Polymenorrhea: causes and treatment

Polymenorrhea is cyclically recurring menstrual bleeding with a short interval of no more than 21 days. Polymenorrhea is not always associated with pathology; as a rule, frequently recurring menstruation often does not have a pathological nature in girls entering puberty, as they are associated with imperfect hormonal function, and when their sexual development is completed, the correct menstrual rhythm is established independently. Polymenorrhea during menopause can also be provoked by natural causes, namely the attenuation of the hormonal function of the ovaries and the entry into menopause. During the childbearing period, polymenorrhea is often the first harbinger of a serious menstrual disorder due to pathological causes.

Many different medical terms are used for disorders of normal menstrual function, sometimes they have the same meaning and differ only in the wording. It can be difficult for patients to understand this diversity. However, in order to understand the essence of pathological changes in the menstrual cycle, it is not at all necessary to decipher the diagnosis made by the doctor. It is much more important to know the characteristics of the menstrual cycle, which are conventionally accepted as the norm, and to understand how it is formed.

The menstrual cycle consists of cyclically repeating changes in a woman's body from one bleeding to the start of the next. The onset of menstrual bleeding is simultaneously the last day of the previous and the first day of the subsequent menstrual cycle.

The “norm” is taken to be the characteristics of the menstrual cycle that are characteristic of most women, namely:

- Regularity. Menstruation should come in a constant rhythm with small acceptable deviations of 1-3 days.

— Time interval between menstruation. The majority (60%) have periods every 28-30 days. It is permissible to change boundaries up to 21-35 days.

- Duration. Menstrual bleeding should not be too short (less than two days) or long (more than seven days).

- Period of active menstrual bleeding. As a rule, the “heavy days” end after two or three days, and then the bleeding subsides and more scanty (sometimes spotting and/or dark) blood discharge appears.

- Blood loss. The volume of blood lost during menstruation is the most difficult parameter, since it is difficult to measure accurately. For convenience, patients are asked to measure it by the number of pads that they change daily. As a rule, with physiological blood loss (40 - 150 ml), no more than four pads are required daily.

— Subjective sensations. Usually, unpleasant sensations, which a woman defines as “pulling”, “sore”, accompany only “heavy days”. There should be no severe pain during menstruation.

The concept of “norm” for the menstrual cycle is very relative, since in some healthy women, periods are “wrong” from the point of view of this norm and do not lead to negative consequences. If, after examination, no abnormalities are detected in such patients, they are considered healthy, and menstrual abnormalities are accepted as an individual physiological norm.

With polymenorrhea, periods come too often - after 21 days. However, they can be abundant and/or prolonged. They often last longer than a week, but if they do not stop after 12 days, they are classified as cyclic bleeding.

It should be noted that polymenorrhea rarely exists as an isolated clinical condition. Much more often it is combined with other menstrual disorders, among which heavy menstrual bleeding (hypermenorrhea) is the leader.

Among the causes of frequent menstruation, hormonal dysfunction, pelvic inflammatory diseases, fibroids and endometrial polyps are often diagnosed.

In order to return the usual, physiological rhythm to menstruation, it is necessary to first find the cause of polymenorrhea. The diagnostic search includes the study of complaints, gynecological examination, laboratory and instrumental examination.

Therapy for polymenorrhea involves eliminating its cause. The physiological causes of polymenorrhea at the age of 40 or in young girls during puberty do not imply drug therapy.

Essence of the disease

The menstrual cycle of a healthy woman has the following characteristics:

• regularity (minor deviations up to three days are acceptable);
• a certain time interval between critical days. It ranges from 21 to 35 days.
• duration of menstruation from two to seven days with a gradual decrease in the amount of blood released;
• periods are accompanied by pain in the abdomen, nausea and weakness.

Daily blood loss, that is, the amount of blood released per day during menstruation, should not exceed 150 ml. A woman should have three pads per day, and a fourth is placed at night. Otherwise, it is difficult for the body to cope with large blood loss, so the woman’s condition can deteriorate greatly. This problem is called polymenorrhea. Among specialists, the name of the disease “pollacymenorrhea” is also common.

Video: How to distinguish periods from bleeding

Polymenorrhea is cyclically recurring menstrual bleeding with a short interval of no more than 21 days. Polymenorrhea is not always associated with pathology; as a rule, frequently recurring menstruation often does not have a pathological nature in girls entering puberty, as they are associated with imperfect hormonal function, and when their sexual development is completed, the correct menstrual rhythm is established independently. Polymenorrhea during menopause can also be provoked by natural causes, namely the attenuation of the hormonal function of the ovaries and the entry into menopause. During the childbearing period, polymenorrhea is often the first harbinger of a serious menstrual disorder due to pathological causes.

