Content
- Physiological features of the menstrual cycle
- What is delay
- Natural factors that can affect the arrival of menstruation
- Postpartum period
- A sharp change in the climatic zone
- Stress and physical overload
- Unbalanced diet
- Excessive body weight
- Taking certain medications
- Failure of hormonal levels
- Puberty
- Approaching climax
- After consumption OK
- Pathological causes of delay in the absence of pregnancy
- Infection
- Polycystic ovary
- Myoma of the uterus
- Endometriosis
- Diseases of the endocrine system
- How to improve your menstrual cycle
The first thought that comes to a woman who suddenly had a delay in her period is the onset of pregnancy. But after making the test after the right amount of time, the lady finds out that conception did not occur, and there are no symptoms of pregnancy and PMS. Not only physiological factors that do not pose a threat, but also pathological factors that are dangerous to the health and even the life of a woman can provoke a violation of the menstrual cycle.
Physiological features of the menstrual cycle
In order to understand the reasons why menstruation may be delayed, it is necessary to understand the physiological characteristics that occur in the organs of the reproductive system on a monthly basis.
The menstrual cycle consists of several successive phases that affect the structure of the endometrium (the inner layer of the uterus) and the ovaries. The average duration is 28 or 30 days, but the duration of the intervals between periods is 21-35 days does not mean deviation - these are variants of the norm, due to the individual characteristics of the female organism.
Stages:
- Follicular - begins on the first day of menstruation, lasts 14 days (varies from 7 to 21 days, depending on the length of the cycle). At this time, follicles mature inside the epididymis. Later, one of them will become larger than the others, displace the rest and will carry an egg.
- Ovulatory - there is an exit of the female reproductive cell from the ovary into the fallopian tube. Ovulation lasts 1-2 days, during which the woman's body is ready to conceive.
- Luteal - lasts 13-14 days, followed by ovulation. In place of the ruptured follicle, the corpus luteum matures. It prepares the endometrium for the implantation of the embryo in the event of fertilization by the production of progesterone. If fertilization has not occurred, the level of the hormone decreases, the corpus luteum atrophies.
During menstruation, if conception has not happened, the endometrium is rejected and comes out along with bloody discharge. This process is necessary to cleanse the uterus from the old mucous layer and prepare the walls of the genital organ for the next cycle in which conception will occur.
A normal monthly cycle is a logical sequence of phases that each time have the same duration.
The indicators of hormones necessary for the maturation of follicles, rupture of the dominant vesicle and release of the egg, formation of the corpus luteum are maintained at the proper level.
What is delay
What is a delay in regular menstruation in girls - this is a violation in which critical days come with a delay for more than 7 days or absent for more than six months outside of pregnancy (in medicine, this syndrome is called amenorrhea). Primary amenorrhea is diagnosed in girls during puberty. The secondary type of pathological condition is associated with various factors - a violation of the level of hormones, somatic diseases, damage to the pelvic organs.
In addition to the term amenorrhea, doctors use the concept of oligomenorrhea - this is an increase in the duration of the intervals between periods and a decrease in the duration of the menstruation themselves.
If earlier the girl had a stable 28-day cycle, but in the last six months menstruation came less than four times, lasted 2 days or less, the diagnosis is made of oligomenorrhea.
What can be considered a delay - a one-time increase in the cycle length by 2 or 3 days, up to 5-7 days is not a deviation from the norm and can be caused by physiological external and internal factors.
If menstruation comes every time 7-10 days later than the expected period, the woman needs to go to the doctor's office and find out the reasons for the constant delays.
In addition to the onset of pregnancy, various reasons can cause a delay in menstruation. It is important to distinguish natural factors that provoked a temporary failure and non-hazardous hazards from pathological ones, in order to seek medical help in time.
Natural factors that can affect the arrival of menstruation
With a one-time delay in menstruation, it is important to make sure that the pregnancy alarm is false - to do a test, undergo an ultrasound scan, find out how much hCG (a hormone that begins to be produced during gestation) is contained in the blood. If the results of the examination are negative, and the patient has no abnormalities in the work of the reproductive system, inflammatory processes and serious somatic diseases, the delay could be provoked by physiological causes.
Postpartum period
In women who, after childbirth, refuse to breastfeed the baby (or this is due to the physical impossibility of breastfeeding), menstruation is restored after 3-4 months. Why menses are delayed for a long time during lactation and breastfeeding - this is due to the action of the hormones prolactin and oxytocin.
Thanks to them, the function of development in the epididymis of the follicles and the maturation of oocytes is inhibited - an artificial menopause occurs. Hormones maintain a constant production of breast milk and prevent the process of sexual activity of the organs of the reproductive system from starting. Against the background of breastfeeding, menstruation is restored 6–8 months after childbirth, when the baby begins to be fed. The prolactin level falls, milk is produced less, the pelvic organs activate the reproductive function. That is why the long absence of menstruation during lactation is a natural phenomenon.
