Normalmente le mestruazioni si succedono regolarmente ogni ventotto giorni. Vi sono dei casi però in cui questo ritmo non viene rispettato: quando there is a shortening of the interval between a
menstruation and the other, we talk about
proiomenorrea , but when you look at an increase in the interval between periods, it is called
opsomenorrea . Both the decrease and the increase
interval between periods, however, does not have pathological significance in themselves: it is possible that women present these changes since puberty. In such cases, these changes
menstrual rhythm, so if we can call, are entirely physiological. Become a sign of changes in the regulatory mechanism of the menstrual cycle in women if it appears that for a certain period of time presented at regular intervals between menstruation and the other one.
In other words, what has pathological significance is the fact that the intervals between periods are not regular. Generally these changes do not occur in isolation but are also accompanied by alterations in the quantity and duration of menses.
The irregular intervals between menses is a sign of ovulation or irregular (in turn linked to irregularities in the pituitary function), or irregularly sensitivity to stimuli
endometrial estrogen and progesterone.
order to accurately determine the deterioration is at the basis of these disorders are needed prolonged medical examination, so that the terapia possa intervenire nel modo più efficace
possibile.
ALTERAZIONI DELLA QUANTITÀ DELLE MESTRUAZIONI La quantità di sangue eliminata a ogni mestruazione si aggira sui 100-200 grammi: quando tale quantità diminuisce, si parla di
ipomenorrea , mentre quando aumenta, si parla di
ipermenorrea .
Se la quantità aumenta in modo molto considerevole, tale da assumere l'aspetto di una vera e propria emorragia, si parla allora di
menorragìa . Queste variazioni quantitative si accompagnano anche con variazioni della durata del flusso mestruale: la ipomenorrèa è associata con una diminuzione della durata (oligomenorrea), mentre la Hypermenorrhea with increasing duration of flow (polymenorrhea).
The causes that determine it are similar to those involved in producing amenorrhea: they are mainly related to ovarian and uterine disorders. Among the ovarian dysfunction include an insufficient production of hormones, especially estrogen, the ovary against regressive phenomena after ovarian inflammation and infantilism. On ovarian function can then also be reflected endocrine pituitary or thyroid.
dell'ipomenorrea When the cause lies in the womb, come into play especially endometrial lesions after operative interventions, or the decrease in sensitivity of the endometrium to ovarian stimulation.
The hypomenorrhea not a serious disorder, but do not be neglected. The cure, as in all the disorders of menstruation, should not be directed simply to clear the most obvious sign (ie the alteration of menstruation), but must be directed to the root cause which has determined: the regularization of menstruation is the consequence of its elimination.
Hypermenorrhea AND THE menorrhagia While you can not make a clear distinction between Hypermenorrhea menorrhagia and a clinical point of view, on the other side you can not even differentiate between the causes of these dysfunctions . The reason why the amount of sangue eliminata con la mestruazione è supcriore alla norma e il flusso si protrae per un periodo maggiore sta essenzialmente nel fatto che esiste un'alterazione della capacità dell'utero di frenare la fuoruscita del sangue (emostasi), al momento del distacco dello strato funzionale della mucosa.
Se esiste una congestione della mucosa uterina alla quale si somma quella fisiologicamente dovuta alla mestruazione, è evidente che i mezzi di emostasi saranno insufficienti.
D'altra parte se la capacità contrattile del miometrio è minore della norma, i fasci muscolari attraverso cui passano le arterie destinate all'endometrio non saranno in grado di comprimerle a sufficienza al momento del distacco dello strato funzionale: una certa quantità of blood will continue to go through them, and this is revealed to the outside with an increase in the quantity and duration of menstrual flow.
And if there is a general disease that causes a decrease in blood coagulation, this will also manifest with alterations in the menstrual cycle.
The first event occurs in the states in which the endometrium is congested due to acute inflammation (endometritis), or a prolapsed uterus retrodeviazione (which are often due to venous stasis in the uterus), a submucosal fibroid seat or interstitial in endometrial or cervical polyps, malignant tumors in the uterus, a cndometriosi, tumors of other abdominal organs performing compression or cause venous stasis in the uterus.
Excessive state of congestion of the endometrium can also be determined by some forced attitudes that are taken for business reasons (eg. Sewing machine for an extended period), the practice of violent sports, from the sexual exertions.
A decrease in contractile capacity of muscle is in the case of poor uterine development, and in fibrosis: in these conditions there is an increase of connective tissue than muscle tissue, which sees so diminished its ability to act.
changes in ovarian function may also determine Hypermenorrhea. In the case of an excessive production estrogen, the endometrium stops piolilerativa phase, the glands become very bulky and the thickness of the mucosa becomes significant. In the absence of stimulation produced by progesterone, it is a change in the secretory phase, and regular menstruation does not occur, but at some point, the mucosa is thickened in necrosis and flake, causing a considerable loss of blood. In the case that insufficient estrogen production occurs, the mechanism by which occurs Hypermenorrhea is completely different: the lack of estrogen is due to an insufficient development of the uterine muscle, and this in turn is due to the decrease haemostasis. Even an excess of progesterone può determinare ipermenorrea.
Tra le malattie generalizzate che si ripercuotono sulla funzione mestruale, determinando ipermenorrea, ricordiamo le malattie del sangue che causano una diminuzione della sua coagulabilità: la porpora trombopenica; le leucemie: le malattie di cuore; l'ipertensione arteriosa; alcune malattie infettive, nelle quali le tossine prodotte dai germi patogeni causano lesioni ai capillari della mucosa dell'utero.
