Tag: menstrual cycle

The Irregular Shedding of Endometrium: Understanding Menstrual Cycles

JiangRuoan

– Abnormal uterine bleeding refers to heavy or unusual bleeding from the uterus.
– Symptoms include vaginal bleeding between periods and extremely heavy bleeding during periods.
– Abnormal uterine bleeding can be caused by hormonal imbalances, pregnancy, polycystic ovary syndrome (PCOS), growths in the uterus (polyps or fibroids), infection, liver/kidney/thyroid disease, bleeding disorder, or cancer of the uterus/cervix.
– In teenagers and young adults, common causes include pregnancy, certain birth control methods, and hormonal imbalances.
– In the 40s and early 50s, abnormal uterine bleeding can be caused by a lack of ovulation, thickening of the uterine lining, or uterine cancer.
– Hormone replacement therapy is a common cause of uterine bleeding after menopause. There are various causes of abnormal uterine bleeding, including endometrial and uterine cancer. It is more common in older individuals. Other problems can also cause bleeding after menopause. It is important to consult a doctor if experiencing bleeding after menopause. Diagnosis may involve pregnancy tests, blood tests, ultrasound exams, endometrial biopsies, and hysteroscopy. Most causes of abnormal uterine bleeding are not preventable, but maintaining a healthy weight can help in some cases. Treatment options include birth control pills and intrauterine devices.
– One type of hormonal birth control, known as intrauterine devices (IUDs), can cause abnormal bleeding.
– A dilation and curettage (D&C) procedure involves stretching the cervix and using a surgical tool to scrape away the lining of the uterus. This procedure can be used to both diagnose and treat abnormal bleeding.
– Hysterectomy, the surgical removal of the uterus, stops menstrual bleeding and prevents pregnancy. It is a major surgery that requires general anesthesia and a hospital stay.
– Endometrial ablation is a surgical procedure that destroys the lining of the uterus but does not remove the uterus itself. It can often stop menstrual bleeding.
– Living with abnormal uterine bleeding can have a negative impact on daily life, causing anxiety and limiting activities.
– Ibuprofen can be taken during periods to help reduce pain and cramping.
– It is important to ensure adequate iron intake to prevent anemia.
– Questions to ask a doctor include the likely cause of abnormal bleeding, the seriousness of the condition, recommended treatment options, and the impact on future pregnancy chances.
– Doctors can determine if a woman has endometrial hyperplasia through medical history, symptoms, physical exam, and diagnostic tests.
– Medical history includes asking about irregular menstrual bleeding, menstrual history, pregnancy history, and medication usage.
– A pelvic exam may be normal as endometrial hyperplasia doesn’t cause physical changes to the reproductive system.
– Additional tests may be recommended, such as a transvaginal ultrasound to check the thickness of the uterine lining.
– If the uterine lining is too thick, a biopsy may be offered to diagnose the condition.
– In some cases, a procedure called dilation and curettage (D&C) and hysteroscopy may be performed.
– Results of the biopsy may show normal, abnormal non-cancerous, abnormal precancerous, or abnormal cancerous uterine lining cells.
– Abnormal findings that are non-cancerous and precancerous indicate endometrial hyperplasia.

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The Fascinating Functions and Importance of Corpus Lutein

JiangRuoan

– corpus luteum
– temporary endocrine structure
– female ovaries
– produces progesterone, estradiol, and inhibin A
– remains of ovarian follicle after ovulation
– inhibits release of gonadotropin-releasing hormone and luteinizing hormone
– new corpus luteum forms with each menstrual cycle
– size ranges from under 2 cm to 5 cm in diameter
– develops from follicular cells
– produces progesterone from cholesterol
– increase in enzyme P450scc during corpus luteum development
– involved in metabolism and produces antioxidant enzymes
– secretes progesterone and relaxin
– responsible for development and maintenance of endometrium and softening of pubic symphysis
– if egg is not fertilized, corpus luteum degenerates into scar tissue
– if egg is fertilized, corpus luteum continues to secrete progesterone
– prostaglandins can cause degeneration of corpus luteum and abortion of fetus
– in placental animals like humans, placenta takes over progesterone production
– luteal support involves administration of medication (progestins)
– corpus luteum gets yellow color from carotenoids, particularly lutein
– temporary endocrine structure in female mammals that forms after ovulation
– carotenoids concentrated from animal’s diet
– similar structures and functions in some reptiles
– dairy cattle follow similar cycle
– mentions pathology of corpus luteum cyst
– yellow hormone-secreting body in female reproductive system
– formed in ovary after ovulation
– made up of lutein cells
– secretes estrogens and progesterone
– prepares uterus for implantation and nourishment of embryo
– becomes inactive after 10-14 days if egg is not fertilized
– leads to menstruation.

