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13 days late period symptoms: Signs, Symptoms, and Ectopic Pregnancy

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Missed period and gassy stomach: Am I pregnant?

A missed period is when menstruation does not occur or does not follow its usual pattern. A gassy stomach may occur at any time. However, when gas or pressure appears in the abdomen at the same time as experiencing a late or missed period, many people think they may be pregnant.

It is normal to occasionally experience a period that is a few days late. However, a missed period is when the cycle completely changes. A missed period may be a sign of pregnancy or another underlying cause.

Early signs of pregnancy can be easy to miss, especially if the person has not been pregnant before. There are some signs that, along with a missed period, may be indicators of pregnancy.

However, every person is different, and each may experience different symptoms. The best way to find the answer is to use an at-home pregnancy test.

In this article, we examine some of the potential causes of a missed period and a gassy stomach.

Pregnancy

People may have gas and a missed period in early pregnancy.

It is possible that these symptoms occurring together are early signs of pregnancy. There may also be other early signs of pregnancy alongside these symptoms.

As a study that appears in the journal American Family Physician notes, pregnancy is the first thing that doctors need to rule out if someone has these symptoms.

If a person is not pregnant, the doctor will move on to other possible causes.

The reason for this is that many people experience symptoms such as abdominal gas, along with a missed period, early in their pregnancy.

Other early signs of pregnancy include:

  • morning sickness
  • sore breasts
  • enlarged breasts
  • changes in the nipples, such as sore nipples or darkened areolas
  • frequent urination
  • light cramping
  • constipation due to slow digestion
  • feeling full after eating very small meals or nothing at all
  • fatigue
  • implantation bleeding, which is spotting that can occur when the egg implants itself to the uterus
  • food cravings or aversions
  • changes in vaginal discharge or cervical mucus

People may experience any of these symptoms at any time during pregnancy. Some may experience symptoms just after conception, while others may only notice symptoms a long time after their missed period.

Many of these symptoms are also common in other conditions. The best way to determine whether someone is pregnant is to wait until they can take a pregnancy test.

Premenstrual syndrome

While most people understand how their period makes them feel, small fluctuations in hormones from issues such as stress may lead to changes in premenstrual syndrome symptoms.

Hormonal changes may make some symptoms worse or cause different symptoms. In some cases, these changes may even alter the course of the menstrual cycle, such as causing a period to come late.

Menopause

People aged 50 and over who experience a missed period may be entering menopause. This occurs when the ovaries stop releasing eggs and the person has not had a period for at least 12 months.

Ectopic pregnancy

An ectopic pregnancy occurs when the fertilized egg does not reach the uterus. It attaches to other areas such as the fallopian tubes, cervix, or abdominal cavity.

While ectopic pregnancy causes similar symptoms to pregnancy early on, it can lead to other more severe symptoms as the pregnancy continues.

Some risk factors may make an ectopic pregnancy more likely. However, the American College of Obstetricians and Gynecologists note that about half of all females who experience an ectopic pregnancy have no risk factors.

An ectopic pregnancy needs immediate attention and can be a medical emergency if a person does not seek treatment.

Ovarian cysts

Ovarian cysts and PCOS can cause hormone levels to change.

Ovarian cysts are small fluid-filled sacs that may develop on the ovaries. The ovaries produce eggs and hormones. Ovarian cysts may cause changes in these hormones.

The United States Department of Health and Human Services note that ovarian cysts develop during ovulation, but that these cysts pass on their own before becoming an issue.

Sometimes, however, the cysts do require treatment.

Polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) causes hormone levels to change. The U.S Department of Health and Human Services note that PCOS causes an increase of certain hormones that can cause cysts to grow in the ovaries.

This may increase the risk of a missed period or infertility and cause other changes in overall health.

Stress or anxiety

While it is common to feel stress or anxiety occasionally, having constant stress or anxiety may cause hormonal changes that lead to similar symptoms. Finding ways to balance this stress or relieve anxiety may be helpful.

Anorexia nervosa

People with anorexia nervosa may become fixated on losing weight or staying thin. They will typically try to achieve this by reducing their calories or continuously exercising, at risk of harming the overall health of the body.

This may lead to other issues, such as changes in hormones, digestive problems, and missed periods.

Ovarian cancer

While not as common as many other issues, a missed period and a gassy stomach might also be a sign of ovarian cancer. The American Cancer Society suggest that a woman has about a 1 in 78 chance of developing ovarian cancer. The cancer most often appears in older people.

Other disorders

Other disorders may cause similar symptoms. Such disorders include:

  • thyroid disease
  • endocrine gland disorders
  • complications from certain medications, such as antidepressants, blood pressure medications, or opiates
  • autoimmune conditions
  • congenital disorders
  • fragile X-associated primary ovarian insufficiency, wherein the ovaries stop functioning before the normal menopause age

This list is not exhaustive, however. Anyone uncertain about their symptoms should see a doctor.

When to see a doctor

A person should see a doctor if they miss more than two periods.

Sometimes, a slight change in hormones can cause changes in the natural menstrual cycle. This is not typically a cause for concern.

At other times, symptoms such as a missed period and gassy stomach may be signs of a more serious condition that needs treatment.

If symptoms continue or get worse, a person should visit their doctor. Likewise, anyone who misses more than two periods should see a doctor for a diagnosis.

Anyone experiencing the following symptoms, along with signs of ectopic pregnancy or other potentially serious issues, should see a doctor immediately:

  • pain in the lower pelvis
  • abnormal vaginal bleeding, such as dark-colored blood
  • lower back pain
  • cramping on one side of the pelvis in particular
  • sudden, severe pain in the abdomen or pelvis
  • shoulder pain
  • dizziness or fainting
  • blood in the stools

Anyone who feels that their symptoms are out of the ordinary should see a doctor or seek medical attention.

Summary

It is possible that a female who is experiencing a gassy stomach and bloating along with a missed period is pregnant.

However, many things can affect the hormones in the body. Fluctuations in these hormones may cause similar symptoms.

The only way to know for sure is to take a pregnancy test or see a doctor. They will be able to diagnose any underlying condition. If there is an underlying condition, treating it should stop the symptoms.

Missed period and gassy stomach: Am I pregnant?

A missed period is when menstruation does not occur or does not follow its usual pattern. A gassy stomach may occur at any time. However, when gas or pressure appears in the abdomen at the same time as experiencing a late or missed period, many people think they may be pregnant.

It is normal to occasionally experience a period that is a few days late. However, a missed period is when the cycle completely changes. A missed period may be a sign of pregnancy or another underlying cause.

Early signs of pregnancy can be easy to miss, especially if the person has not been pregnant before. There are some signs that, along with a missed period, may be indicators of pregnancy.

However, every person is different, and each may experience different symptoms. The best way to find the answer is to use an at-home pregnancy test.

In this article, we examine some of the potential causes of a missed period and a gassy stomach.

Pregnancy

People may have gas and a missed period in early pregnancy.

It is possible that these symptoms occurring together are early signs of pregnancy. There may also be other early signs of pregnancy alongside these symptoms.

As a study that appears in the journal American Family Physician notes, pregnancy is the first thing that doctors need to rule out if someone has these symptoms.

If a person is not pregnant, the doctor will move on to other possible causes.

The reason for this is that many people experience symptoms such as abdominal gas, along with a missed period, early in their pregnancy.

Other early signs of pregnancy include:

  • morning sickness
  • sore breasts
  • enlarged breasts
  • changes in the nipples, such as sore nipples or darkened areolas
  • frequent urination
  • light cramping
  • constipation due to slow digestion
  • feeling full after eating very small meals or nothing at all
  • fatigue
  • implantation bleeding, which is spotting that can occur when the egg implants itself to the uterus
  • food cravings or aversions
  • changes in vaginal discharge or cervical mucus

People may experience any of these symptoms at any time during pregnancy. Some may experience symptoms just after conception, while others may only notice symptoms a long time after their missed period.

Many of these symptoms are also common in other conditions. The best way to determine whether someone is pregnant is to wait until they can take a pregnancy test.

Premenstrual syndrome

While most people understand how their period makes them feel, small fluctuations in hormones from issues such as stress may lead to changes in premenstrual syndrome symptoms.

Hormonal changes may make some symptoms worse or cause different symptoms. In some cases, these changes may even alter the course of the menstrual cycle, such as causing a period to come late.

Menopause

People aged 50 and over who experience a missed period may be entering menopause. This occurs when the ovaries stop releasing eggs and the person has not had a period for at least 12 months.

Ectopic pregnancy

An ectopic pregnancy occurs when the fertilized egg does not reach the uterus. It attaches to other areas such as the fallopian tubes, cervix, or abdominal cavity.

While ectopic pregnancy causes similar symptoms to pregnancy early on, it can lead to other more severe symptoms as the pregnancy continues.

Some risk factors may make an ectopic pregnancy more likely. However, the American College of Obstetricians and Gynecologists note that about half of all females who experience an ectopic pregnancy have no risk factors.

An ectopic pregnancy needs immediate attention and can be a medical emergency if a person does not seek treatment.

Ovarian cysts

Ovarian cysts and PCOS can cause hormone levels to change.

Ovarian cysts are small fluid-filled sacs that may develop on the ovaries. The ovaries produce eggs and hormones. Ovarian cysts may cause changes in these hormones.

The United States Department of Health and Human Services note that ovarian cysts develop during ovulation, but that these cysts pass on their own before becoming an issue.

Sometimes, however, the cysts do require treatment.

Polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) causes hormone levels to change. The U.S Department of Health and Human Services note that PCOS causes an increase of certain hormones that can cause cysts to grow in the ovaries.

This may increase the risk of a missed period or infertility and cause other changes in overall health.

Stress or anxiety

While it is common to feel stress or anxiety occasionally, having constant stress or anxiety may cause hormonal changes that lead to similar symptoms. Finding ways to balance this stress or relieve anxiety may be helpful.