A sharp change in the climatic zone
A common psychosomatic reason for delaying menstruation by 7 or 10 days, except for pregnancy, there is adaptation to new living conditions - a long flight, a trip to a country with hot and humid climate. If a woman dramatically changes the conditions of the external environment, the body sends a signal to the brain about a stressful situation, the need to suspend ovulation and block fertilization.
The usual duration of the absence of menstruation when traveling is no more than 10 days. After adaptation, the cycle is restored, the body regains fertility. If bleeding does not occur for more than 14-15 days, you should see a doctor.
Stress and physical overload
The menstrual cycle is regulated by special parts of the brain - the pituitary gland and hypothalamus, which produce hormones necessary for the full functioning of the reproductive system. The endocrine glands and the brain work harmoniously, therefore, with severe stress and emotional upheaval, the hormonal system can respond to negative factors by disrupting the cycle.
The work of the hormonal glands changes, the body prevents ovulation in order to avoid conception. The duration of the delay is individual - for someone the cycle is restored after 6-7 days after a strong stress, someone notes the absence of menstruation for more than two weeks after a slight emotional shocks.
Excessive physical exertion can be the cause of the delay (this problem is common among professional athletes). The delay in this case is due to a sharp increase in testosterone. With overestimated hormone levels, the interaction of the pituitary gland and the appendages is disrupted, due to which there is a delay in the ovulatory phase and the beginning of menstruation.
Unbalanced diet
As a result of exhausting oneself with strict diets, when a woman excludes fats, proteins and carbohydrates from the diet in the amount necessary for life, a large amount of adipose tissue is lost. Normally, its mass is about 15% of the total weight of a person.
Fat cells contain estrogen, a sex hormone responsible for the maturation of follicles in the ovaries and the bearing of an egg. With significant thinness, a woman may experience delays in menstruation for more than a month - the situation is aggravated not only by a lack of estrogen, but also by polyunsaturated fatty acids and vitamin E.
Excessive body weight
In obesity, on the contrary, there is an excessive accumulation of estrogens in the fat cells, which negatively affects the regularity of the cycle. In women with excessive body weight, the process of controlling the production of insulin is deactivated - the cells of the body lose the necessary sensitivity to the substance. The pancreas produces more and more insulin, which is why testosterone levels in the blood jump, and this hormone provokes disruptions in the menstrual cycle.
Taking certain medications
Another reason for the delay in menstruation, in addition to pregnancy by 5-7 days, is taking certain medications, especially low-dose oral contraceptives. Often the duration of the cycle becomes longer, and the critical days themselves last about two days, the discharge is scarce.
Also, the effect on the cycle and the occurrence of delays can be exerted by:
- prolonged-release gestagens - they are prescribed to patients during the therapy of endometriosis;
- glucocorticosteroids - Prednisolone, Hydrocortisone, Dexamethasone, Betamethasone, etc.;
- drugs used during chemotherapy.
With a special sensitivity of the body to drugs, it can respond with a delay even to long-term use of conventional painkillers - Analgin, Baralgin, Spazmalgon, etc. Therefore, if a girl's period is late on the background of therapy with certain drugs, it is better to notify the attending physician about this.
Failure of hormonal levels
If the fair sex does not have regular periods, but she is not pregnant, an unstable hormonal background may become the cause.
Violation options:
Puberty
In the period of two to three years from the onset of menarche (the first menstruation), girls experience hormonal jumps caused by the process of regulation of the functioning of the ovaries. Menstrual bleeding may appear with delays of 1–2 months to six months, going every 15–20 days. This is not a deviation from the norm - the situation should stabilize when the girl reaches the age of 17-18.
Approaching climax
Against the background of the extinction of reproductive function, which can begin at the age of 43 to 55, estrogen production decreases. The intervals between menstrual bleeding increase, periods become scarce, and then disappear altogether. The beginning of the climacteric period can be suspected by the clinical picture, except for delays - hot flushes to the body, increased sweating, irritability, and changes in blood pressure.
After consumption OK
In some women, after a sharp refusal of contraceptive pills, withdrawal syndrome quickly develops (the follicles begin to actively mature, sometimes carrying two eggs at the same time). For other ladies, it takes 2-3 months to fully restore the cycle, during which menstruation delays are observed.
Critical days can stay for several days after using emergency contraceptives - Postinor, Escapel. They contain a large dose of hormones that prevent the gamete from penetrating into the uterine wall and can provoke a sharp cycle failure.
Pathological causes of delay in the absence of pregnancy
If the delay of critical days, provoked by physiological factors, is easily corrected lifestyle changes and adjusting the diet, then there are a number of pathological reasons that affect monthly cycle. What to do when menstruation does not come on time for a long period is to be diagnosed for the causes of violations.
Infection
Any inflammatory processes, especially in the pelvic organs, are always perceived by the female body as negative conditions for the completion of fertilization, therefore, a sharp shift or blockage occurs ovulation. In especially sensitive women, the delay can occur as a result of a long cold illness, previous pathologies of the upper and lower respiratory tract (tonsillitis, pharyngitis, bronchitis, pneumonia).
