Why is my period late? Discover the potential reasons, causes, and what you need to know about a late period, from stress and low body weight to chronic diseases and more.

Reasons for a Late Period

If your period is late but you’re not pregnant, there can be several possible reasons. Common causes of a late or missed period include:

1. Stress

   Chronic stress can disrupt your hormones and affect the part of your brain that regulates your menstrual cycle, the hypothalamus. This can lead to a late or missed period.

2. Low Body Weight

   Extreme weight loss, as seen in eating disorders like anorexia nervosa or bulimia, can pause ovulation and cause irregular periods. Intensive exercise can also contribute to late or missed periods.

3. Obesity

   Being overweight can cause an imbalance in reproductive hormones, leading to menstrual irregularities and even a complete cessation of periods.

4. Polycystic Ovary Syndrome (PCOS)

   PCOS is a condition that causes the body to produce more male hormones, leading to irregular or absent periods. Treatment often involves birth control or other medications.

   

5. Birth Control

   Going on or off birth control can disrupt your cycle, and it can take up to 3 months for your period to become regular again after stopping contraceptives.

6. Chronic Diseases

   Conditions like diabetes, celiac disease, Cushing’s syndrome, and congenital adrenal hyperplasia can all affect your menstrual cycle and cause irregularities.

7. Primary Ovarian Insufficiency (POI)

   Also known as premature ovarian failure, POI occurs when the ovaries stop functioning normally before age 40, leading to early menopause symptoms like a late or missed period.

Understanding Menstrual Cycle Irregularities

Most people with a uterus have a period approximately every 28 days, but a healthy menstrual cycle can range from 21 to 40 days. If your period falls outside of this range, it could be due to one of the reasons mentioned above.

It’s important to note that irregular periods are common, especially when your cycle first begins or as you approach menopause. However, if you have consistently late or missed periods, it’s a good idea to see a healthcare provider to determine the underlying cause and receive appropriate treatment.

Addressing a Late Period

If you’re concerned about a late period, the first step is to take a pregnancy test to rule out pregnancy. If the test is negative, you can then consider the other potential causes and take steps to address them.

For example, if stress seems to be the culprit, try incorporating relaxation techniques into your daily routine, such as meditation, yoga, or deep breathing exercises. If low body weight or obesity is a factor, work with a healthcare provider or registered dietitian to develop a plan for achieving a healthy weight.

If you have an underlying condition like PCOS or a chronic disease, your healthcare provider can provide the appropriate treatment and management plan to help regulate your menstrual cycle.

Seeking Medical Advice

If you have consistently late or missed periods, it’s important to see a healthcare provider, such as your gynecologist or primary care physician. They can perform a thorough evaluation, which may include blood tests and other diagnostic tests, to determine the underlying cause and develop an effective treatment plan.

Don’t hesitate to seek medical attention if you’re concerned about your menstrual cycle. Your healthcare provider can help you understand the reasons for a late period and provide the necessary support to address the issue.

Maintaining Menstrual Health

Regardless of the reason for a late period, it’s essential to prioritize your overall health and well-being. This includes maintaining a balanced diet, engaging in regular physical activity, managing stress, and getting enough sleep.

By taking proactive steps to address the underlying causes of a late period, you can help regulate your menstrual cycle and support your reproductive health in the long run.

Key Takeaways

• A late period can have various causes, including stress, low body weight, obesity, PCOS, birth control, and chronic diseases.
• Irregular periods are common, especially during the start of menstruation and the transition to menopause.
• If you have consistently late or missed periods, it’s important to see a healthcare provider for evaluation and treatment.
• Addressing the underlying cause and maintaining overall health can help regulate your menstrual cycle.

Why Is My Period Late? Reasons, Causes, and What To Know

If you’re not pregnant, your period may be late due to a great deal of stress or low body weight. Certain conditions, including polycystic ovary syndrome (PCOS), diabetes, and others, can also affect your menstrual cycle.

Worried about a late period but know you’re not pregnant? Missed or late periods happen for many reasons other than pregnancy. Common causes can range from hormonal imbalances to serious medical conditions.

