irregular menstruation
Introduction
Introduction to irregular menstruation Irregular menstruation, also known as menstrual disorders, is a common gynecological common disease, manifested as abnormal menstrual cycle or bleeding volume, or abdominal pain and systemic symptoms before and during menstruation, the cause may be organic lesions or function Abnormal. Many systemic diseases such as blood diseases, hypertension, liver disease, endocrine diseases, abortion, ectopic pregnancy, hydatidiform mole, genital tract infections, tumors (such as ovarian tumors, uterine fibroids) can cause menstrual disorders. From the beginning of menstruation, you should learn, understand some common sense of health, have a correct understanding of the physiological phenomenon of menstrual cramps, eliminate fear and nervousness, prevent primary dysmenorrhea or increase pain threshold to reduce pain, pay attention to menstrual period And sexual life hygiene, prevention of menstruation, ascending infection during the production period, and actively prevent and treat diseases that may cause menstrual blood retention. basic knowledge Sickness ratio: 0.1% Susceptible people: women Mode of infection: non-infectious Complications: dysmenorrhea, premenstrual syndrome, polycystic ovary syndrome, perimenopausal syndrome
Cause
Irregular menstruation
Caused by organic lesions or drugs (25%):
Including local inflammation of the reproductive organs, tumor and dysplasia, malnutrition, intracranial disorders, other endocrine disorders such as thyroid, adrenal gland dysfunction, diabetes, Xi's disease, liver disease, blood disorders, etc., using psychosis Drugs, endocrine preparations or contraceptives with intrauterine devices may have irregular menstruation. Some occupations such as long-distance runners are prone to amenorrhea. In addition, some abnormal bleeding during pregnancy is often mistaken for irregular menstruation.
In clinical diagnosis of menstrual diseases with neuroendocrine dysfunction, various organic causes must be excluded.
Emotional abnormalities cause menstrual disorders (20%):
Emotional abnormalities Long-term mental depression, suffocation or major mental stimulation and psychological trauma can lead to menstrual disorders or dysmenorrhea, amenorrhea, because menstruation is formed by hormones secreted by the ovary to stimulate the endometrium, and ovarian secretion hormones are affected. The control of hormone release from the pituitary gland and hypothalamus, so whether the ovary, pituitary gland, or hypothalamus function abnormally, will affect menstruation.
Cold stimuli cause less menstruation or even amenorrhea (20%):
According to the study of living, women's menstrual period is stimulated by cold, which will cause excessive contraction of blood vessels in the pelvic cavity, which may cause less menstruation or even amenorrhea. Therefore, women's daily life should be regular, avoiding overwork, especially during menstruation to prevent cold and damp.
Dieting causes irregular menstruation (15%):
Over-dietary related experts have shown that girls' fat accounts for at least 17% of body weight, before menarche can occur, body fat can reach at least 22% of body weight, in order to maintain a normal menstrual cycle, excessive diet, due to insufficient energy intake, the body A large amount of fat and protein are consumed, resulting in a lack of estrogen synthesis disorders, affecting menstrual cramps, and even a small amount of menstruation or amenorrhea, therefore, the pursuit of slim women, must not blindly diet.
Aphrodisiac causes irregular menstruation (10%):
Some of the ingredients and alcohol in alcoholic cigarette smoke can interfere with the physiological processes related to menstruation, causing irregular menstruation. Among women who smoke and drink excessively, 25%-32% of them are treated in hospital due to irregular menstruation. Among women who smoke more than 1 pack per day or drink more than 100 mg of high-alcohol liquor, menopause is three times that of non-smokers and women, so women should not smoke or drink less.
Neuroendocrine dysfunction caused: mainly in the lower hindbrain - raw tea cup - ovarian axis is unstable or defective, that is, menstrual disease.