Anorexia nervosa

People with anorexia nervosa may become fixated on losing weight or staying thin. They will typically try to achieve this by reducing their calories or continuously exercising, at risk of harming the overall health of the body.

This may lead to other issues, such as changes in hormones, digestive problems, and missed periods.

Ovarian cancer

While not as common as many other issues, a missed period and a gassy stomach might also be a sign of ovarian cancer. The American Cancer Society suggest that a woman has about a 1 in 78 chance of developing ovarian cancer. The cancer most often appears in older people.

Other disorders

Other disorders may cause similar symptoms. Such disorders include:

  • thyroid disease
  • endocrine gland disorders
  • complications from certain medications, such as antidepressants, blood pressure medications, or opiates
  • autoimmune conditions
  • congenital disorders
  • fragile X-associated primary ovarian insufficiency, wherein the ovaries stop functioning before the normal menopause age

This list is not exhaustive, however. Anyone uncertain about their symptoms should see a doctor.

When to see a doctor

A person should see a doctor if they miss more than two periods.

Sometimes, a slight change in hormones can cause changes in the natural menstrual cycle. This is not typically a cause for concern.

At other times, symptoms such as a missed period and gassy stomach may be signs of a more serious condition that needs treatment.

If symptoms continue or get worse, a person should visit their doctor. Likewise, anyone who misses more than two periods should see a doctor for a diagnosis.

Anyone experiencing the following symptoms, along with signs of ectopic pregnancy or other potentially serious issues, should see a doctor immediately:

  • pain in the lower pelvis
  • abnormal vaginal bleeding, such as dark-colored blood
  • lower back pain
  • cramping on one side of the pelvis in particular
  • sudden, severe pain in the abdomen or pelvis
  • shoulder pain
  • dizziness or fainting
  • blood in the stools

Anyone who feels that their symptoms are out of the ordinary should see a doctor or seek medical attention.

Summary

It is possible that a female who is experiencing a gassy stomach and bloating along with a missed period is pregnant.

However, many things can affect the hormones in the body. Fluctuations in these hormones may cause similar symptoms.

The only way to know for sure is to take a pregnancy test or see a doctor. They will be able to diagnose any underlying condition. If there is an underlying condition, treating it should stop the symptoms.

9 Signs You Need to Take a Pregnancy Test

Most over-the-counter pregnancy tests are 99% effective when you take them after a missed period. But how do you know when it’s time to pee on a stick?

Pregnancy symptoms are different for everyone, and as the levels of the pregnancy hormone human chorionic gonadotropin (hCG) rise, your symptoms may increase, says OBGYN Jessica Brown, MD. “At four weeks, you may have a little bit of cramping, but classic symptoms like sore breasts, nausea and fatigue may not begin for six or seven weeks,” she says.

So, how do you know if your symptoms point to pregnancy? Brown discusses some of the very first symptoms, along with how to ease the discomfort and the best time to take a pregnancy test.

A Missed Period and Light Bleeding

A missed period is probably the most well-known pregnancy symptom, and the one that most often prompts women to take a pregnancy test. If your period is late or doesn’t come at all, you may be pregnant.

But newly pregnant women—one-third to be exact—may have what’s called implantation bleeding, or bleeding that is lighter, shorter and spottier than a regular period. When you become pregnant, the fertilized egg latches on to the uterus lining and embeds itself, which initiates the pregnancy. The movement may cause light bleeding a few days before your period is supposed to start. And while the amount differs from woman to woman, implantation bleeding is typically pinkish or dark brown (almost rust) in color. It will likely occur for a few days to a few weeks.

Brown recommends that all women track their menstrual cycle, especially if they are trying to get pregnant. You can use a regular calendar, or one of many phone apps. These apps can help you see what a normal menstrual cycle looks like for you, including how long it is and how heavy your period is. They can also anticipate your period and ovulation days for the months to follow, says Brown. “I think this is really helpful for patients who are trying to get pregnant. It can help them track when they’re most fertile.”

Tender Breasts

As early as one to two weeks after conception, pregnant women may notice changes in their breasts. Having tender, sore or enlarged breasts is a common body response to hormonal changes at the beginning of pregnancy. You may also see nipples begin to change in color, usually becoming slightly darker.

The sensitivity should subside after a few weeks, when your body gets used to the fluctuation of hormones. Your breasts may continue to grow and darken as your pregnancy progresses, however. This is completely normal—it’s your body’s way of preparing for breastfeeding after birth.

Abdominal Cramping

Just as you have cramping during your period, light cramping is pretty common during the first trimester (12 to 13 weeks) of pregnancy. This tends to occur on one or both sides of your lower abdomen, as a result of an expanding uterus and stretching ligaments; it may even feel like something is pulling on that side.

Here are some ways to relieve these cramps:

  • Take a warm bath.
  • Put a hot water bottle wrapped in a towel on the painful area.
  • Stay hydrated.

If you have severe cramping that doesn’t go away, heavy bleeding, dizziness or lower abdominal pain, see your OBGYN. They will want to rule out other serious conditions like an ectopic pregnancy or miscarriage.

Nausea And Vomiting

Roughly half of all pregnant women will experience vomiting, and many more will have some kind of nausea—especially towards the beginning of pregnancy. These feelings usually start two weeks to two months after conception, and don’t necessarily strike exclusively in the morning. Some women will have just a few minutes of stomach trouble daily, while others may have severe symptoms that last for hours each day.

Nausea and vomiting should go away as you approach the second trimester, around 13 weeks, but they may continue throughout the pregnancy. These symptoms are not normally harmful to you or your baby. However, if you can’t keep any food down and you’re losing weight, see your OBGYN so they can access whether or not you’re malnourished or dehydrated, since this can affect your health and the baby’s development.

Your OBGYN can also make sure you don’t have an ulcer, food-related infection, thyroid disease or gallbladder disease.

If you’re having trouble with nausea, here are some remedies that can help soothe your stomach:

  • Keep toast or crackers by your bed, so you can eat a snack before moving around on an empty stomach each morning.
  • Stay hydrated.
  • Try eating smaller, more frequent meals rather than three large meals.
  • When you’re feeling bad, stick to the BRATT diet: bananas, rice, applesauce, toast and tea.
  • Try food and drinks made with real ginger, like candies and soda.

Changes In Bathroom And Stomach Habits

In addition to nausea and vomiting, you may experience other stomach problems when you first become pregnant—like constipation, frequent urination and bloating, to name a few.

Constipation is normally characterized by fewer than three bowel movements a week, hard stool, dry stool or stool that is difficult to pass. “The progesterone that starts to form from the placenta slows the bowels down,” says Brown. Constipation can occur early on in pregnancy, but can come back during the third trimester, too.

Frequent urination is common. Symptoms can start even earlier than your missed period, since the fertilized egg implants itself into the uterus and begins making the pregnancy hormone hCG, prompting you to run to the bathroom more often.

Bloating can happen early on in pregnancy, and may continue throughout your nine months. The progesterone hormone causes your muscle tissues to relax, slowing down digestion. That, in addition to an expanding uterus, can put pressure on your rectum and cause it to feel heavy.

Here’s how to keep your stomach happy during pregnancy:

  • Aim to get at least 25 grams of fiber a day from foods like leafy greens and whole grains.
  • Stay hydrated.
  • Exercise regularly.
  • Talk to your OBGYN about any iron supplements you’re taking.
  • Discuss with your OBGYN whether you need to try over-the-counter medications.
  • When you feel the urge, do not hold in bowel movements.
  • Eat slowly.
  • Take it easy on foods that may upset your stomach, like beans, cabbage and fried items.

Fatigue

Does it feel like you just can’t hold your head up come 2 p.m.?

High levels of the hormone progesterone can cause fatigue, especially during the first trimester. In the first months of your pregnancy, your body is generating more blood to pass along nutrients to your baby and your blood sugar and blood pressure levels take a dip, bringing about exhaustion.

It’s important that you take time to rest during pregnancy; listen to your body and go to bed earlier than usual if you’re feeling pooped. Eat a well-balanced diet that includes iron, protein and calories so you’ll feel more energized during this exciting time. And unless your OBGYN advises against exercise, make sure you squeeze moderate activity into your weekly routine.

Sniffly? It may be because you’re pregnant! “Mucus membranes swell during pregnancy, so even if you don’t have a sinus infection or allergies, it may feel that way,” says Brown. The pressure on your sinuses may cause sneezing, a sore throat, congestion, drainage or headaches.

Higher levels of the hormone estrogen trigger the swelling, which can lead you to produce more mucus. The increase in blood circulation also contributes to swollen blood vessels in your nose, causing congestion.

Here are some ways to minimize sinus issues during pregnancy:

  • Drink plenty of fluids.
  • Prop your head up when you sleep.
  • Take a warm, steamy shower or bath.
  • Add moisture to the air in your bedroom by using a humidifier or vaporizer.
  • Steer clear of things that may make symptoms worse, like smoke, alcohol, paint and chemical fumes.

Food And Odor Aversions Or Cravings

Aversions to certain foods or odors are caused by your body’s hormonal changes during the first trimester of pregnancy. You may start to despise the way your favorite dinner smells or tastes, or, on the flip side, you may crave certain snacks, meals, beverages or food combinations.

When it comes to cravings or aversions, listen to your body. It’s okay to occasionally indulge in late-night ice cream runs—just don’t overdo it. Talk to your OBGYN if you’re unable to stomach major food groups like vegetables or whole grains. The two of you can discuss foods that can easily be substituted in.

This article originally appeared on Sharecare.com.

How Late Can a Period Be Without Being Pregnant?

