Delayed menstrual cycle causes. Delayed menstruation - causes and treatment

Regular menstruation is a sign of the health of the female body, an indicator that a woman is ready and capable of conception, pregnancy, and childbirth. That is why the absence of menstruation is always a warning symptom. Prolonged (6 months or more) absence of menstruation. There are many reasons for its onset, so it is important to consult a doctor in a timely manner in order to establish the cause of the onset of amenorrhea and begin the necessary treatment.

All reasons for the absence of menstruation are divided into two groups: physiological (natural states of the reproductive system) and pathological (caused by some disease of the reproductive system or other organs).

Physiological causes

At the heart of regulation menstrual cycle is a hierarchical process control system. The central link is the cerebral cortex, hypothalamus and pituitary gland, where signals are received from the peripheral link - the ovaries and other target organs for sex hormones (adrenal glands, thyroid gland, uterus, mammary glands).

Pregnancy

When pregnancy occurs, there is an active release of progesterone. It has an overwhelming effect on the production of hormones that trigger the menstrual cycle.

Lactation

Prolactin and oxytocin are the two main lactation hormones. Prolactin promotes milk production and is secreted by the pituitary gland. He plays a major role in the inhibition of ovulation. Someone has a lack of regular menstruation for 2 months or a little more, and for some women, the entire feeding period.

Climax

Menopause occurs in the life of every woman. This is a normal, natural stage of aging. During such a period, the reproductive function fades and, as a result, the activity of the gonads gradually decreases until complete extinction. This process causes amenorrhea after menopause.

Pathological causes

There are many pathological causes of amenorrhea. They are divided into primary and secondary. Primary causes can be true or false.

Primary amenorrhea

Primary amenorrhea is considered when menstruation does not occur in girls of 14 years old who do not have secondary sexual characteristics: development of the mammary glands, body shape and body hair according to female type. Or secondary signs are developed, but there are no periods in girls of 16 years.

It is worth considering the fact that in adolescents the cycle may be irregular.

In this case, for example, the following picture is observed: no menstruation 3 months after the onset of menarche (first menstruation). The described situation is not primary amenorrhea.

False amenorrhea

In this case, cyclic changes occur in the organs of the reproductive system, characteristic of the normal cycle, but there is no outflow of blood from the vagina. The reasons for this may be the following conditions:

• infection or synechia of the vagina;
• infection of the cervical canal;
• continuous hymen;
• obstruction of the uterus.

The symptoms of false amenorrhea are as follows:

• cyclic pulling pains in the lower abdomen, due to distension of the uterus with blood;
• lack of menstruation;
• large volumes of blood are a surgical emergency - acute abdomen with severe pain;
• normal development of secondary sexual characteristics;
• characteristic visible features during gynecological examination.

True amenorrhea

With true amenorrhea, cyclic changes in the reproductive system in the body do not occur. The regulatory connection between the brain, gonads and uterus is broken. The main reasons may be such states and processes:

• chromosomal abnormalities;
• congenital adrenal hyperplasia;
• delayed menarche;
• anomalies in the development of the uterus and / or ovaries;
• chemotherapy and/or radiation therapy in childhood;
• removal of the uterus and / or ovaries in childhood (for example, due to trauma).

The main symptoms of true amenorrhea:

• lack of secondary sexual characteristics;
• low growth;
• characteristic features for a particular syndrome of chromosomal pathology;
• infantile (children's) genitals;
• dryness of the mucous membranes of the vagina;
• fragility of hair.

Secondary amenorrhea

With this type, menstrual flow is absent for a period of 6 months or more, but previously the woman had regular or irregular periods.

The main causes that provoke secondary amenorrhea can be the following conditions:

• malnutrition;
• cancellation of oral contraceptives;
• postpartum pathology of the pituitary gland;
• endocrine pathology;
• inflammatory diseases of the reproductive system.

Why is there no period for a long time

Prolonged absence of menstruation can be, as previously mentioned, primary or secondary.

Primary amenorrhea

Primary amenorrhea is difficult to correct, since it is most often caused by genetic changes.

Turner syndrome

Turner-Shershevsky syndrome refers to anomalies of the chromosome set. There are three forms of the disease. At the same time, in most cases, the second X chromosome is missing, with a mixed form, the Y chromosome may be present, and a mosaic type of pathology also occurs.

The characteristic features of the disease are the following signs:

• underdevelopment of the genital organs;
• low growth;
• pterygoid neck;
• low hair growth;
• never had a period;
• secondary sexual characteristics are poorly expressed;
• the ovaries are in the form of strands, the uterus is small, the endometrium is thin.

Anomalies in the development of the uterus and ovaries

The most common developmental anomaly is uterine atresia in combination with the absence of a vagina. At the same time, there are ovaries, and, accordingly, secondary sexual characteristics develop according to age.

Delayed menarche

The delay in the onset of the first menstruation can be in girls northern peoples. It's constitutional national feature. In this case, development does not suffer, and therefore the prolonged absence of menstruation is not subject to treatment in this case. In addition, the delayed onset of menarche may occur as a result of mental retardation in girls with organic brain pathology.

Congenital adrenal hyperplasia

With this pathology, the tissues of the adrenal glands grow, excessive formation of glucocorticosteroids, which act depressingly on the hypothalamic-pituitary system. The disease is characterized by the following features:

• lack of menstruation of a true nature;
• obesity;
• stretch marks on the hips, abdomen;
• moon face;
• excessive male pattern hair growth;
• high blood pressure;
• violation of water-salt metabolism.

Secondary amenorrhea

Much easier to deal with. You should find out the cause that caused the cessation of menstruation, eliminate it, and the cycle will be restored.