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Anovulatory Functional Bleeding: Causes, Symptoms, and Treatment Explained

JiangRuoan

– Anovulatory functional bleeding is a condition characterized by irregular or heavy bleeding without ovulation.
– Treatment options for anovulatory functional bleeding include combination oral contraceptives, medroxyprogesterone acetate, megestrol, and levonorgestrel-releasing intrauterine systems.
– Combination oral contraceptives with ≤35 mcg of ethinyl estradiol are effective for contraception but are contraindicated in certain individuals with specific medical conditions.
– Medroxyprogesterone acetate and megestrol do not provide contraception and caution is advised in patients with severe hepatic dysfunction.
– Levonorgestrel-releasing intrauterine systems provide contraception for five years and may cause irregular bleeding or amenorrhea. They are contraindicated in patients with breast cancer, uterine anomalies, acute pelvic or cervical infection, and severe cirrhosis or liver cancer.
– Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, naproxen sodium, and mefenamic acid can be used to treat dysmenorrhea associated with anovulatory bleeding.
– Tranexamic acid is an option approved by the FDA for menorrhagia associated with anovulatory functional bleeding, but caution is advised in patients with a history or risk of thromboembolic or renal disease. It is contraindicated in patients with active intravascular clotting or subarachnoid hemorrhage.
– Anovulatory bleeding is a type of abnormal uterine bleeding that occurs when ovulation does not happen.
– Anovulation can be caused by physical or psychological stressors and is common for women to experience an occasional anovulatory cycle.
– Chronic anovulation can lead to the lining of the uterus building up without being shed, resulting in irregular and potentially heavier bleeding.
– Causes of anovulatory bleeding can include hormonal imbalances during adolescence and the perimenopausal transition, as well as obesity.
– Treatment options for anovulatory bleeding typically involve hormonal methods such as the oral contraceptive pill or progestin-containing IUD.
– Weight loss is important for obese individuals experiencing anovulatory bleeding. Medical advice should be sought if there are concerns about irregular bleeding or menstrual cycle issues.

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Biphasic Basal Body Temperature: Unraveling the Menstrual Cycle

JiangRuoan

– biphasic basal body temperature
– fluctuations over a menstrual cycle
– BBT values divided into two phases
– ovulation as the dividing line
– first phase influenced by estrogen
– lower BBT in the first phase
– second phase controlled by progesterone
– higher BBT in the second phase
– decrease in basal body temperature before menstruation
– variation in BBT changes between individuals
– variation in BBT changes from cycle to cycle

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Understanding and Managing Ovulatory Dysfunctional Uterine Bleeding: A Comprehensive Guide

JiangRuoan

– Aberrations in uterine bleeding are now referred to as abnormal uterine bleeding (AUB) and dysfunctional uterine bleeding (DUB)
– In 2011, the Fédération International de Gynécologie et d’Obstétrique (FIGO) defined causes of AUB using the acronym PALM-COEIN to standardize etiologies
– AUB is defined as a change in volume, regularity, or timing that has been present for 6 months or longer
– AUB affects 14-25% of women of reproductive age and is a major cause of loss of work and productivity
– Symptoms of AUB can include irregular or excessive bleeding, with excessive volume defined as an amount greater than 80 mL
– Symptoms of endometrial polyps include intermenstrual bleeding and may be asymptomatic in one-third of cases
– Symptoms of adenomyosis include heavy menses, dysmenorrhea, and midline dyspareunia
– Symptoms of leiomyomata (fibroids) depend on their size and location, with submucosal fibroids resulting in heavy unpredictable bleeding and intramural fibroids resulting in heavy but predictable bleeding
– Endometrial cancer is the most common cause of AUB-M, with postmenopausal bleeding being a common symptom
– In patients with coagulopathies, AUB typically presents in adolescence with the most common patterns being heavy menses and heavy irregular menses