Many different medical terms are used for disorders of normal menstrual function, sometimes they have the same meaning and differ only in the wording. It can be difficult for patients to understand this diversity. However, in order to understand the essence of pathological changes in the menstrual cycle, it is not at all necessary to decipher the diagnosis made by the doctor. It is much more important to know the characteristics of the menstrual cycle, which are conventionally accepted as the norm, and to understand how it is formed.

The menstrual cycle consists of cyclically repeating changes in a woman's body from one bleeding to the start of the next. The onset of menstrual bleeding is simultaneously the last day of the previous and the first day of the subsequent menstrual cycle.

The “norm” is taken to be the characteristics of the menstrual cycle that are characteristic of most women, namely:

- Regularity. Menstruation should come in a constant rhythm with small acceptable deviations of 1-3 days.

— Time interval between menstruation. The majority (60%) have periods every 28-30 days. It is permissible to change boundaries up to 21-35 days.

- Duration. Menstrual bleeding should not be too short (less than two days) or long (more than seven days).

- Period of active menstrual bleeding. As a rule, the “heavy days” end after two or three days, and then the bleeding subsides and more scanty (sometimes spotting and/or dark) blood discharge appears.

- Blood loss. The volume of blood lost during menstruation is the most difficult parameter, since it is difficult to measure accurately. For convenience, patients are asked to measure it by the number of pads that they change daily. As a rule, with physiological blood loss (40 - 150 ml), no more than four pads are required daily.

— Subjective sensations. Usually, unpleasant sensations, which a woman defines as “pulling”, “sore”, accompany only “heavy days”. There should be no severe pain during menstruation.

The concept of “norm” for the menstrual cycle is very relative, since in some healthy women, periods are “wrong” from the point of view of this norm and do not lead to negative consequences. If, after examination, no abnormalities are detected in such patients, they are considered healthy, and menstrual abnormalities are accepted as an individual physiological norm.

With polymenorrhea, periods come too often - after 21 days. However, they can be abundant and/or prolonged. They often last longer than a week, but if they do not stop after 12 days, they are classified as cyclic bleeding.

Reasons for the development of pathology

In women aged 40, the causes of polymenorrhea are associated with hormonal changes due to the body's predisposition to menopause.

Hormonal imbalances in women can cause illness at a young age. Other causes of polymenorrhea include the following factors:

• Violation of personal hygiene rules in the intimate area.
• The presence of acute or chronic inflammatory processes of the uterus, appendages or ovaries.
• Infections of the body, including STDs (sexually transmitted diseases).
• Malignant formations or oncology in the genital area.
• Severe or periodic stress.
• Unsuccessful abortion or installation of a contraceptive device. In both cases, the uterus is damaged.
• Excess body weight.
• Endocrine disorders and kidney diseases.
• Other diseases, such as diabetes.
• Taking strong medications.

Sometimes the disease appears due to a sudden change in climate. In this case, pollakimenorrhea should subside several months after a change in environmental conditions. During this time, the body adapts to climate conditions, and the woman will no longer experience discomfort.

Causes

In a condition such as polymenorrhea, the causes at 40 years of age may be associated with premenopausal hormonal dysfunction, neoplasms of the uterus in the form of fibroids of various locations, and hyperplastic processes of the endometrium. In addition, reasons may include:

• Hepatitis;
• Thrombocytopenia (idiopathic thrombocytopenic purpura);
• Taking anticoagulant drugs;
• Inflammation of the uterine mucosa (endometritis);
• Vitamin K deficiency;
• Psycho-emotional stress.

Symptoms and signs

The main symptom by which every woman can notice the presence of a problem is a change in the duration of the cycle or the nature of the discharge. If the malfunction of the female body does not have another reason, for example, pregnancy or menopause, it becomes a reason to see a specialist.

Polymenorrhea is accompanied by other symptoms. These include:

• the appearance of blood outside of critical days;
• increased abdominal pain and other ailments before menstruation and their appearance in the middle of the cycle;
• general weakness due to large blood loss, fatigue, drowsiness;
• pain in the solar plexus area, as the body does not have time to produce enough blood;
• increased appetite and thirst.

At first, the disease may be asymptomatic, characterized only by impaired blood loss. General weakness comes after a few months.

In addition, polymenorrhea is often accompanied by symptoms of the problems that caused it. For example, if hygiene is poor or there are infections in the genitals, itching or copious white cheesy discharge may appear.