Weight fluctuations

Being overweight or underweight can cause hormonal imbalances since fatty tissue plays a role in synthesizing hormones. Additionally, gaining or losing a significant amount of weight in a short amount of time can affect your hypothalamus. The hypothalamus is part of one of your body’s systems responsible for hormones. If the function of your hypothalamus is disrupted from an abrupt weight change, it can disrupt ovulation and cause a late or missed period. 

Medications

Certain medications, such as certain antipsychotics, can create hormonal imbalances that can cause a late or missed period. Check with your health care provider or pharmacist about the possible side effects of any medications you’re taking.

Polycystic Ovary Syndrome 

Polycystic ovary syndrome (PCOS) is a condition that can cause irregular periods because it affects your ovulation. Other symptoms of PCOS include:

  • Excessive body hair growth (hirsutism) 
  • Scalp hair loss
  • Weight gain or difficulty losing weight
  • Acne on the face, chest, and upper back
  • Difficulty getting pregnant
  • Darkening of skin, particularly along neck creases, in the groin, and underneath breasts

If you believe that you could have PCOS, a health care provider can give you a proper diagnosis and prescribe the treatment that you need.

There are other conditions that can cause late or missed periods other than pregnancy. These conditions include:

  • Perimenopause
  • Thyroid disease
  • Pituitary tumors
  • Breastfeeding
  • Change in sleep schedule
  • Dietary changes
  • Excessive exercise

Having a late period doesn’t always mean that you’re pregnant. In some cases, such as when you’re experiencing stress, your cycles could return to normal once you’re feeling better. However, if you’re worried about the underlying cause of your late period, it’s always helpful to take a pregnancy test and/or contact your health care provider if other symptoms arise.  

How to know when you are pregnant

Early pregnancy symptoms

If you notice one or more of these symptoms, it might be an early sign of pregnancy and a good idea to take a pregnancy test.

•      Late period
•      Extreme tiredness
•      Need to wee more often
•      Nausea
•      A metallic taste in your mouth
•      Sensitivity to smells
•      Tender or sore breasts.

Are you ready to conceive? Try our free tool to find out.

How do pregnancy tests work?

Pregnancy tests work by detecting one of the key early signs of pregnancy: a hormone called human chorionic gonadotrophin (hCG). This hormone is only made when a woman is pregnant.

Traces of hCG can be found in the urine from three to four days after implantation, but the concentration needs to continue to build up to a level at which the test can detect it and give a positive result. The best time to take a pregnancy test is from the day that the period is missed. 

Where can I get a pregnancy test?

GP pregnancy test

These tests are either free or a small fee is charged.

You’ll need to take a sample of your urine in a clean container (you can get sample pots from your GP’s surgery). The best time to collect a urine sample is first thing in the morning. This is because levels of hCG will have built up overnight.

If the urine sample is tested on the spot, you probably will be given the result after just a few minutes. You may have to wait up to a few days for the pregnancy test results though.

Home pregnancy test

These tests are available to buy from chemists or supermarkets and enable you to find out if you are pregnant in private after a few minutes.

The tests are considered to be quite accurate, although it is essential that you follow the manufacturer’s instructions carefully.

Choose a kit that you think will be easy for you to use and make sure that you understand what mark or symbol will appear if the test is positive.

Find out more about taking a pregnancy test.

How accurate is the pregnancy test?

It is important to know that whilst a positive result is likely to be accurate, a negative result may be misleading. Some women have a negative result and test again a week later to find that it is positive.

This is due to the levels of pregnancy hormone gradually building up to a level at which they can be detected. If you test yourself very early on and you have a negative result, you should carry out another test in 2-3 days’ time if you have still not had a period.

If you continue to get negative results and still no period, you should consult your doctor.

What should I do if I am pregnant?

Once you get a positive pregnancy test, make an appointment to see your doctor or a midwife.

Tell the doctor’s surgery when you are making the appointment that you have had a positive pregnancy test result as you might need a longer appointment.

Late Period? Here are some reasons why

This article is also available in: português, español

You go to the bathroom, pull down your underpants and… nothing. You expected your period to be here by now, but it’s not. Before you start to worry about why it could be late, take a deep breath and read this.

Your body is not a clock, and variation in your menstrual cycle is normal, especially if you are a teenager, breastfeeding or nearing menopause. Stress, travel, diet, illness and medication (including birth control) can also affect your cycle length, symptoms and the length and heaviness of your period. Up to 7–9 days of variation cycle-to-cycle is considered normal for adults.

How to know if your period is late

It can be hard to know if your period is late, if you don’t know your average cycle length or when your last period was. With Clue you can view your recent period dates, cycle averages and predictions for your next three cycles. You can set a reminder to let you know when your period is coming, and to alert you if it’s late.

Download Clue to track your cycle length and changes.

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What to do if your period is late

You are only at risk of pregnancy if you had unprotected penis-vagina sex or had sperm touching your vagina or vulva — during.

The best time to take a pregnancy test

If you have a regular menstrual cycle (for example, your cycle length rarely varies by more than a couple days), then you are only at risk of pregnancy if you had unprotected heterosexual sex or had a high risk of sperm touching your genitals during your fertile window. This is the six days leading up to and including ovulation, usually around the middle of your cycle (note that the ovulation day displayed in Clue is only an estimate — your actual ovulation day might have different timing, which can vary cycle-to-cycle along with the start date of your period). You can take a pregnancy test about two weeks after your estimated ovulation day, but the earlier you take a test the less accurate it may be and some brands are more sensitive than others (1). You should probably take a pregnancy test or contact your healthcare provider if your period is nine or more days late.

If you have an irregular cycle (i.e. you don’t know when your period is going to come and the difference between your longest cycle and shortest cycle is more than 7–9 days), then unprotected sex or exposure of sperm on your genitals at most times represents a risk. You can take a pregnancy test about two weeks after your last unprotected sexual encounter, though the earlier you take a test the less accurate it may be and some brands are more sensitive than others (1).

If you get a negative result at first and your period still hasn’t come after a week, you might want to try taking another pregnancy test—just to be sure. The sooner you know if you are pregnant or not, the sooner you’ll be able to develop a plan (if you do continue a pregnancy, certain vitamins are usually recommended right away). You can get confidential testing and counseling in most healthcare providers’ offices and clinics.

Read more here about the different types of pregnancy tests and how to use them.

Unsure where to go?

The International Planned Parenthood Federation lists member associations in over 170 countries on their site. Planned Parenthood has over 600 clinics in the USA and Family Planning offers services in the UK, Australia and New Zealand. To find a service provider in Canada, try the Canadian Federation for Sexual Health (CFSH). If you are transgender or nonbinary, there are many organizations worldwide that can help you to find a trans-friendly ob/gyn.

If you’ve had a negative pregnancy test and you haven’t had a period in more than 90 days, make an appointment with your healthcare provider. Tell them about your previous periods, cycle length and heaviness, and any other symptoms you have noticed. They may want to run a few tests to check if your cycle is being affected by another health condition.

A late period can be emotional, but try not to jump to conclusions until you find out what’s really going on. It’s completely normal for the length of your menstrual cycle to vary sometimes—maybe it’s nothing at all.

Download Clue to learn about your cycle and get accurate period predictions.

Negative Pregnancy Test but No Period?

When you miss your period, you may be wondering ‘Am I pregnant?’ Perhaps you’re feeling a little nauseous, your breasts are tender, or you’re experiencing other early signs of pregnancy, but you’ve taken the test, and the results say you’re not pregnant. You may be asking: Can I trust the results? Sometimes you can get a false negative on your pregnancy test – meaning you’re pregnant, but the test says otherwise. On the flipside, you can miss your period, but you’re not pregnant. Read on to find out what a negative pregnancy test result means. 

  • A pregnancy test works by detecting the hCG hormone, which is usually only present in your body if you’re pregnant.
  • Your hCG levels will increase over time if you are pregnant.
  • A negative pregnancy test result means the test hasn’t detected hCG in your urine.
  • If your period is very late, or you’ve skipped your period, and you get a negative result, you are unlikely to be pregnant.
  • If you are testing before the date of your expected period, you may be pregnant but your hCG levels are too low for the test to detect.
  • You may get a negative result when testing early if you’re not using the first urine of the day, you drank too much liquid, or the test is not sensitive enough for early testing – even if you’re pregnant.

Why did I get a negative test result?

You can get a negative result on your pregnancy test for two reasons: You are not pregnant or you are pregnant, but you tested too early for the pregnancy test you used to pick up the hCG ‘pregnancy’ hormone in your body.  

Pregnancy tests work by picking up (detecting) a hormone known as hCG (human Chorionic Gonadotrophin), which is produced when you get pregnant and will continue to increase over the first couple of months of pregnancy. You can see how hCG levels increase from ovulation to your missed period in the graph below. 

Rise of pregnancy hormone

(hCG) in early pregnancy

Relative hCG
concentration

Ovulation

hCG can start to appear in urine around this time

First day you can test with Clearblue® Early Detection Pregnancy Test

Expected
period

Missed
period

Days before missed period

Adapted from: Gnoth C. and Johnson S. Strips of Hope: Accuracy of Home Pregnancy Tests and New Developments. GeburtshilfeFrauenheilkd 2014;74(7):661–669.

If you test too early, a test may not pick up enough hCG to turn positive. If you’re testing before the day of your expected period, you may see a negative result – even if you’re pregnant – if:  

  • Your test wasn’t sensitive enough for early testing. 
  • You didn’t use the first urine of the day, so concentration of hCG in your urine wasn’t high enough.
  • You drank too much liquid before testing and you diluted the hormone in your urine. 

But what if you got a negative result, and your period is late? Chances are you are not pregnant and your period may be late or you may even skip it due to stress or illness. If the test is negative and you didn’t test early, you may have missed your period if:

  • You’re breastfeeding
  • You’ve been ill
  • You have irregular periods (e.g., due to Polycystic Ovarian Syndrome, often called PCOS)
  • You’ve been travelling
  • You’ve not been sleeping properly
  • You’ve been under very high stress
  • You’re on fertility medication like Clomid®
  • You haven’t had a period for months
  • You’re menopausal or peri-menopausal

See your doctor for further advice if you’re worried about a missed or skipped period. 