The article discusses ovulatory dysfunctional uterine bleeding (AUB), which is a common type of abnormal uterine bleeding. There are different subtypes of AUB, including ovulatory dysfunction (AUB-O), primary endometrial dysfunction (AUB-E), iatrogenic causes (AUB-I), and etiologies not otherwise classified (AUB-N). A complete history and physical examination should be conducted to establish a differential diagnosis and targeted laboratory and imaging studies may be necessary. Laboratory tests may include hormone levels such as human chorionic gonadotropin (hCG), thyroid-stimulating hormone (TSH), prolactin, follicle-stimulating hormone (FSH), estradiol (E2), and luteinizing hormone (LH). Women with signs of androgen excess should have tests for testosterone, dehydroepiandrostenedione sulfate (DHEAS), and 17-hydroxyprogesterone (17OHP). Screening for certain conditions, such as Cushing disease, may also be necessary. Prothrombin time (PT), activated partial thromboplastin time (aPTT), fibrinogen, von Willebrand panel, platelet function, and coagulation factor levels should be tested for patients with AUB-C, especially if they have heavy bleeding and a history of easy bruising or bleeding from dental extraction, surgery, or the nose. Women should also have an up-to-date Pap test and human papillomavirus (HPV) testing. Imaging studies may be necessary for women with an abnormal uterus or specific bleeding patterns. This article provides information on uterine evaluation and treatment options for ovulatory dysfunctional uterine bleeding (AUB-O). The optimal imaging study depends on the specific disease process. Hysteroscopy is the best diagnostic tool for detecting polyps, while a saline infusion sonogram (SIS) is the best screening test for fibroids. Adenomyosis is best evaluated with a magnetic resonance imaging (MRI) scan, but a standard transvaginal ultrasound (TVUS) can also be used. Endometrial testing is recommended for women aged 45 and older to exclude endometrial cancer. In premenopausal patients, there are no specific ultrasound findings or endometrial thickness measurement to exclude cancer. In postmenopausal women not taking hormones, an endometrial thickness of 4 mm or less has a 94.8% sensitivity for excluding cancer. Endometrial evaluation should also be considered in women under 45 with certain conditions such as obesity, diabetes, polycystic ovary syndrome (PCOS), failed previous therapy, and prolonged estrogen exposure. Women with Lynch syndrome should undergo annual screening with endometrial biopsy and TVUS starting at age 25. Women on tamoxifen with bleeding and those with estrogen-producing ovarian tumors also require endometrial evaluation. Treatment depends on the cause of the ovulatory dysfunctional bleeding and can include hysteroscopy for polyp removal, constant progestin exposure, elimination of systemic estrogen, or surgical intervention for symptomatic adenomyosis. This article discusses the treatment options for different types of abnormal uterine bleeding. For ovulatory dysfunctional uterine bleeding, continuous progestin therapy can provide pain relief. If progestin therapy does not work, estrogen deprivation can be induced with a gonadotropin-releasing hormone agonist or an oral GnRH antagonist. Vaginal symptoms may benefit from vaginal moisturizers or low-dose vaginal estrogen. Hysterectomy is recommended for those who do not desire future pregnancy, while uterine artery embolization is an option for those who do not want a hysterectomy. Endometrial ablation is not effective for treating adenomyosis. The treatment of fibroids depends on size, location, and symptoms. Hysteroscopic myomectomy is preferred for those who desire childbearing, while hysterectomy is an option for those with complete families. Estrogen deprivation can be used to induce amenorrhea until surgery in anemic patients. Intramural fibroids may benefit from suppressing endometrial growth with progestin therapy, and surgical intervention options depend on the desire for childbearing. The management of endometrial cancer is not discussed in this article. Coagulation disorders causing abnormal bleeding can be treated according to the underlying cause, with options including tranexamic acid and desmopressin. In severe cases, von Willebrand factor concentrates or recombinant activated factor VII may be considered. Medical induction of amenorrhea is generally the preferred option for treating coagulation disorders. Summary: This article discusses the treatment options for ovulatory dysfunctional uterine bleeding. The most common bleeding disorder associated with ovulatory dysfunction is chronic anovulation due to polycystic ovary syndrome (PCOS). PCOS results in prolonged unopposed estrogen with continuous endometrial proliferation and unpredictable structural breakdown. Treatment for this condition requires chronic therapy, usually with continuous or sequential progestin exposure. Hormonal therapies such as combined oral contraceptives (COCs), progestin-secreting intrauterine devices (IUS), implants, and various progestin medications can be used. Acute treatment for heavy bleeding depends on the severity of the bleeding and the patient’s stability, and may involve the use of intravenous conjugated equine estrogens, monophasic COCs, or tranexamic acid. Common side effects of hormonal therapy include nausea, vomiting, and breast tenderness. There is a significant risk of venous thrombotic events with estrogen treatment, so non-estrogen options should be considered for women with thrombophilia or other risk factors. Tranexamic acid has an FDA warning against concomitant use with estrogen products, but studies are lacking on this interaction. The article discusses different types of ovulatory dysfunctional uterine bleeding (AUB) and their respective treatment options. AUB-E is primarily a diagnosis of exclusion and is characterized by heavy menses in ovulatory women. Treatment options for AUB-E include progestin-secreting intrauterine systems (IUS), combined oral contraceptives (COC), tranexamic acid, and nonsteroidal anti-inflammatory drugs (NSAIDs). Some authors also include chronic endometritis in this category. Endometritis can be diagnosed by the presence of plasma cells in an endometrial biopsy during the follicular phase, and empirical treatment with antibiotics such as doxycycline or a combination of a quinolone and metronidazole can be effective. For women who have completed their families, endometrial ablation or hysterectomy may be considered. AUB-I refers to iatrogenic causes of AUB, such as medications that affect the integrity of the endometrium like continuous progestins and induction of chronic endometritis with intrauterine devices. Treating AUB-I may involve short courses of vaginal estrogen or addressing inflammation related to intrauterine device use. AUB-N refers to non-specific causes of AUB, with one possibility being delayed postpartum hemorrhage due to subinvolution of the placental site. This condition can be treated with intravenous conjugated equine estrogen therapy, while dilation and curettage should be avoided.