Complications and consequences

The main complication of polymenorrhea is the appearance of infertility due to the development of ovarian dysfunction. Hormonal imbalance in such a disease can become pathological, causing disruptions in the functioning of the endocrine system. The following consequences can also be dangerous for women:

• premature aging due to wear and tear of the body;
• development of anemia (anemia);
• early onset of menopause;
• pathological insomnia;
• sudden mood swings, depression.

Prevention of polymenorrhea includes general strengthening of the body: a healthy lifestyle, physical activity and proper nutrition. Polymenorrhea must be diagnosed and treated promptly. Only an experienced gynecologist can do this, so consultation with a doctor should not be neglected. Also, with this disease, you should not attempt self-medication. Getting rid of polymenorrhea means living a full life again.

The menstrual cycle of a healthy woman has the following characteristics:

Ovarian dysfunction: polymenorrhea, polymenorrhea

Polymenorrhea, half-menorrhea is characterized by a reduction in the cycle interval, which is normally at least 21 days. The fact is that in such a short period of time the egg cannot develop normally, ovulation is incomplete and, as a result, ineffective. With such disturbances in the reproductive system, a woman cannot conceive a child. Of the many diseases leading to infertility, one of the most pronounced is polymenorrhea. The causes of infertility from polymenorrhea are failure of ovulation.

Polymenorrhea, half-menorrhea: consequences

For women who already have children, or who have no plans to have children, infertility may seem like a minor problem. However, polymenorrhea, pollakimenorrhea and a woman’s hormonal imbalance affect not only the reproductive system. Hormonal changes can also cause premature aging, constant irritability and many other unpleasant symptoms.

But no matter how unpleasant these symptoms may be, the most terrible consequence that polymenorrhea entails is, of course, infertility.

Everyone knows that one of the most important indicators of a woman’s health and her ability to conceive a child is the menstrual cycle.

Every woman knows that regular menstruation is a sign of healthy and regular ovulation, which allows a woman to become a mother.

But the menstrual cycle cannot always please us with its regularity, painlessness and normal amount of discharge. For various reasons, the menstrual cycle may shift or be completely absent during the month. And you should know when to sound the alarm.

Until the age of nineteen, a woman’s menstrual cycle in most cases is considered not fully established, and therefore may be irregular. However, after twenty years, a woman’s body begins to work like a clock, and any disruption of the cycle can be a sign of unpleasant diseases with very dire consequences.

If your menstrual cycle is irregular, shortened or lengthened, you should immediately consult a doctor, as any disturbances in the genital area can cause infertility.

Hyperpolymenorrhea

Polymenorrhea: what is it?

Hyperpolymenorrhea is a pathological condition of the female reproductive system, which is expressed in an increased amount of menstrual flow, called hypermenorrhea, as well as an increase in the duration of menstruation, this condition is called polymenorrhea.

The ovarian-menstrual cycle itself is often preserved, or rather, its duration, however, an increase in blood loss due to an increase in the abundance and duration of menstrual bleeding leads to undesirable consequences for the body of the fair sex. Diagnostic criteria for polymenorrhea are the release of menstrual blood more than 150 milliliters, as well as the duration of the discharge from 7 to 12 days.

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The causes of such pathological conditions can be both genital and extragenital diseases. The pathogenesis of these conditions often lies in the lack of ability of the uterus to adequately contractile activity. These pathologies may be endometriosis, uterine fibroids, which protrude into the cavity, or are located intramurally. Inflammation of the endometrium (endometritis), endometrial hyperplasia are all causes of the development of hyperpolymenorrhea. Hyperpolymenorrhea in puberty is a borderline norm, since the menstrual cycle is still undergoing changes and has not been established.

Polymenorrhea after 45 years

In the premenopausal period, due to hormonal imbalance, such phenomena can also be observed.

NMC of the oligomenorrhea type: what is it?

Oligomenorrhea, opposite to the concept of polymenorrhea, is a shortening of menstrual flow that lasts less than three days. This condition is a manifestation of hypomenstrual syndrome. Oligomenorrhea can quite often be combined with hypomenorrhea, which is a decrease in the volume of menstrual flow (scanty menstruation). The causes of this condition can be a variety of hormonal imbalances due to diseases of the reproductive sphere, as well as somatic pathology. Timely diagnosis of such pathological conditions is the key to the success of therapy aimed at their correction.

Overview of Abnormal Uterine Bleeding

Abnormal uterine bleeding is defined as bleeding from the uterus that is abnormal in regularity, volume, frequency, or duration. Bleeding may be acute or chronic and occurs in non-pregnant women.