Is it possible to be pregnant and get a negative pregnancy test result? 

Yes, it is possible.  Getting a negative result doesn’t mean you’re not pregnant, it may just mean your hCG levels are not high enough for the test to detect the hormone in your urine. Even the most sensitive, ‘early detection’, pregnancy tests available can only detect pregnancy up to six days before your missed period (which is five days before you expect your period) and even then, these tests won’t be able to detect every pregnancy that early. 

Also, if you’re testing very early, your test may only detect hCG in your urine in the morning when it’s most concentrated. This is also why it’s important not to drink too much water before using a home pregnancy test, as this can dilute your hCG levels as well. 

Other reasons you may get a negative result on a test when you’re pregnant could be because you’re using a test that has expired (check the packaging for the date) or has not been stored properly (you need to keep your test between 2-30°C). 

There is also the incredibly rare chance you have an ectopic pregnancy that doesn’t give a positive result– fewer than 3% of ectopic pregnancies show a negative result. 

If you get a negative test result and you think you are still pregnant – take another test on the day you expect your period.  If your period is overdue, test again three days later.  If you are still unsure, see your doctor. 

What is happening when my pregnancy test is negative, and I missed my period? 

It’s easy to jump to the conclusion a missed period means pregnancy, but sometimes your period is late for other reasons. To start with, your menstrual cycle length can vary between cycles and, in fact, 46% of cycles can vary by seven days or more. Your period can be very late or you may even skip your period due to:

  • illness
  • travel
  • poor sleep 
  • very high stress

You may also experience irregular periods after you’ve had a baby and you’re breastfeeding. If you’ve recently given birth and are breastfeeding, your periods may not start again until you’ve stopped breastfeeding – but that doesn’t mean that you can’t get pregnant so don’t forget to use contraception if that’s not in your plan!

Another reason you may have irregular or absent periods is you’re entering menopause. But even if you’re over 45 and you’ve noticed your period is late, it’s still a good idea to take a pregnancy test just in case.

Birth control pills can also affect the regularity of your periods when you come off them. This is because hormonal contraceptives actually control your menstrual cycles while you’re taking them so you may be irregular for the first couple of months as your body ‘recalibrates’. 

If you haven’t had a period for months and you’re not pregnant, this could be due to an imbalance in your hormone levels, a side effect from medication, excessive exercise, or being severely over or underweight. If you haven’t had your period for months, see your doctor to find out the cause. 

When is it too early to test?

It depends on the test. Some tests are sensitive enough to detect hCG in your urine six days before your missed period (which is five days before you expect your period). Read the instructions on the pack to understand what the brand of test you’re using means by early detection. Some women still prefer to test on the day they expect their period, when all home pregnancy tests claim to be over 99% accurate.   

Conception usually happens around two weeks before your period would normally be expected. If you’re trying for a baby you can use an ovulation test not only to know your peak fertile days, but it will inform you about your cycle, so you know when it’s best to take the test. This can help you feel more confident in the results you see.

Do I have to take the test first thing in the morning?

Not unless you are testing early. Otherwise your test should detect hCG any time of day if you are pregnant. However, if you’re taking a pregnancy test before your missed period, it’s better to test first thing in the morning when concentrations of hCG are the highest. 

You can also dilute the amount of hCG in your urine by drinking too much liquid, so try not to drink more than you usually would.

Can I do the test wrong?

It’s important you read the instructions that come with your test carefully and follow them. This way you can be sure you can trust the result. Some tests are easier to read than others – for a test that gives a result in words such as ‘pregnant’ or ‘not pregnant’, is clear – whereas visual tests where you have to interpret lines can be harder to read and can leave you wondering whether you’re pregnant or not. If you doubt you’re reading the result correctly and the uncertainty makes you feel anxious, then get a test that is easy to read, like  the Clearblue Digital Pregnancy Test, so you can be sure of the result you see. 

You can see what a negative pregnancy test result looks like in our infographic below. 

 

 

What if there is something wrong with the test? 

You can get a false negative with a pregnancy test that has passed its expiry date, so check the packaging before use. 

I got a negative result, what should I do next? 

If you’re still not sure about the result, you wait until the day of your expected period to test, or test again in three days’ time if you’ve missed your period, with a pregnancy test from a reliable brand and follow the instructions carefully. You can also go to your doctor if you have doubts. You may get tested at the clinic or your doctor may recommend another brand of test to use.  

90,000 Tracking your periods with Cycle Tracker

With iOS 13 and watchOS 6 and later, it’s easy to track your menstrual cycle and better understand your health.

You can track your menstrual cycle in Health on iPhone or Cycle Tracker on Apple Watch. You can also turn on notifications to know when your next period is approaching or fertile days.

Cycle Tracker is included with watchOS 6. watchOS 6 is compatible with Apple Watch Series 1 and later. To update to watchOS 6, an iPhone 6s or later with iOS 13 or later is required.

Setting of the program “Cycle tracking”

  1. On iPhone, open the Health app and go to the Overview tab.
  2. Click Cycle Tracking.
  3. Click “Proceed” and follow the instructions on the screen.

Cycle Tracking

  1. On iPhone, open the Health app and go to the Overview tab.
  2. Click Cycle Tracking.
  3. Swipe to select the day you want and click the oval icon to register your period.
  4. To add more information, scroll down, select a category, make your changes and click Done. Can track symptoms, bleeding, basal body temperature, etc.

To track your cycle on Apple Watch, open Cycle Tracker, swipe to select the day you want, and tap the oval icon to record your period.

Checking the date of the last and next period

  1. On iPhone, open the Health app and go to the Overview tab.
  2. Click Cycle Tracking.
  3. Scroll to Guess to see the approximate start date for your next period.If you don’t see an estimated date, click Show All next to Guess.
  4. Scroll to Statistics to see your last menstrual period and your typical cycle length.

To view dates on Apple Watch, open Cycle Tracker, scroll down to Guess or Last Menstruation.

Color value

By opening Health or Cycle Tracker, you can quickly and easily get information about your period or fertile days.Below is information about the meaning of symbols and colors.

A blue oval icon indicates an indicative 6-day fertile period.

Red stripes on the circumference indicate the estimated start of menstruation.

The dark red dots mark the menstrual days recorded.

The purple dots mark the days when the data was recorded.

Set up notifications to track menstruation and fertile days

  1. On iPhone, open the Health app and go to the Overview tab.
  2. Click Cycle Tracking.
  3. Scroll down and select Options.
  4. Select Guess and Notification options. With these notifications, you can find out the approximate start and end date of your period.
  5. Select the Possible Auspicious Days and Auspicious Days Alert options. With the help of these notifications, you can find out the approximate date of the beginning of a favorable period for conception.

Assumptions are available after entering your last menstrual period in Cycle Tracker and are based on logged data.If you log your period before it is suspected to start, you will not receive a notification for that cycle. Apple Watch and iPhone receive notifications depending on which device you use.

Calculation of assumptions

Period prediction is based on the length of your previous periods and cycles that you recorded, including the number of days your period usually lasts and the length of your regular cycle.When you set up Cycle Tracker, you can enter information about past cycles, including the day your last period started, how long it usually took, and how long your regular cycle was. You can enter this information manually, or you can confirm the information available in the Health program from using third-party programs.

The fertile period is 6 days, during which there is a high probability of becoming pregnant. In this case, recorded information about menstruation or positive results of an ovulation test are taken into account.The assumption about a favorable period for conception is calculated in the traditional calendar way: 13 days are subtracted from the approximate date of the beginning of the next menstruation (luteinization phase). If you enter a positive ovulation test, your fertile period may change so that day 5 coincides with the first positive ovulation test in your cycle.

Hide Cycle Tracker

You can uninstall apps directly from the Apple Watch Home screen.

  1. Press the Digital Crown to display the Home screen.
  2. Press and hold the Cycle Tracker icon until it wiggles. If the program icon does not wiggle, make sure not pressing too hard.
  3. Click the Uninstall button () and then click Uninstall a Program. Not all built-in Apple programs can be uninstalled.
  4. Press the Digital Crown to complete.

Learn how to reinstall Cycle Tracker.

Important Information

  • Cycle Tracker and Estimated Fertility Periods should not be used for birth control.
  • Health and Cycle Tracker data should not be used to diagnose health conditions.
  • Cycle Tracker can also be used with third-party Health-compatible programs.

Information about non-Apple products or third-party websites not controlled or tested by Apple is not endorsement or recommendation. Apple is not responsible in any way for the selection, functionality, or use of third party websites or products.Apple is also not responsible for the accuracy or reliability of information posted on third party websites. Check with your supplier for more information.

Date of publication:

Why pregnancy does not occur – Medical Center “Lotos”

Pashkina Natalya Valentinovna

Head of the Department of Assisted Reproductive Technologies – obstetrician-gynecologist

One of the reasons for not getting pregnant is the lack of ovulation.

As a rule, this is facilitated by endocrine diseases, such as:

  • hypogonadotropic hypogonadism (insufficient production of hormones by the brain that regulate the work of the ovaries),
  • polycystic ovary syndrome,
  • an increase in the hormone prolactin in the blood (hypeprolactinemia),
  • thyroid disease (hypothyroidism),
  • dysfunction of the adrenal glands, ovarian failure.

Patients may have the following complaints:

  • irregular menstrual cycle
  • rare menstruation
  • maybe even the absence of menstruation,
  • weight problems: both underweight and overweight.

Other complaints are also possible: increased hair growth, acne and others.

