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Amenorrhea, what is it? Causes, forms and treatment of the disease

The normal development of the female reproductive system, throughout life, largely depends on the mechanism of the "lunar cycle" associated with fertility (the ability to conceive) and fertility.

The term familiar to us is the menstrual cycle. As in any other system of the body, the reproductive system of a woman is subject to various pathologies that provoke the development of failures in the menstrual cycle. A representative of one of these pathologies - amenorrhea, what is it?

Amenorrhea is a symptom of the absence of menstruation for two or more menstrual cycles. It can develop in different periods - from puberty (adolescent), to the period of menopause . The nature of this violation is due to the absence of menstrual discharge for a long time (up to six months or more).

Self-developing pathology (gestation period) is considered a normal condition (physiological form of dysfunction). But, and a possible symptom of various failures in the body: anatomical, biochemical, genetic or mental nature (pathological form).


Classification - forms of amenorrhea


Pathological form of amenorrhea is classified into types, form and level of lesion:

  1. According to the mind, amenorrhea is true, caused by a sharp decrease in the hormonal functions of the sex glands (ovaries), which leave no chance for a woman to become a mother.
  2. With a false view of amenorrhea, hormonal functions are not impaired, but there is no discharge.
  3. Lactational (postpartum) amenorrhea is characterized by the absence of menstrual flow for the entire period (from one to three years) of feeding the baby with breast milk.

According to the form of detection, manifested primary and secondary forms of dysfunction.

Primary amenorrhea is detected in adolescent girls under 14 - 16 years old who are not yet familiar with the menstrual cycle.

The form of secondary amenorrhea is often diagnosed in adolescents immediately after the first menarche (menstruation), when there is a pause of 0.5 years, as well in women and girls who have not previously experienced problems with menstruation.

Often in women after 30 years, spontaneous menopause occurs, which also refers to the secondary form of the disease.

Causes of Menstrual Dysfunction (Amenorrhea)

Causes of Amenorrhea

The cause of amenorrhea depends entirely on the localization of the pathological process that causes menstrual dysfunction:

Маточные патологии развития, обусловленные препятствием выхода отторгнутых клеток эпителия матки (менструальной крови) в результате заращения гимены (девственной перегородки) влагалища или маточной шейки. 1) Uterine developmental pathologies caused by the obstruction of the exit of the rejected cells of the uterus epithelium (menstrual blood) as a result of the clogging of hymen (virgin septum) of the vagina or uterine cervix. Which leads to the development of false amenorrhea.

In the secondary form, it may manifest as amenorrhea after curettage, due to partial or complete fusion of the cervical uterine canal or complications caused by the formation of internal uterine synechia (adhesions).

Патологии половых желез, проявляющиеся полиэндокринным синдромом (Штайна-Левенталя). 2) Pathologies of the genital glands, manifested polyendocrine syndrome (Stein-Leventhal). It is characterized by structural and functional disorders of the gonads (manifested by the secondary form of the disease, disorders in the vascular system, infertility).

Психические и нервные расстройства, обусловленные повышенной секрецией гонадотропинов плаценты и гипофиза, осуществляющих регуляцию функций яичников. 3) Mental and nervous disorders due to increased secretion of placenta and pituitary gonadotropins, which regulate the function of the ovaries.

Недостаток секреции гормонов гонадотропина, обусловленный снижением гонадолиберина (фолликул-стимулирующего гормона). 4) The lack of secretion of gonadotropin hormones, due to a decrease in GnRH (follicle-stimulating hormone). The increase in endorphins (endogenous oploids), which block neurotransmitters, causes a psychogenic pathology. This is facilitated by stressful situations.

Онкологические патологии – доброкачественные гипофизарные образования, провоцирующие повышенную секрецию пептидных гормонов, влияющих на регуляцию овуляции и «лунный цикл» женщин. 5) Oncological pathologies - benign pituitary formations, provoking increased secretion of peptide hormones that affect the regulation of ovulation and the "lunar cycle" of women.

Опухоли, развивающиеся из зиготы (оплодотворенная яйцеклетка) – пузырный занос. 6) Tumors that develop from zygotes (fertilized egg) - blistering. False pregnancy, in which the menstrual cycle is terminated, but the symptoms correspond to a normal pregnancy.

Высокие дозы гормоносодержащих препаратов, особенно инъекции, вызывают нарушения в женской половой системе. 7) High doses of hormone-containing drugs, especially injections, cause disturbances in the female reproductive system. Amenorrhea after taking hormonal contraceptives, a common occurrence after abrupt withdrawal.

