How Covid affects the menstrual cycle and how to restore it

Every girl or woman may experience menstrual irregularities.

At some point in her life, cycle disturbances probably occurred in every woman. Irregular periods, which many women are accustomed to considering as something ordinary, are actually a signal of problems with women’s health.

What is NMC in gynecology? This is a disrupted menstrual cycle that happens to women at different periods of their lives.

Irregular menstruation - delays or a shorter cycle, indicate disturbances in the physical or mental state of the woman. The monthly cycle is a kind of biological clock of the body. A disruption in their rhythm should alert you and cause you to consult a doctor so that diseases can be identified in a timely manner. Below we will talk about why the menstrual cycle fails and what a woman should do in such a situation.

A little about menstruation and the menstrual cycle

The first menstruation or menarche occurs in girls around 12–14 years old, and the further south the child lives, the earlier her periods begin. Menstruation ends around 45–55 years of age (this period is called premenopausal).

Menstruation is the shedding or desquamation of the functional layer of the uterine lining in response to decreased progesterone production. This is why gynecologists like to repeat that menstruation is the bloody tears of the uterus due to an unfulfilled pregnancy. To understand this definition, it is worth remembering the physiology of the menstrual cycle. As you know, a woman’s monthly cycle is divided into 3 phases:

• In the first, follicular phase, estrogens are produced, the action of which causes the maturation of follicles. From these follicles the main or dominant follicle is released, from which a mature egg is subsequently released.
• The second phase is the shortest (about a day), it is during this period that the main follicle ruptures, and the mature egg is released “free”, ready to meet the “live animals” and fertilize.
• In the third phase, the luteal phase, the synthesis of progesterone by the corpus luteum, which arose at the site of the ruptured follicle, begins. It is progesterone that prepares the endometrium for implantation of a fertilized egg. If conception does not occur, the corpus luteum slowly “dies” (regresses), progesterone production drops and endometrial rejection begins, that is, menstruation.

Then estrogen production gains strength again and the cycle repeats.

From all that has been said, it becomes clear that the menstrual cycle is called cyclic changes that occur in the body after a strictly defined time.

The reason for delayed menstruation is termination of pregnancy

Delayed menstruation can also occur after termination of pregnancy. The reason is a hormonal imbalance, as well as the fact that during instrumental curettage of the uterus, an excessive amount of tissue can be removed, including that part of the inner lining of the uterus, which normally grows during the menstrual cycle and is released in the form of menstrual blood. To restore this functional layer sometimes takes a little longer than during a normal cycle. That is, after an abortion, menstruation may occur not after 28-32 days, but after 40 days or more. This delay is not normal: the woman requires examination and treatment.

Causes of menstrual irregularities

The main reason for the disruption of the menstrual cycle is hormonal imbalance. This happens in various diseases and conditions. The hereditary factor also plays an important role - if ancestors on the female line had disruptions in the cycle or other disorders, it is quite possible that this will affect the nature of menstruation in women in subsequent generations.

Lack of sleep, stress, excessive physical activity, psychological fatigue, change in time zone or climatic conditions can lead to irregular periods. It is not uncommon to experience menstrual problems in those who regularly stay awake at night. Brain tumors and neuroviral infections can also lead to menstrual irregularities.

Disturbed hormonal cycles are also observed in many diseases. Most often this happens against the background of pathologies of the endocrine and genitourinary systems, such as:

• genetic and hormonal pathologies of the ovaries;
• inflammation of the uterus and appendages;
• infectious lesions of the pelvic organs;
• diabetes;
• diseases of the thyroid gland, adrenal glands;
• obesity, etc.

Functional disorders of the endocrine system, manifested in the accumulation of estrogen with a simultaneous deficiency of progesterone, also cause menstrual irregularities. The cycle can be disrupted due to any infectious and non-infectious diseases, acute or chronic.

How can a gynecologist help?

If menstruation is long and heavy, then girls over 18 years of age are prescribed special hormonal medications that will need to be taken throughout the year. Heavy bleeding can lead to anemia, so you should not hope for self-healing. As a result, two pathologies will have to be treated: hormonal imbalance and anemia.

The doctor prescribes hormones

A visit to the doctor is also necessary in case of irregular, infrequent menstruation. They can be caused by:

• diseases of the thyroid gland or hypothalamus;
• polycystic ovary syndrome;
• malformations of the reproductive system (for example, hypoplasia of the ovaries, uterus);
• certain medicines (mostly steroids, which are used, for example, to treat asthma).