Research shows that the prevalence of irregular menstrual cycles is 5-35.6% depending on your age, your occupation, and where you live.

There are also two times when it’s typical for your period to be irregular: when it first begins and when the menopause transition starts. As your body goes through the transition, your cycle can become irregular.

In this article, we discuss eight reasons your period may be late besides pregnancy.

Most people who haven’t reached menopause usually have a period approximately every 28 days. However, a healthy menstrual cycle can range from every 21-40 days.

If your period doesn’t fall within these ranges, it could be because of one of the following reasons.

1. Stress

Chronic stress can throw off your hormones, change your daily routine, and even affect the part of your brain responsible for regulating your period: your hypothalamus. Over time, stress can lead to illness or sudden weight gain or loss, all of which can impact your cycle.

If you think stress might be throwing off your period, try practicing relaxation techniques and making lifestyle changes.

Chronic stress can also affect other health conditions you’re living with, so addressing it yourself or with the help of a medical professional is an important part of taking care of your overall well-being.

2. Low body weight

People who have eating disorders, such as anorexia nervosa or bulimia, may experience irregularities in their cycle. Losing too much weight can cause irregular periods and may even stop your cycle altogether. This is because not having enough body fat can pause ovulation.

Getting treatment for your eating disorder and getting to the point where your body fat is optimal again can return your cycle back to its original length.

People who participate in extreme exercises, such as marathons, may also experience cycle irregularities as well.

3. Obesity

In the same way that living with a low body weight can cause hormonal changes, living with a high body weight can also cause irregularities.

Obesity can cause the body to produce an overabundance of estrogen, which is a key reproductive hormone. Too much estrogen can cause irregularities in your cycle and may even stop your periods altogether.

If your doctor has determined that obesity is a factor in your late or missed periods, they may advise you to lose weight through lifestyle changes, such as focusing on nutrient-dense foods and exercising.

4. Polycystic ovary syndrome (PCOS)

PCOS is a condition that causes your body to produce more of the male hormone androgen. Cysts form on the ovaries as a result of this hormone imbalance. This can make ovulation irregular or stop it altogether.

Other hormones, such as insulin, may also become unbalanced. This is due to insulin resistance, which is often associated with PCOS.

Treatment for PCOS focuses on relieving symptoms. Your doctor may prescribe birth control or another medication to help regulate your cycle.

5. Birth control

You may experience a change in your cycle when you go on or off birth control. Birth control pills contain the hormones estrogen and progestin, which prevent your ovaries from releasing eggs.

It can take up to 3 months for your cycle to become consistent again after you stop taking the pill.

Other types of contraceptives that are implanted or injected can cause missed periods as well.

6. Chronic diseases

Chronic diseases, such as diabetes and celiac disease, can also affect your menstrual cycle. Changes in blood sugar are linked to hormonal changes, so even though it’s rare, unmanaged diabetes could cause your period to be irregular.

Celiac disease causes inflammation that can lead to damage in your small intestine, which may prevent your body from absorbing key nutrients. This can cause irregular or missed periods.

Other chronic conditions that may lead to cycle irregularities include:

• Cushing syndrome
• congenital adrenal hyperplasia
• Asherman’s syndrome

7. Primary ovarian insufficiency (POI)

Most vagina owners begin menopause between the ages of 45-55. Those who develop symptoms around age 40 or earlier may be experiencing primary ovarian insufficiency (POI) or early natural menopause.

About 1% of women before the age of 40 experience POI. While this condition can arise from the surgical removal of the ovaries, other causes include genetic disorders and autoimmune conditions.

If you’re experiencing missed periods and you’re 40 years old or younger, contact your doctor to talk about POI testing and treatment.

8. Thyroid issues

An overactive or underactive thyroid gland could also be the cause of late or missed periods.

The thyroid regulates your body’s metabolism, so hormone levels can be affected as well. Thyroid issues can usually be treated with medication. After treatment, your period will likely return to your normal cycle.

If your period is late and you think you might be pregnant, you can take a pregnancy test. Most home tests are pretty accurate, but if you think your result may be wrong, you can see your doctor for a blood or urine test.

