervix for targeted diagnosis. Performed ultrasound of the genitals and abdominal organs. Consultation of an endocrinologist, a neurologist and, if necessary, a neurosurgeon is necessary to exclude concomitant pathology.
How to treat pathology?
The diagnosis is the reason for consulting specialists of various profiles. Given the risk of complications of this disease in the form of infertility, the examination should not be postponed “for later”. Moreover, the absence of periods does not add health either.
Treatment of opsomenorrhea is complex and asymptomatic, which implies pathology therapy depending on the degree of its manifestation.
The general meaning of treatment is to combat the cause of this pathology. In the presence of genital infections as a matter of urgency they are treated. The same applies to the inflammatory processes of any localization.
After elimination of the identified pathology, it is necessary to perform a blood test to clarify hormonal background and the presence of changes. If hormonal changes are detected, they are corrected. Duration of treatment with hormonal drugs depends on the duration of the disease, the presence of prior treatment, the body's response to the therapy.
More specifically, in the presence of infections, antibacterial therapy is conducted with a preliminary study of the patient's biological material for sensitivity to antibiotics.
Elimination of hormonal imbalances is carried out with the help of hormone therapy, the duration of which is controlled by laboratory. Normalization of psycho-emotional status to normalize the menstrual cycle is carried out with the help of homeopathic remedies, the action of which is potentiated and corrected with the help of hormones. The duration of such treatment is individual and depends on the duration of the disease, the presence of a combined pathology and prior treatment.
Immunomodulators must be connected to the treatment in order to activate the body's own forces. In the presence of some functional disorders, manifested by a sharp weight loss or suddenly increased physical exertion, you need to change the nature of the life cycle.
Do not interfere with the use of vitamins in order to eliminate their deficiency. It is necessary not only to influence the drug on the patient, but also to try to change the way of life.
In order to establish and stimulate blood circulation in the pelvis, physiotherapeutic methods can be used. Of these, electrotherapy deserves special attention, the most common form of which is electrophoresis with the addition of thiamine or zinc. Localization of the latter should be directed to the collar area.
Treatments such as acupuncture and therapeutic mud baths occupy a separate niche. However, the appointment of physiotherapy should take into account the presence of comorbidities, namely: uncorrected arterial hypertension, various pathologies of the nervous system, which require surgical treatment, and brain neoplasms.
Obsmenorrhea is a complex of symptoms, and its treatment must begin with lifestyle changes and the exclusion of adverse factors. As for neglected cases, their treatment should be carried out strictly under the supervision of a doctor and in the conditions of a medical institution.
Opsomenorrhea in menopause and puberty: pathology or norm
During puberty, the menstrual cycle is only forming and may be unstable. Therefore, any fluctuations are not considered a deviation from the norm, but are quite acceptable even in a healthy organism.
Pathology is often observed during the onset of menopause. This is a long process, so the body needs time to restructure. There is nothing terrible in the occurrence of scanty bloody discharge. This is considered normal.
The causes of the problem
Share two forms manifestations of the disease:
Primary develops in the case of congenital abnormalities of the genitals or their underdevelopment. Opsomenorrhea occurs with the onset of the first menstruation and constantly recurs.
The causes of the secondary form are provoking factors. They are:
- Endocrine disorders.
- Surgical intervention.
- Infectious diseases.
- Psychologically disturbed.
- Hormonal disruptions.
- Strong physical exertion.
- Diseases of the genitourinary system.
- Depletion of the body.
- A brain tumor.
- Climate period.
The main symptom of opsomorei - increase the interval between cycles. Also available:
- Lower abdominal pain.
- Low back pain.
- Fast fatiguability.
Much reduced menstruation. They can begin and end in one day. And the amount of discharge is too meager, possibly of a scanty character.
There is an increase in weight, acne appears on the face and chest. Perhaps the appearance of hair on the male type:
- Over lip.
- On hands.
