delayed menstruation
Introduction
Introduction The menstrual cycle of women is generally 28 to 30 days. It is still within the normal range of 7 days in advance or delayed, and the length of the cycle varies from person to person. However, if menstruation has not come after 7 days, it is delayed. Delayed menstruation mainly needs to consider two reasons, the first is pregnancy, followed by irregular menstruation. Chinese medicine believes that the water is out of the kidneys, pointing out that menstrual disease and kidney function are related, and the spleen, liver, qi and blood, rushing pulse, Renmai, and uterus are also related. There are two main types: First, the deficiency syndrome, that is, "not glory is painful", is caused by qi and blood weakness or liver and kidney loss, such people should pay attention to adjustment, qi and nourish the liver and kidney. The second is empirical evidence, that is, "nothing is painful", which is caused by poor blood flow. Such people should be relieved of pain and pain.
Cause
Cause
1, pregnancy:
For women of childbearing age who have had sex, when menstruation is delayed, they often suspect that they are abnormal menstruation or have become pregnant. This problem is very common in daily life. How to rule out pregnancy and how to determine it is menstrual disease, this is the first question to be distinguished. First determine if it is pregnant. If the menstrual cycle has been normal, there has never been a sign of delay, and some signs of pregnancy reaction, should be on the fifth day after the menstrual delay (can also be calculated from the fifth day of menstruation), using early pregnancy test paper to test urine, if Positive should be combined with gynecological pelvic examination; if the cervix changes purple blue, the uterus is full or enlarged, and may have breast pain, nausea and other accompanying symptoms, can be diagnosed as pregnancy. Of course, you can quickly determine if you are pregnant through B-ultrasound.
2. Side effects of the drug:
For example, endocrine disorders after long-term use of contraceptives can also cause menstrual delays. According to the patient's report, the doctor also found that a new generation of gastric motility drugs, porphyrin, also known as domperidone may also be caused. Since porphyrin does not easily penetrate the blood-brain barrier, it is considered to have no inhibitory effect on central dopamine receptors. The central dopamine receptor is inhibited, resulting in a decrease in the amount of hypothalamic release factor into the anterior pituitary. Therefore, the gonadotropin and corticotropin secreted by the anterior pituitary are reduced, leading to menopause and delayed ovulation.
3, caused by surgery:
1. Menstruation after abortion or drug flow is determined by the degree of recovery of the endometrial wall, which may cause postponement of menstruation to a large extent.
2. Intrauterine surgery causes cervical adhesions and causes menstrual blood retention, thus delaying menstruation.
4, endocrine disorders:
Endocrine causes such as polycystic ovary syndrome and premature ovarian failure may also delay menstruation, and the application should be checked in time. Once abnormalities are found, treatment should be carried out as soon as possible.
5, premature ovarian failure:
Premature ovarian failure is caused by abnormal ovarian function. Often manifested as delayed menstruation, thinning, amenorrhea and infertility. There may be symptoms such as vaginal dryness, difficulty in sexual intercourse, hot flashes, insomnia, and the like. If only 1-2 times of menstrual delay, and no other accompanying symptoms, it is not a category of menstrual disease. When the menstrual cycle interval is longer than 35 days, it is called menstrual thinning, and menopause is more than 3 menstrual cycles called amenorrhea. Because of ovulation after amenorrhea, it can also cause osteoporosis, endometrial hyperplasia and other issues that must be taken seriously. have a thorough checkup in hospital immediately.
6. Long-term exposure to harmful substances:
Long-term exposure to harmful rays, chemotherapy drugs, etc. may also cause premature ovarian failure, delayed menstruation. Pay attention to ovarian protection. For older women (over 40 years old), delayed menstruation, other endometrial lesions, etc., mostly due to the gradual decline of ovarian function, clinical special treatment is not available.
7, other:
Such as mental stress, stress, environmental changes and other psychological factors, some diseases that affect endocrine. Both can cause menstrual delays. Such as:
(1) Living without degree
According to the study, 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 and even amenorrhea. Therefore, women's daily life should be regular, avoid overwork, especially during menstruation to prevent cold and damp.
