- Lyudmila Belkina: One can speak about the loss of menstruation (now we mean only those cases that are not the norm) only if they are completely absent. Scanty discharge is another pathology.

— So, if a woman has lost her period, what could be the reason for this? Surely this happens not only with diseases. For example, the first thing that comes to mind is pregnancy. Let's first talk about cases where a woman does not need to worry that her period has not started on time. Tell about the physiological reasons

— Olga Cherepanova: Among the physiological reasons, three states of a woman can be named:

1. Pregnancy, as it was said. If a woman is pregnant, one of the first changes she will see is a missed period. They will be absent throughout the pregnancy. The woman takes a test and finds out that it is positive. In this case, you need to make an appointment with a gynecologist to monitor changes in the body and the development of the unborn baby.
nine0039 Lactation. During this period, milk is produced in the mammary glands.
2. Menopause. If a woman is over 50 years old, age-related changes usually begin to occur in her body, leading to the absence of menstruation. In the case when the woman's health does not bother, but the menstrual flow is gone, you can not go to the gynecologist: this is a normal process. However, at the age of 50, pregnancy can also occur, and then the cessation of menstruation indicates the corresponding processes in the body.
nine0045

Separately, I would like to say about contraception. Menstruation may temporarily disappear when taking certain contraceptives. With their help, you can, in particular, regulate the appearance of menstruation. If a woman, for example, goes on vacation and does not want to menstruate for a month, then after consulting a gynecologist, she can take a contraceptive drug that allows you to delay the onset of menstruation. However, it must be remembered that not all oral contraceptives have such an effect on the body.

— And what are the reasons for the cessation of menstruation, if we are talking about pathology? What diseases does this occur in?

— Olga Cherepanova: Menstruation may disappear with:

• some diseases of the endocrine system;
• taking any toxic drugs or exposing the patient's body to a number of chemicals;
• weight changes, in particular obesity or a sharp decrease in body weight. Some patients ask us if periods can disappear due to diet. There is such a risk: a sharp decrease in body weight negatively affects the hormonal background of a woman. For young girls, this is especially true, since even a slight weight loss in them can cause the disappearance of menstruation. nine0040

- Lyudmila Belkina: We are also often asked if periods can disappear due to stress. Yes they can.

— Does the cessation of menstruation occur at the initial stages of the pathology and is it its first symptom? Or does menstruation disappear when the disease is already clearly expressed?

- Lyudmila Belkina: Since the absence of menstruation can be the result of many diseases, it is impossible to say for sure.

A girl may have menstrual irregularities for a long time, which will eventually lead to the loss of her periods if she is not examined and treated. nine0003

Absence of menstrual flow often becomes one of a whole complex of manifestations.

This symptom may be the first sign of the disease.

— Tell me, please, what should a woman do if her period has disappeared for one reason or another? What are the principles of treatment for the cessation of menstruation?

— Olga Cherepanova: The most important thing is to visit a gynecologist. Sometimes they ask how to return menstruation with folk remedies if they are gone. I will say right away that self-medication (including with the help of traditional medicine) is not worth it: the pathology is most often complex, and it is extremely difficult to choose a treatment without a doctor and the necessary examinations. nine0003

As soon as the body has signaled a violation of the cycle, and even more so the absence of menstruation, you need to visit a doctor.

- Lyudmila Belkina: We identify the level at which there is a violation. It depends on the method of treatment and the prescribed drugs. It is necessary to understand how a woman regulates the menstrual cycle. A series of biochemical processes take place, which begins in the brain and ends when it reaches the reproductive organs. Any step may fail. It is important for the doctor to find out exactly where the problem is, for which certain tests, procedures, and examinations are carried out. nine0003

Pathology can be treated as follows:

• a set of measures to correct hormonal levels;
• vitamin therapy;
• for stress - sedatives, antidepressants, nootropics.

But these are not all methods of treatment.

— What awaits a woman at a gynecologist's appointment?

- Lyudmila Belkina: If there is no menstruation, at least two appointments will be required, as well as a mandatory ultrasound. The first appointment is an introductory one, during which we collect an anamnesis, examine the reproductive organs and mammary glands. I note that 50% of a successful diagnosis is a correctly collected anamnesis. nine0003

— Can a woman not come to the clinic, but consult online, from home?

- Lyudmila Belkina: Most often this is not enough. The patient should come for a face-to-face consultation, because due to medical specifics, she will not be able to tell everything about herself. But during the examination, the doctor will ask questions, the need for which is not obvious during an online conversation. Next, he will prescribe an examination, including an ultrasound. Then, already with all the tests, the patient must come to the appointment again. nine0003

Based on the results, the doctor will be able to prescribe treatment. Repeated ultrasounds are also possible.

