Primary amenorrhea - is the absence of menstruation in women older than 16 years. Amenorrhoea is combined with infertility. In the case of primary amenorrhea infertility can carry genetic nature and be combined with various other anomalies, as well as developmental disorders.

Primary amenorrhea - the causes of

Menstrual irregularities Menstrual cycle and its characteristics   by type of primary amenorrhea can occur at any level of neurohormonal systems - the cerebral cortex - the hypothalamus - pituitary - ovary. In addition, "breaking" may be at the level of the uterus, in that case would be considered primary amenorrhoea false as neurohumoral system will not be activated.

The most common cause of primary amenorrhea are genetic disorders (chromosomal abnormalities) that affect the condition of the ovaries. Each person has a set of 46 chromosomes (23 pairs). The 23rd pair of chromosomes - is the sex chromosomes in women is two X chromosomes, and males - XY. To female reproductive system to function properly in the 23rd pair must have two X chromosomes. If this policy is somehow broken, then there are violations, including developing primary amenorrhea. In some genetic disorders (for example, in Turner syndrome) egg in the ovaries are replaced by connective tissue and restore them is not possible.

Sometimes primary amenorrhea is the consequence of serious illness or intoxication suffered by a girl in utero or in early childhood. This also kills ovarian oocyte and replaced by connective tissue.

The blood of these girls found very low levels of female hormones and high levels of pituitary gonadotropins (pituitary struggling to stimulate ovarian function, but it does not work). Such species are called primary amenorrhea hypergonadotrophic.

The cause of primary amenorrhea may also be the defeat of the hypothalamus that evolved with severe physical and neuropsychiatric load and stress and poor nutrition among adolescent girls. Such amenorrhea The absence of menstruation (amenorrhea) - ambiguous symptom   called the center, as a rule, it is a functional one, and with proper treatment runs independently. Sometimes the cause of primary amenorrhea are tumors and diseases of the hypothalamus and pituitary gland. This is a violation of development the hypothalamic gonadotropin-releasing hormone, which leads to a suppression of the secretion of pituitary gonadotropins (TG), as well as this there will be no ovarian stimulation Ovarian stimulation: if you want to get pregnant To fall and the content of female hormones. And this, in turn, is often accompanied by increased secretion of male sex hormones and promotes the emergence of virilnogo syndrome (increased body hair, changes in the figures for male pattern), moderately expressed in the hypothalamus-pituitary disorders.

Primary amenorrhea is called false in case neurohormonal system is functioning normally, but there is no menstruation because of the obstacles to the outflow of menstrual blood. This happens, for example, when there is no hole in the hymen.

The main symptoms of primary amenorrhea

Since the primary amenorrhea may develop on the background of various diseases and conditions, their signs may also be different. For example, the central (hypothalamic) amenorrhea usually manifests itself only in the absence of monthly, but the long flowing hypothalamic amenorrhea body and face girl gradually undergoes characteristic changes: weight increases, fat is stored mainly in the abdomen, pelvis, hips and breast. The face becomes round, soft leather, with a marble shade, pubic hair and armpits rare or completely absent. External genitals are usually underdeveloped, narrow vagina, the uterus is too small.

Severe genetic abnormalities in the ovaries are usually combined with the general underdevelopment. For primary amenorrhea is of genetic origin, such as Turner syndrome Shershnevskoye, when the primary defect in ovarian tissue develops due to genetic damage. Girls with Turner syndrome are short stature, short neck, the predominance of the lower half of the body over the top. Secondary sexual characteristics are poorly developed, osteoporosis Osteoporosis - he threatens you?   (brittle bones associated with calcium deficiency). Sometimes these symptoms are combined with other severe anomalies.

Diagnostics

An experienced doctor after the questioning and examination of the girl is about, the cause of primary amenorrhea. To confirm the diagnosis, the girl takes blood on hormones, hormone tests are carried out when using a specific hormone stimulated by a particular segment of the neurohormonal system - it allows you to more accurately determine exactly where the violation occurred.

Held as ultrasound pelvic X-ray and magnetic resonance imaging of the brain, if necessary - endoscopic examinations.

The menstrual cycle plays an important role in a woman's life. According to the flow, duration and delay menstruation can identify abnormalities in reproductive health, pregnancy and the beginning of the extinction of the reproductive function. Therefore, every woman should keep your calendar menstrual cycle to calculate the most favorable days for conception, or, conversely, "safe" days.

Menstrual cycle

The menstrual cycle (from the Latin word menstruus) literally means "moon" cycle. The menstrual cycle - a periodic change in the female body, aimed at the possibility of conception. Its duration is individual for each woman and depends on the physiological processes in the body of the woman, and does not depend on the phases of the moon. The average duration is 28 days, but can range from 21 days to 35. The beginning of the menstrual cycle is considered the first day of menstruation.

Menarche

Menarche - the first menstrual cycle, which is the main event of puberty Puberty child - stages of a complex path Indicating the possibility of conception. On average, menarche begins at the age of twelve, but may start menarche range from 8 to 16 years. It depends on heredity, by social factors, an illness, climate and ethnicity. Only 30% of girls established a regular menstrual cycle is very fast. The rest of the time it takes at least a year.

Cessation of the menstrual cycle

Termination of the menstrual cycle or menopause occurs on average at age 40-58 years. During this period, the extinction of reproductive function, and it also depends on genetic factors, chronic diseases or surgical interventions. But today, the concept of "climax" and "menopause" are becoming increasingly rare. More generally accepted the following terminology:

• premenopausal period - 45 years before menopause;
• perimenopausal period - pre-menopausal and post-menopausal for two years;
• Menopause - the last menstrual period, which comes to an average of 50 years;
• postmenopausal period - begins after menopause and lasts until the death of the woman.

The phases of the menstrual cycle

There are four phases of the menstrual cycle:

• follicular phase;
• ovulatory phase;
• secretory phase;
• desquamation phase.

Follicular phase

The follicular phase begins on the first day of the menstrual cycle The days of the menstrual cycle: Four phases . At this time the maturation of the dominant follicle, from which the later will mature egg. The duration of each woman her own, from 7 to 22 days, and an average of 14 days. In the uterus at this time begins to grow and thicken the endometrium, which is prepared to accept a fertilized egg.

Ovulatory phase

By the seventh day is determined by the dominant follicle, which continues to grow and secrete estradiol, while other follicles in this period undergo reverse development. This phase lasts three days, this is accompanied by the release of luteinizing hormone (LH), which under the influence of the dominant follicle bursts and the egg leaves mature. That is, ovulation occurs within 24 hours. In order to get pregnant, you need to calculate the day of ovulation in advance, as long there is no egg and sperm remain viable up to three days. Therefore intercourse should occur in advance of ovulation, sperm managed to penetrate into the fallopian tube to meet with the mature egg.

The secretory phase

Luteal or secretory phase - is the period between ovulation Ovulation - How to determine as accurately as possible?   and the onset of menses. The secretory phase is more constant and lasts 13-14 days. During this period formed the corpus luteum, which starts producing progesterone Progesterone - norm and pathology   (pregnancy hormone), estradiol and androgens. During the secretory phase endometrial glands mature, proliferate and begin to secrete. If fertilization has occurred, it is implanted in the endometrium is already prepared. If fertilization does not happen, the corpus luteum is reduced (growing back), progesterone levels fall and menstruation begins.

Phase desquamation

Phase desquamation or menstruation lasts from three to seven days and is accompanied by uterine bleeding, during which rejected the endometrium.