Besides polymenorrhea, other causes of abnormal uterine bleeding include:

• Oligomenorrhea: menstrual cycle length exceeding 37 days
• Amenorrhea: no period for six months
• Menorrhagia: heavy bleeding during periods
• Metorrhagia: bleeding or spotting between periods
• Menometrorrhagia: long duration of menstrual bleeding that occurs at unpredictable intervals
• Postmenopausal bleeding: bleeding that occurs more than 12 months after a woman's last menstrual period
• Postcoital bleeding: bleeding or spotting after sex

Polymenorrhea describes a menstrual cycle abnormality in which a woman experiences regular bleeding at intervals of less than 21 days.

The normal menstrual cycle for an adult woman ranges from 21 days to 37 days.

When researching the term “polymenorrhea” or “short menstrual cycle,” you may have come across the word “abnormal uterine bleeding.” This is because the term polymenorrhea (and other terms associated with abnormal menstruation) tend to fall under this term.

Polymenorrhea - what is it?

In women who do not have problems with the functioning of the reproductive and reproductive systems, the menstrual cycle is regular with a permissible deviation from the norm of no more than 3 days. The time interval between the onset of critical days is in the range of 21-35 days, and the duration of menstrual bleeding is 7 days. The condition, accompanied by pain symptoms in the lower abdomen and weakness, develops with a gradual increase at the beginning and a gradual decline towards the end of the flow of blood released. The maximum volume of daily blood loss is normally 150 ml.

The pathological phenomenon is not considered an independent disease, but for treatment it is important to establish the cause of the anomaly.

Deviations from the normal course of the menstrual cycle such as polymenorrhea are associated with problems in the functioning of the organs of the reproductive system and can develop according to two types of scenarios.

• Polymenorrhea with heavy blood loss is more often diagnosed in middle-aged patients on the eve of menopause (3-5 years before it). The condition is caused by a violation of the contractile function of the uterus, which retains blood flow. At an advanced stage of the disease, open vaginal bleeding is not excluded.
• Polymenorrhea, leading to infertility, is manifested by an increase in the arrival of menstruation with a shortening of intermenstrual breaks. The problem of frequent menstrual periods is associated with ovarian dysfunction, when the egg does not have enough time to be fertilized or exit the woman’s body.

In the International Classification of Diseases (ICD-10) system, polymenorrhea is coded 92.0. The description of the pathology is included in block number 80-98 “Non-inflammatory diseases of the female genital organs,” which belongs to the broad class of “Diseases of the genitourinary system.” The list of paragraph 92 contains the wording of seven types of heavy and frequent menstruation (regular and irregular), except for bleeding after menopause.

Potential Causes of Polymenorrhea and Other Types of Abnormal Uterine Bleeding

There are many possible causes of abnormal uterine bleeding, so it is important to see a doctor.

In addition to a thorough medical history, your gynecologist will perform a physical examination to examine the vagina, cervix, uterus, and ovaries.

Sometimes testing includes a pregnancy test, blood tests, transvaginal ultrasound, hysteroscopy, or endometrial biopsy (where a tiny piece of tissue is removed from your uterus and examined under a microscope).

However, here are some potential causes of abnormal uterine bleeding:

• Structural problems. Examples of anatomical problems that can cause abnormal menstrual bleeding include fibroids, polyps, endometriosis, endometrial hyperplasia, or certain types of cancer (such as uterine cancer).
• Hormonal imbalances. Various hormonal abnormalities can lead to abnormal uterine bleeding, such as dysfunction of the thyroid, adrenal or pituitary glands. Polycystic ovarian syndrome is a fairly common cause and occurs when a woman's ovaries produce large amounts of male hormones (called androgens).
• Bleeding. Other possibilities are bleeding disorders such as von Willebrand disease or a bone marrow disease (such as leukemia).
• Medications. Some medications may affect uterine bleeding, such as steroids, chemotherapy, blood thinners, or some herbal products. Some birth control methods, such as intrauterine devices or birth control pills, may cause abnormal bleeding.
• Infections. Sexually transmitted infections (such as chlamydia or gonorrhea) can cause inflammation of the uterus and abnormal bleeding.
• Diseases of the body. Liver or kidney disease, anorexia, obesity, or rapid weight changes can lead to abnormal menstrual bleeding.

Understanding Polymenorrhea

After your doctor conducts a thorough examination and the necessary tests, he may not find anything abnormal with your increased menstrual frequency.

In other words, for some women, the normal menstrual cycle is shorter than average, and the answer remains unclear.