How to find out if you are ovulating or not

There are several methods for determining ovulation.The easiest way to determine ovulation at home is to buy ovulation tests from the store. These tests are similar to those used to diagnose pregnancy.

How they work

Before ovulation, there is an increase in the blood luteinizing hormone LH, which appears in the urine. The ovulation test detects the appearance of LH in the urine.

Which tests to use

There are many of them on the market, manufacturers from Canada, China, Germany and others (Ovuplan, Clearble, Frautes, etc.)

Be sure to read the instructions! As a rule, all tests are reliable and informative.

When is it better to do tests

The tests usually need to be done from day 12 of your cycle if you have a 28-day cycle. If you have a short cycle (21-26 days) – from day 8.

If the cycle is long (30-34 days), then most likely your ovulation is late and may occur on 17-21 days or even later. Then the tests must be done from 14-16 days.

Moreover, it is better to do testing 2 times a day – in the morning and in the evening, so as not to miss the peak of LH (for some, it is short).

How to decipher test indicators

If you have 2 strips, then the test is negative and there is no ovulation.

If a second stripe appears, but it is not as bright as the first, then the test is also negative. In this case, it is necessary to continue to do tests until the two stripes are the same color.

As soon as the color of the stripes becomes the same or approximate in color – Hurray, the test is positive!

In the next day, two of you will ovulate. We have sex, have fun and visualize how a new life is being born in us. And everything will work out! Good luck and success to everyone!

Whether the tests are false negative or false positive.

Unfortunately yes. Therefore, ovulation should be monitored using several methods.

Ultrasound monitoring of ovulation

This method is quite effective and intuitive.

Briefly about physiology. On the 10-12th day of the menstrual cycle (a standard menstrual cycle lasting 28-30 days), a dominant follicle appears in the ovary – this is the largest follicle in which the egg will mature. The follicle grows about 2 mm per day, ovulation can occur when the follicle size is 17-25 mm. The follicle secretes a very important hormone called estradiol.In the uterus, under the influence of estradiol, the endometrium grows (this is the inner lining of the uterus, where the processes of embryo attachment take place). The endometrium immediately after menstruation is approximately 5 mm, as the follicle grows (the concentration of estradiol increases), the thickness of the endometrium increases from 5 mm to 8-12 mm – this stage is called the proliferation phase. If ovulation has taken place, the follicle turns into a corpus luteum, and the corpus luteum begins to produce progesterone. Under the influence of progesterone in the uterus, in the endometrium, characteristic changes occur – the secretion phase begins.

We will be able to see these changes that occur with the follicle and endometrium on ultrasound!

If you come on the 12th day of the cycle, I will see a large follicle in the ovary, 10-12 mm in size – this is great! Then in 2-3 days we will see its growth and the growth of the endometrium, remember that the growth rate of the follicle and endometrium is about 2 mm per day. Having done an ultrasound on the 14-15th day, we will see that the follicle, which was 17-20 mm yesterday, disappeared. So ovulation has occurred.

We will see the fluid behind the uterus, which also indicates that the follicle has burst. Further, having made an ultrasound scan on days 17-19-21 of the cycle, we state that a corpus luteum has formed in place of the bursting follicle and characteristic changes have occurred in the endometrium. And if you, even at this time, did ovulation tests and if you still donate blood to determine the amount of the hormone progesterone, we are most likely to decide that you had ovulation. So we need to look for another reason for the absence of pregnancy.

It is very important to do ultrasound monitoring along with the tests. This will most accurately determine the presence of ovulation. An ultrasound machine is the most important assistant for a reproductive physician. Make an appointment for an ultrasound scan with a reproductologist.

Ultrasound picture, if there is no ovulation

It is important to do ultrasound monitoring for more than one month, but preferably 2-3. In general, a healthy woman can have cycles without ovulation 1-2 times a year.With age up to 40 years, the number of anovulatory cycles increases and this is the norm.

Earlier I told you what we see on the ultrasound if everything goes right. Now let’s talk about what’s wrong …

  1. We can fix that there is a dominant follicle, it grows normally, but at a certain stage its growth stops before reaching 17-20 mm. And then it begins to decrease (regress). This is a violation of ovulation by the type of follicle atresia.
  2. The dominant follicle grows, reaches ovulatory size, but ovulation does not occur and it continues to grow further, releasing estrogens, affecting the endometrium. Since the corpus luteum is not formed, the proliferation stage remains in the uterus. And prolonged stimulation of the endometrium with estrogens can lead to the formation of polyps in the uterus. This is a violation of ovulation by the type of follicle persistence. Often we see such a follicle in the next cycle. And very often a follicular cyst is formed with a size of 3 to 8 cm.This scares my patients. But, as a rule, such cysts disappear in 1-2 months. If we want to speed up this process, then gynecologists prescribe birth control pills.
  3. And the last option, the dominant follicle grew to ovulatory, but ovulation did not occur, premature luteinization occurs, a slow, gradual follicle shrinkage. The main cause of hormonal dysfunction: increased prolactin, thyroid-stimulating hormone, androgens.
  4. 90,021 90,000 disease or condition? – SPB GBUZ “Dermatovenerologic dispensary No. 4”