Stress

Various stressful conditions, whether it is a single exposure (the death of a loved one) or a constant stay in depression, disrupt the central link in the regulation of the menstrual cycle. Impulses to the hypothalamus cease to flow from the cerebral cortex, and menstruation is delayed.

Sharp weight loss

With a strict diet, which causes a sharp decrease in weight and a deficiency of various substances, there is a gradual inhibition of the release of hormones by the hypothalamus. For this reason, the pituitary gland does not receive signals for the formation of follicle-stimulating hormone.

In addition, do not forget that in the cells of adipose tissue, the synthesis of sex hormones partially occurs. A decrease in the lipid layer can therefore result in a hormonal failure.

postpartum amenorrhea

Postpartum amenorrhea can result from damage to the pituitary gland after a difficult birth with massive bleeding. Due to circulatory disorders, necrosis of the pituitary gland occurs. Depending on the degree of damage to the organ, patients experience not only the absence of menstruation, but also other symptoms:

• hair loss;
• weight loss
• memory loss;
• weakness and chilliness;
• hypotrophy of the mammary glands and genital organs.

Cancellation of oral contraceptives

After the abolition of second-generation oral contraceptives, ovarian hyperinhibition syndrome occurs. At the same time, against the background prolonged use COC develops persistent inhibition of the hypothalamic-pituitary structure and sex glands. After a few months, menstruation returns on its own.

Endocrine pathology

Excess or deficiency of hormones thyroid gland main reason amenorrhea lies in the oppression of the pituitary gland and, as a result, a decrease in the production of hormones. In diabetes mellitus, excess blood insulin acts suppressively on the ovaries.

Inflammatory diseases of the reproductive system

With salpingitis, oophoritis, meningitis and encephalitis, due to the pronounced process of inflammation, the hormone-producing function of the affected organs decreases. Amenorrhea can last for a long period until the pathological process subsides completely.

Resistant ovary syndrome

In this case, the ovarian tissues become insensitive to pituitary hormones. The reason may be a genetic anomaly. The first menstruation in women comes on time, gradually they occur less frequently, and by the age of 35 they completely stop. Pregnancy is very rare. Unlike early menopause (up to 40 years), with resistance there will be no hot flashes and other manifestations menopause.

Risk factors

Risk factors for the development of amenorrhea may include the following conditions:

• stress;
• excessive physical exercise(especially among professional athletes);
• malnutrition (both starvation and overeating);
• frequent inflammatory diseases of the genital organs;
• micro- and macroadenomas of the pituitary gland (in which hyperprolactinemia is observed, which inhibits ovulation);
• frequent traumatization of the mucous membrane of the genital tract during abortions, diagnostic curettage.

Diagnostics

Due to the fact that the reasons for the absence of menstruation are diverse, their diagnostic search is quite extensive. When a patient contacts a gynecologist, a thorough questioning is first carried out to identify the provoking factor. Then a general examination and examination on a gynecological chair are shown. In addition, other diagnostic methods are used.

Pregnancy test

If your period is more than a week late, you should perform a simple pregnancy test. During pregnancy, the hormone hCG (human chorionic gonadotropin) is produced, which is determined by lowering the test strip into a container with urine. The test is informative and sensitive.

Prolactin

As you know, an increased level of prolactin has a depressing effect on the ovulatory function of the ovaries. To determine its level, morning venous blood sampling is performed. Normally, the level of prolactin should not exceed 23 ng / ml.

progesterone test

For its implementation, a gestagen (progesterone) is used. With the help of such a test, the hormonal activity of the gonads and the possibility of blood outflow are determined. The test is positive for bleeding that occurred within a week while taking progesterone. This confirms the presence of the uterus, ovaries and free outflow of blood.

Ultrasound of the pelvic organs

It can be performed both abdominally (through the abdomen) and transvaginally (by inserting a special sensor into the vagina). Ultrasound allows you to visualize the internal genital organs and assess their condition, size, determine whether pathological changes are absent or present.

X-ray of Turkish saddle

A survey X-ray of the skull is carried out, while the Turkish saddle, where the pituitary gland is located, is clearly visible. Changes in this structure may indicate pathology of the pituitary gland.

Assessment of the state of the endometrium

It is carried out using ultrasound or hysteroscopy. Its presence, structure, thickness are assessed depending on the phase of the menstrual cycle.

Computed and magnetic resonance imaging

This diagnostic method allows you to visualize with great accuracy the structure of the genital organs and the brain, including the area of ​​the hypothalamus, pituitary gland.

Treatment

It is aimed at restoring the reproductive capacity of a woman or the appearance and regulation of the menstrual cycle. Depending on the cause, therapy can be of the following types:

• hormone replacement therapy (use of estrogen);
• body weight stabilization;
• surgical correction for developmental anomalies;
• the use of drugs that reduce the level of prolactin in the blood;
• surgery for pituitary tumors;
• stabilization of thyroid hormones, blood sugar levels;
• antimicrobial therapy in inflammatory processes.

Answer the question: why long time no menstruation, a gynecologist will help. Only a well-conducted examination and adequate timely treatment will help a woman or girl to restore reproductive function.

https://youtu.be/WfFQ7JucrX8?t=9s

Menstruation, menstruation, or regulation, is a periodic rejection of the endometrium of the uterus, accompanied by bleeding. The absence of menstruation in the first place causes a woman of reproductive age to suspect pregnancy. However, you need to know that, in addition to pregnancy, there are a number of reasons that affect the menstrual cycle.

Menstrual cycle: norm, failures, violations

The menstrual cycle is the periodic changes in a woman's body aimed at the possibility of conception. Its beginning is considered to be the first day of menstruation, the end is the day before the start of a new menstruation.