Normal menstruation is an important indicator of the health of mature women. Many women suffer from menstrual disorders, but only from uterine hypoplasia, acute and chronic pelvic inflammatory disease, uterine fibroids and other gynecological diseases, but ignore the reason outside the uterus. I don't know, many bad habits can also cause menstrual disorders.
Prevention
Irregular menstruation prevention
1. Since the menarche, you should learn, understand some common sense of health, have a correct understanding of the physiological phenomenon of menstrual cramps, eliminate fear and nervousness, prevent the occurrence of primary dysmenorrhea or increase the pain threshold to reduce the pain level. Pay attention to menstrual period and sexual hygiene, prevent infection during the period of labor, and actively prevent and treat diseases that may cause menstrual blood retention.
2, menstrual period should pay attention to keep warm, avoid cold, cold, raw, cold stimulation, to prevent cold evil invasion. Pay attention to rest, reduce fatigue, strengthen nutrition, and enhance physical fitness; try to control severe emotional fluctuations, avoid strong mental stimulation, and maintain a happy mood; usually prevent excessive room labor, and absolutely prohibit sexual life during menstruation.
3, menstrual period should pay attention to diet conditioning, pre-menstrual and menstrual period eat cold cold and cold products, in order to avoid cold blood clots and dysmenorrhea increased the amount of menstrual flow, it is not appropriate to eat spicy and dry things, so as not to be forced to blood, bleeding more, and Be careful not to abuse the drug, according to the cause of dysmenorrhea, syndrome differentiation.
Complication
Irregular menstruation Complications of dysmenorrhea, premenstrual syndrome, polycystic ovary syndrome, perimenopausal syndrome
Menstrual disorders abnormal menstruation or other symptoms are the following:
1, dysmenorrhea: menstrual period combined with severe pain in the lower abdomen, affecting work and daily life. Both primary and secondary.
2, premenstrual syndrome: a series of abnormal signs of a few women before menstruation, such as mental stress, emotional instability, inattention, irritability, depression, insomnia, headache, breast pain and so on. Mostly caused by sexual hormone metabolism disorders and mental factors. Treatment should be based on appropriate rest, sedation and diuretics if necessary, and anti-estrogen therapy such as progesterone, androgen, and bromocriptine.
3, polycystic ovary syndrome: the cause is unknown. It is characterized by menstrual thinning or amenorrhea, infertility. Symptoms such as hairy and obese, double ovarian polycystic enlargement, can be treated with hormone surgery.
4, menopausal syndrome: refers to a series of physical and mental symptoms caused by fluctuations or reduction of sex hormones in some women before and after menopause, divided into natural menopause and artificial menopause. Such as sexual dysfunction, paroxysmal bleeding.
Symptom
Symptoms of irregular menstruation Common symptoms Menstrual cycle changes Menstrual volume Multi-menstrual blood clots Menstrual menstrual period Menstrual period Prolonged menstrual period Pain pain Menstrual period Delayed menstrual period Menstrual period Before and after abdominal pain Falling bleeding
There are several cases of disturbances in the menstrual cycle or bleeding volume:
1, irregular uterine bleeding, including: menorrhagia or duration is too long, common in uterine fibroids, endometrial polyps, endometrial hyperplasia, endometriosis, etc.; less menstruation, menstrual volume and Menstrual period is small, frequent menstruation, that is, menstrual interval is less than 25 days, menstrual cycle is extended, that is, menstrual interval is longer than 35 days, irregular bleeding, can be caused by various reasons, bleeding is not regular, the above several conditions can be caused by local causes, endocrine Caused by or caused by systemic diseases.
2, functional uterine bleeding, refers to internal and external genital without obvious organic lesions, and abnormal uterine bleeding caused by imbalance of endocrine regulation system, is the most common type of menstrual disorders, common in adolescence and menopause, divided into ovulation And anovulatory, about 85% of cases are anovulatory dysfunctional uterine bleeding.
3, postmenopausal vaginal bleeding, refers to bleeding after 6 months of menstruation, often caused by malignant tumors, inflammation and so on.
