Menstrual Irregularity
Irregular menstrual bleeding is heavy, frequent or irregular menstrual bleeding outside of its normal period. While approximately 25% of menstrual bleeding disorders are caused by diseases related to the reproductive organs, in the remaining 75%, hormonal irregularities are the cause of irregular menstrual bleeding. Vaginal bleeding before puberty or after menopause are serious situations that must be investigated.
Among the non-hormonal causes of irregular vaginal bleeding; bleeding due to trauma in the sexual organs, inflammation of the uterus or cervix, uterine myomas, adenomyosis disease, benign or cancer-type diseases of the inner lining of the uterus. Age is important in women with irregular vaginal bleeding. While irregular bleeding before the age of 40 is mostly due to hormonal reasons, after the age of 40 it is likely to be due to non-hormonal reasons.
The use of intrauterine devices (spiral), birth control pills or monthly birth control injections can also cause irregular vaginal bleeding. . Early complications of pregnancy (for example, miscarriage, ectopic pregnancy, molar pregnancy) may also cause bleeding complaints.
Complaints of irregular menstrual bleeding should be evaluated by a gynecologist. During the examination, factors that may cause bleeding are reviewed one by one. Vagina, uterus and ovaries are evaluated. The presence of tumors in the uterus and ovaries is investigated with ultrasound. The thickness of the uterine lining is measured using the same method. If an obvious cause of bleeding after the age of 40 cannot be determined, a biopsy of the inner lining of the uterus is required. In this way, the structure of the inner lining of the uterus is evaluated microscopically and uterine cancer is investigated.
If the cause of bleeding originates from the reproductive organs, that is, if it is not a hormone irregularity, the treatment is carried out according to the cause. For example, if there are uterine myomas, surgical treatment is applied. If, as a result of all these investigations, no disease that may cause bleeding is detected, menstrual irregularity is due to hormonal imbalance. In this case, bleeding is tried to be regulated with menstrual regulating drugs. Although birth control drugs are mostly used in this treatment, alternative drug treatments are also available.
Premenstrual Tension
As menstruation approaches, 75% of women experience some complaints due to changing hormone levels. In half of these women, the complaints are mild and do not affect the person's daily life. In the other half, more serious complaints, including depression, occur. (Premenstrual Syndrome, PMS)
As menstrual bleeding approaches, 75% of women experience some complaints due to changing hormone levels. In half of these women, the complaints are mild and do not affect the person's daily life. In the other half, more serious complaints, including depression, occur. Premenstrual complaints can be physiological or psychological and may be affected by cultural differences. PMS is a combination of both physiological and psychological events. Studies show that different complaints occur in women from different cultures. While the most common complaint in Far Eastern women is pain, depression is the most common symptom in developed western societies. Complaints that occur every month and negatively affect a person's social life may even cause a woman to lose her self-confidence.
Physical symptoms
Almost all women with PMS symptoms have breast tenderness and A slight temporary weight gain is detected. Other symptoms include digestive system disorders, headache, rashes, muscle and joint pain, weakness, bleeding gums, palpitations, balance disorders, hot flashes, extreme sensitivity to sounds and smells, agitation, and insomnia. Painful or heavy menstrual bleeding, that is, dysmenorrhea, is not considered PMS.
Emotional symptoms
Emotional hypersensitivity is very common in PMS. There may be many different emotional states, from depression to anxiety and extreme irritability. Some women may experience mild memory loss. Concentration disorder is a not uncommon condition in PMS. The state of depression, restlessness and tension seen in some women is called premenstrual dysphoric disorder (PMDD). However, some theories s are available. If some hormones that suppress ovulation are administered, PMS symptoms regress. Accordingly, reproductive hormones may cause PMS, but what this role is has not been explained. There is strong evidence that PMS occurs as a result of the joint action of these hormones and some substances that provide transmission in the nerves. The substances most commonly blamed are those called GABA and serotonin. Some researchers believe that an imbalance in calcium and magnesium causes PMS. The distribution of these two minerals in the body may cause the condition by affecting the communication between nerve cells. These researchers suggest that magnesium deficiency or calcium excess causes complaints in women with PMS. Another reason suggested in the etiology of PMS is stress hormones. Excess of these hormones may cause complaints to be more intense. Almost all hormones and substances secreted in the body are blamed for the etiology of PMS. However, no proven cause has been found.
Who sees it?
PMS is a condition encountered in all cultures around the world. In a study, PMS findings at different levels were found in 88% of women. As age increases, the severity of the complaints decreases, but the severity increases with the number of children. Complaints are also more common in women whose mothers have PMS. PMS can also increase the severity of some diseases. For example, in women with migraine, most of the attacks occur in the premenstrual period. Again, in diabetic patients, blood sugar levels and insulin needs vary during the premenstrual period. Asthma attacks are more common and many chronic diseases have flare-ups. During this period, the person's harmony with his/her environment is disrupted, and his/her relationships with the people he/she interacts with at work or at home and with his/her children may become disrupted. The tendency towards suicide may increase in young girls during adolescence. Eating disorders may be encountered.
Diagnosis
The diagnosis of PMS is not based on positive findings. The most reliable way for diagnosis is to record complaints for 2-3 months and score their severity. Complaints should be divided into physical and psychological, and when they start and end should be recorded regularly.
Treatment
Since the cause of PMS is not fully known, its treatment is not certain. There are many different treatment approaches on this issue. Diet: There are reports that eating small and frequent meals reduces complaints. During the premenstrual period, consuming fresh fruits and vegetables, avoiding red meat and frozen oils, and not consuming foods containing additives. It can be useful sometimes. Likewise, reducing caffeine and alcohol consumption may also be beneficial.
Exercise: A study found that PMS is more common in women who do not exercise. A 30-minute walk every day may be beneficial.
Calcium and Magnesium: There is a study reporting that daily 1200 mg calcium intake reduces complaints by half after 3 months. Some women have benefited from magnesium supplementation. However, there are no definitive findings on this issue yet.
Vitamins: Although it has been suggested that vitamins A, E and B6 cause PMS, there is no definitively proven finding.
/> Other treatment options include drugs related to serotonin metabolism, hormone drugs, psychiatric drugs such as antidepressants and anxiety, diuretics, and male hormones, but none of these have any proven benefit. Other rare treatment approaches include psychotherapy and acupuncture.
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