You should also consult a gynecologist if there is no menstruation or the bleeding stops very quickly. In the latter case, this may be the result of carefully hidden anorexia or bulimia from others, or an unwanted pregnancy.

Any woman can experience menstrual irregularities

Failures can be associated not only with diseases of the pelvic organs, but also with disorders in the endocrine, nervous, and immune systems. It should also be remembered that sometimes they signal the development of certain infectious diseases or pathological conditions:

• ectopic pregnancy;
• neoplasms in internal organs;
• malignant or benign neoplasm in the uterus or on its surface;
• STD;
• tuberculosis.

Some girls believe that tampons also provoke changes in the cyclicity of menstruation, but this opinion is incorrect. They are the same means of hygiene during menstruation as pads and menstrual cups.

Algodismenorrhea (dysmenorrhea)

The appearance of nagging and cramping pain in the lower abdomen and lower back shortly before the onset and during menstruation. General health worsens, weakness, dizziness, and headache occur. The entire symptom complex fits into the general concept: algodismenorrhea.

Dysmenorrhea can be primary or secondary.

♦ Primary - it is also called functional - is observed in girls from the moment of the first menstruation - menarche. Typically, the intensity of symptoms decreases after the first birth. ♦ The secondary form occurs when inflammatory processes of the female reproductive system occur; hormone-dependent diseases, such as endometriosis, uterine fibroids, ovarian cysts, etc. Also the cause may be previous operations on the appendages and uterus and complicated childbirth.

If you find symptoms of algodismenorrhea, you should consult a gynecologist. After all, the sooner the doctor finds out its causes, the sooner he will prescribe appropriate treatment, and, accordingly, your quality of life will improve.

What is considered a menstrual disorder?

• Delay of menstruation by more than 10 days.
• Shortening the cycle by 5-7 days.
• Increase or decrease in the volume of menstrual flow.
• Accompanying menstruation with deterioration of well-being and/or severe pain.
• Discharge of blood outside of menstruation (minor bleeding during ovulation is part of the norm).
• Complete cessation of menstruation before menopause.
• Uterine bleeding during menopause.

In order for a change in a cycle to be called a violation, it must be repeated over several cycles. Situational, that is, single changes (increasing or shortening the cycle by 5-7 days) are not violations and are considered a type of norm.

Symptoms of menstrual irregularities

Too scanty or, conversely, abnormally heavy periods have their own characteristic symptoms. It is well known that any disturbances in the human body never go away without a trace, and a disruption in the menstrual cycle can be recognized by the following signs:

• disturbance in the regulation of bleeding;
• copious discharge with the presence of clots;
• significant delay;
• very scanty menstruation;
• painful attacks of various types;
• premenstrual syndrome.

In the case of normal menstruation, the woman does not feel any significant symptoms. In some cases, a nagging pain in the lower abdomen may appear, which does not particularly disturb the general rhythm of life. If the menstrual cycle is disrupted, the pain syndrome can become too severe, the pain can radiate to the hip and lower back.

The intensity of the syndrome is determined by the following indicators:

• loss of ability to work – it’s hard to sit, do usual work, there is a constant desire to lie down;
• number of painkillers taken;
• In adolescents, menstrual irregularities are often caused by excessive emotional stress that arises from the expectation of bleeding.

Irregular periods during adolescence

In teenage girls, menstrual irregularities are quite common. This is due to physiological reasons. That is, the hormonal background has not yet been established and the duration of both the cycle itself and menstruation may be different each time. The norm is considered to be the formation of a cycle over 1 – 2 years.

Pathological factors and causes of irregular periods include:

• traumatic brain injuries;
• infectious lesions of the brain and its membranes;
• tendency to colds;
• vegetative-vascular dystonia;
• obesity;
• sclerocystic ovaries and genital infections.

Of no less importance is the craze among girls for dieting, which leads not only to significant loss of body weight, but also to hypovitaminosis and menstrual irregularities. In addition, the regularity of the menstrual cycle is also affected by the girl’s character (too emotional, impulsive or aggressive).

The following also play a role in cycle disruption:

• early and promiscuous sexual intercourse;
• bad habits;
• malformations of the reproductive system.