— Olga Cherepanova: In many cases, after we have decided on the treatment, the patient follows the recommendations of the gynecologist for 3-6 months, and then comes back to control the disease. Perhaps at this reception it will be established that the woman has recovered. For example, during stress: the cause was found, complex treatment was carried out, the cycle was restored, everything was over. Then you can come for preventive examinations. nine0003

If there are still pathologies, we continue to treat.

- Let's say a girl notices the absence of menstruation, but does not go to the gynecologist. What might this mean for her?

- Olga Cherepanova: Let's start with the fact that she can miss the start of pregnancy if there were prerequisites for this.

As we said earlier, the absence of menstruation can also indicate problems in the reproductive system. There is a risk that a woman will form a cyst in the reproductive organs - so the woman can get on the operating table. nine0003

Impaired ovary syndrome may develop (menopause will come much earlier than expected).

One of the possible reasons for the cessation of menstruation is a decrease in the production of estrogens (female sex hormones). With a decrease in the amount of these hormones, estrogen-dependent organs will suffer. It can be, for example, bones, skin, urinary system. The patient will feel increased fatigue. Possible aggravation of chronic stress, deterioration of the brain.

With delayed treatment, other problems arise, for example, those associated with the cardiovascular system.

— How to prevent the cessation of menstruation? Tell us about prevention

— Olga Cherepanova: You need to regularly visit a gynecologist once a year and undergo an ultrasound examination of the pelvis and mammary glands. You should also avoid stress, eat right and generally lead a healthy lifestyle.

Interviewed by Yulia Kovalenko

Book an appointment with an obstetrician-gynecologist here
You can sign up for an ultrasound here
ATTENTION: services are not available in all cities

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Reference:

Cherepanova Olga Valerievna, obstetrician-gynecologist

Graduate of the Perm State Medical Academy in 2000.
In 2001, she completed her internship in the specialty Obstetrics and Gynecology.

Lyudmila Viktorovna Belkina, doctor of ultrasound diagnostics

Graduate of the Perm State Medical Academy in 1997. In 1998, she completed her clinical internship in Obstetrics and Gynecology. Later she specialized in ultrasound diagnostics. nine0003

Doctors are admitted to the "Expert Clinic" Perm at the address: st. Monastyrskaya, 42a.

Eight causes of irregular menstruation :: Clinician

18 03.2018

• Danger of delayed or irregular menstruation

• What is the menstrual cycle. Natural ways to protect the body from irregular periods

• Most common causes of delayed or irregular periods

1. Increased stress level
2. Malnutrition
3. Excessive weight loss and low weight
4. Increased physical activity
5. Thyroid disorders
6. Stopping oral hormones
7. Chronic hormonal imbalance and other hormonal disorders
8. Food allergies and food sensitivities

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According to a 2017 study on missing periods published in the Journal of Clinical Endocrinology and Metabolism, long-term missed periods are relatively common in 5% of women of childbearing age and will experience them at some time in their lives. An even greater number of women experience a malfunction in the menstrual cycle from time to time. nine0003

The hypothalamus and brain, pituitary, ovarian, adrenal and thyroid glands help regulate the menstrual cycle and normalize hormone levels naturally, so it's important to watch your bad habits that can negatively affect your hormone levels.

Danger of delayed or irregular menstrual cycles

Women with regular menstrual cycles ovulate every 25-28 days. Although the interval between periods is individual for each woman and may differ, especially during puberty and premenopause, but in any case, menstruation occurs once a month if the woman is healthy. nine0003

If a woman stops menstruating, which is called “amenorrhea”, then this is a clear sign that you have some kind of health problem. Primary amenorrhea is the absence of menstruation in girls when they have never had a period, which will begin when they reach the age of puberty. Secondary amenorrhea is when a woman has already had periods, but suddenly stopped and has been absent for three or more months.

The presence of regular moderately painful or painless menstruation every month is a sure sign that the hormonal background is normal and the reproductive system is in order. The opposite picture is observed if irregular menstruation, delayed menstruation, or very painful and intense periods are recorded. They indicate that the level of one or more hormones is too high, or one or another hormone is absent altogether. If you have any health problems, chronic stress, poor nutrition, heavy physical exertion, frequent delays in menstruation, then such problems should never be left to chance (if you are sure that you are not pregnant). nine0003

Unfortunately, according to recent data, many women prefer not to talk to their doctor about frequent delays or irregular periods, which is quite a risk, since hormonal imbalance and amenorrhea are associated with a number of serious diseases, and also increase risks of developing osteoporosis, heart disease, infertility and other hormonal complications.