Certain pregnancy symptoms during the first six weeks after conception can also suggest that you might be pregnant. If you haven’t received your period within six weeks, it’s not likely that the cause is related to natural variations in your menstrual cycle.

If your periods seem irregular, or you’ve missed a period but know you’re not pregnant, it’s a good idea to talk with your doctor ASAP, as there are many reasons and conditions that could be causing the issue.

Your doctor can properly diagnose the reason for your late or missed period and discuss your treatment options. If you can, keep a record of changes in your cycle as well as other health changes. This will help them make a diagnosis.

If you have the following symptoms, contact a doctor immediately, or call 911:

• unusually heavy bleeding
• fever
• severe pain
• nausea and vomiting
• bleeding that lasts longer than 7 days
• bleeding after you’ve entered menopause and have not had periods for at least a year

Just as every person is different, every menstrual cycle is different. While 28 days is the generalized cycle length, cycles can range from 28-40 days.

Occasional cycle irregularities can happen for a variety of reasons, from chronic stress to weight loss or weight gain, to stopping or starting birth control.

If you’ve noticed that your cycle has been irregular lately, or you’ve missed a period and know for a fact you’re not pregnant, it’s a good idea to talk with your doctor right away. The quicker they can make a diagnosis, the quicker you can work on regulating your cycle again.

Read this article in Spanish.

How to Induce a Period: Natural Remedies, Methods, Risks

Certain treatments, remedies, and lifestyle changes like reducing stress or exercise may help induce a delayed or missing period, depending on the cause.

There are various reasons why you might wish to induce your period. Perhaps you want to get your period over and done with before a holiday or a special occasion. Maybe you have an irregular cycle and want more predictability so that you can plan a pregnancy. Or maybe your period is delayed, causing you to feel stressed or worried.

If your period is delayed, or you stopped getting it, treating the cause may help you regulate your monthly cycle.

A typical menstrual cycle is considered to be 21 to 35 days.

The absence of menstruation during the reproductive years is called amenorrhea. For people who regularly have their period, if you go without it for 6 months, you may have amenorrhea. This condition affects about 1 percent of females in the United States.

Amenorrhea can be caused by conditions that may include:

• pregnancy
• stress
• low or high body weight
• polycystic ovary syndrome (PCOS)
• hormonal contraceptives
• chronic conditions such as diabetes or celiac disease
• certain acute illnesses
• thyroid issues, such as hypothyroidism or hyperthyroidism
• hormonal issues, such as those caused by the pituitary gland or hypothalamus
• menopause
• tumors affecting the ovaries or pituitary gland
• chronic ovulation

Girls who haven’t started their periods by the age of 15 or 5 years after initial breast development are considered to have primary amenorrhea.

There are several possible causes of delayed or missing periods:

• anatomical differences, such as those that can cause a vaginal blockage or the absence of a vagina or cervix
• injury to the reproductive organs, such as Asherman syndrome or cervical stenosis
• PCOS
• elevated levels of follicle-stimulating hormone (FSH)
• hyperprolactinemia, or having high levels of the hormone prolactin
• pituitary gland issues

Substances that can help induce a period are called emmenagogues. Be aware that some emmenagogues are also abortifacients, which is a substance that can cause miscarriages in pregnancy.

Pregnancy warning

If there’s a chance your period is late because you are pregnant, using emmenagogues to induce a period may terminate your pregnancy. This can be dangerous. If there’s a chance you are pregnant, do not take these substances.

If you are trying any herbs, be sure to get them from a reputable source. The U.S. Food and Drug Administration (FDA) does not monitor herbal supplements the same way they monitor other medications and drugs. While the FDA sets guidelines surrounding dietary supplements, supplements are not required to be proven safe to these standards before being sold. However, some safety monitoring steps are in place once they are in the market, such as the reporting of adverse events.

There may be concerns with quality, purity, or dosage. They may contain more or less of the ingredients on the label.

It is best to look for herbal supplements that may be verified by a third party, such as ConsumerLab or USP.