- On the back.
Disappears sex driveand the sexual act itself does not bring satisfaction.
The secondary form may manifest itself in the form of symptoms of the underlying disease that provoked it. Possible itching, rash, redness of the skin.
NMC type opsomorei
NMC type opsomorei - impaired duration or phase of reproductive function. Most often manifested in puberty, but may occur after its stabilization. The intervals between menstruation may occur during both two-phase and single-phase cycle.
The development of pathology in reproductive age is an obstacle on the way to conception. But the menstrual cycle can be adjusted, after which it is possible to get pregnant.
If a disease is suspected, a diagnosis is made. It consists of:
- History taking.
- Inspection of the genitals.
- Blood and urine analysis.
- Hormone analysis.
- Ultrasound of the pelvic organs.
If the diagnosis is confirmed, an individual treatment plan is developed. It depends on the indications of diagnosis and is selected individually for each patient.
First of all it is necessary eliminate the cause developmental pathology. Only after that you can count on positive results of treatment.
Primary Osomenorrhea difficult to treat. Participate in the process endocrinologists, genetics, surgeons.
To eliminate the inflammatory processes are assigned antibiotics. They also help destroy genital infections.
Why are monthly painful and what to do to reduce pain? The answer is here.
Is required hormonal drugs. The duration of their admission is determined by the attending physician. Depending on the situation, hormone therapy can be carried out in courses or before menopause.
It is recommended to strengthen the body and raise immunity. taking vitamin complexes. It is also necessary to adhere to a special diet. It is necessary to saturate the diet fresh:
Refuse to use too fatty, spicy, fried foods. And also from alcoholic beverages and tobacco.
Adipose tissue in the female body is a source of sex hormones. In case of their excess or deficiency, the reproductive system suffers. To eliminate this problem, you need to adjust body weight. A nutritionist works with a woman for these purposes. He makes a daily menu and makes good recommendations.
To improve blood circulation in the pelvic organs, physiotherapy methods are used:
- Healing mud.
Detection of pathology at an early stage of development significantly increases the chances of recovery. Therefore, in case of detection of characteristic symptoms, you should immediately contact a gynecologist.
Video: Opsymenorrhea: symptoms, treatment and prevention.
What happens to opsenorrhea
Often a woman does not pay due attention to her menstrual cycle. This usually happens until the moment when the desire to become pregnant suddenly becomes an unattainable dream, while gynecologists and fertility specialists are already shrugging.
Menstruation reflects the state of health of a woman and her ability to continue the race. Fine:
- bleeding lasts 3 to 5 days,
- the intervals between the “critical days” of 21–35 days (from the first day of the beginning of one cycle to the first day of the beginning of the second cycle),
- blood loss of about 40 ml.
Allocate primary and secondary form. Types of amenorrhea vary with manifestations. In the primary form of a woman, menstruation is initially pathological. When a secondary disease develops as a result of disruption of the organs of the reproductive system - the normal cycle is extended to 36 or more days. The primary and secondary NMCs of the type of opsomenorei are also sometimes referred to as congenital and acquired, respectively.
Signs and symptoms of pathology
The main symptom of obssenorrhea is the absence of periods for 36 days or more. Sometimes a break between cycles can be up to 4-6 months or more. Other symptoms characteristic of the hypomenstrual syndrome can also be added:
- decrease in the volume of menstrual blood (the norm is about 40 ml),
- reducing the number of "critical days" less than three.
With careful questioning, you can identify other non-specific signs and symptoms:
- decreased libido - libido,
- miscarriage at different times,
- skin changes: excessive dryness, acne and others,
- reduced performance
- frequent depression,
- pain in the abdomen, including during sexual intercourse.
Disruption at the level of the uterus and ovaries
The manifestation at the level of the female genital organs is expressed in the following:
- Genital hypoplasia is a significant decrease in the size of the female genital organs while maintaining proportions in the structure.