4, amenorrhea, refers to the future menstruation or menstrual cycle has been established and stopped more than 3 cycles, the former is primary amenorrhea, the latter is secondary amenorrhea.
Examine
Irregular menstruation
In order to accurately determine the cause, the physician can select an appropriate examination according to the patient's condition. The commonly used examination methods are as follows:
1. Ask your medical history in detail to find out the possible causes. Patients should strive to provide accurate information.
2, a comprehensive physical examination to see if there is a serious systemic disease.
3, pelvic examination to get a preliminary understanding of the reproductive organs with or without deformity, tumor or inflammation.
4. Auxiliary inspection:
(1) B-ultrasound examination: reflecting the uterus, ovary and pelvic conditions.
(2) Cytological examination: examination of ovarian function and exclusion of malignant lesions.
(3) Biopsy: Determine the nature of the lesion and use it for the diagnosis of the tumor.
(4) Endocrine measurement: It is currently possible to measure hormones secreted by pituitary gonadotropins, prolactin, ovary, thyroid and adrenal cortex. The simple methods commonly used to understand ovarian function are vaginal smear, cervical mucus, basal body temperature and endometrium. Biopsy and so on.
(5) X-ray examination, uterine lipiodol angiography can understand the condition of the uterus, with or without submucosal fibroids or polyps, the positive lateral lesion of the sella can understand the presence or absence of pituitary tumors.
(6) Hysteroscopy or laparoscopy: observation of lesions in the uterine cavity and pelvic organs.
(7) Check liver, kidney function and blood system as appropriate, and perform chromosome examination if necessary.
Diagnosis
Irregular diagnosis of menstruation
Diagnostic points
1. The menstrual cycle is advanced or delayed more than 7 days, or there is no regularity.
2, the amount of menstruation is small or a little bit is net.
3. The amount of menstruation is more than or more than 8 days.
If the above situation persists during normal time, it may be irregular menstruation, which should be taken seriously, because irregular menstruation is usually a related factor that causes infertility. Therefore, if you are preparing for pregnancy, it is best to have menstruation. The situation is improved without adjusting the situation, so as to ensure the smooth progress of pregnancy.
Differential diagnosis
According to clinical symptoms and signs, gynaecological examination can be distinguished from most diseases:
1, early menstruation
(1) The menstrual cycle is more than 7 days in advance, or even a half-monthly line, for more than 3 consecutive menstrual cycles.
(2) The menstrual cycle is half a month earlier, and should be differentiated from intermenstrual bleeding, puberty, and menopause.
2, late menstruation
(1) The menstrual cycle exceeds 35 days and continues for more than 3 menstrual cycles.
(2) The postponement of women of childbearing age should be differentiated from pregnancy, adolescence, and menopause.
(3) gynecological examination, B-ultrasound or pneumoperitoneography to exclude uterine and ovarian organic diseases.
3, menstruation has no regular
(1) The menstrual cycle or before or after, more than 7 days, and more than 3 consecutive menstrual cycles.
(2) Menstrual cycle disorders should be distinguished from adolescent and menopausal menstrual disorders.
(3) gynecological examination and B-ultrasound and other abnormal lesions, basal body temperature, vaginal smear, cervical mucus crystallization examination to understand ovarian function.
4, more menstruation
(1) The menstrual cycle is basically normal, the amount of menstruation is significantly increased, more than 50 ml, or more than 7 days.
(2) gynecological examination and B-ultrasound examination, to exclude uterine fibroids and other organic diseases.
(3) Excluding thrombocytopenia and coagulopathy caused by menorrhagia.
5, less menstruation
(1) The menstrual cycle is basically normal, the amount of menstruation is very small, less than 30 ml, or even a drop.
(2) The disease should be differentiated from early pregnancy.
(3) Eliminate less menstruation caused by tuberculosis.