In this case, treatment may not be necessary, although your doctor may want to monitor you for anemia, when your body cannot produce enough hemoglobin to replenish blood cells after loss of menstrual blood. Symptoms of anemia include pale skin, weakness, fatigue and shortness of breath.

If you have anemia and polymenorrhea or are bothered by frequent menstrual cycles, your doctor may recommend a combined hormonal contraceptive pill to lengthen the interval between your bleeding periods.

Another option is to use a contraceptive method that temporarily stops menstrual flow or makes bleeding very light, such as Mirena, Depo-Provera, or Nexplanon.

In addition to reducing your menstrual cycle, your doctor may recommend diet changes or iron supplements.

Ultimately, it's important to visit your gynecologist if you're experiencing changes in your menstrual cycle.

You can try tracking your time until your appointment using an app on your phone or calendar. In addition to noting the date of your bleeding, it is helpful to note the severity of the bleeding (mild, moderate, and severe).

Sometimes testing includes a pregnancy test, blood tests, transvaginal ultrasound, hysteroscopy, or endometrial biopsy (where a tiny piece of tissue is removed from your uterus and examined under a microscope).

Treatment methods

After a thorough examination and analysis of test results, the doctor may not identify any problems in the patient’s body that indicate the cause of polymenorrhea. It’s just that for some women, a shortened menstrual cycle is normal, then treatment will not be required. It is necessary to treat anemia accompanying extensive and frequent bleeding. To lengthen the intervals between the flow of blood, COC drugs are prescribed.

General technique

If a decision is made to treat polymenorrhea, the principles of therapy are based on three main objectives:

1. Stop the bleeding. The fight against blood loss is carried out by hemostatic hormonal therapy. If the method is not effective, after curettage of the uterine mucus and analysis of the scraping, an individual treatment regimen is developed.
2. Eliminate the causes of the pathological condition. To treat established causes of dysfunction, it is necessary to take antiviral and anti-inflammatory drugs, as well as antibiotics. Endocrine disorders are eliminated by prescribing thyroid hormones.
3. Normalize hormonal levels and the menstrual cycle with ovulation. Restoring balance and the normal arrival of menstruation is facilitated by treatment with contraceptives with a high content of progesterone. Conception is stimulated with fertility drugs.

The development of polymenorrhea is most often provoked by hormonal disorders, which in a certain phase can be eliminated with medication. The selection of drugs that have the required ratio of estrogens to gestagens is individual for each patient. In each specific case, taking into account the results of complex diagnostics, the doctor chooses the option of hormone therapy.

To regulate the monthly cycle with polymenorrhea, medications with progesterone are most often prescribed - Duphaston, Progestogel, Utrozhestan tablets. If, based on the results of hormonal testing, an estrogen deficiency is established, it is necessary to take Ovestin, Microfollin, Estrofem or Proginova. To ensure the ovaries sleep mode, they use oral contraceptives - Regulon, Jess, Yarina, Novineta tablets.

The usual period of hormonal treatment lasts 6 months, but the duration of therapy can be adjusted by the gynecologist based on the severity of the pathology.

If a course of anti-inflammatory therapy is necessary, you will have to go to the hospital to receive injections of antibiotics and vitamin B.

In the case of infertility, to stimulate ovulation, which is prevented by polymenorrhea, the task of therapeutic measures is related to the restoration of the normal ovulatory cycle, which passes through two phases. After the menstrual rhythm is restored, dysfunctional bleeding stops.

Operative methods

If during the examination a benign or malignant tumor was discovered, it is removed surgically, choosing an abdominal or laparoscopic type of operation. Using the classical method of abdominal intervention, a large tumor is eliminated. Laparoscopy is used for diagnostic purposes or to get rid of small tumors.

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With the unstable nature of polymenorrhea, it is enough to avoid stress by following a healthy lifestyle in order to get rid of abnormal blood loss. If the manifestations of the pathology are isolated, treatment with hormonal drugs will not be required. To protect against possible bleeding, it is necessary to optimize the nutrition process against the backdrop of a healthy lifestyle with proper rest and abandonment of bad habits. No less important is the fact of regular visits to the gynecologist in order to detect the disease in time and promptly begin treatment of its causes.

Diagnostics

Before you begin treatment for hyperpolymenorrhea, you need to find out about the causes of the disease.

• Conduct a study of hormonal levels (gonads and other parts of the endocrine apparatus),
• Perform an ultrasound of the pelvic organs,
• Take a smear to determine the degree of vaginal cleanliness,
• Test blood for sexually transmitted infections
• Collect anamnesis and identify hereditary pathologies,
• Measure basal temperature for six months or more.