- Sexual infantilism - asymmetrical underdevelopment of the reproductive organs.
- Perimenopause when ovarian function fades away. NMCs, especially osmenorrhea, always accompany this period in a woman’s life, which lasts from 2 to 4 years on average.
- Formation of menarche. Within two years from the beginning of the first menstrual period, any girl may have significant fluctuations in the cycle.
- Lack of ovarian function.
- Frequent abortions and other manipulations inside the uterine cavity can lead to the inferiority of its inner lining - the endometrium, and subsequently the development of opsymenorrhea. In addition, abortion has a negative effect on the ovaries and the hypothalamic-pituitary system.
- Inflammatory diseases of the genital organs.
- Polycystic ovary syndrome.
- Autoimmune diseases of the ovaries.
Changes in the level of the pituitary and hypothalamus
The pituitary and hypothalamus are brain structures that secrete a large number of active substances that regulate the functions of all internal organs in the body, including the sex organs. The latter are controlled by regulating the production of sex hormones. The problems with the menstrual cycle are:
- hypothalamic-pituitary insufficiency, as well as an imbalance in hormone production,
- Sheehan syndrome,
- brain tumors, including the pituitary gland.
Other factors affecting the occurrence of a woman’s problem
In addition to the above, problems with the menstrual cycle can be influenced by the following factors:
- overweight or underweight,
- psycho-emotional overload,
- violation of the work of other endocrine glands (thyroid, adrenal glands, etc.,
- intoxication of the body against the background of chronic pathology (tuberculosis, HIV and others), as well as after severe infectious diseases,
Treatment of omenorrhea should begin with determining the reliable causes of the disease. This often requires consulting not only the gynecologist, but also other related specialists - an endocrinologist, a psychiatrist and a psychologist, a neurologist, a nutritionist, a therapist, and others.
The most frequent therapeutic measures:
- Purpose of hormonal drugs: analogues of female sex hormones, thyroid gland, adrenal glands. Dosage, regimen and duration of treatment is determined by the attending physician.
- Therapy of STIs and other inflammatory diseases of the pelvic organs.
- Correction of body weight. In the female body, adipose tissue, in addition to all its functions, is a source of female sex hormones. Therefore, with an excess or lack of lipids in the body, the reproductive system suffers.
- Appointment of sedative drugs, including antidepressants.
- Herbal medicine, homeopathic medicines.
- Physiotherapy - acupuncture, electrophoresis, massage, etc.
We recommend reading the article on algomenorrhea. From it you will learn about the types and classification of the disease, primary and secondary algomenorrhea, the causes of painful periods, diagnosis and treatment.
Prevention of Osomenorei Development
Mom should still take care of the state of the future reproductive health of the girl when the baby is just beginning her life in utero. Favorable psychological climate in the family, school - all this affects the development of the girl. In adult life, the girl to monitor their health, which includes:
- prevention of sexually transmitted infections
- minimizing all manipulations inside the uterus, including abortions,
- competent management of childbirth and the postpartum period,
- regular sex life
- diet rich in vitamins, minerals, trace elements, tartar,
- sufficient physical activity.
Opsomenorrhea is a menstrual disorder, often indicative of serious diseases in a woman’s body. Treatment of this pathology should be carried out on time and by high-level specialists. This is the only way to avoid the unpleasant effects of this condition, including infertility. Anxious attitude towards their health will lead to a happy, sometimes long-awaited motherhood, as well as family well-being.
Causes of Omenorrhea
Primary opsmenorrhea is formed as a result of malformations of the genitalia, delayed sexual development, general and genital infantilism, adhenia during puberty. In this case, menarche usually comes late, and in the future the rhythm of menstruation becomes rare. Various acquired pathological conditions that adversely affect menstrual function lead to the development of secondary opsomonorrhea. This may be alimentary dystrophy, psycho-emotional trauma, hard physical labor, severe intoxication. Changes in the rhythm of menstruation by the type of opsomenorrhea may be associated with surgical operations - abortions, RFD, ovarian resection, oophorectomy, adnexectomy.
