Rare menstruation is a disorder of the menstrual cycle, in which its duration exceeds 35 days (opsomenorrhea). A variant of the disorder is spaniomenorrhea with the appearance of spotting 2-4 times a year. The symptom may be accompanied by a decrease in the amount of spotting, constant pain and discomfort in the lower abdomen. It is observed with physiological hormonal changes, overload, diseases of the genital organs. To determine the causes of rare menstruation, a gynecological examination, ultrasound of the pelvic cavity, endoscopic methods, and laboratory tests are used. Medications are prescribed only after verification of the diagnosis.
In adolescent girls, in the first two years from the onset of menstruation, the menstrual cycle may have a different duration, sometimes the interval between bleeding increases to 40-5 days. This is due to the formation of sexual function, insufficient synthesis of estrogens and progesterone by the ovaries. Normally, the cycle is established 1-2 years after the first menstruation. If a girl’s rare periods persist for more than 2 years, spotting is combined with sharp pains in the lower abdomen or other unpleasant symptoms, you should contact a pediatric gynecologist.
The menstrual cycle lengthens after 45 years, due to age-related changes in the ovaries and a decrease in the synthesis of sex hormones. Premenopausal patients note that rare menstruation is accompanied by a reduction in the duration of bleeding to 2-3 days. Bloody discharge scanty, dark brown. As you move into menopause, the intervals between menstrual periods gradually increase. Consultation with a specialist is necessary if such menstrual disorders develop in women under 35-4 years of age.
In patients who have been taking oral contraceptives for a long time, the production of their own sex hormones is reduced. Therefore, with the abolition of such drugs, the level of estrogen, the main substance that regulates the onset of menstruation, sharply decreases. At the end of taking the pills, several cycles often fall out, when menstruation occurs, a small amount of blood is released, bleeding lasts 1-2 days. Such changes in a woman of reproductive age are an indication for a visit to a gynecologist.
A sharp change in climatic conditions causes stress, while the functionality of the nervous structures changes and the regulation of menstrual bleeding is disrupted. Rare periods within 1-2 cycles are considered physiological after moving to a region with a radically different climate, resting in hot countries. Then, in most patients, the intervals between menstruation return to normal. If the symptom worries longer, the duration of bleeding and the amount of discharge decrease, opsomenorrhea often indicates the development of diseases of the reproductive sphere.
Menstrual dysfunction can occur in the absence of pathologies from the reproductive or nervous systems. Often, cycle failures are provoked by chronic stress, in which the production of progesterone and estrogen is disrupted, there is a general asthenization of the body and functional (temporary) disorders of the neurohumoral regulation of the onset of menstruation. It is important to diagnose such a condition in time, because without appropriate therapy, reproductive function is seriously affected, up to infertility. The main reasons for the lengthening of the intermenstrual period:
With congenital organic pathology, symptoms occur in adolescence during the first menstruation. In girls, scanty rare periods are observed, spotting is characteristic. Bleeding is combined with severe pain in the lower abdomen and perineum. Over time, the symptoms worsen, up to amenorrhea. Most often with opsomenorrhea, uterine anomalies occur - infantilism, hypoplasia, kinks, and underdevelopment of the fallopian tubes and vagina also leads to menstrual dysfunction.
In PCOS, the lengthening of the menstrual cycle is associated with progressive ovarian dysfunction. Due to various reasons, the process of ovulation is disrupted, cysts form in the gonads, which inhibits the synthesis of estrogens. Intermenstrual intervals last from 4 days to 4-6 months, the duration of bleeding is reduced to 1-2 days (oligomenorrhea). Women note that against the background of menstrual dysfunction, body weight gains for no reason, hair growth on the face and limbs increases. Without treatment, the condition is complicated by secondary amenorrhea.
Acute and chronic inflammation of the genital organs can be manifested by rare menstruation, which is due to both hormonal dysfunction and pathological changes in the endometrium. A characteristic lengthening of the interval between periods occurs against the background of dull pulling pains in the lower abdomen, fever, itching and discomfort in the perineum. Periodically there are white or yellowish discharge from the vagina. With violations of the menstrual cycle, the type of opsomenorrhea occurs:
Since rare periods are often caused by damage to the genital area, the obstetrician-gynecologist is engaged in the primary diagnosis. Women are prescribed a comprehensive examination using laboratory and instrumental methods, which are aimed at finding out the root cause of menstrual dysfunction. The most diagnostic value are:
In order to clarify the diagnosis, magnetic resonance imaging of the pelvic organs is prescribed. If genital pathology is excluded, a neurological examination may be required: EEG, X-ray examination of the bones of the skull and the area of the Turkish saddle. If systemic hormonal disorders are suspected, consultation with an endocrinologist is recommended.
With rare periods, a comprehensive gynecological examination is performed
In cases where rare periods are associated with physiological hormonal changes, treatment is not prescribed. Such patients are shown constant monitoring by a gynecologist. It is important to exclude all provoking factors - stress, physical overwork. For teenage girls and young girls, it is especially important to eat a calorie- and vitamin-balanced diet. Specific drug therapy is prescribed only by a specialist upon completion of a comprehensive examination and identification of the disease that caused the lengthening of the intermenstrual interval.
Modern gynecology has a wide range of treatments for oligomenorrhea. The tactics and sequence of therapeutic actions is selected depending on the diagnostic results. The treatment of oligomenorrhea is usually handled by a gynecologist-endocrinologist. An important role in the treatment is played by restorative therapy, including the normalization of nutrition, the intake of vitamins, immunostimulation, physiotherapy, and acupuncture. To activate blood circulation in the pelvis, a special gynecological massage and gymnastic exercises are prescribed.
Drug therapy for oligomenorrhea includes taking hormonal estrogen-containing drugs that stimulate the ovulation process and normalize the menstrual cycle (clomiphene, starting from the 2nd to the 6th day of the menstrual cycle). Since oligomenorrhea may develop endometrial hyperplasia and carcinoma, it is necessary to take hormonal contraceptives in order to cause regular menstrual bleeding. In addition to the therapeutic effect, these drugs have a contraceptive effect. A number of conditions that cause oligomenorrhea require surgical intervention. In polycystic ovary syndrome, the use of point diathermocoagulation of the ovaries (cauterization of ovarian tissue with high-frequency current through laparoscopic access), which normalizes the ovulatory cycle, is effective.
An indicator of the cure of oligomenorrhea is the restoration of the duration of menstrual bleeding and a decrease in the intervals between them less than 4 days, observed for one year. At this time, it is recommended to maintain a menstrual calendar and see a gynecologist every three months. Further prevention of oligomenorrhea consists in the normalization of nutrition, physical activity, emotional reactions, the use of reliable methods of contraception recommended by the doctor.