The infection process in the small pelvis has an even greater effect on the monthly cycle. Delay is usually triggered by:
- thrush - a disease caused by the Candida fungus;
- cystitis - inflammation of the bladder membrane, most often of a bacterial nature;
- sexually transmitted infections - trichomoniasis, ureaplasmosis, mycoplasmosis, gonorrhea, chlamydia;
- violation of the normal microflora of the vagina - bacterial vaginosis, gardnerellosis.
With a delay of 7-10 days, a woman who is sexually active must have a pregnancy test. If the test is negative, and she has signs such as pain in the lower abdomen, pathological vaginal discharge, soreness during intimate contact, it is necessary to be examined as soon as possible infections.
Polycystic ovary
The disease is characterized by multiple violations of the hormonal background due to the incorrect work of the pituitary gland, which may lead to a long delay in the arrival of menstruation against the background of the absence of ovulation. Polycystic ovary disease provokes maturation in the epididymis of not one, but several follicles at once, but none of them is able to endure a mature egg, ready for fertilization. With polycystic disease, the following symptoms appear:
- male body hair growth;
- increased oily skin, causing acne and acne;
- decrease in the timbre of the voice.
During the examination, an increased content of androgens (sex hormones that are present in large quantities in the male body) and their derivatives in the blood is revealed. Testosterone levels are often high. On ultrasound, you can see a large number of follicles in an enlarged ovary.
Myoma of the uterus
Despite the fact that fibroids belong to a number of benign tumors, it can negatively affect the regularity of menstruation. The duration of the delays varies from 2-3 days to several months. If a fibroid is found in the uterine cavity, it is necessary to immediately begin treatment, since if the problem is ignored for a long time, the tumor can degenerate into a malignant one.
Endometriosis
With this pathology, the tissue, which normally should line only the inner part of the uterus, begins to grow in unsuitable places for this:
- vagina;
- cervix;
- rectum;
- peritoneum.
Hormonal disorders can act as both a cause and a consequence of the development of endometriosis; only a doctor can understand the main provoking factor. With endometriosis, menstruation delays of one to two weeks may occur, smearing scanty dark brown discharge in the middle of the cycle. Additional symptoms are pulling pains in the lower abdomen, aggravated before menstruation and during sexual intercourse.
Diseases of the endocrine system
Since all components of the endocrine system must work harmoniously and be controlled by the hypothalamic-pituitary connection, the slightest deviation in the functions of one part causes disturbances in the rest. Delays are regularly diagnosed in women suffering from diseases:
- Hypothyroidism - suppression of the functions of the thyroid gland, caused by insufficient intake of iodine in the body, injuries, diseases of the pituitary gland. With a lack of thyroid hormones, reproductive function is blocked, manifested by delays in menstruation of 7-10 days or a couple of months, up to the complete absence of critical days.
- Hyperprolactinemia. The disease is characterized by a sharp increase in the volume of prolactin production as a result of damage to the pituitary gland (possible reasons - benign or malignant tumor, trauma to the gland, a consequence of the use of potent drugs). As a result of the increased content of prolactin in the body, the effect of artificial menopause is created, as during breastfeeding, and a woman cannot become pregnant. If the concentration of the hormone is not exceeded so much, the periods continue to go, but they constantly appear with delays.
To identify pathologies of the endocrine system, a woman needs to pass blood tests for the content of hormones (prolactin, T3, T4, TSH and those that the doctor considers it necessary), undergo an ultrasound of the thyroid gland if hypothyroidism is suspected and an MRI of the brain if symptoms indicate a tumor or damage pituitary gland.
How to improve your menstrual cycle
To find out the reasons for the absence of menstruation, in addition to pregnancy, you need not study the forums and find out the opinions of other women about delays, but immediately go to the gynecologist. If the doctor does not find pathologies in his specialization, he will refer the patient to the necessary doctors - a psychologist, endocrinologist, surgeon, venereologist.
To eliminate the physiological factors of cycle disturbances, it is necessary:
- eat balanced;
- reduce weight with obesity and gain body weight with severe thinness;
- protect yourself from stress and excessive emotional overload, on the recommendation of a doctor, you can drink a course of sedatives;
- give up alcohol and cigarettes;
- take medicines only as prescribed by a doctor and in strict accordance with the instructions;
- timely diagnose and treat existing diseases of the endocrine, reproductive systems, diseases of an infectious nature.
Most often, hormone therapy with Dufaston, Norkolut, progesterone and others is used to eliminate delays and stabilize the cycle.
If it is undesirable to carry out it (during puberty, with a mild degree of hormonal disturbance), vitamin therapy is prescribed. In the treatment regimen, the intake of folic acid and vitamin B is of great importance, and in the second phase of the cycle of vitamins E and C.
A woman can eliminate mild menstrual irregularities on her own, after making sure that there is no pregnancy and changing her lifestyle.
If the delays are caused by serious somatic diseases that affect the functioning of the reproductive system, they are treated by narrow specialists, selecting drugs individually for each patient. Sometimes, to establish a cycle, surgical intervention is required (tumors of the uterus, ovaries, pituitary gland, advanced stage of hyper- and hypothyroidism).