Vitamin C

Some people believe that vitamin C, also called ascorbic acid, can induce your period. But there is not reliable scientific evidence to back up this claim.

It’s thought that vitamin C can elevate your estrogen levels and lower progesterone levels. This causes the uterus to contract and the lining of the uterus to break down, leading to the onset of menstruation.

A 2016 study observed that vitamin C was associated with increased progesterone and decreased FSH levels. However, the authors of the study note that additional research is needed to better understand the potential role of antioxidants in fertility and how they can affect reproductive hormones.

To try this method, you can take vitamin supplements or simply eat foods that contain vitamin C. Citrus fruits, berries, black currants, broccoli, spinach, Brussels sprouts, red and green peppers, and tomatoes are all good sources of vitamin C.

If taking supplements, be careful to stay within the recommended safety limit — too much vitamin C can be dangerous.

Pineapple

Pineapple is a rich source of bromelain, an enzyme believed to affect estrogen and other hormones.

A 2017 study suggests bromelain may help reduce inflammation. This means it could help causes of irregular periods related to inflammation.

However, there’s no scientific evidence that suggests pineapple or bromelain supplements will induce a period.

Ginger

Ginger is a traditional remedy for inducing periods and is believed to cause uterine contractions. However, this remains unproven by scientific research.

Ginger may have anti-inflammatory properties, and it is used to treat stomach pain and menstrual pain, according to a 2015 review.

In a 2016 review, researchers determined that ginger may be effective in treating heavy menstrual bleeding and menstrual pain.

Ginger can be unpleasant to eat raw, so the easiest way to take it is to make ginger tea. To use this method, boil a fresh piece of peeled, sliced ginger in a pan of water for 5 to 7 minutes. Strain and sweeten the tea to taste, if needed, before drinking.

Parsley

Parsley contains high levels of vitamin C as well as apiol, which may help to stimulate uterine contractions. However, apiol is also toxic in certain amounts and is especially dangerous to pregnant people. You shouldn’t drink parsley tea if you are pregnant, nursing, or have kidney problems.

To make parsley tea, simply pour a cup of boiling water over a couple tablespoons of fresh parsley and allow it to steep for about 5 minutes before drinking.

Turmeric

Turmeric is another traditional remedy believed by some to be an emmenagogue. It’s supposed to work by affecting estrogen and progesterone levels, although scientific research is lacking.

There are many ways to include turmeric in your diet. You can add it to curries, rice, or vegetable dishes. Or you can add it to water or milk with other spices and sweeteners for a warming drink.

Dong quai

Dong quai, also known as female ginsing or angelica sinensis, is an herb native to China and a popular herbal remedy that’s been used for hundreds of years to relieve symptoms associated with menopause and menstruation. It’s thought to help induce a period by improving blood flow to the pelvis as well as by stimulating the muscles in the uterus and triggering uterine contractions.

It may not be safe to consume in large doses or if you are pregnant or nursing.

Dong quai may be made into a tea and is frequently sold in mixtures with other herbs.

Black cohosh

Black cohosh is another herbal supplement that may help regulate the menstrual cycle. It’s said to help tone the uterus and promote the shedding of the uterine lining.

However, studies have not shown any consistent effect on the follicle-stimulating hormone, estrogen, or the tissues of the female reproductive tract. Additional studies are needed to determine the health effects of black cohosh.

Short-term use of this herb appears to be safe.

Black cohosh is known to interact with many medications. It’s not recommended for people who are on blood pressure or heart medications or who have a history of liver problems.

Relaxation

Stress can sometimes be the cause of a delayed or missed period.

A 2018 review of research found that perceived stress was associated with irregular menstrual cycles. The authors of the review suggested that this may be due to cortisol, which is a steroid hormone that is released in response to stress. In animal models, cortisol can delay the rise in other hormones that happen before ovulation.

An increase in stress hormones may affect those hormones that are needed to maintain a regular menstrual cycle.

