On the classification of menstrual disorders and their clinical manifestation

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The second group of amenorea, as already indicated, caused by a primary lesion of effector organs of the ovaries and uterus. Amenorrhea in these cases can be primary or secondary, often accompanied nerezko expressed impaired function of the hypothalamic-pituitary system, which appear some time after the menstrual function, i.e., are secondary.
The cause of primary lesion of the ovaries may be his anatomical changes due to degenerative processes (sclerocactus), the destruction of soil transferred inflammatory diseases, as well as violations of estrogen biosynthesis, called as the first two factors, as well as deficiency of enzyme systems.
The cause of primary lesion of the uterus (endometrium) most often are inflammation caused by specific infection (tuberculosis) or by trauma, when removed almost all of the layer of the endometrium and beyond is its replacement with scar tissue.
Diagnosis of ovarian failure is carried out by means of functional diagnostics tests that determine a pronounced deficiency of estrogen, anovulation, extremely low levels of pregnandiol. The study of such women reveals hypoplasia of the sexual sphere organs.
Diagnosis of lesions of the cervix is based on the absence of a withdrawal bleed response to the introduction of estrogens, and the use of diagnostic scraping mucous membrane of the uterus in which either cannot obtain the endometrium, or are atrophic cells, mostly basal layers. A very valuable method of diagnosis is the x-ray method of detecting or complete absence or reduced and deformed uterus. Treatment in such cases should be comprehensive and aimed not only at elimination of the pathology of the ovary and uterus, but on the hypothalamic-pituitary system, as during primary defeat of effector organs into force feedback is always a defeat centers. Local surgical and heat treatments, it is advisable to combine with vitamin therapy, cyclic hormone therapy moderate doses of ovarian hormones, gonadotropins, the impact on higher centers, using longitudinal diathermy brain, indirect stimulation of the hypothalamus-pituitary region, stimulation of the receptors of the cervix.
The third subgroup belongs to those kinds of amenorei that caused by a primary lesion of adrenal and thyroid gland and is characterized primarily by symptoms change the activities of these endocrine organs. These include, for example, adreno-genital syndrome and miksedema, diagnosis and treatment are well developed.
The second group, which unites cyclical disturbances, manifested anovulation or gipomotilinemii cycles and, less frequently, luteinization. The cause of anovulation in normal time uterine krovoislianiah should be considered violations developing in neurosecretory substances of the hypothalamic-pituitary system, causing a loss of sawtoothed discharge of the respective releasing factors, FSH and LH. As a rule, this condition is often correlated with reduced total production pituitary hormones. Most often, these violations are observed in puberty and menopause, reflecting a certain nedozorelost the hypothalamic-pituitary system in the first case and a reflection of involutional processes age - in the second. Such violations may be in the reproductive period, remaining stable for a long time or appearing sporadically, depending on changes of conditions of existence of the body (seasonal fluctuations, somatic diseases, mental overload, and so on). When these violations symptoms diencephalic structures usually detected simultaneously with symptoms of menstrual irregularities, or may not occur, or be defined only by using special techniques. This allows to assume that the primary changes in the anovulation mainly developed in neurosecretory structures of the hypothalamus.