Sometimes opsomenorrhea develops on the background of endocrine disorders (often - polycystic ovarian disease, hypothyroidism, Sheehan syndrome), autoimmune, parasitic diseases, brain tumors, sluggish infectious processes, including the genitourinary system. In addition to pathologic opsomenorrhea, there is a physiological decrease in menstruation - for example, during puberty and the formation of a cycle, in the premenopausal period, due to the gradual extinction of ovarian function.
Types of the menstrual cycle with opsomorea
In a healthy organism, the cycle is divided into the following phases: menstrual, follicular, ovulatory and luteal. During the first period begin monthly. During the second - the development of eggs in the follicles. Next comes ovulation - the exit of the reproductive cell and its entry into the abdominal cavity of a woman. It is at this time that the sexual process is observed.
In the absence of a fertilized egg in the luteal phase of the cycle, the development and subsequent destruction of the corpus luteum, a temporary gland appearing in the place of a burst follicle, occurs. In the case of opsomenorrhea, the duration of one of the described phases fails. Luteal period may be absent. Depending on this, there are several types of cycles that are characteristic of omenorrhea.
It occurs in 75% of cases of the disease. There are the following types of it:
- With an extended follicular period. With such a course of opsenorrhea, follicle maturation occurs on the 20-30 day of the cycle. Ovulation occurs at the end of this period, followed by the luteal phase. Thus, the beginning of the next menstruation shifts. This form of opsomorei is most often accompanied by inadequate production of follicle-stimulating hormone by the pituitary gland.
- With an extended follicular phase and shortened luteal. In this case, there is a late development of the follicles, a time shift at the time of ovulation and ovulation. But while there is underdevelopment of the corpus luteum. In addition to the lack of production of FSH, there is a shortage of progesterone in the body.
In 25% of cases, it is observed with the underdevelopment of the female reproductive system. With this form of the disease, a mature egg does not come out of the follicle, and continues to exist in it for some time. The body actively produces estrogen, which leads to its excessive concentration. This, in turn, provokes endometrial hyperplasia. After the follicles begin to break down, the level of estrogen decreases. A thick layer of the uterine mucosa is rejected, abundant uterine bleeding occurs.
The disease is classified according to two types: congenital (primary) and acquired (secondary). They differ in the causes of appearance, and also have different methods of treatment. In the congenital form of the disease, the cycle has a pathological character from the first critical days. Acquired disease is a violation of the rhythm of menstruation after a period when the menstrual cycle was normal. The illness develops on the background of certain phenomena and conditions that can affect female sexual function.
A delay in identifying opsomonorrhea and its causes leads to infertility. The examination of the patient includes:
- blood chemistry,
- collecting history of life,
- inspection on the chair,
- Ultrasound of the pelvic organs,
- HIV and STD tests,
- hormone analysis
- smear fence.
Perhaps you will need the advice of allied specialists, an endocrinologist. The full volume of diagnostic studies for each patient is selected individually.
Symptoms of opsomenorrhea
Clinically, ossenorrhea occurs in the form of rare periods. The intermenstrual interval is over 35 days, but not more than 3 months. The intensity of the menstrual bleeding is usually insignificant (smears or blood drops), the duration is short. Changing the phase of the menstrual cycle causes the inferiority of ovulation or anovulation, so many patients with osomenorrhea suffer from infertility. In some cases, opsenorrhea becomes secondary amenorrhea. Along with rare periods, there are symptoms of the underlying disease.