Menstruation occurs in young women at the age of 10-15 years. After that, it is believed that the body has entered the phase of the ability to conceive and carry a child. Menstruation continues up to 46-52 years. Then there is a decrease in their duration and the amount of blood released during this.

The duration of a normal menstrual cycle is 28 to 35 days. Its duration and the amount of discharge depends on the mental and physical condition women. Failures and irregularities of the menstrual cycle can be caused by many reasons:

• pregnancy (uterine and ectopic) and lactation;
• hormonal fluctuations in adolescence and adulthood or against the background of taking hormonal drugs;
• stress
• disease;
• taking or withdrawing medications.

For reference. A prolonged delay or absence of menstruation is called amenorrhea. It can be secondary (acquired) or primary.

What is considered a delay?

A delay in the menstrual cycle, caused by one reason or another, sometimes happens to most women. Under the delay means deviations from the usual menstrual cycle for 10 days or more.

For reference. Every woman has a slight delay in menstruation 1-2 times a year.

Why is there a delay in menstruation:

As already noted, the delay in menstruation occurs for many reasons. The reasons can be both physiological (diseases, stress) and natural (adolescence, pregnancy, lactation, menopause). Some causes can be combined, causing difficulties in diagnosis. Let's look at the delay factors in more detail.

- pregnancy

During the entire period of bearing a child, a woman usually does not have menstruation. After childbirth, the restoration of the cycle occurs in different ways - it all depends on individual features female body. Enhanced Level the hormone prolactin when feeding a baby can prevent the start of the work of eggs. For this reason, during lactation, a woman does not have menstruation.

Important. The absence of menstruation does not mean that a woman cannot become pregnant.

- ectopic pregnancy

An ectopic pregnancy differs from a uterine pregnancy in that the fertilized egg attaches itself outside the uterus. However, the hormone progesterone, which inhibits the menstrual cycle, is produced in the same way as during normal pregnancy. Therefore, it is extremely important for a woman to monitor the fluctuations of her cycle. At the slightest delay, she needs to exclude the possibility of an ectopic pregnancy, which almost always has an unfavorable outcome.

- adolescence

Delay in adolescence should not cause concern. It is due to the fact that the hormonal background of a teenage girl is still unstable. Once hormone levels return to normal, the cycle will become more stable.

Important. If 2 years after the first regulation (otherwise they are called "menarche") the cycle has not been established, the teenager needs to see a doctor.

- approaching menopause

Rare intermittent periods after the age of 40 can be harbingers of premenopause (the initial stage of menopause). The main reason for the delay in menstruation during menopause is a change in the hormonal background of a woman. Involutional processes (reverse processes, or aging processes) occurring in the hypothalamus contribute to a gradual decrease in the level of sensitivity of this part of the pituitary gland to estrogenic effects in the body.

- intense sports

Excessive physical activity also does not contribute to the regularity of the menstrual cycle. It is known that professional athletes sometimes experience problems with delayed regulation, and sometimes with childbearing. The same problems haunt women engaged in physically demanding work.

- weight changes

Among the reasons for the delay in regulation, a significant weight loss is noted. In medicine, there is a term "critical menstrual mass". If the weight of a woman trying to lose weight is less than 45 kg, then menstruation stops. The body does not have the resources for the normal functioning of the reproductive system. The same thing happens if the excess weight goes beyond what is permitted, approaching the third degree of obesity. Fat layer in case of excess weight, it accumulates the hormone estrogen, which negatively affects the regularity of the cycle.

- stress

Stress regardless of duration can cause a delay. Stress includes: constant nervous tension, an upcoming important event, problems in the family and at work, a change in the nature of activity, climate change.

For reference. The tense expectation of the onset of menstruation can cause an even longer delay.

- diseases

Some diseases cause fluctuations in the menstrual cycle. So, disorders of the thyroid gland, pituitary gland, adrenal glands directly affect the production of hormones. Hormonal imbalance leads to ovarian dysfunction. Inflammatory diseases of the genitourinary system, polycystic ovary syndrome, endometriosis also lead to cycle fluctuations. Seemingly harmless colds(for example, influenza or SARS), as well as chronic diseases kidney, diabetes, gastritis can cause a delay. Tumors of various etiologies are sometimes detected precisely by the delay in menstruation. It is important that with neoplasms, a pregnancy test can show false positive result.

- withdrawal of hormonal drugs

Sometimes the female body receives hormones from the outside - when taking hormonal drugs. When they are canceled, the woman is faced with a delay in regulation. This is due to the fact that while taking hormonal agents, the ovaries are in a state of temporary hyperinhibition. It will take 2-3 months to restore a normal cycle, otherwise a gynecologist's consultation is necessary.

The same result should be expected after taking emergency contraceptives (for example, Postinor), which contain a large dose of hormones.

- medicines

In addition to hormonal drugs, antibiotics can cause a delay. Means of an antibacterial series negatively affect the production of hormones by the female body. Therefore, they should be taken after a thorough examination and consultation with a specialist. To reduce the negative impact of drugs on a woman's body, you need to drink a course of vitamins, bifidobacteria and lactobacilli.

- body poisoning

Alcohol, smoking, drugs taken by a woman regularly and for a long time can cause intoxication of the body. Also, intoxication, which causes a delay in menstruation, can also be provoked by work in hazardous industries.

What to do if you have a delay in menstruation?

If a woman is experiencing a delay in regulation, she first needs to take a pregnancy test. After ruling out the suspicion of pregnancy, a woman should consult a specialist. Both gynecologists and endocrinologists deal with the problems of delayed menstruation. Only a doctor can identify the cause or even a combination of causes of delayed menstruation.

The specialist, in addition to collecting an anamnesis, may prescribe the following:

• checking for ovulation;
• tests for STDs;
• blood test for hormones;
• curettage of the inner layer of the uterus and its histological examination;
• Ultrasound of the pelvic organs;
• Ultrasound of the thyroid gland and adrenal glands;
• CT ( CT scan) and MRI (magnetic resonance imaging) of the brain.

