On the classification of menstrual disorders and their clinical manifestation

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Until recently it was believed that anovulatory processes ("persistent follicle") are accompanied by high levels of estrogen. Detailed studies of a number of authors, and especially A. F. Dobrotino (1968)showed that there are various types of excretion of estrogen low levels constant, high constant, fluctuating level, gradually increased and, finally, slowly rising from low to very high. However, despite the presence of different types of production and secretion of estrogen, more than half of the patients as the content of individual fractions and total estrogen is lower than women with two-phase of the menstrual cycle, and thus well established among clinicians opinion about the leading role of hyperestrogenism in the Genesis of dysfunctional uterine bleeding is refuted.
In our opinion, it is more correct to consider the nature of acyclic dysfunctional uterine bleeding as the "persistence of estrogen on the background of absence (or low content) progesterone.
Different types excretion of estrogen may largely be explained and clinic anovulatory processes in which the second phase of disease, uterine bleeding begins, as a rule, in connection with falling estrogen levels and less frequently in the local necrobiotic endometrium at long preservation of nicolellsche level of estrogen.
Diagnosis phase amenorrhea is based on the definition of some increase of the uterus with its dense consistence, a strong symptom of "maybe" with abundant Department vitreous thick clear mucus from the cervical canal, which gives at drying pronounced symptom "fern", fourth colpocytology reactions in follikulina the type of stroke, the lack of pregnandiol in the urine. If a woman is on the observation and measuring the basal temperature is detected monophasic curve. These symptoms allow us to provide snow described the state from uterine pregnancy early period, when there are signs of the influence of progesterone.
Diagnosis phase anovulatory bleeding when the process is based on the definition of increased thick uterine moderate siania cervical canal, the expiration of his blood mixed with mucus, folikulyarnogo type of stroke, the discovery of proliferative changes in the endometrium, obtained by scraping or vacuum biopsy. A good way of diagnostics is servicesinteractive produced using water-soluble contrast media, when found gaping cervical canal with relatively spazmirovannah the body of the uterus. In the observation is defined as the basal temperature, against which starts bleeding. Pregnandiol in urine missing or found in extremely small quantities. These symptoms help differentiate developed bleeding with tubal abortion.
Treatment anovulatory process in phase amenorrhea should be aimed at the prevention of bleeding, and in the phase developed bleeding stop him and the subsequent normalization of the cycle. With this purpose are used hormone therapy and methods aimed at highlighting the hypothalamic-pituitary system respective releasing factors and gonadotropic hormones. For the latest tools include longitudinal diathermy brain, indirect stimulation of the hypothalamus-pituitary region, the blockade of the upper cervical sympathetic ganglia and the impact on the cervix.