When to go to the gynecologist

The most important symptom indicating the need to consult a specialist is a change in the duration of the cycle or the quality of blood discharge. Polymenorrhea is not an isolated disease, but is a consequence of gynecological diseases. Therefore, to prescribe treatment, it will be necessary to identify the main problem in the female body in order to cure it.

The most common cause of cyclic rhythm disorder is associated with hormonal dysfunction. To normalize hormonal levels, the patient will have to undergo testing to determine the faulty area of ​​the menstrual process. After interviewing the patient and a gynecological examination with a smear taken for flora, the woman is asked to start keeping a menstrual calendar for six months. It marks the days when menstruation arrives with a description of their characteristics - duration, intensity, symptoms. Basal temperature is measured (rectally) for six months.

To obtain confirmation or refutation of suspicion of polymenorrhea, the woman is sent to undergo additional examination, the results of which help to clarify the diagnosis.

What does the action plan for diagnosing the cause of blood loss look like:

• blood testing using PCR diagnostics determines the presence of sexually transmitted infections;
• after examining the results of a biochemical blood test, the doctor assesses the severity of the anemic condition;
• by analyzing the hormonal profile, receives information about hormones not only of the sex hormones, but also of the thyroid gland;
• to assess the condition of the endometrium and other reproductive organs, an ultrasound scan of the pelvic area is prescribed;
• based on the results of an ultrasound of the thyroid gland, the condition of the tissues and the presence of abnormalities are tested;
• Based on X-rays of the skull, MRI results, and CT scans of the brain, possible disorders of the pituitary gland are checked;
• to identify local pathologies affecting the brain, an electroencephalogram of the brain (EEG) will be required;
• material for endometrial hysteroscopy is obtained by diagnostic curettage with collection of a biopsy sample of the cervix for biopsy.

An interrupted menstrual cycle cannot be tolerated without the presence of special discomfort, even if one gets used to such a rhythm.

Causes of polymenorrhea

There is no single reason for heavy menstruation with short breaks.

The pathology can have a primary (appear during puberty) or secondary (form after the establishment of regular menstruation) form.

The following causes of hyperpolymenorrhea are known:

• underdevelopment of the genital organs, decreased muscle tone in the cavity of the reproductive organ,
• excess estrogen,
• lack of ovulation,
• excess progesterone,
• inflammatory processes in the uterus and ovaries,
• venereal diseases,
• formation of neoplasms,
• endometriosis,
• stressful conditions,
• surgical and instrumental interventions in the cavity of the reproductive organ,
• use of intrauterine contraceptives,
• climate change,
• diet.

Symptoms

It is important to know about polymenorrhea, that this is a condition in which the menstrual cycle shortens. Normally, it varies from 21 to 35 days.

It is necessary that bleeding be regular and not exceed 7 days. You can suspect the disease based on the following signs:

• short cycle of no more than 3 weeks,
• each coming menstruation does not agree with the previous one and does not have a cyclicity,
• prolonged menstrual bleeding lasting a week or more,
• heavy blood loss (more than 150 ml per day, which requires at least 5-7 pads),
• pain in the abdomen during bleeding,
• discomfort during sexual intercourse,
• anemia,
• general deterioration of health.

Most patients with short cycles and heavy bleeding experience infertility.

The absence of pregnancy during regular sexual activity without contraception is due to the lack of ovulation, thinning of the mucous membrane of the reproductive organ and various infections.

Polymenorrhea (promenorrhea) is a condition characterized by shortening of the menstrual cycles and prolongation of the bleeding period. Pathology is not an independent disease.

The formation of a symptom has different reasons.

Therefore, before prescribing treatment, it is necessary to perform differential diagnosis and identify provoking factors.

Hyperpolymenorrhea is a condition in which menstrual bleeding becomes not only frequent and prolonged, but also heavy.

Blood loss in patients exceeds the permissible norm and negatively affects their health.

Polymenorrhea is dangerous because over time it can lead a woman’s health to a critical situation. The disease may be a sign of serious illness.

Treatment of polymenorrhea

Polymenorrhea is not an independent isolated pathology, but a symptom of a disease, therefore, to treat it, it is necessary to first detect the underlying disease and eliminate it.

Most often, menstrual rhythm disturbances occur due to hormonal dysfunction. To eliminate it, you must first find out at what stage of the formation of the menstrual cycle the failure occurred. For this:

— The patient is asked to keep a menstrual calendar for 3 to 6 months, where he should mark the beginning of the next menstruation and record its characteristics.