Important. Don't put off seeing a doctor if you're not sure exactly what's causing the delay.

Thus, a normal menstrual cycle is an indicator of women's health. Any deviations in it can signal problems in the nervous, endocrine, reproductive and other systems.

Specially for- Elena Kichak

Delayed menstruation is one of the most early signs coming conception. However, not always the absence of menstruation on time indicates pregnancy. Sometimes a delay is a consequence of stress, emotional stress, hormonal failure, or other pathology.

All girls and women of reproductive age should carefully monitor their cycle. For greater accuracy, gynecologists recommend keeping a special calendar that indicates the start and end date of each menstrual bleeding. The regularity of the cycle indicates the correct functioning of the reproductive system.

The average length of the menstrual cycle is . However, its length is healthy women can be shortened up to 21 days or lengthened up to 35 days.

Ovulation - the process of release of the female germ cell from the ovary into the free abdominal cavity. This event corresponds to the middle of the menstrual cycle - 12-16 days. During ovulation and 1-2 days after it, the female body is ready to conceive a child.

Menarche is the first menstrual cycle in a girl's life, it is the beginning of the reproductive activity of the female body. Usually this event occurs between the ages of 11 and 14 years, but the period from 9 to 16 years is considered the norm. The time of menarche depends on many factors - genetics, physique, diet, general health.

Menopause or menopause is the last menstrual cycle in life. This diagnosis is established after the fact, after 12 months of no bleeding. The normal range for the onset of menopause is the period from 42 to 61 years, with an average of 47-56 years. Its onset depends on the number of pregnancies, the supply of eggs, the use of oral contraceptives, and lifestyle.

Menstruation or menstruation is part of the female cycle, characterized by the development uterine bleeding. Normally, its duration is from 3 to 7 days, on average - 4-5 days. Menstruation is the rejection of the endometrium of the uterus - its inner mucous layer.

Due to menstruation, the uterine endometrium is renewed. This process is necessary to prepare the organ wall for the next cycle in which conception is possible.

A delay in menstruation is considered to be its absence for more than 6-7 days during a normal cycle. A shorter period is not considered a pathology. Normally, cycle shifts of 2-3 days are possible. Delayed menstruation can occur in women and girls of any age due to natural (physiological) and pathological causes.

Reasons for delayed menstruation

stress

Psychological and emotional stresses are an unfavorable environment for pregnancy. That is why the brain gives a signal to the endocrine system that conception should not occur. In response to this, the hormonal glands change their mode of operation, preventing the onset of ovulation.

The reason for the delay in menstruation can be various stresses. Some women calmly endure severe shocks (death of a loved one, diagnosis of an illness, dismissal from work, etc.). In some patients, the absence of menstruation may be associated with minor experiences.

To possible reasons delays in menstruation also include severe lack of sleep and overwork. To restore the cycle, a woman should exclude the action of a provoking factor. If this is not possible, the patient is advised to consult a specialist. Usually, a delay in menstruation during stress does not exceed 6-8 days, but in severe cases, it may be absent for a long time - 2 weeks or more.

Heavy physical activity

The reason for the delay in menstruation during heavy physical exertion is the production of an increased amount of testosterone, the male sex hormone. Thanks to him, the growth of muscle tissue in response to its tension is possible. Normally, the female body has a small amount of testosterone, but its increase leads to disruptions in the menstrual cycle.

High testosterone levels affect the complex mechanisms between the pituitary gland and the ovaries, which disrupts their interaction. This leads to delayed menstrual bleeding.

If there are failures in the menstrual cycle, a woman should exclude strength training. They can be replaced with aerobic exercises - dancing, running, yoga.

What are the reasons for the delay in menstruation?

climate change

A change in environmental conditions is a signal of the need to prevent conception. This mechanism is similar to the delay in menstruation during emotional stress and shock. The brain sends a signal to the ovaries to block ovulation.

Another reason for delayed menstruation negative test on pregnancy is a long exposure to the sun. Ultraviolet rays have a negative effect on the functioning of the ovaries. The delay can be observed with the abuse of the solarium.

Typically, the delay in menstrual bleeding during travel does not exceed 10 days. With its longer absence, a woman should consult a specialist.

Hormonal changes

The reason for the delay in menstruation after 40 years is the onset of menopause, characterized by the extinction of the reproductive function. Typically, the menopausal period lasts for 5-10 years, during which there is a gradual increase in the period between bleedings. Quite often, menopause is accompanied by other symptoms - a feeling of heat, sweating, nervousness, jumps in blood pressure.

Also, a long delay in menstruation is a natural reaction of the body after pregnancy. During breastfeeding, the pituitary gland produces a special hormone - prolactin. It causes blockage of ovulation and absence of menstrual bleeding. This reaction is conceived by nature, since the female body must recover after childbirth.

If a woman does not breastfeed immediately after giving birth, her normal cycle is restored in about 2 months. If a young mother begins lactation, menstruation will come after it ends. The total duration of bleeding delay should not exceed one year.

Natural hormonal changes occur after the abolition of oral contraceptives. During their intake, the ovaries stop functioning, so they need 1-3 months to recover. This reaction of the body is considered absolutely normal, it does not require medical adjustment.

Another reason for delaying menstruation for a week or more is taking emergency contraception (Postinor, Escapel). These drugs contain artificial hormones that block the synthesis of their own. Due to this effect, ovulation is blocked and the menstrual cycle is shifted.

Underweight and malnutrition

Insufficient nutrition is the cause of severe weight loss, which leads to amenorrhea - the absence of menstruation. With a strong lack of mass, cyclic bleeding may not be observed for a long period of time. This feature is adaptive in nature - the brain sends signals that a woman will not be able to bear a child.