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Anovular Menstruation: Causes, Symptoms, and Effective Treatment Options

JiangRuoan

– Anovular menstruation is when an egg does not come out of the ovary during the menstrual cycle.
– Chronic anovulation is a common cause of infertility.
– Ovulation is the release of the egg from the ovary, typically on day 14 of a 28-day menstrual cycle.
– Ovulation is regulated by hormones including gonadotropin-releasing hormone, follicle-stimulating hormone, and luteinizing hormone.
– After ovulation, the egg travels through the fallopian tube to reach the uterus.
– Progesterone is produced to prepare the uterine lining for pregnancy.
– Low progesterone levels during anovulatory cycles can cause significant bleeding.
– Symptoms of anovulation include missing periods, irregular periods, lack of cervical mucus, abnormal periods (heavy or light), and irregular basal body temperature.
– Girls who have just started their periods and women approaching menopause are at higher risk of anovulatory cycles.
– Other factors increasing the risk for anovulation include excessive exercise patterns.
– Anovulation is caused by an imbalance of hormones involved in ovulation.
– Hormonal disorders and circumstances such as hyperandrogenism, hypogonadotropic hypogonadism, hypothyroidism, hyperprolactinemia, low levels of gonadotropin-releasing hormone, and certain medications can cause anovulation.
– Irregular periods are a common sign, and diagnosis can be done through blood tests and pelvic organ examination.
– Treatment involves lifestyle changes, adjusting current medications, and potentially using a human chorionic gonadotropin injection.
– Treatment options for anovulation include hormonal medications such as clomiphene citrate, follicle-stimulating hormone injections, and gonadotropin-releasing hormone agonists and antagonists injections.
– If these treatments are unsuccessful, options such as intrauterine insemination or in vitro fertilization are available for those trying to conceive.
– Anovulatory bleeding can cause irregular, prolonged, and heavy bleeding.
– The return to ovulation after an anovulatory cycle can vary from person to person.
– Women with an anovulatory cycle typically do not experience ovulation but may experience bleeding due to hormonal changes.
– Lifestyle modifications can help naturally treat an anovulatory cycle, such as improving sleep quality, balancing hormones naturally, and adjusting dietary habits.
– Ovaries play a role in menstruation and conception by producing eggs and hormones.
– Around 1000 immature eggs are lost every month during menstruation.
– There are four phases of ovulation: menstrual phase, follicular phase, ovulatory phase, and luteal phase.
– Ovulation can be induced using medication like Clomiphene citrate.
– The egg can live for 12 to 24 hours after ovulation, and the fertile window for pregnancy is five days before until one day after ovulation.
– Ovulation can cause abdominal pain and light bleeding. The pain depends on which ovary is releasing the egg.
– Anovulation is when the ovaries don’t release an egg, causing irregular or absent periods.
– It is common for young girls, women approaching menopause, and women with regular cycles to experience anovulation.
– Anovulation occurs when hormonal levels are out of balance.
– Potential causes of anovulation include PCOS, weight issues, over-exercising, thyroid and pituitary disorders, and certain medications.
– Symptoms of anovulation may include heavy periods, irregular bleeding, or no bleeding at all.
– To diagnose anovulation, it is recommended to track your menstrual cycle and discuss any concerns with a doctor. They may also recommend blood tests to measure hormone levels.
– The treatment for anovulation varies depending on the underlying cause. Weight loss or weight gain, depending on whether the person is overweight or underweight, can help regulate periods.
– Fertility drugs may be prescribed if lifestyle changes do not work, and the person is otherwise healthy to conceive.
– Getting pregnant with anovulation can be challenging, but treating underlying conditions such as polycystic ovary syndrome (PCOS) and hypothyroidism can increase the chances of pregnancy.
– In some cases, the assistance of a fertility specialist may be necessary.

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