    For almost 60 years, penicillin has been the drug of choice in the treatment of syphilis.In the history of chemotherapy for infectious diseases, this phenomenon is unique in its own way, since during this period the range of drugs used to treat other sexually transmitted infections (STIs) has been significantly updated. Against the background of penicillin, other antibiotics are periodically used to treat syphilis: tetracyclines, macrolides, cephalosporins, which form a group of reserve drugs.
    In addition to the evolution of clinical manifestations, the main criterion for the effectiveness of treatment is serological reactions – complement binding (CBC) and microprecipitation (PM).Under the influence of specific therapy, pale treponema is eradicated from the patient’s body, which leads to clinical recovery and, accordingly, a negative antibody response, i.e. negative complex of serological reactions (RSK + RM). However, regardless of the methods used for treating syphilis, there is always a certain proportion of patients (according to various sources, 2-10%), in whom a complete negative serological reaction does not occur.
    Why in some patients, despite the complete treatment, complete negativity of CSW does not occur? Are they epidemic dangerous? How likely is the recurrence of the disease? Is additional treatment required in these cases? Unfortunately, there are still no answers to these questions. This happens for many reasons, but the main one, apparently, is that the subject of the discussion itself is not clearly formulated. Seropositivity persisting in patients after treatment for syphilis is called seroresistance, but there is no consensus regarding the time frame for this phenomenon. The discrepancies in the formalization of the concept of seroresistance are partly due to the fact that it was assessed by the degree of seroreaction positivity (from + to 4+), i.e. in a rather subjective way.In international practice, to assess the effectiveness of treatment, a semi-quantitative method for assessing the negative reaction of seroreactions has been adopted: if, within a year after the end of treatment, the antibody titer in the RM decreases by 4 times or more, then the treatment is recognized as undoubtedly effective and the observation of the patient is stopped.
    Recently, interest in this issue has begun to grow again, due to a number of circumstances. First, the analysis of the results of treatment of patients with syphilis with durant drugs benzathine penicillin, which have been used in Russia since 1993, begins.It is very important that this assessment is carried out by researchers from the same position, otherwise it becomes impossible to compare the results obtained. Since evidence-based medicine has not yet been sufficiently developed in our country, the role of such multicenter studies is high, and it is on their basis that future syphilis treatment regimens are being developed.
    On the other hand, over the years of the epidemic, hundreds of thousands of people who have had syphilis have become seropositive. It is very important to understand whether positive results of serological tests are associated with delayed negative or with the development of persistent seropositivity, i.e.e. seroresistance? In addition to the psycho-emotional trauma associated with the need to recognize the past infection and constant explanations of the reasons for the positive reactions, these people may really need additional or preventive treatment.
    At present, two definitions are used to denote the positive serological reactions that persist in patients after full treatment (meaning only the reactions of the standard complex): seroresistant syphilis and seroresistance in syphilis.Do both of these definitions correspond to the nature of the described phenomena and are they not synonyms?
    According to leading experts (N.M. Ovchinnikov, T.V. Vasiliev, I.I. Ilyin and others), the definition of “seroresistant syphilis” is incorrect, since it presupposes that a patient has syphilis with positive CSR. It would be more correct to talk about seroresistance in patients treated for syphilis or, more precisely, about “persistently positive serological reactions in patients treated for syphilis.”In essence, having established a diagnosis of seroresistant syphilis in persons with positive DAC, we agree that the infectious process caused by treponema pallidus continues, although this is not always true.
    The concept of “seroresistant syphilis” is largely nosological and presupposes the independent existence of a separate form of the disease with constantly positive serological reactions. Developing this position, one should further recognize the existence of special strains of pale treponema, resistant to therapy, the persistence of which causes a similar serological form of the disease.In this case, the same seroresistance would be observed in other sexual partners, which almost never happens.
    Studies of the variability of treponema pallidus are very difficult due to the impossibility of cultivating it. Clinical experience indicates the need to increase the administered doses of penicillin, which proves a gradual increase in the resistance of treponema pallidum to penicillin. If, in schemes
    of 1955, an aqueous solution of penicillin was administered for all forms of syphilis at 50,000 units every 3 hours (daily dose of 400,000 units), then after 50 years, penicillin is administered already at 1,000,000 units every 6 hours (daily dose 4,000 000 UNITS). Currently, it has been possible to fix a strain of treponema pale, insensitive to erythromycin, while seroresistance is observed regardless of the type of treatment.
    Seroresistance is not an independent disease (nosology), it reflects the state of the relationship between the pathogen and the patient’s specific organism, therefore it is more correct to characterize this phenomenon as seroresistance after treatment. Scientific studies have shown that sometimes, for various reasons (late treatment, the introduction of low dosages of drugs, interrupted treatment), the complete destruction of treponemas does not occur and some of them turn into peculiar forms, the so-called cysts, or L-forms.Being resistant to antibiotics, they are able to persist in the patient’s body for an indefinitely long time. Being a weak antigenic irritant, modified forms of treponema contribute to the formation and maintenance of unstable, fluctuating positive serological reactions.
    M.V. Milich proposed to distinguish between true, relative and pseudo-resistance. Relative seroresistance develops in patients who have received specific treatment, in whose body pale treponemas continue to persist in the form of avirulent cyst forms or polymembrane phagosomes.Most often, relative seroresistance develops after treatment of late latent, late congenital, secondary recurrent and early latent syphilis (more than 6 months old), i.e. in cases where pale treponema is in the patient’s body for a long time without treatment. The appointment of additional treatment in these cases does not give an effect.
    True seroresistance was determined as a result of the progressive course of syphilis, when, for some reason, microbiological sterilization of the body did not occur after the treatment.True seroresistance usually develops in primary, secondary and early latent (lasting no more than 5-6 months) syphilis. In true seroresistance, the appointment of additional treatment usually leads to a negative seroreaction.
    Pseudo-resistance was proposed to be considered a condition when, despite positive serological reactions after treatment, the pathogen is no longer present in the body. The concept of pseudo-resistance has not become widespread due to the fact that it is almost impossible to differentiate it with true resistance.
    The concepts of relative and true seroresistance have not found wide application and distribution in practical work, since both terms mean the presence of a pathogen in the body in an unknown form of existence.
    To date, two points of view have been established on the immune basis of seroresistance. It is generally accepted that, for various reasons, pale treponemas continue to persist in the patient’s body after treatment. This position is fundamental, and the very form of existence of treponemes does not matter (M.P. Frishman, 1984; N.M. Ovchinnikov et al., 1987; E.V. Sokolovsky, 1995; Luger a. Petzoldt, 1979).
    According to other authors, seroresistance in syphilis is associated with the formation of so-called anti-idiotypic antibodies, i.e. secondary antibodies formed in response to the emergence of anti-treponemal antibodies (T.M. Bakhmetyeva et al., 1988; S.I.Danilov, 1996). With this variant of seroresistance, the causative agent of infection in the body is absent, therefore, it makes no sense to carry out additional treatment.
    Thus, the determination of the causes of seroresistance is a rather difficult task, which is of practical importance in deciding whether to prescribe additional treatment. Its implementation depends on the identification of specific markers of persistent infection. One of them is class M anti-treponemal immunoglobulin (IgM). Already 10-14 days after infection, IgM to the main species-specific protein antigens of treponema appear in the patient’s blood. Anti-treponemal IgG do not appear earlier than the 4th week after infection and can subsequently remain in the blood for decades.After full treatment of early acquired syphilis, anti-treponemal IgM disappear after 3–12 months, and after treatment of late syphilis – after 12–24 months. The detection of anti-treponemal IgM in persons with persistently positive serological reactions is very valuable, since it allows one to determine the activity of the infectious process and determine the tactics of further treatment. In one of the observations (T.V. Vasiliev, 1984), IgM was studied in the RIF-abs reaction in 100 patients with seroresistance. In 90 of them, the reaction was positive with a titer of at least 1: 100, which indicated incomplete elimination of treponema pallidum from the patient’s body.After additional specific treatment, IgM-RIF-abs were negative in 50% of patients; in the remaining patients, the antibody titer decreased to 1:13.
    In our studies (I.A. Chimitova, V.A. Akovbyan et al., 1999) positive results for IgM were revealed in enzyme-linked immunosorbent assay (ELISA) in 42.9% of patients with seroresistance, questionable results were observed in 9 more ,five%. After additional treatment, 66% of these patients had IgM negative ELISA results.
    Thus, the presence of anti-treponemal IgM in some patients with seroresistance is an indicator of the presence of a pathogen in the body, indicates the activity of the infectious process and may serve as an indication for additional specific treatment.
    High-dose water-soluble penicillin is recommended for additional specific treatment for seroresistance. In recent years, the use of the 3rd generation cephalosporin ceftriaxone has been increasing. Possessing high treponemicidal activity and penetrating ability, ceftriaxone was effective in seroresistance: complete negative reactions of the standard complex occurred in 45.7% of patients within 6 to 24 months (I.A.Chimitova, 2000).
    What is meant by the definition of “seroresistance”?
    After the treatment of syphilis, this is a certain state of the body, which is characterized by the absence of a decrease in the titers of reagins in the RM by 4 times or more within a year after the end of the specific treatment or the preservation of positive (weakly positive) results for more than 2 years with early and 3 years with late forms of syphilis . ..In the case of a decrease in titers of more than 4 times that occurred within 1 year, the further preservation of positive or weakly positive results of the microreaction within 2 years can be assessed as a delayed negative seroreaction. The detection of antitreponemal IgM in patients with seroresistance in the blood is an indication for additional therapy, the outcome of which is most often successful. The absence of IgM casts doubt on the success of additional therapy, if additional treatment for these patients has already been carried out earlier, then repeated courses are inappropriate.
    Can it be argued that long-term persistence of positive serological reactions after treatment for syphilis has any negative impact on health in general? We are talking about the influence of those reasons that underlie seroresistance. Studies of health indicators of persons with positive reactions of the standard serological complex 15–20 years after the end of specific treatment have shown that in addition to disorders in the psychoemotional sphere in comparable age groups in persons with seroresistance, the frequency of lesions of the cardiovascular and nervous systems is significantly higher than in those who have had syphilis and who have achieved complete negativity of the DAC (K.A. Yuldashev, 1966). In this work, the results of treatment of patients with the use of heavy metal preparations are analyzed, which does not exclude the possibility of their damaging effect on the parenchymal organs and the nervous system. Obviously, this issue requires further study, taking into account the currently used treatment regimens for patients with syphilis, as well as new possibilities for serological diagnostics.
    For further study of the phenomenon of seroresistance in syphilis, it is necessary to conduct retrospective and prospective multicenter studies in order to obtain reliable data on the effectiveness of the most common methods of treatment.It is necessary to continue scientific research to use in the future the possibilities of molecular biological methods for the identification of treponema pale, as well as test systems for the determination of anti-treponemal immunoglobulins of various classes in everyday practice.

    MD Professor I.N. Telichko, Ph.D. E. V. Khodosevich

    90,000 What is Postoperative Medical Rehabilitation?

    The goal of cardiac rehabilitation is to develop an individual comprehensive program designed to reduce the consequences of surgical treatment, prevent the development of complications of the disease, improve the quality of life by identifying and developing reserve and compensatory capabilities of the body.

    Cardiac rehabilitation
    is teamwork. The patient must confront the disease in cooperation with
    a multidisciplinary team of specialists: cardiologists, physiotherapists,
    psychotherapists, physical therapy doctors, as well as family and nearest
    surroundings.

    Three stages of medical rehabilitation

    At the first stage, the patient receives the necessary assistance after surgery in the intensive care unit and specialized department in accordance with the recommendations of the multidisciplinary team of specialists.In the absence of postoperative complications, the first stage of medical rehabilitation is on average 10 days.

    The second stage of medical rehabilitation assistance is carried out after the patient is discharged from the hospital in the early recovery period of the course of the disease, the late rehabilitation period, with residual symptoms of the course of the disease or the chronic course of the disease without exacerbation. This stage, lasting 14 days, the patients undergo on the basis of the medical rehabilitation department, located on the territory of the Sosnovka resort-hotel.


    For whom is the second stage of cardiac rehabilitation indicated?

    • Patients with ischemic heart disease after surgical treatment: coronary artery bypass grafting, mammary coronary artery bypass grafting, angioplasty of coronary arteries.
    • Patients with ischemic heart disease after myocardial infarction and stenting associated artery infarction, myocardial infarction in the stage of scarring.
    • Patients who have undergone heart valve replacement for acquired heart defects.
    • Patients after surgical treatment of complex heart rhythm and conduction disorders.

    Third
    the stage of medical rehabilitation is carried out in the late rehabilitation period
    and the period of residual effects of the course of the disease on an outpatient basis.

    For whom is the third stage of cardiac rehabilitation indicated?

    Patients
    with chronic ischemic heart disease a year or more after
    surgical treatment.

    For each stage of rehabilitation, a standard for the provision of medical care has been developed, which fixes the types and volume of procedures, drug therapy.The rehabilitation program is appointed by the multidisciplinary commission during the hospitalization of the patient based on individual characteristics: comorbidities; time elapsed after surgery; type of surgery; psychoemotional state of the patient.

    Experience
    The Meshalkin Center in the implementation of all stages of cardiac rehabilitation is
    a unique opportunity for patients to be under a competent medical
    observation in one institution from primary treatment to distant
    postoperative period.


    What is included in the cardiac rehabilitation program?

    Drug therapy

    Upon admission to the medical rehabilitation department, the patient adheres to the regimen of taking medications in accordance with the prescriptions of the medical institution where the surgical treatment was performed. Correction of drug therapy occurs exclusively in cases when the patient’s condition requires it, in agreement with the attending cardiologist.During the period of rehabilitation, in addition to the main group of drugs, patients take medications that improve metabolism at the cellular level.


    Physiotherapy

    Physiotherapy
    restorative treatment methods are aimed at improving the functional
    conditions of the cardiovascular and nervous systems. Department specialists
    used as hardware physiotherapy (drug electrophoresis,
    sinusoidal modulated currents, electrosleep, transcranial electrostimulation,
    magnetotherapy, magnetic laser therapy, exposure to polarized light),
    and balneotherapy treatments aimed at improving
    extracardiac mechanisms of regulation of coronary and general blood circulation,
    improvement of myocardial contractility, compensatory and reserve
    capabilities of the body (circular shower, steam-air “dry” carbon dioxide and
    medicinal baths).