Permanent delays in menstruation may be associated with insufficient intake of polyunsaturated fatty acids and vitamin E. These substances are involved in the endocrine function of the ovaries, causing the normal division of female germ cells.

To restore the cycle, a woman should gain the missing kilograms and revise her diet. It should include sea fish, red meat, nuts, vegetable oil. If necessary, vitamin E preparations can be used.

Obesity

Also, against the background of obesity, insulin resistance occurs - a condition in which cells human body become less sensitive to insulin. In response to this, the pancreas begins to synthesize more and more hormone. A persistent increase in the amount of insulin in the blood increases testosterone levels.

An increased amount of male sex hormones disrupts the normal menstrual cycle. That is why women are advised to monitor their weight and avoid obesity.

infectious process

One of the most common causes of delayed menstrual bleeding is the common cold and other upper ailments. respiratory tract. Usually, with such pathologies, the cycle shifts by no more than 7-8 days.

Specific diseases of the genitourinary organs (,) can cause a prolonged absence of menstruation due to disruption internal organs. If a woman has pain or pulls in her lower abdomen, pathological discharge from the genital tract is observed, body temperature rises, pain occurs during intercourse, she should consult a specialist.

This pathology is characterized by multiple changes in the hormonal background, causing blocking of ovulation and a shift in the menstrual cycle. With polycystic ovary syndrome, the endocrine function of the pituitary gland is disrupted. This leads to the maturation of several follicles, however, none of them becomes dominant.

With polycystic ovary syndrome, an increased amount of male sex hormones is observed in the blood of a woman. They aggravate the course of the disease, further preventing ovulation. Quite often, against the background of pathology, insulin resistance is observed, which increases the secretion of testosterone.

To diagnose the disease, it is necessary to conduct an ultrasound examination. Ultrasound shows enlarged ovaries with many follicles. With pathology in the blood, an increase in androgens (male sex hormones) and their derivatives is observed. Quite often, polycystic ovary syndrome is accompanied by external symptoms- male pattern hair, acne, seborrhea, low voice.

Pathology treatment includes hormonal contraceptives with antiandrogenic effects. When planning a pregnancy, a future mother may be shown to stimulate ovulation with the help of drugs.

Hypothyroidism

Thyroid hormones are responsible for all metabolic processes in the human body. With their deficiency, a decrease in reproductive function is observed due to blocking ovulation. That is why with hypothyroidism, there are often long delays in menstruation, up to its absence.

To diagnose pathologies of the thyroid gland, its ultrasound examination and the calculation of the amount of hormones in the blood are used. Treatment is based on the type of disease and may include iodine supplementation, replacement therapy, and surgery.

Hyperprolactinemia

Diagnosis of pathology includes a blood test for hormones, as well as an MRI or CT scan of the brain. For treatment this disease dopamine agonists are used.

Hyperprolactinemia: the main mechanism for the development of PMS

Pregnancy

In addition to pregnancy, a delay in menstruation can be caused by more rare pathologies and diseases:

• Itsenko-Cushing's disease (hyperproduction of hormones of the adrenal cortex);
• Addison's disease (underproduction of the adrenal cortex);
• tumors of the hypothalamus and pituitary gland;
• damage to the endometrium of the uterus (as a result of surgery, cleaning, abortion);
• resistant ovary syndrome (an autoimmune disease);
• ovarian exhaustion syndrome (premature menopause);
• ovarian hyperinhibition syndrome (against the background of long-term use of oral contraception, radiation exposure).

The absence of menstruation at the time when it is supposed to begin is called a delay in menstruation. If menstruation is absent for more than six months, then doctors talk about amenorrhea.

If you haven't had any for a long time blood secretions, you should first make sure that you are not pregnant. It is conception that is the main reason for the absence of the next menstruation.

You can clarify the situation at any time by buying a pregnancy test at a pharmacy. If a woman has had unprotected intercourse in the last two months, then the test should be done without fail.

After the first negative test, you can do a second one after waiting a few days. If he also showed a negative result, then you should understand in more detail the reasons that could provoke such a condition.

Reasons for delayed menstruation

Failure in the hormonal system is one of the main reasons. The menstrual cycle occurs as a result of complex and interrelated processes. The slightest change in the hormonal system, it can manifest itself as the absence of menstruation. Normally, the cycle should be regular.

Its duration is different, depending on the individual characteristics of the organism. A normal cycle lasts about 28 days. The cycle is counted from the first day of menstruation to the date of the next menstrual flow.

If the period did not start at the right time and is absent for more than 5 days, then this is a delay. Experts say that in healthy women with a regular cycle, this can happen, but not more than twice a year. If they are repeated constantly, then you should consult a doctor.

Let's figure out what factors can cause disturbances in the hormonal system

• stress;
• underweight or overweight;
• malnutrition;
• too high physical activity;
• chronic diseases of internal organs, poor health, weak immunity;
• inflammatory diseases and pathologies of female organs (endometritis, adnexitis, dysfunction, etc.);
• congenital or acquired ovarian defects;
• endocrine diseases;
• emergency contraception after intercourse (such methods deal crushing blows to the hormonal system);
• long-term use of certain drugs;
• miscarriages, abortions, violations in the position of the intrauterine device (cause changes in the hormonal status);
• heredity;
• a sharp change in climate, the abuse of sunbathing and solarium;
• the abolition of hormonal contraceptives, which were taken for a long time;
• menopause (after 40 years);
• various gynecological procedures (colposcopy, cauterization of erosion, etc.);
• bad habits and chronic intoxication (smoking, alcohol, drugs).

