• Healthy stimulation from the brain to the ovaries,
• This stimulation affects the ovaries, causing the release of estrogen, the female hormone, from the ovaries and ovulation, followed by the secretion of the second important hormone, progesterone.
• A normal uterus and genital system for menstrual bleeding,
• Being psychologically healthy
Bleeding that occurs as a result of physiological conditions being affected for any reason is called irregular bleeding.
Bleeding that usually occurs regularly between 21-35 days and lasts 3-7 days can be considered within normal limits. The average blood loss is around 35-40 ml during a menstrual period. This can generally be expressed as 3-5 pets per day. Generally, bleeding over 80 ml is considered abnormal. However, it is not easy to determine whether the amount of bleeding is normal or not. Due to meticulousness when evaluating blood loss, differences in interpretation from person to person prevent being objective.
Menstrual irregularities during the first menstrual period and puberty
The first menstrual bleeding occurs in girls, on average, at the age of 12-13. With the first menstrual period, we begin to become a young girl. However, since the maturation of the hormonal system is completed in a period of one or two years, some of the menstrual periods occur without ovulation. Therefore, menstrual delays and/or menstrual periods lasting longer than normal are common during adolescence. Sometimes, during these periods, irregular and prolonged bleeding may be severe enough to require treatment with medications.
If the first menstruation occurs before the age of 9, there may be a hormonal disorder. If menstruation does not occur until the age of 16, there may be a hormonal disorder or some structural defects (such as the hymen being completely closed and not allowing blood to flow, the absence of genital organs). Therefore, in such a case, a detailed gynecological evaluation is definitely required.
Irregularities in the fertile period
Starting from a certain stage of puberty, ovulation becomes regular and menstruation becomes regular. This is the period when a woman can become pregnant and continues until menopause. In fact, irregularities that require treatment and bring women to the gynecologist are mainly observed during this period.
Menstrual irregularities; Delays, intermittent bleeding, heavy menstrual periods and long periods, or low menstrual periods and short periods may occur.
spiral If bleeding irregularity occurs after the IUD insertion in women carrying the IUD, the first approach for some physicians may be to remove the IUD, but since the bleeding usually regulates after the first months, if other contraceptive alternatives do not seem attractive, we should not be in a hurry to remove the IUD. Treating it with some pills will help you get through this period.
Polycystic ovary is the most common problem in this period and is usually manifested by infrequent menstruation. (Polycystic Ovary) This is the problem we call. In this disease, if the development of the egg slows down or stops for any reason at the beginning of its cycle, a cyst forms in the place where the egg will develop and crack and it remains unhatched. This situation recurs every month and the number of cysts in the ovaries increases. This picture may often be accompanied by hair growth due to excess male hormones, acne on the face, and excess weight.
A typical ovarian appearance is observed during ultrasonographic examination. Of course, these women also have problems getting pregnant, and treatment is often required.
A special form of bleeding ovulation bleeding (mid-cycle bleeding). These are spotting-like bleeding that occurs as a result of the decrease in estrogen following ovulation in the middle of two menstruals. Rarely, bleeding may be as heavy as menstrual bleeding. It is not a serious problem and if necessary, 1-2 days of hormone support specific to that period can be taken.
spotting before menstruation Since bleeding like this is usually an indication of a hormonal failure, they may require taking medication starting in the premenstrual period and lasting for 1 week or 10 days.
Menstrual Delays
In fact, when a woman with an active sexual life experiences a menstrual delay, the first thing to consider is whether or not she is pregnant.
The second possible reason is that there is no ovulation at that time for any reason and the bleeding is delayed due to this. When there is no ovulation, the water sac containing the egg cell, which needs to hatch, will continue to grow and secrete hormones, so menstruation will be delayed and there will be no abnormality in the right or left ovary during examination. cyst Fluid-filled structures that we call the formation of fluid are formed.
For more information about cysts, please Click here.
Following a long period delay, the next menstrual period will be longer and more abundant as the tissue in the uterus has thickened. It would be beneficial for the physician to warn his patient about this issue. The reason for an unexpected delay in a woman who has a regular menstrual period can usually be psychological effects.
In cases where there is no pregnancy and there is no stress that will affect menstruation, the reasons for menstrual delay should be investigated. For this purpose, the person will definitely need to consult a Gynecologist and have some hormone tests done as an examination. Events that are likely to cause menstrual delay are generally milk hormone and thyroid hormone disorders.
Heavy and prolonged menstrual bleeding
Increased menstrual bleeding often indicates the presence of a condition that requires treatment. Excessive menstrual bleeding will leave the woman anemic and harm her general health. In such cases, it is important to reveal the underlying cause. Examination by a gynecologist is essential.
The underlying causes are often myoma benign tumors, which we call hyperplasia excessive thickening of the inner layer of the uterus, which we call endometritis It may be due to reasons such as inflammation in the inner layer of the uterus or pieces of flesh called polyps. All of these must be treated by a physician.
Breakthrough bleeding
Another common menstrual irregularity during the fertile period is unexpected breakthrough bleeding. Although the most likely cause may be psychological effects, it must first be investigated whether there is a more serious reason. Hormonal imbalances, inflammations in the cervix, myomas (benign tumors in the uterus) and pieces of flesh called polyps in the cervix may be the cause. In addition, the use of IUDs, the first months of birth control pill use, taking hormone therapy during menopause, monthly or quarterly injections, and contraceptive sticks applied under the skin can also cause breakthrough bleeding in the form of spotting.
It is frequently seen that cervical problems and wounds are responsible for bleeding, especially after intercourse. The most important approach here is to determine whether the wound seen in the cervix is related to cancer or pre-cancerous images. This is taken from the cervix. smear It is possible with the scanning method called. After excluding precancerous abnormalities with a smear (swab from the cervix), if there is a complaint of bleeding or disturbing discharge, this wound must be treated by burning or freezing methods.
It should also not be forgotten that menstrual irregularities are very common in women who are about to enter menopause. These are usually seen as frequent menstrual intervals or widening of the intervals in the following periods, rather than unexpected breakthrough bleeding.
Bleeding after menopause
No bleeding is normal during this period, and although bleeding in this period is usually caused by cell weakness, 10-15% of them occur. cancer It should not be forgotten that this may be the reason and it must be investigated in the most detail. Sampling from inside the uterus must be done, the cervix should be evaluated well, and medication intake should be questioned.
Every woman who has unexpected breakthrough bleeding should see her gynecologist without delay and have it examined whether there is a serious underlying cause.