    Physical rehabilitation

    Physical
    exercise is indicated for both healthy people and patients with cardiovascular
    diseases after surgery. Physical activity works
    tonic, stimulates motor-visceral reflexes. She promotes
    acceleration of metabolism in tissues, activation of endocrine processes.

    Program
    physical rehabilitation adapted to the individual capabilities of the patient and
    assigned depending on the state at the time of admission to the department.For
    assessing exercise tolerance each patient performs a test
    6 minute walk. According to its results, patients are divided into three groups.

    To the first
    the group includes patients who underwent an “open” operation and were admitted to
    the second stage of cardiac rehabilitation on the 10-11th day after the intervention. how
    as a rule, in this category of patients pain syndrome persists, they are
    in a state of psychasthenia, manifested in general weakness, rapid fatigability,
    disturbance of mood, sleep.These patients are limited in activity, activities for
    they are held in the hall of physiotherapy exercises in small groups. Main complex
    exercises is aimed at restoring correct breathing, the work of the upper and
    lower limbs. Patients perform all exercises while sitting.

    In the event that a multidisciplinary team of specialists determines the improvement of physical
    the patient’s condition, the physical rehabilitation program includes daily
    dosed walks through the territory.

    Second
    physical rehabilitation program is designed for patients with large
    physical abilities who entered the department in the late rehabilitation
    period. This group of patients attends daily classes in the medical room.
    physical education, during which various instruments are involved –
    gymnastic balls, sticks and so on. The hiking route has been extended for them.
    on the territory, which alternate with Nordic walking.

    Third
    a physical rehabilitation program designed for patients who have undergone surgery
    indirect myocardial revascularization (stenting of the coronary arteries) and not
    having severe limitations in physical activity. In addition to classes in the hall
    physiotherapy exercises for them are provided training using
    simulators, and also increased the route of walking.


    Power supply mode correction

    One of
    risk factors for cardiovascular disease is an unbalanced
    nutrition that provokes an accelerated process of atherosclerotic lesions
    vessels.This is primarily associated with the consumption of a large amount
    fatty and sweet foods. In this regard, the majority of patients with
    cardiovascular diseases are overweight. Excess
    weight and high blood pressure are closely related. Special
    unfavorably excess fat deposition in the abdominal area. Weight reduction
    body reduces blood pressure, normalizes fat and carbohydrate metabolism.

    For 14 days
    in the department of medical rehabilitation, specialists help patients
    redefine dietary stereotypes.The Meshalkin Center has developed and
    a nomenclature of therapeutic diets has been approved, which includes six types: basic,
    sparing, low and high protein, low and high calorie. Depending on the
    pathology, the attending physician prescribes the patient a certain type of diet, which he
    must stick to.

    For
    department of medical rehabilitation developed a 14-day menu for six meals
    nutrition. The basic principles on the basis of which the patient’s diet is built
    compartments are the degree of temperature processing of food (boiled, steam and
    stews), nutritional balance (required amount
    proteins, fats and carbohydrates in the diet) and calorie calculation.

    Also for
    patients with cardiovascular diseases, there are limitations in
    consumption of table salt, foods containing refractory fats and
    easily digestible carbohydrates.

    Psychological support

    Recovery
    psycho-emotional balance is an important step towards the patient’s recovery.
    Upon admission to the department, a clinical psychologist conducts diagnostics,
    allowing to determine the psychological state of the patient, to reveal the hidden
    anxiety, depression, fears.In individual consultations, a specialist helps
    develop the patient a sense of self-confidence, restore a holistic
    inner image, draw boundaries between oneself and the disease, teach to cope
    with fears.

    One of
    effective treatment and rehabilitation techniques used in the department
    medical rehabilitation, are art therapy sessions. Art therapy promotes
    early postoperative rehabilitation of patients: there is an improvement
    the emotional state of a person, reducing anxiety, stabilizing
    psychological state.The arsenal of techniques used by the art therapist,
    includes drawing and floristry. During the course, a specialist helps
    patients to overcome embarrassment and indecision before an unusual activity.
    Another challenge is to create a special atmosphere that will promote
    creative expression. With art therapy, a person’s attitude towards
    own traumatic experience and related experiences. In addition to
    stabilization of the patient’s emotional state, art therapy sessions give
    the ability to regain coordination skills and improve fine motor skills.


    Educational Lectures

    Important
    a factor in consolidating a positive treatment result is a change
    the patient’s lifestyle, which implies nutritional correction, smoking cessation,
    maintaining a healthy weight, regular physical activity, changing household and
    social habits. The department’s specialists conduct educational lectures for
    patients who are fully informed about risk reduction
    development of coronary heart disease, methods of adaptation to new living conditions.

    “The internal recovery capabilities of the human body are great. It is important to be able to choose the right key for them. The body should not experience stress during the rehabilitation process; for this, a multidisciplinary team of specialists competently selects a program that includes a set of procedures aimed at a lasting therapeutic effect. Thanks to psychological support, the patient quickly adapts to new living conditions after surgery, copes with the stress caused by the traumatic experience. “

    Head of the Medical Department
    rehabilitation, cardiologist Taisiya Valentinovna Kuznetsova


    Conditions of stay

    Patients undergo the second and third stages of cardiac rehabilitation at the resort-hotel.
    “Sosnovka”, located in a forest area of ​​an ecologically clean zone. Hotel
    has a unique territorial location: the windows of the chambers open
    picturesque view of the pine forest bordering a large reservoir.Surrounding
    natural conditions have a beneficial effect on recovery processes
    in the body of patients. Hotel-type chambers provide for double
    accommodation with an individual bathroom. Department of Medical Rehabilitation
    provides the possibility of hospitalization of the patient with relatives who
    can get the necessary medical care on a paid basis. Round the clock
    the work of the department is provided by medical posts located on the floors.

    Hypoglycemic syndrome (insulinoma): pathogenesis, etiology, laboratory diagnostics.Literature Review (Part 1) | Yukina

    https://doi. org/10.14341/probl2017634245-256

    Full Text:

    Abstract

    Hypoglycemic syndrome is a symptom complex that develops as a result of an imbalance in the system for maintaining blood glucose levels with the development of hypoglycemia and is stopped by the administration of glucose.A rapid and significant drop in glycemia can lead to a life-threatening condition called hypoglycemic coma. Chronic hypoglycemia leads to irreversible changes in the central nervous system, and the forced frequent intake of food with a high content of easily digestible carbohydrates – to an increase in body weight up to the development of morbid obesity. Thus, hypoglycemic syndrome is an urgent problem in modern medicine. The most common cause of pancreatogenic hypoglycemia in patients without diabetes mellitus is insulinoma.The causes of hypoglycemic syndrome can also be: exogenous administration of hypoglycemic drugs, severe multiple organ and tumor pathology, the consequences of bariatric surgery, deficiency of counterinsular hormones, genetically determined enzyme disorders and autoimmune diseases. The primary diagnostic tasks that determine the choice of treatment tactics are the confirmation of the hypoglycemic syndrome and the determination of its etiology. For this purpose, a 3-day fasting test and other tests are used.This review discusses the main causes and features of the pathogenesis of hypoglycemic syndrome, the criteria for differential diagnosis, the possibility of introducing new diagnostic tests and markers.

    Keywords

    For citation:

    Yukina M.Yu., Nuralieva N.F., Troshina E.A., Kuznetsov N.S., Platonova N.M. Hypoglycemic syndrome (insulinoma): pathogenesis, etiology, laboratory diagnostics. Literature review (part 1). Problems of Endocrinology . 2017; 63 (4): 245-256.
    https://doi.org/10.14341/probl2017634245-256

    For citation:

    Yukina M.Yu., Nuralieva N.F., Troshina E.A., Kuznetsov N.S., Platonova N.M. The hypoglycemic syndrome (insulinoma): pathogenesis, etiology, laboratory diagnosis (review, part 1). Problems of Endocrinology . 2017; 63 (4): 245-256.
    (In Russ.) Https://doi.org/10.14341/probl2017634245-256

    Hypoglycemic syndrome is a symptom complex that develops as a result of an imbalance in the system for maintaining blood glucose levels with the development of hypoglycemia (a decrease in blood glucose concentration below 2.2-2.5 mmol / l) and is stopped by the administration of glucose.

    Chronic neuroglycopenia leads to irreversible changes in the central nervous system, manifested by epileptic seizures, pyramidal disorders, personality changes and dementia. In addition, chronic hypoglycemia forces patients to frequent meals with a high content of easily digestible carbohydrates, which leads to an increase in body weight up to morbid obesity.

    Normal glycemic regulation

    There is a complex system of hormonal regulation of carbohydrate metabolism.Maintaining the level of glycemia within physiological concentrations is provided by the secretion of insulin (the only hormone in the human body that reduces the concentration of blood glucose) and counterinsular hormones (which have the opposite effect). Insulin synthesis occurs in the β-cells of the islets of Langerhans in the pancreas. The predecessor of insulin is

    Information for parents | Ministry of Health of the Amur Region

    Medical rehabilitation for children is carried out in the presence of a confirmed by the results of the examination of the prospects of restoration of functions (rehabilitation potential), depending on the severity of the patient’s condition in three stages.

    The first stage of medical rehabilitation is carried out in the acute period of the course of the disease or injury in the intensive care and intensive care units of medical organizations of the region according to the profile of the underlying disease in the absence of contraindications to rehabilitation methods.

    The second stage of medical rehabilitation is carried out in the early recovery period of the course of the disease or injury, the late rehabilitation period, the period of residual symptoms of the course of the disease, in the chronic course of the disease without exacerbation in stationary conditions in GAUZ JSC “Children’s City Clinical Hospital”, at the address: g.Blagoveshchensk, st. Hospital, 45.

    The specialized departments (pediatric, neurological, orthopedic) of GAUZ JSC “Children’s City Clinical Hospital” are sent to patients with dysfunctions who need or do not need round-the-clock medical supervision of specialists in the profile of the care provided.