Main symptoms:

• cycle lengthening;
• menstruation did not start at the right time;
• a few days have passed since the expected date of the start of menstruation, but there is no menstruation.

Gynecologists believe that a regular cycle should be established within 2 years after the arrival of the first menstruation.

Gynecologists believe that a regular cycle should be established within 2 years after the arrival of the first menstruation.

But this statement is controversial, since there are healthy women who have irregular cycles throughout their lives.

But too long and frequent delays should cause concern. In this case, it is necessary to undergo an examination by a specialist.

Symptoms that may accompany this phenomenon (brown discharge, etc.)

• bloody, pinkish spotting discharge from the vagina;
• aching pain in the lumbar region;
• pain of a pulling nature in the lower abdomen;
• tension, pain and hypersensitivity chest.

Such signs indicate that menstruation will begin any day. You just have to wait a little. But for some women, these symptoms accompany the onset of pregnancy. Therefore, you need to do a pregnancy test to make sure your assumptions.

How is the diagnosis carried out

Diagnosis of the reasons for the absence of menstruation is based on the study of the patient's medical history, examination data, blood tests and ultrasound. The doctor determines secondary or primary amenorrhea. In the first case, it excludes pregnancy.

First delay of menstruation

The very first periods occur in teenage girls between the ages of 13 and 16. In some girls, they appear in more early age. The first menstruation is irregular. The correct cycle is established only a few months after the appearance of the first menstruation.

The very first periods come at significant intervals. Their duration varies. In such cases, we are not talking about delays. Irregular cycles in adolescents are normal.

Some girls have a long break after the first menstruation. The second time menstruation can begin in a few months. In the first year after the onset of menstruation, doctors do not talk about this phenomenon.

They are physiological, since the system of hormones is only being formed during this period. Everything will work out later, when the hormonal system comes to a stable state.

If, after 2 years after the appearance of the first menstruation, the cycle has not been established, then you need to contact a gynecologist.

What does white discharge mean?

curdled discharge white color- enough common symptom with prolonged absence of menstruation. They may be accompanied by mild itching in the genital area. Discharge may indicate candidiasis (thrush). Sometimes they are accompanied by violations in the genital organs.

If you notice white discharge, be sure to visit a gynecologist. In case of pregnancy, thrush can cause damage to the fetus.

An accurate diagnosis can only be made by a doctor. Thrush is not as safe as it may seem. Sometimes it is almost asymptomatic, turning into a chronic form.

Discharge may indicate candidiasis (thrush)

Whites sometimes occur during pregnancy in healthy women. They have a dense texture and are considered the norm. The body in this way protects the genitals from the penetration of pathogens.

In some cases, white discharge indicates hormonal disorders. Then the doctor conducts an examination and prescribes the optimal treatment regimen. Proper hormone therapy allows you to restore the normal functions of the hormonal system. Allocations disappear, and the menstrual cycle is getting better.

Another reason for white discharge is inflammatory diseases of the female genital organs. If a woman has a complex of signs - discharge, retention and abdominal pain, then she needs to be examined by a gynecologist.

The doctor will definitely take a smear to examine the microflora. If you suspect problems with the female organs, an ultrasound is prescribed.

A dangerous sign is the absence of menstruation and brown discharge. If there is a pregnancy, then this is a sign of problems (ectopic pregnancy, placental abruption). Therefore, with such a symptom, you should urgently run to the gynecologist.

If you notice signs, do not postpone the examination. By taking action in time, you can prevent and eliminate violations in the reproductive system.

How many days can it last

The menstrual cycle should normally be regular, but even in healthy girls it is not always accurate. Changes in the cycle can be triggered by many factors. Therefore, minor deviations from the date of the start of menstruation should not bother you.

Thus, doctors consider it normal if a woman's menstruation starts a little late a couple of times a year (no more than 7 days).

We are talking about a delay in cases where, with a stable cycle, menstruation is absent for several days. There are women whose menstrual cycle is unstable. Therefore, it is very difficult for them to establish the fact. In this option, it is almost impossible to predict the exact date of the beginning of menstruation.

What to do if the test is negative

If you have not had a period for a long time, and the test showed a negative result, then it should be repeated in a week. In addition, you should purchase tests from different manufacturers. This will make it possible to accurately verify the absence of pregnancy.

If the test is carried out at a very early date, then it cannot yet determine the presence of pregnancy. The correct result can be seen 4-5 weeks after conception. It's very rare to get bad tests. That is why it is so important to purchase a second test from another manufacturer.

If the second test is negative, then there is no pregnancy. In this case, the delay is due to other reasons mentioned above.

If the second test is negative, then there is no pregnancy.

Most often, menstrual irregularities occur due to diseases. endocrine system or pathologies of the reproductive organs.

If in the adrenal glands, thyroid gland or the hypothalamic-pituitary sphere has undergone some changes, they can lead to ovarian dysfunction.

This leads to cycle disruptions and delays. Often, the absence of menstruation occurs due to inflammatory processes in the ovaries.

In this case, the test shows a negative result, but menstrual bleeding does not start. Very often, pathology is observed in women with polycystic ovaries. Such patients have an irregular menstrual cycle and suffer from infertility.

Chest pain

Sometimes the disease is accompanied by chest pain. These symptoms may be accompanied by pulling pains in the lower abdomen. There can be many reasons for this. Pregnancy can have such signs. Therefore, it is first necessary to exclude its probability.

If the test showed a negative result, then chest pain, which is accompanied by a delay in menstruation, may indicate a number of diseases. It is necessary to be examined by a specialist. common cause chest pain is mastopathy. This disease is characterized by changes in the tissues of the breast.

Mastopathy is a common cause of chest pain.

Changes are wearing benign character. If you find a lump in your chest, you should immediately consult a doctor. If you start the pathological process, then later you will have to do an operation.