Opsomenorrhea can have 2 different types of flow: with the presence of a prolonged two-phase or monophasic menstrual cycle. With an extended two-phase cycle, the delay in menstruation is due to the prolonged process of maturation of the follicle. In the first phase of the cycle, the follicle either does not develop at all or undergoes atresia at one of the developmental stages. The secretion of estrogen in this case is low, the basal temperature is single phase, and colpocytology indicates a low degree of epithelial proliferation. Subsequently, after growth retardation, the follicle still matures, but ovulation can occur on the 20-30 day of the menstrual cycle. The duration of the corpus luteum phase is shortened or not changed. The level of sex hormones does not differ from that with a normal menstrual cycle, the basal temperature in the second phase becomes higher than 37 ° C, the cytology of vaginal smears reflects the secretory changes of the endometrium.
Obsomonorrhea with monophasic cycle is less common - in 22-24% of cases, usually in patients with hypoplasia of the genitals. At the same time, the state of the endometrium remains unchanged and corresponds to the beginning of the proliferative phase. Another cause of opsomonorrhea with a monophasic cycle may be the persistence of the follicle. In this case, the phase of the corpus luteum does not occur, and the persistent follicle creates the conditions for endometrial hyperplasia. The reverse development of the follicle is accompanied by a sharp drop in the level of estrogen and rejection of the functional layer of the uterus of the endometrium, which is clinically expressed by menorrhagia.
Opsomenorrhea and its forms
NMCs by type of osmenorrhea are caused by congenital or acquired factors.
Primary disorders are noted from the time of menarche (first menstruation), they are the result of the pathology of the development of the reproductive system or its underdevelopment (infantilism).
About such a violation of the menstrual cycle, as a secondary opener, can be said if the woman's earlier periods were regular, but under the influence of external or internal causes, the cycle length increased.
Opsomenorrhea occurs in two forms:
- The extended two-phase stage at which the process of maturation of the follicle is delayed. In the first phase of the cycle, the follicle does not develop at all or its growth stops. Estrogen levels are low. During the second phase, the follicle still matures, but the timing of ovulation is postponed, which can cause infertility.
- Monophasic type - is found several times less, characteristic of genital hypoplasia. In this case, the corpus luteum phase does not occur, the amount of estrogen drops sharply, and endometrial cells are rejected.
All NMCs in reproductive age lead to disturbances in the course of the phases and negatively affect fertility; therefore, every woman should know what opsymenorrhea is.
Symptoms of pathology
When opamenorai women notice an increase in the duration of the menstrual cycle and a decrease in the intensity of bleeding. The nature of menstruation changes, there are spotting within 2–3 days.
With this form of impairment, ovulation can occur very late. In some cases, there are nagging pain in the lower abdomen, general weakness, and increased body fatigue. There are signs of the underlying disease that led to the NMC.
The state of the reproductive system in the absence of treatment worsens, secondary open-back pain can lead to the onset of secondary amenorrhea (cessation of menstruation). To determine the exact cause of the violations can gynecologist after conducting a diagnostic examination. During puberty, you need to monitor the development of the girl, so as not to miss the symptoms of primary osomenorei. Before menopause, changes in the duration of the menstrual cycle have physiological causes.
The directions and volume of therapeutic measures are determined by the main pathology, age and reproductive plans of the woman. Congenital anatomical defects, severe forms of sexual infantilism are difficult to correct. In these cases, the tactics of treatment of opsomenorrhea is developed together with geneticists and endocrinologists. Some types of pathology (brain tumors, PCOS) may require surgery.
The leading role in the regulation of the menstrual cycle is played by hormone therapy. It allows you to restore the normal rhythm of menstruation. If this is not enough for the onset of pregnancy, resort to stimulation of ovulation. If the cause of omenorrhea was inflammatory gynecological diseases, antibiotic therapy, vitamin therapy, immunostimulation are performed. Use of natural factors (balneotherapy, mud therapy), neck area electrophoresis, gynecological massage, acupuncture. With a deficiency of weight, an individualized diet is developed with a complete diet. Patients with osmenorrhea are advised to avoid physical exertion and psycho-emotional upheaval.