— Functional diagnostic tests (FDT) are performed: measurement of rectal (“basal”) temperature, determination of the cervical index, colpocytology.

— Data from an ultrasound examination of the pelvic cavity are being studied.

Treatment of polymenorrhea depends on the examination results obtained. Since in most cases patients are diagnosed with hormonal disorders, therapy is aimed at eliminating them. Hormonal drugs with a suitable ratio of estrogens and gestagens are used, which is selected individually. Treatment is often continued for six months.

The presence or absence of ovulation is of great importance for determining therapeutic tactics, since sometimes polymenorrhea is a sign of anovulation and is diagnosed in women with infertility. In this case, all therapeutic measures are aimed at restoring the normal two-phase ovulatory cycle. When normal menstrual rhythm is restored, polymenorrhea disappears. If ovulation does not occur, they resort to the method of artificial stimulation with the help of hormones.

The information presented in this article is intended for informational purposes only and cannot replace professional advice and qualified medical care. If you have the slightest suspicion that you have this disease, be sure to consult your doctor!

The menstrual cycle is a natural process that is subordinate to the reproductive function. But, like any mechanism in the human body, it can deviate from the normal course. Menstrual cycle disorders vary in nature depending on external and internal factors, but the most common type is hyperpolymenorrhea.

Why does menstrual disorder occur?

After emotional stress, a sharp change in climatic conditions and under the influence of other external factors, a woman may begin to have heavy and prolonged menstruation. It is isolated in nature and will occur in the next cycle according to the usual scenario.

In adolescence, hyperpolymenorrhea is associated with the physiological development of ovarian function and hormonal fluctuations. The onset of menopause is also a cause of disruption due to the natural decline of reproductive function.

Pathological causes of hyperpolymenorrhea include the presence of neoplasms in the uterus - polyps, fibroids, adenomyosis. They interfere with the rejection of the endometrium in the second phase of the menstrual cycle and interfere with the contractile function of the uterine wall. Under such conditions, a woman experiences prolonged and heavy bleeding. The presence of ovarian dysfunction, hyperestrogenism or endometriosis leads to pathological proliferation of the endometrium, which leads to hyperpolymenorrhea.

Other causes of hyperpolymenorrhea include:

• genetic predisposition;
• ectopic pregnancy;
• taking hormonal contraceptives;
• presence of an intrauterine device;
• bleeding disorder;
• chronic diseases.

According to statistics, hyperpolymenorrhea is diagnosed in 50% of women with uterine fibroids, and up to 10% of patients using intrauterine contraceptives.

NMC of the type of proyomenorrhea in a two-phase and single-phase menstrual cycle

The origins of the pathological phenomenon are closely related to the formation of the menstrual process; together with the reproductive system, other parts of the female body take part in it. The mechanism of coordinated function regulates the brain with the help of two sections - the pituitary gland and the hypothalamus, which provide the synthesis of hormones for the implementation of the reproductive process.

During the monthly menstrual cycle, the endometrium undergoes the greatest structural changes, the cyclic processes of which are controlled by ovarian hormones. With the onset of the first stage of the monthly period, the ovaries provide the supply of estrogen, causing the growth of the endometrium. The endometrial layer, which has increased in volume and is penetrated by a network of blood vessels, undergoes rejection in the second phase of the cyclic process under the influence of progesterone.

Symptoms of abnormal menstruation rarely develop in isolation; the symptoms are often accompanied by other menstrual disorders, among which hypermenorrhea with heavy menstrual-type bleeding is distinguished.

Polymenorrhea most often progresses against the background of the following problems:

• Hypoplasia of the genital organs. The condition develops with reduced estrogen function and underdevelopment of the uterine muscles. The deviation is manifested by a decrease in the contractility of the uterus and the regenerative properties of the endometrium, which results in problems with conception and gestation.
• Infectious and inflammatory process. Due to inflammation, intrauterine pathologies associated with the function of the endometrial layer develop. Delayed endometrial rejection and inflammation of renewed tissues leads to secondary blood loss.

The presence of nodes, polyps, and endometriosis in the uterus disrupts the general blood flow, which is manifested not only by frequent, but also by heavy periods.

Polymenorrhea can also be caused by sexually transmitted infections, individual developmental characteristics, or protection from unplanned pregnancy by taking combined oral contraceptives, called COCs.

Hormonal imbalances

Signs characteristic of frequent menstruation are also associated with problems with hormonal function at different age stages:

• In girls entering puberty, it is imperfect, which causes polymenorrhea. After the completion of sexual development, the cycle returns to normal on its own.
• In women over 45 years of age, a disrupted cycle is associated with the decline of reproductive function and a decrease in the amount of hormones produced by the ovaries due to the onset of menopause.