Breast pain and retention may occur after a strict diet has been followed for a long time. In this option, it is enough to establish the correct diet to get rid of problems.

If you are too active in sports, then you too may experience these symptoms. Then you need to determine what is most important for you: sports or the preservation of childbearing function.

What to do

If the delay is observed in a woman who leads sexual life then the following steps should be taken:

1. buy and do a home pregnancy test (if the result is negative, do a second test in a week);
2. calculate what factors could have influenced the change in the menstrual cycle;
3. consult a gynecologist in case of repeated and long delays.

If the woman is not sexually active:

1. take into account factors that could affect the change in hormonal status;
2. if menstruation is absent for more than a month, and there are no obvious reasons for this, then you should consult a doctor.

If a delay is observed in a woman after 40 years, then this may be a sign of the onset of the menopause. In this case, you also need to visit a gynecologist. If there is no blood after an abortion or if there are signs of gynecological diseases (abdominal pain), you should consult a doctor and undergo an examination.

Is treatment required

If you have lost your menstrual cycle, then this does not always indicate the need for treatment. Some women seek to get their period back by any means necessary to avoid unwanted pregnancies.

This is the wrong approach. If the pathology arose as a result of conception, then it is too late to prevent pregnancy. Indiscriminate use of various drugs leads to complications.

If there is no pregnancy, then you should look for the root cause of this condition. By eliminating the cause, you can restore a normal menstrual cycle.

Sometimes it is enough to establish a nutrition system and reduce physical activity so that the delay stops.

If it is caused by any disease of the female genital area, then the doctor draws up a treatment regimen for this pathology. By itself, the delay cannot be eliminated. She goes after proper treatment underlying illness.

Thus, there are no drugs that would eliminate the absence of menstruation. There are drugs that can cause menstruation, but they are used only under medical supervision. Such drugs are taken to provoke a spontaneous abortion. You can not take this type of medicine on your own, as you can get serious complications.

Minor and rare inconsistencies in the cycle do not cause concern. They usually go away on their own and do not require any action.

Pain in the lower abdomen

Pain in the lower abdomen during menstruation is common occurrence for many women. But if the pain is accompanied by a lack of blood, then this is a concern. Sometimes slight pulling pains and delay are the first signs of pregnancy. If chest pain is added to them, then many women know almost 100% that they are in an interesting position.

In this case, it remains only to do a test to confirm your guess. But if you did 2 tests that showed negative results, then the cause of abdominal pain should be looked for further. Absence of menstruation can be caused by many factors.

Most often, cycle disorders that are accompanied by aching pain are observed in those who suffer from polycystic ovaries.

Inflammatory diseases of the female genital area are the most likely factors for abdominal pain. If the delay lasts more than a week, and the pain does not go away, then you should consult a gynecologist. If you want to preserve childbearing function, then such symptoms must be treated very carefully.

If you start the inflammatory process in female organs this will lead to infertility. Frequent delays in menstruation are a bad sign that indicates hormonal problems. If in this condition there is also pain in the abdomen, then the woman should urgently visit a doctor.

You should not delay the examination, as serious hormonal disorders turn into infertility and miscarriage in the future.

Severe abdominal pain and lack of menstruation is a very dangerous sign. This happens with an ectopic pregnancy. If you do a test, it will show a positive result. But pregnancy develops in the wrong place. Therefore, there are strong pain sensations.

Sometimes pulling pains in the lower abdomen indicate premenstrual syndrome. It is also manifested by increased irritability, tearfulness, aggressiveness, nervousness, increased appetite, drowsiness, fatigue, swelling.

If you have a combination of such signs, then wait for the arrival of menstruation. To get rid of pain in the lower abdomen before menstruation, you need to healthy lifestyle life and eliminate all chronic diseases. Only your gynecologist can give specific recommendations on this issue.

Delay in pregnancy

Any woman who is sexually active, in the absence of menstruation on time, immediately thinks about pregnancy. Conception leads to a change in hormonal levels. An embryo appears in the uterus, and the body creates optimal conditions for gestation. Normally, during pregnancy, menstruation should not be. But there are times when after conception they do not stop. In this case, you need to urgently see a gynecologist.

Immediately after childbirth, the menstrual cycle is unstable. They are restored a couple of months after the birth of the baby. If the mother does not breastfeed the baby, then the menstrual cycle is restored faster. For lactating women, these terms are individual. Therefore, during this period of life it is very difficult to predict the onset of ovulation.

If you become pregnant, you will be able to notice the delay at least 2 weeks after conception. The development of pregnancy at this time cannot be stopped with the help of emergency contraception. Folk and home remedies can only harm. In this option, there is only one relatively safe procedure for a woman - an abortion.

Do not attempt to terminate a pregnancy on your own. It leads to dangerous consequences. Sometimes there are also deaths. If you are in the mood for an abortion, then you should not delay it. The most easily tolerated procedure is made on early stages pregnancy.

Medicines that can cause periods

Duphaston

Duphaston is widely used in gynecological practice. It is analogous to sexual female hormone progesterone. It is this hormone that is responsible for the second phase of the menstrual cycle. The drug acts on the principle of progesterone.

It makes the endometrium thicker, which makes it more likely to bleed. Sometimes the endometrium grows too fast under the influence of duphaston. In this case, a woman may have bleeding between periods.

Duphaston is prescribed for ovarian dysfunction, with painful periods, and also to alleviate premenstrual syndrome. Pregnant women take the drug with a lack of progesterone. This helps prevent miscarriages.

Duphaston is an indispensable medicine in many cases. It is used for carrying out replacement therapy as well as in the treatment of infertility. At total absence menstruation duphaston is taken along with estrogens. It is also prescribed during menopause.