При значительных физических нагрузках, влекущих за собой резкую потерю веса, развивается аменорея гормонального характера. 8) With significant physical exertion, entailing a sharp weight loss, hormonal amenorrhea develops.

Снижение или повышение функций ЩЖ и опухолевые образования в коре надпочечников, регулирующих выработку гормонов. 9) Reduction or increase in the functions of the thyroid gland and tumor formation in the adrenal cortex, regulating the production of hormones.

Clinical symptoms

The main symptom of amenorrhea

The main symptom of amenorrhea is the absence of menstrual flow. Often there is a sequence of menstrual disorders (hypomenstrual syndrome), flowing into a certain form of menstrual dysfunction, with pathological disorders of discharge in the initial period of the disease - irregular, rare scanty or thinning secretions.

Lack of ovulation during the period of the disease leads to the inability to conceive (loss of fertility) and infertility. More than half of patients (up to 65%) have:

  • autonomic dysfunctions - lowering blood pressure, mental disorders, headache, etc .;
  • depressive states;
  • weight gain or drastic weight loss;
  • hormonal disruptions cause skin problems (too oily skin, acne);
  • the prevalence of male hormones causes coarseness of voice, hirsutism (hairiness);
  • disorder of adrenal and thyroid function;
  • galactorrhea (excretion of milk-like fluid from the mammary glands in non-lactating and non-pregnant women), may be accompanied by neurological abnormalities;
  • colic pains with false periods;
  • toxicosis and swelling of the mammary glands in the expected period of menstruation;
  • menopausal symptoms in young women - sharp hot flushes, heartaches, and more.

Diagnostic program

The diagnostic examination program includes:

1) Ultrasound diagnosis.
2) Radiographic characteristics of the "Turkish saddle".
3) Research on hormones.
4) Functional diagnostics - tests.
5) Cytogenetic research on the determination of sex chromatin.
6) Genetic studies.
7) Hormone-functional tests.
8) Hysteroscopy.
9) Hysterosalpingography.
10) Laparoscopy and histology of the gonadal biopsy.

Features of the treatment of amenorrhea

amenorrhea treatment

The treatment protocol for the primary form of dysfunction

The protocol of treatment of primary amenorrhea is aimed at treating or correcting and eliminating the causes of its provoking. Patients with congenital anomalies caused by a structural violation of chromosomes (Sheshesovsky-Turner's genomic disease) are given lifelong intake of sex hormones.

With delayed sexual and physical development in adolescent girls, treatment is due to the selection of a diet and hormonal drugs that promote stimulation and elimination of menstrual disorders.

Correction of congenital defects that prevent the outflow of secretions to the outside, is performed surgically. Patients with emotional instability are selected therapy that strengthens the central nervous system. Particular attention is paid to the correction of the diet in girls of puberty.

Methods of treatment of secondary forms of amenorrhea

Menstrual cyclical disorders associated with sudden weight loss or due to physical exertion, requires urgent correction of the diet and regimen, elimination of common psycho-emotional disorders. Compliance with established standards can eliminate the use of hormone therapy.

To completely eliminate the secondary dysfunction of the menstrual cycle, it is advisable to prescribe progestogen contraceptives without estrogenic components.

Treatment of pathology caused by changes in the gonads, based on the elimination of background diseases. Normalization of ovulation functions is carried out by hormonal contraception, or by laparoscopic diathermocoagulation of the tissues of the sex glands.

Excess hyperprolactenemia, serving as a causative factor, is regulated by drugs that reduce the concentration of prolactin-like proteins.

The effectiveness of medical therapy is due to the presence of rectal temperature indicators, the increase of which indicates the successful completion of ovulation function. Pituitary neoplasms are removed by various techniques of neurosurgical operations.

Dangerous consequences

Unexpected amenorrhea in reproductive age is, as a rule, the “distress signal” of the body, indicating various malfunctions. The danger of the disease is that it is always accompanied by unpleasant consequences:

  • infertility;
  • osteoporosis, with a long course of the disease;
  • vegetovascular pathologies;
  • hormonal changes, provoking the development of endometrial cancer, atrophic colpitis.

Preventive measures

Important components of prevention:

  • rational nutrition - low-calorie foods with carefully balanced content of vegetable fats, carbohydrates and proteins should dominate the diet;
  • mandatory control of body weight;
  • prevent fatigue;
  • dispense physical and psycho-emotional stress;
  • timely treat gynecological diseases;
  • do not violate the contraception regimen;
  • visit a gynecologist twice a year.

To solve the problem of dysfunction of the "lunar cycle" will help doctors-specialists: endocrinologist, gynecologist and neurologist.


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