On the classification of menstrual disorders and their clinical manifestation

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It should be mentioned that the last subgroup of reasons () leading to acyclic the menstrual function is not deemed to all and part of the researchers of the appearance of such bleeding, provided the yellow body relates to the pathology, caused by a miscarriage at a very early period of pregnancy. Clinical practice confirms the high prevalence in the third group acyclic bleeding on soil processes of anovulation. So, according to our data, the production of diagnostic curettage of the uterus 801 sick only 19 were found secretory transformation, and the rest were signs of the influence only of oestrogen hormones.
When considering the peculiarities of the development of the disease in women, considered by us to group II and group III, it is necessary to emphasize once again that the main difference between these groups is to: (a) the loss of the patients in group III of rhythm sexual cycles; b) the priority violation in patients of group III ovulation or according to other terminology - the development of the persistence of the follicle.
Thus, there are significant differences when anovulation, decisive phase of the cycle, and when anovulation, defining acyclic bleeding: in the first case there is a logical development and atresia of the follicle, stacked on time, corresponding to the normal cycle; in the second case there indefinitely long time the process of the existence of the follicle.
As stated, the first group of functional disorders of menstrual function related pathological amenorrhea, attributed primarily to the primary defeat of the hypothalamic-pituitary system, the primary defeat of effector organs (ovaries and uterus) and the primary defeat of adrenal and thyroid gland.
Clinical features of the disease at preferential primary defeat of the hypothalamic-pituitary system pretty Fully revealed M. L. Crimea. For such patients, the most characteristic of the disease was originally arisen malfunction of the hypothalamus and already subsequent (secondary) appearance of menstrual disorders. The illness began with manifestations of cortical-subcortical disorders: headache, deterioration of health, fatigue, sleep disorders. There were symptoms characteristic lesions diencephalic structures: hot flashes, sweating, increased appetite, thirst, polyuria, crises, the state in the form of shivering, short-term hypertension and so on, Usually only after several years (2-6) joined disorders of menstrual function. When clinical study in such patients, there was uneven fat on the abdomen, thighs, back, white or red lines stretching, and various disorders of the cardiovascular system (hypertension, tachycardia, hypotension, and so on), changes in metabolism. Gynecological examination (after the appearance of menstrual function in the form of amenorrhea) was determined by the different degree of hypoplasia of the uterus, and the tests of functional diagnostics revealed varying degrees of failure estrogenprogestogen ovarian function and anovulation. Thus, the identification of complex, diverse pathological syndrome with acute neuro-psychiatric, vegetative-vascular, endocrine and trophic changes in the body, against which appear disorders of menstruation, always characterized by the primacy of violations in subcortical structures with the involvement of the hypothalamic-pituitary system. As regards the expression of menstrual disorders, most often they are manifested in the development of persistent amenorrhea or in the rare occurrence of menstruation, passing sometimes bleeding.
Treatment is similar to the Genesis of dismenorea, naturally, should be aimed primarily at normalizing the activity of the higher brain centres. The choice of method of therapy should be based on the determination of the specific reasons for such violation (liquidation of consequences of neuroinfections and vascular changes that are often the cause of the defeat diencephalic structures; identification and appropriate surgical treatment of tumors of the brain). In the absence of contraindications (tumours) in such kinds of dismenorei pathogenetic therapy methods will be directed at the normalization of the function of the hypothalamic-pituitary system: indirect stimulation of the hypothalamus-pituitary area, longitudinal diathermy brain, combined with galvanic collar on Shcherbakov, endonasal electrophoresis, impacts on the cervix, neurologice and substances that affect the hypothalamic neurosecretory (clomiphene, reserpine, chlorpromazine, etc), together with supporting trophic sexual sphere therapy with small doses of estrogen (M. L. Crimean, 1971).