Duphaston

Duphaston is considered a safe drug. It very rarely causes side effects. If they occur, it is only due to an incorrect reception scheme. Therefore, this drug can only be prescribed by a gynecologist.

The dose of this medicine is always selected individually. The doctor takes into account the state of the patient's hormonal system. Usually, the daily dose of duphaston is divided into parts, taking them evenly throughout the day.

If a woman does not have menstruation, then the drug is prescribed together with estrogens. Such combined treatment carried out within 3 months.

Pulsatilla

If the menstrual cycle fails, the doctor may prescribe the hormonal drug Pulsatilla. It is considered very effective and is often used in the treatment of such disorders. The medicine is considered homeopathic. At its core, Pulsatilla is a sleep-grass or backache. It has been used in homeopathy for over 200 years.

If the menstrual cycle fails, the doctor may prescribe this hormonal drug

The drug helps to establish a normal menstrual cycle. It is taken in the form of granules. The optimal dose is 6-7 granules per dose. But here much depends on the characteristics of the patient and the severity of the disease. Therefore, the right dose should be selected only by a doctor.

The granules should be placed under the tongue. Pulsatilla can bring a positive result after the first application. She does not provide side effects and does not violate general state female body. This medicine is prescribed by a specialist after an examination.

Elecampane (instruction)

Elecampane is powerful herbal remedy from the arsenal of folk healers. It causes menstruation in the shortest possible time. A few doses of the decoction are enough for a woman to start menstruating. This remedy is used by many women who want to induce menstruation.

A decoction of elecampane is useful for uterine diseases. It is also drunk when the uterus is prolapsed. To induce menstruation, you need to drink 50 ml of decoction 2 times a day. It usually helps within the first day.

Recipe:

Buy elecampane root at the pharmacy. Pour a large spoonful of grass into 200 ml of boiling water. Boil the decoction for about 5 minutes. Then it should be infused for half an hour. After that, it must be filtered and taken orally. Decoction of elecampane has a bitter taste. In pregnant women, it causes spontaneous abortion.

Contraindications:

• pregnancy (abortion occurs a few hours after taking the decoction);
• menstruation (drink causes severe bleeding).

If the delay was too long, this could be due to serious problems. Do not postpone the appointment with the gynecologist, because it is better to underdo than overdo.

A stable menstrual cycle is evidence that there are no failures and deviations in a woman's body.

A delay in menstruation always causes an ambiguous reaction in a woman, especially if it was not planned in the near future.

But conception is not the only likely cause of the delay.

The absence of menstruation on time sometimes indicates pathologies that are dangerous to women's health.

What delay in menstruation is considered normal?

The normal duration of the menstrual cycle is 26-28 days. At the same time, the duration of the delay, in which a visit to the gynecologist is not necessary, should not exceed 5-7 days.

But even such a delay may not cause concern only if it is not accompanied by pain and discomfort.

A long delay is considered the norm in such cases:

1 Irregular menstrual cycle. After the arrival of the first menstruation (menarche), a delay before the next up to 6 months is permissible. A full cycle in young girls is formed over several years.

2 Premenopausal period. In women aged 45-50 years, a prolonged absence of menstruation indicates the onset of menopause. With each cycle, the delays become longer and longer, and then the monthly stops completely.

3 Pregnancy and lactation. Bearing a child eliminates the possibility of any discharge with bloody impurities.

During lactation, the delay in menstruation is associated with the hormone prolactin, which limits the maturation of eggs.

As soon as the concentration of prolactin decreases (complementary foods are introduced, the child is transferred to artificial or mixed feeding), menstruation is restored.

4 Artificial delay. In the treatment of certain diseases accompanied by heavy and painful periods, women are prescribed special drugs to stop the cycle.

It is not recommended to provoke a delay on your own, especially if there are no really serious reasons for this.

Delayed period with a negative pregnancy test

When in a critical state, the body starts an "energy saving mode" that prevents fertilization. This defensive reaction will be the delay in menstruation. Such failures do not require special treatment: the cycle is restored immediately, as soon as the annoying factor disappears.

If a combination of symptoms is found, you can take a blood test for the presence of a hormone.

Gynecological causes of delayed menstruation

Frequent and long delays indicate the threat of pathologies of the genital area. A gynecologist, having learned about your problem, must definitely conduct a series of studies for the presence of such disorders:

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1 Uterine fibroids. Cancer that occurs with sharp pains and characteristic highlights. The type of treatment is chosen depending on the degree of fibroids.

2 Polycystic ovaries. This syndrome occurs due to endocrine problems in the body. The pathology affects appearance women: work is activated sebaceous glands, increased hair growth on the body, excess weight is possible. The violation is corrected quickly if hormonal treatment was correctly selected.

3 cyst. The appearance of such neoplasms is also a consequence of hormonal imbalance. In the early stages, cysts are treated with medications and physiotherapy.

Cycle instability is likely after treatment of bacterial diseases with antibiotics. The cycle stops for a while after some procedures: colposcopy, cauterization of cervical erosion.

Also, the absence of critical days after the detection of an ectopic pregnancy or abortion is considered normal.

How to induce menstruation with a delay?

If the critical days have not come on time, you should not resort to the help of medicines on your own. Inducing menstruation artificially can cause even more serious harm to health. Only a gynecologist can prescribe drug treatment after complete examination, and only if comorbidities are detected.

You can return your period in quite harmless and pleasant ways:

1 Warm bath. Taking a bath with your favorite aromas will not only optimize blood flow to the pelvic organs, but will also have an excellent calming effect. And this is especially useful when the failure was caused by stress.

2 Sex. When excited, there is an increase in the tone of the uterus, which, together with a rush of blood, should cause the required reaction of the body the very next day.