    Selection, examination of patients to determine the indications for medical rehabilitation in the conditions of GAUZ JSC “Children’s City Clinical Hospital”, the preparation of an individual rehabilitation program is carried out by the attending specialist of the specialized inpatient department and (or) outpatient department of the medical organization where the patient is observed …

    The decision to send a patient for treatment to the inpatient department of GAUZ JSC “Children’s City Clinical Hospital” is taken by the attending specialist of the specialized inpatient department and (or) the outpatient department of the medical organization where the patient is observed, on the basis of the developed individual rehabilitation program, with issuing a referral for hospitalization.

    A referral for treatment to an inpatient department at GAUZ JSC “Children’s City Clinical Hospital” is made out by the attending physician-specialist through a single information resource. The application is considered by GAUZ JSC “Children’s City Clinical Hospital” within 3 days. The date of hospitalization of the patient is agreed by the head of the profile department of medical rehabilitation of GAUZ JSC “Children’s City Clinical Hospital”. The department maintains a waiting list for the provision of specialized medical care in a planned form.

    The patient (parents, legal representatives) on the day of treatment is informed about the queue number and the date of the proposed hospitalization. The waiting period for planned hospitalization is no more than 14 days.

    Reception of patients for planned hospitalization is carried out by the admission department of the Children’s City Clinical Hospital on the appointed day from 9.00 to 14.00.

    Patients entering medical rehabilitation are preliminarily examined by all available methods and means at the disposal of the referring medical organization.

    The third stage of medical rehabilitation is carried out in the early and late rehabilitation periods, the period of residual symptoms of the course of the disease, in the chronic course of the disease without exacerbation in the departments (offices) of rehabilitation, physiotherapy, physiotherapy, reflexology, manual therapy, psychotherapy, medical psychology, offices of a speech therapist (teacher-defectologist), specialists in the profile of the care provided by medical organizations that provide medical care on an outpatient basis.

    Selection, examination of patients, to determine the indications for the third stage of medical rehabilitation, the preparation of an individual rehabilitation program is carried out by the attending specialist of the specialized inpatient department and (or) outpatient department of the medical organization where the patient is observed.

    Rehabilitation after hip arthroplasty

    • Articles /
    • Recovery after hip replacement

    Rehabilitation after hip replacement is divided into three postoperative periods: early, late and late.At the first stage, the patient does simple gymnastics, learns to move with crutches and take the correct positions. In the second stage of recovery, the patient is engaged at home independently and attends classes.

    Rehabilitation after hip replacement is divided into three postoperative periods: early, late and late:

    • Early period – hospital, first two weeks. In the hospital, the patient does simple gymnastics, learns to move with crutches, to take the correct positions.
    • Late – up to two months after surgery. The patient is doing self-rehabilitation at home and attending classes. During this period, efforts are aimed at restoring muscles and acquiring skills for solving everyday problems.
    • Remote – up to six months after surgery. Work continues with a rehabilitation therapist, physiotherapist. The patient is engaged in exercise therapy, restores leg performance, learns to walk without support.

    Let’s consider the rehabilitation process in more detail.

    How is the recovery course developed?

    The primary rehabilitation program is usually developed by the doctor who observes the patient in the postoperative period. After discharge, she is corrected. Any classes, exercises should take place only according to the program prescribed by the doctor. Before this, the patient must be examined, the X-ray and the results of the MRI are studied.

    There is no standard rehabilitation course for everyone. The program is always compiled strictly individually, for each patient.

    Medical centers use medication and non-medication recovery methods for rehabilitation. To prevent complications after surgery, anti-inflammatory drugs, antibiotics, pain relievers are prescribed.

    The main part of the rehabilitation course is exercise therapy and therapy. The rehabilitation therapist conducts workouts that begin with simple exercises with a gradual increase in the load. The patient moves from simple movements to exercise machines and other sports equipment.

    Therapy includes many techniques, the most effective of which are physiotherapy, massage, acupuncture, reflexology. All this is aimed at relieving muscle tension, accelerating recovery processes, getting rid of pain, normalizing sleep and preventing complications.

    The hip joint is one of the largest supporting joints. When it is replaced, the ligaments are removed, the muscles are dissected and re-stitched, which I will hold the endoprosthesis. In order for muscles to cope with their function, they need to be trained and strengthened.Otherwise, the prosthesis may shift, which will lead to bad consequences.

    General recommendations for the rehabilitation period

    • In a hospital, a person must acquire skills for safe movement and acceptance of body positions that do not harm the prosthesis. So, you can not put your legs on your legs, draw your legs to the body during sleep, lean on a sore leg, bring your knees while sitting, make rotational and flexion movements in the area of ​​the endoprosthesis.
    • Do not bend the hip in the operated joint more than 90 °.This poses a risk of dislocation.
    • You cannot sit in one position for more than 20 minutes. The hip joints should be above the knees or level while sitting. It is not recommended to sit on very soft chairs. The chair should be firm, durable, with a back and armrests, on which you need to get up.
    • You need to go to bed as follows: sit on the bed, then raise your legs and turn them along with your torso to the middle of the bed.
    • It is better to sleep on your back, and move the operated leg to 20 °, this will relax the muscles.
    • To prevent unwanted movements and turns during sleep, a pillow or cushion should be placed between the thighs.
    • During exercise therapy, you can not take analgesics. The patient must pre-tune for the pain through which all exercises will need to be performed. Otherwise, you may simply not feel when something goes wrong.
    • It is not recommended to drive a car for the first 1.5-2 months.
    • Do not lift or carry heavy loads.
    • In the first weeks after surgery, it is important to avoid falling. You should move very carefully, it is desirable that someone is at these moments nearby and insures.

    Guidance on walking:

    • Walk slowly on level and non-slip surfaces;
    • to take steps of the same length, the time of support on a cane or walker is the same for each leg;
    • procedure for climbing stairs: in front of the first step, the legs stand together, then – the healthy leg, the operated leg, support.
    • descending stairs: support, operated leg, healthy leg.

    Life after hip arthroplasty

    Let’s consider in more detail the three main periods of rehabilitation after joint replacement, as well as methods of recovery.

    Important! An early start of recovery procedures is a guarantee of a high quality of life, protection from complications and injuries.

    Preoperative step

    Even before the operation, the patient prepares for rehabilitation after it: learns to walk with crutches and use objects for support, trains the respiratory and cardiovascular systems.It is very important to strengthen the muscles of the healthy leg, because after the replacement of the joint, a high load will fall on it.

    Early postoperative period

    The main goal in this period is to prevent complications, to improve the mobility of the prosthesis. In the first three days, you can only lie and only on your back. The operated limb is fixed in position by moving it slightly to the side using a roller. The foot should be perpendicular to the lower leg, with the toes pointing up. Three to four times a day, the position of the knee joint is changed with a roller for 10-20 minutes.You can turn on your side only to the healthy side; this is allowed from the fourth day. From the fifth to the eighth day, you can lie on your stomach.

    In order not to provoke vascular pathologies, in the first seven days after the operation, both legs are wrapped with elastic bandages, and then for another seven days the bandage is applied only during the daytime.

    In the first weeks, the patient is gradually included in the motor mode, he is assigned sparing exercise therapy programs. During this period, you also need to take antibiotics, and to improve the quality of life – pain relievers and, if necessary, sedatives.

    Late period

    The main emphasis at this stage is on increasing the strength of the leg muscles, learning how to climb and descend stairs, followed by mastering the technique, and strengthening the gait. In the first 1.5-2 months, you need to walk with crutches so that the body “accepts” the endoprosthesis.

    Long-term period

    Three months after the operation, rehabilitation measures begin, aimed at maximizing the strengthening of the muscles of the operated leg and adapting the patient to everyday life and daily activities.

    The period of full restoration is individual. It depends on the initial pathology, due to which it was necessary to change the joint, age, general condition, etc. On average, this takes a year.

    Rehabilitation methods used in the recovery process

    • Drug therapy – antibiotics for the prevention of infection in the early period, pain relievers, anti-inflammatory. After that – vitamin complexes, calcium preparations, immunostimulating drugs.
    • Physiotherapy – techniques to improve blood circulation, stimulate metabolic processes, reduce pain and increase muscle tone.
    • Hydrokinesitherapy – water exercises to develop the joint, speed up recovery and reduce the risk of complications.
    • Cryotherapy – cold therapy. Special forms filled with hydrogel are cooled and placed on the endoprosthesis for 15 minutes. It relieves pain, relieves swelling.
    • Magnetotherapy is a hardware technique for stimulating microcirculation in tissues and accelerating healing.
    • Electrical stimulation – the tissues are affected by an alternating weak current, due to which the muscles maintain their tone even with limited motor activity. Lymph and blood flow improves.
    • Laser therapy for anti-inflammatory effect, relieve pain and swelling.
    • Use of orthoses if the joint needs additional stabilization. An orthosis (bandage) is selected by an orthopedic traumatologist. This device fixes the joint, relieves it and corrects the function of the leg.The load is redistributed to healthy areas, the treatment time is reduced.
    • Kinesitherapy is a set of exercises that is selected taking into account the history, the patient’s condition and a number of other factors. The load is gradually increasing, walkers, crutches, exercise machines are used. This technique allows you to return the motor function.
    • Exercise therapy, which is best done under the supervision of a trainer. But in the long-term period, practiced exercises can be done at home.
    • Massage – indicated in the absence of acute pain.It is performed in order to increase blood flow and oxygenate tissues for better regeneration.

    Read also

    Surgical treatment of hernias of the anterior abdominal wall

    A hernia is an opening or “weak” place in the muscles of the anterior abdominal wall – the so-called “hernial gates” – through which organs or fatty tissue enter the skin under the skin …

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