A sharp change in climate often causes a disrupted monthly cycle, which returns to normal after adaptation. The anomaly can be provoked by exposure to sexually transmitted diseases, the development of cancer, and bone marrow pathologies. Women suffer from the frequency of heavy blood loss after nervous exhaustion or overstrain, as a result of improper installation of the intrauterine device, after an abortion.

Too frequent bleeding may be a consequence of problems with blood clotting, a consequence of the growth of polyps in the structures of the uterus or its cervix, or ovarian cysts. Polymenorrhea is often caused by disturbances in the functioning of the endocrine system (thyroid problems), tumors of the ovaries and uterus (including cervical cancer), as well as signs of internal endometriosis. When prescribing treatment, it is also important to make sure that there is no early stage of pregnancy.

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Two-phase menstrual cycle with a shortening of the follicular phase, caused by too rapid maturation of the dominant follicle and earlier ovulation. The second (luteal) phase is not shortened in duration. The function of the corpus luteum, which develops at the site of the burst follicle and produces progesterone and estrogens for some time, is preserved.

Two-phase menstrual cycle with a reduction in the duration of the luteal phase. The follicle develops normally, after which ovulation occurs, but the function of the corpus luteum is insufficient, and its involution does not occur after 12-14 days, as is normal, but earlier. Luteal phase deficiency is a common cause of infertility.

A single-phase anovulatory menstrual cycle, when a non-ovulated follicle continues to exist for a short period, that is, persistence of the follicle occurs. The mature egg does not leave the ovary, and the corpus luteum does not form.

Proyomenorrhea, coupled with hypermenorrhea (too heavy periods) and polymenorrhea (too long periods) is a sign of hypermenstrual syndrome.

Treatment

Many women with long and heavy menstruation try to independently eliminate the symptoms of hyperpolymenorrhea. They stop bleeding with drugs such as Vikasol, Tranescam, and relieve pain with No-shpa.

But menstrual irregularities require elimination of the causes and more in-depth treatment. Symptomatic treatment consists of taking medications:

Surgical treatment in the form of hysteroscopy and curettage of the uterine cavity is required for women with inflammatory processes in the organ that cannot be corrected with medications. Also, the endometrium is removed in the presence of tumor-like formations and pathological changes in its structure.

Polymenorrhea: treatment

It is impossible to say unambiguously about the treatment of amenorrhea. After all, this condition has a completely different etiology. Depending on the cause of this condition, it is necessary to prescribe therapy. For example, with polymenorrhea and uterine fibroids, depending on its size, either conservative treatment or a surgical method of correcting the condition is chosen; for hyperplastic processes of the endometrium, either curettage of the uterine cavity or hysteroresectoscopy is necessary.

In case of coagulopathic conditions, their competent correction is necessary with the joint work of related specialists.

Diagnostic methods

• A gynecological examination will determine the possible presence of inflammatory processes in the genitals.
• An ultrasound of the pelvic organs will assess the condition of the mucous membranes of the uterus and ovaries.
• Taking smears and their further microscopic and bacteriological examination will determine the infectious origin of hyperpolymenorrhea.
• A clinical blood test will show the degree of iron deficiency anemia.

In addition, in severe cases, the gynecologist may decide to perform a diagnostic curettage. This is necessary for histological examination of the endometrium in case of severe bleeding.

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Hyperpolymenorrhea: description of the problem and its features

Hyperpolymenorrhea refers to disorders of the menstrual cycle , characterized by increased bleeding and an increase in the duration of menstruation. In this case, most often, patients experience preservation of the periodicity of critical days.

A violation is determined when the daily volume of menstrual flow exceeds 150 ml, and the duration of bleeding is up to 7 days. If a woman notices a decrease in the period between menstruation and an increase in the intensity of discharge, then, most likely, proyomenorrhea has joined hyperpolymenorrhea.

• genetic predisposition;
• ectopic pregnancy;
• taking hormonal contraceptives;
• presence of an intrauterine device;
• bleeding disorder;
• chronic diseases.

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Lifespan

Polymenorrhea does not affect life expectancy. In this case, polymenorrhea can have a different character. Only the presence of pathology in polymenorrhea changes the nature of the situation.

If provocateurs are present, their elimination guarantees an increase in the quality of life. The quality of life will increase by eliminating the factors, but it is important to eliminate these factors completely.

Life expectancy decreases in the presence of chronic diseases. These chronic processes worsen the quality of life and increase the risk of developing persistent polymenorrhea.