(2) Emotional abnormalities
Long-term mental depression, sulking or major mental stimulation and psychological trauma can lead to menstrual disorders or dysmenorrhea and amenorrhea. This is because menstruation is formed by the hormone secreted by the ovary to stimulate the endometrium. The ovarian secretion hormone is controlled by the pituitary gland and the hypothalamic release hormone, so the function of the ovary, pituitary gland, or hypothalamus is abnormal. Will affect menstruation.
(3) excessive dieting
Expert research shows that adolescent girls' fat accounts for at least 17% of body weight before menarche can occur, and body fat can reach at least 22% of body weight to maintain a normal menstrual cycle. Excessive dieting, due to insufficient energy intake of the body, causing a large amount of fat and protein in the body to be 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 Blind dieting.
(4) excessive weight loss
In order to achieve significant weight loss, some women not only control their diet, but also take a variety of weight-loss drugs. Such excessive weight loss can also delay menstruation.
(5) Great mental stress
Heavy work tasks, excessive mental stress, and low mood are the reasons for the delay in menstruation. Stress in daily life is more or less affecting women's menstruation, so it is necessary to adjust mood and maintain an optimistic positive attitude.
(6) thyroid dysfunction
Many women have problems with thyroid abnormalities, such as hyperthyroidism or thyroid function, which can lead to decreased menstruation and delayed menstruation.
(7) Lack of vitamin E
Vitamin E is stored in various cooking oils. If the diet is too light, it will cause vitamin E deficiency, resulting in abnormal menstrual cycle. Therefore, vitamin E supplementation is particularly important at this time.
(8) Irregular menstruation
Diet, lifestyle and other factors can lead to irregular menstruation, menstrual delay is also a category of irregular menstruation, such as the reproductive function of middle-aged women gradually decline, hormone secretion disorder, menstrual cycle disorder, followed by menstrual delay.
Examine
an examination
Related inspection
Urine pregnancy test (HCG) Pneumocystis intradermal test sputum immunological examination serum immunoglobulin G subclass Daamato sign
There are several types of checks that are generally required:
1. Check if the chromosome development is abnormal.
2, pituitary function examination: 1 direct measurement of blood LH, FSH levels and PRL levels; 2 pituitary stimulation test.
3, B-ultrasound: early pregnancy examination and B-ultrasound examination to understand whether the ovary has polycystic changes.
4, ovarian function test: 1 vaginal exfoliation cell examination; 2 endometrial biopsy; 3 serum E2, P determination; 4 cervical mucus crystallization examination; 5 basal body temperature determination.
Diagnosis
Differential diagnosis
diagnosis
Diagnosis can be performed based on clinical manifestations and examinations.
TCM diagnosis
First, qi:
Menstruation: After menstruation is delayed, the amount of menstruation is less, the color is normal or the blush is blocked, and the discharge is not smooth.
Whole body: mental depression, or less abdominal pain, or breast swelling, chest pain, tongue or see a little sputum, tongue coating or see thin yellow.
Second, the resistance:
Menstruation: After menstruation, the color is light and mucus-like.
Whole body: body obesity, dizziness, palpitations, bloating, vomiting, coughing, poor appetite, fat body, tooth marks, greasy fur.
Third, blood deficiency:
Menstruation: delayed, small amount, light color, thin.
Whole body: pale complexion or pale, dizzy, palpitations, insomnia, and even lower abdomen pain, not only like to press, licking lips, thin white fur.
Fourth, kidney deficiency:
Menstruation: After menstruation, the amount of menstruation is small and the quality is thin, and the color is black or dull.
Whole body: lumbosacral pain, nocturia, more vaginal discharge, lighter color, or dizziness, tinnitus, pale tongue, thin white fur.
Differential diagnosis
Should be differentiated from menstrual disorders, menstrual cycle changes.
