On the classification of menstrual disorders and their clinical manifestation

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In 1967 Arronet and Arrata offered their classification, based on the violation of follicle development and yellow body cancer. The advantage is given to the phenomenon of ovulation, which ultimately determines the norm and pathology of the menstrual cycle. There are a group of disorders that have ovulatory disorders associated only with premature or late maturing, involution of the follicles and yellow body and manifest only minor changes rhythm of menstruation. The second group is related disorder caused subfoldername violations, i.e. such at which anovulatory cycles alternated with ovulatory and are accompanied by temporary changes in menstrual rootdelay by the number of loose blood and duration. The third group is represented disorders associated with anovulation. It includes diseases such as anovulatory cycle, the persistence of follicles with different periods of existence of persistence, amenorrhea, due to the termination of maturing follicles.
A similar principle of consideration of a variety of disorders from the position of the presence or absence of ovulation is put in a basis of classification, proposed by M. L. Crimean (1968). However, as rightly emphasizes M. L. Crimea, its allocated pathological syndromes may not be considered as a manifestation of an isolated lesion of one of the links of the hypothalamic - pituitary - ovaries uterus, but only as a manifestation of pre-emption and the primary lesion one of the links with the compulsory participation in the development of painful process all this circuit. This classification includes 4 groups of lesions that lead to the violation of ovulation: a) anovulation with clear signs of infringement of function of the hypothalamic-pituitary system (the primacy of its disorders); b) anovulation with moderately severe similar characteristics; C) anovulation without obvious signs of defeat of the hypothalamic-pituitary system (primary defeat of the ovaries); d) anovulation without expressed similar characteristics (primary defeat of the uterus).
This classification is convenient in practical terms, since it allows the direct vote of therapeutic activities. At the same time, in our opinion, this classification would be more complete if included a group of ovulation disorder, which depends on the changed functions of other glands (the glands, thyroid gland), and is a disease in which ovulation occurs, but the yellow body is defective (rapid reverse development).
We suggest a classification that combines some of the previously proposed and at the same time complements the inclusion of clinical symptoms, the most characteristic of the disease.
All functional disturbances divided into three main groups.
I group. The complete absence of menstruation - amenorrhea, which may be false (Kintrishi) and true. In turn, can be true physiological (amenorrhea during pregnancy, lactation, menopause, before puberty) and pathological i.e. due to: (a) the priority of the primary lesion of the hypothalamic-pituitary system; b) primary defeat of effector organs of the ovary and uterus; C) the primary defeat of adrenal and thyroid gland.
II group. Cyclic disorders that appear correct periods of time uterine rootdelay and due to: a) anovulation, which is based on the initial changes in the hypothalamic-pituitary system, but with preservation of rhythm sexual cycles; b) violated the process of ovulation, mostly in the form of shortening phase of existence of the yellow body, and change ovulation follicle his luteinization as a result of primary lesions of the hypothalamic-pituitary system, and as a result of changes, developing directly in the ovaries.
Group III. Acyclic disorders that appear wrong time (violation of periodization) Royal rootdelay that depend on: a) of anovulation on the soil of the primary changes of the function of the hypothalamic-pituitary system with the loss of rhythm allocation of hormones; b) of anovulation on the soil of primary lesions of the ovary with the loss of rhythm allocation of hormones; C) ovulation with the detainee in time reverse development of the yellow body.