Since puberty, due to certain cyclic changes in hormones, a woman has a menstrual cycle. These are successive changes in the body over a certain time period (usually about a month), preparing the reproductive sphere for a possible conception. At the beginning of the cycle, spotting is typical, in the middle — ovulation, during which the egg matures, capable of giving life to the baby during fertilization. If pregnancy does not occur, there is a change in the level of hormones, due to which the next cycle occurs. However, in some women, the clarity and sequence of changes are violated, there are problems with the menstrual cycle. Why are they dangerous?

Period problems: delays in discharge, pain, discomfort

Period problems: delays in discharge, pain, discomfort

The most frequent complaints of women to gynecologists are problems with the menstrual cycle. Their spectrum is diverse — these are delays or the onset of bleeding ahead of time, irregular discharge, soreness, chest changes, discomfort in the lower back or groin. There may be complaints of discomfort before the onset of discharge associated with physical or psycho-emotional disorders, which doctors often combine into the concept of «premenstrual syndrome». Possible problems of the menstrual cycle associated with an imbalance of hormones and lack of ovulation. It is detected according to measurements of basal temperature or ultrasound, ovulation tests.

There may also be complaints of discharge between menstrual bleeding of a spotting or bloody, breakthrough nature. All of them require the control of a doctor and a detailed examination, identifying the reasons why the discharge changes, pain or discomfort occurs, and delays are formed.

Hormones that regulate cyclic changes

Changes in the reproductive organs and the entire female body initiate sex hormones synthesized by the ovaries and partly by the adrenal glands. Fluctuations in the level of sex hormones are formed under the influence of control compounds of the hypothalamus, which secretes releasing factors, and the pituitary gland, due to luteinizing and follicle-stimulating hormones.

The menstrual cycle, depending on which hormones and what their effects predominate, is divided into three phases — the follicular, the ovulation period and then the progesterone phase. The successive change of one phase to another proceeds with certain changes in the area of ​​the uterus and ovaries, as well as the entire female body. This is necessary for successful conception, and then implantation of the embryo with its subsequent gestation and birth. If conception does not occur in the cycle, under the influence of hormonal stimuli, the endometrium that has lost its functionality and is outdated is updated. Spotting occurs at the beginning of the next cycle.

Body changes during ovulation and before menstruation

The female body changes throughout the cycle, although sometimes not very noticeable externally, more in terms of sensations. The greatest discomfort is felt at the end of the cycle, before the start of the discharge. This is due to a sharp decrease in hormone levels, a gradual preparation for endometrial detachment. Perhaps a slight malaise with an increase in temperature up to 37.0 ° C, chest tension and increased sensitivity of the nipples, a change in the depth of breathing and pressure. This does not require any intervention, if it does not bring discomfort to the woman. You need to consult a doctor with a severe headache, nausea, pain in the lower abdomen, fainting in preparation for menstruation.

Ovulation also implies certain changes in the female body. It falls in the middle of the cycle, from the 12th-13th to the 17th day. During this period, pulling sensations are possible in the groin on the left or right, in the projection of the ovulating ovary, a change in the viscosity of the vaginal mucus. By changing the balance of sex hormones, a woman’s sexual desire increases. Ovulation does not form any pain or pronounced discomfort, and even more so bleeding. When they appear, you should immediately consult a doctor — these are signs of pathologies.

Normal menstrual cycle length and delay

Normal menstrual cycle length and delay

The duration of the menstrual cycle is considered from the first day of bleeding to the next first day. It is individual for each woman, but physiologically has the limits of the norm, ranging from 24 to 36-38 days. In a healthy woman, the menstrual cycle is stable, deviations from the due date of 1-2 days are acceptable. After pregnancy and childbirth, it is quite possible to change the duration of the menstrual cycle due to certain hormonal changes. Sometimes, against the background of stressful situations, serious illnesses, operations or bleeding, a physiological delay in menstruation is possible. It usually does not exceed a week, and then the cycle returns to normal. Irregular is the menstrual cycle, in which menstruation occurs with delays of 1-3 weeks, or earlier than the deadline, more than 2-3 days. Similar phenomena, repeated in a row for at least 2-3 cycles, require a visit to a doctor.

Physiological and pathological delay: pregnancy and pathology

If a woman is healthy, has a regular menstrual cycle, and is sexually active without contraception, the most likely reason for a missed period is pregnancy. Usually, after 5-7 days from the date of the expected menstruation, a pregnancy test can be performed, if available, it will show a positive result. However, there may be other, less joyful reasons for the delay. Sometimes a strong physical or emotional stress, a change in climate and region of residence, a serious illness can delay the next menstruation. Usually, after the elimination of the pathogenic factor, the cycle is restored. If these are genital infections, inflammation of the uterus or ovaries, cystic lesions, tumors or hormonal disruptions, they can lead to permanent menstrual irregularities. The use of hormonal contraceptives, especially emergency ones, abortions or miscarriages dramatically affect the menstrual cycle. Such health problems are a reason to see a doctor.

Obstetrics / Ed. Savelieva G.M. 2000

Endocrinology / Ed. Dedova I.I., Melnichenko G.A. 2013