According to the Mayo Clinic Department of Endocrinology, “Amenorrhoea can indicate a wide range of anatomical and endocrine disorders. Amenorrhea can lead to a weakening of the ability to reproduce. When estrogen levels are low, amenorrhea is often accompanied by an imbalance of minerals, blood glucose, and impaired fat metabolism. These metabolic changes affect bones and the cardiovascular system, including an increased risk of osteoporosis and coronary heart disease later in life.” nine0003

What is the menstrual cycle. Natural Ways to Protect the Body from Irregular Menses

Anovulation is a disruption in the ovulation cycle that prevents the egg (or "ovium") from maturing and leaving the follicle. Usually, the disease is recognized if this phenomenon continues for a certain period of time, usually more than three months in a row. One of the main signs of anovulation is a delay or irregular periods. For a non-pregnant woman of reproductive age (between 15-40 years), anovulation is abnormal and is considered the main cause of infertility in about 30% of patients of childbearing age. Oligomenorrhea is another name for irregular, but completely incessant periods. It is characterized by a long interval between periods, which is more than 36 days, or when menstruation occurs less than eight times a year. nine0003

This predictable pattern of the ovulation and menstrual cycle is caused by a specific set of changes in a number of sex hormones, especially estrogen. There is a fairly large variety of estrogen in a woman's body, the three main of which are estradiol, estriol and estrone.

Estradiol is produced in the ovaries and adrenal glands. It is considered the most active of the three main estrogens and is closely related to the menstrual cycle, while the other types of estrogen are more responsible for pregnancy. Upon reaching the age of 50, the ovaries begin to produce less estrogen, and the main burden for their production, or the biochemical substance of their precursor used for the synthesis of estrogen, is assigned to the adrenal gland. For this reason, women naturally stop menstruating when they reach menopause. nine0003

For many women of reproductive age, low estrogen levels can cause delayed or irregular periods. Thus, amenorrhea in young women is one of the surest clinical signs of estrogen deficiency. With today's sources of abnormal estrogen dominance, such as toxins and unhealthy diets, it's hard to imagine that anyone could be deficient, but such women do occur.

It is believed that low estrogen levels can be caused not only by an inability to produce enough sex hormones due to hereditary hormonal problems, but in many cases due to the effect on the body of increased levels of the stress hormone. If you have frequent irregular periods, then you should try to avoid stress, because. sex hormones are negatively affected by metabolic, physical and psychological stress factors. nine0003

Stress hormones can dominate due to many factors, with malnutrition and chronic emotional stress being the main causes. We need a surge of stress hormones in life-threatening situations to get out of them, but modern women experience constant tension that is considered low-level stress, and for this reason it is often overlooked, although in reality such stress is strong enough to affect our health. nine0003

The most common causes of delayed or irregular periods

Unlike pregnancy and menopause, which naturally stop menstruation, the following causes of amenorrhea and irregular periods are highly undesirable and negatively affect our health, but they can be tried eliminate.

1. Increased stress level

If a woman experiences severe stress for a long time, her body begins to conserve energy without ovulating. If a woman experiences a sudden traumatic event, it can cause increased stress on the adrenal glands, leading to a halt in the production of estrogens and other reproductive hormones (a condition called hypothalamic amenorrhea). When a woman has an insufficient amount of estrogens, then her uterine mucosa cannot be maintained in a normal state, as a result, menstruation is delayed. nine0003

Why is this happening? Your body reacts to emergency situations. Comfort is very good, and fertility is very important, but still, in terms of survival, they are secondary. We all have an innate natural survival mechanism that involves the constant production of vital stress hormones, otherwise known as the “fight or flight” response, such as cortisol and adrenaline. Adrenaline and cortisol are the two main hormones responsible for the body's response to stress, helping us to escape from threats (whether real sudden or imaginary threats). These hormones are vital and sometimes very helpful in helping us run, climb, increase strength, make us sweat, and regulate our heart rate, but too much of them can lead to health problems. nine0003

The body has always given priority to the production of stress hormones that help to survive critical situations, considering sex hormones as secondary during periods that it considers difficult. With chronic stress, there is a lack of nutrients, such as amino acids that contribute to the normal functioning of neurotransmitters, and they are not enough to produce enough hormones, so the body has to choose between stress hormones and sex hormones, and preference is always given to the first. Under conditions of high stress, such as dieting, strenuous physical activity, or emotionally intense events, all such situations can provoke amenorrhea with or without weight loss. nine0003

2. Improper diet

Foods that are low in nutrients, antioxidants, and probiotics, but high in stimulants, can put stress on the thyroid and adrenal glands. For example, cortisol levels may rise if the following factors are present:

• high intake of sugar, hydrogenated fats, and artificial additives or pesticides;
nine0039 thyroid problems;
• adrenaline fatigue.