An disrupted menstrual cycle in girls can result in a complication such as juvenile uterine bleeding. In this case, periods last more than a week and are heavy, which leads to anemia in the child (see iron supplements for anemia). Typically, juvenile bleeding is provoked either by an infectious process or by nervous strain.

Amenorrhea

Amenorrhea is a cycle disorder when menstruation is completely absent. It can be primary or secondary. The following types of amenorrhea are distinguished:

♦ True, or physiological – this is the most “correct” type of absence of menstruation, due to reasons such as pregnancy, lactation, menopause.

♦ False amenorrhea occurs when menstruation occurs, but cannot come out due to anatomical features. For example, due to a dense hymen or a narrowed cervical canal.

♦ Pathological is the most difficult of all types of amenorrhea, since it is one of the symptoms of serious diseases. For example, it may be a manifestation of low or excessive production of certain hormones, or ovarian diseases, or disruption of the cerebral cortex. It can also be a consequence of inflammation of the appendages, adhesive disease, or surgical intervention.

Treatment of amenorrhea is quite difficult and lengthy. You should not put it off until later, since amenorrhea tends to progress, and accordingly, it is even more difficult to respond to treatment.

Diagnosis of a disrupted menstrual cycle

Many women who have problems with menstruation put off visiting the doctor because they are afraid of prescribing hormone therapy. In fact, hormones are indicated only in some cases, and careful diagnosis is necessary to select an adequate treatment regimen.

In addition to a gynecological examination, smear and general blood and urine tests, the following may be prescribed:

• Ultrasound of the pelvic organs and thyroid gland;
• hormone analysis;
• hysteroscopy;
• studies to identify chromosomal pathologies;
• PCR, etc.

The doctor decides exactly what tests are needed after a detailed questioning, in which he can find out the presence of a genetic predisposition, features of the patient’s lifestyle and other nuances that affect the frequency and intensity of menstruation. You may also need to consult doctors of other specialties (endocrinologist, therapist) and additional studies (computed tomography, skull radiography, etc.).

Diagnostics of NMC

On your first visit to the clinic, you talk with the doctor, show him the results of previous studies (if you have them), tell him details about your health, lifestyle, and the presence of chronic diseases. Next, the doctor conducts an examination in a gynecological chair. During the examination, a smear is taken for cytology (PAP test), flora, as well as colposcopy to obtain a complete picture of the condition of the genital organs. You will also undergo ultrasound diagnostics and donate blood. You can bring a container of urine with you to your initial appointment and submit it to the laboratory for testing on the same day.

Laboratory results will be available in a few days or a week. Once you receive all the results by email, you can schedule a follow-up consultation to receive a doctor’s opinion and prescribe a treatment plan.

Treatment of menstruation disorders

Often the irregularity of the cycle is short-lived, but it is necessary to consult a doctor. He will conduct an examination, prescribe a list of tests and help determine the factor contributing to the development of this condition. A failure caused by hypothermia, stress, moving or overexertion does not require serious treatment or the use of medications.

During heavy workloads and sports, it is important to provide the body with rest, walk less, but also not lie down for several days in a row. When the climate changes, you can take vitamins; over time, the body will get used to the changes and will not react sharply to changes in temperature and humidity.

If the disturbances are caused by a diet, you must immediately stop it and start eating a balanced diet. Lack of nutrients provokes vitamin deficiency, the treatment of which begins with the use of vitamin and mineral complexes.

Indications for visiting a doctor if your menstrual cycle is irregular

For any irregularities in the menstrual cycle, it is advisable to consult a gynecologist. This will help you avoid serious consequences and not worry about your condition, thereby aggravating the situation. But in some cases it is necessary to undergo an examination:

• If a teenage girl did not have menarche until she was 15-16 years old.
• A year and a half passed after the first menstruation, and the monthly cycle was still not established.
• Your periods are too long and too heavy.
• The nature of menstrual flow, its color, and smell have changed (this may be a sign of endometrial disease).
• Ovulation is accompanied by painful sensations.
• The discharge is very scanty, and menstruation comes with a significant delay.
• Bleeding is a concern during the period between menstruation (even a single case requires examination).

Even if all these changes do not cause discomfort or cause complaints, you should not ignore them. Menstrual irregularities are often a sign of illness, and timely treatment can avoid complications and life-threatening conditions.