Elevated cortisol interferes with optimal production of many other important hormones, including sex hormones. If the elevated level of cortisol lasts for a long time, then this can lead to problems with the skin, damage to bone and muscle, as well as brain tissue. This high cortisol cycle can lead to protein deficiencies, resulting in muscle loss and osteoporosis. nine0003

If you have problems with your period, check your diet. You should choose foods that are high in antioxidants and nutrients, especially those high in fat (even saturated fat, which is good for your situation) and protein. You can also use high-calorie food supplements if you are underweight, lack adipose tissue, you are actively involved in sports.

3. Excessive weight loss and low weight

When the body mass index (BMI) drops below 18-19, menstruation may be delayed due to too little adipose tissue. Body fat is important for the production of sufficient amounts of estrogens, for this reason women who are too thin or who have a serious disease, such as anorexia and bulimia, may suffer from the absence or delay of menstruation. Increased physical activity and therefore high nutrient requirements due to intense exercise can sometimes lead to weight loss and put you at risk of developing hormonal imbalances. nine0003

Low-calorie, low-fat foods can also cause nutritional deficiencies and fat loss and contribute to irregular periods and bone loss. According to some data, very thin vegans, including those who eat exclusively raw food without heat treatment, and vegetarians who do not eat only meat, are also at risk, most likely because they are more likely to be underweight and lack vital useful substances. nine0003

4. Increased physical activity

While moderate exercise is very important for heart health, mood control, sleep, and maintaining a stable body weight, increased physical activity puts more stress on the adrenal, thyroid, and pituitary glands. Therefore, women who abruptly begin intense physical training, for example, preparing for a marathon or similar important event that requires high physical excretion, may suddenly stop menstruating. nine0003

Like other stress hormones, cortisol spikes in response to any real or perceived stress. The latter can be physical (including sports) or emotional. Such stressors include overwork and physical exhaustion from increased physical exertion, which can be accompanied by lack of sleep, constant haste, infectious diseases and emotional exhaustion. In today's time with the constant desire to be slim and keep fit, some women believe that they need to exercise intensively, they think that profuse sweating is good, and so they exhaust themselves constantly. nine0003

Such physical overload can increase stress and rob the body of energy needed to regulate sex hormones. So, in one of the reports of the University of Michigan it is reported that running and ballet are among the physical activities where the largest number of women suffering from amenorrhea is found. Nearly 66% of women involved in long-distance running or ballet dancing experience amenorrhea at some point in their lives. Things are even worse for women involved in bodybuilding. Almost 81% of them suffer from amenorrhea from time to time, while they eat a diet low in nutrients. nine0008

"Exercise-induced amenorrhea" may indicate a general exhaustion of the body, a decrease in vitality and is more characteristic of young girls. Thus, the number of women involved in athletics in childhood and adolescence has increased by 800% over the past 30 years, at the same time, the number of those suffering from hormonal imbalances has increased. Other problems that often accompany amenorrhea include decreased bone density and eating disorders. Therefore, physicians are concerned about the susceptibility of this category of patients to heart complications, bone problems and nutritional deficiencies. nine0003

5. Thyroid disorders

You may not even suspect that the thyroid gland can be the cause of hormonal disorders.

According to recent studies, thyroid problems are one of the main causes of delayed menstruation, almost 15% of patients with amenorrhea suffer from thyroid abnormalities.

The thyroid gland, considered the main regulating mechanism of the endocrine system, is responsible for metabolism and influences many sex hormones.

Thyroid problems, including hypofunctioning or endemic goiter and hyperthyroidism, can cause a wide range of health problems, such as changes in estrogen and cortisol levels, and delayed periods. An increase in cortisol levels can lead to general hormonal insensitivity, including thyroid resistance. This means that the body becomes descented to estrogen and cortisol, which can cause them to be overproduced. nine0003

6. Stopping oral hormones

Some women deliberately interrupt their periods to prevent pregnancy, but when they stop taking birth control pills, they don't get their period. While some doctors suggest that periods should resume and return to normal within a few months of stopping hormone pills, many women experience delayed or irregular periods for several years afterward. nine0003

A woman's natural menstrual cycle consists of rising and falling levels of estrogen and progesterone, but birth control pills keep estrogen levels high enough to confuse the body into thinking you're pregnant, so it happens. failure of the menstrual cycle. It takes many months and even years for the body to correct this situation and restore homeostasis.

Thus, in a report published in one of the American journals devoted to obstetrics and gynecology, it is reported that about 29% of women suffer from a delay in menstruation for more than three months after using contraceptives. Hence our advice: give up contraceptives if there are signs of a menstrual cycle failure.

7. Chronic hormonal imbalance and other hormonal disorders


Polycystic ovary syndrome (PCOS) is a hormone imbalance in women that negatively affects ovulation. When a woman suffers from PCOS, it means that her hormone levels, including estrogen, progesterone and testosterone, are abnormal, which can be expressed in different ways:

• abnormal growth of body or facial hair;
• problems with sugar levels;
• being overweight;
• acne;
• irregular menstrual cycle.

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