There are many ways to relieve stress and promote relaxation, and what works best will vary between individuals. Ideas can include:

• reducing workload or other stressors, if possible
• spending time with friends and family
• yoga and breathing techniques
• exercising
• engaging in an enjoyable hobby
• using meditation or mindfulness techniques

Warm compress or bath

A warm bath may help relax tight muscles and relieve emotional stress. Perhaps this is the reason for anecdotal reports that this can help to bring on your period.

You can try adding some relaxing scented oil to a bath. You could also try using a warm compress such as a hot water bottle by applying it to the abdomen.

Heat may help you relax. It may also help increase blood flow to the area, thus gently accelerating the menstrual cycle. However, research is needed to support this.

Sex

Regular sex can also reduce the effects of stress and help to promote a healthy hormonal balance.

Reducing exercise if you’re an athlete

Missing periods may occur due to low energy availability, especially in adolescent athletes. This can occur if you aren’t taking in enough energy relative to the energy you’re burning through exercise.

People who limit their food intake and engage in extreme exercise, with or without the use of laxatives, may develop amenorrhoea. This may be considered a warning sign for other health issues associated with low energy, such as poor bone accrual and low bone mineral density, both of which are associated with decreased bone strength.

If you may have amenorrhoea due to low energy availability, it is best to reduce the amount of exercise you do on a daily basis. You may want to see a doctor or trainer to determine how much exercise is safe for you to perform.

Birth control

A more long-term solution to the problem of irregular periods is to use a hormonal contraceptive. By controlling the levels of hormones in the body, these contraceptives can bring a degree of certainty over when your period will arrive.

These can also come with side effects. Speak to your doctor before deciding if this is something you would like to try.

It’s important to remember that missing or delayed periods may be symptoms of an underlying problem. You should seek medical advice if:

• you suspect you may be pregnant
• you miss three periods in a row
• your periods stop before the age of 45
• you’re still having periods after the age of 55
• you experience bleeding in between periods or after sex
• your periods suddenly change, become much heavier, or are more erratic
• you experience postmenopausal bleeding (bleeding more than 12 months after your periods have stopped)
• you experience bleeding while on hormone replacement therapy

If you don’t already have an OBGYN, our Healthline FindCare tool can help you connect to physicians in your area.

Why is it possible not to notice pregnancy until the very birth?

Article author:

Yudina Elena Alexandrovna

, obstetrician-gynecologist

The first type of is a hidden pregnancy, when the body does not show signs of conception, or when its symptoms can be interpreted differently.

The second kind of is when a woman does not allow the thought that she will soon become a mother. Such pregnancies are more often associated with mental disorders or young age. There are not many such cases, but they do occur.

Consider the first type

As a rule, a woman with normal weight monitors her menstrual cycle and regularly visits a gynecologist. The probability of not noticing pregnancy is higher in overweight women. If the menstrual cycle is disturbed, toxicosis may not be noted, and the only sign of pregnancy is only the growth of the abdomen. At the same time, obese women with an irregular menstrual cycle due to hormonal failure believe that they are insured against pregnancy and, thereby, miss the fact of conception. In addition, it is quite possible not to notice pregnancy in the case of a small child and the fullness of the expectant mother. Also, polycystic ovary syndrome, combined with overweight and an increase in subcutaneous fat on the abdomen, can mislead the fair sex.

Along with this, there are anatomical reasons not to notice the “interesting position”. If the fetus is located too high and there is no growth of the abdomen (especially in overweight women with an irregular cycle), which should prompt a woman to think about pregnancy, then the state when the child begins to move is mistaken for flatulence, and poor health and toxicosis are associated with food poisoning. In athletic women, on the contrary, trained abdominal muscles can hide the child and his movements well. In addition, due to anatomical features, such as the bending of the uterus, the abdomen may grow very little.

There are women with false signs of pregnancy, in which all the clinical symptoms of a traditional pregnancy (weight gain, lactation, abdominal growth and toxicosis) appear, but there is no baby in the stomach.

There is a category of women (as a rule, they take pill forms of contraceptives, or have a diagnosis of infertility, or who have had a displacement of the intrauterine device), who do not notice the fact of the onset of pregnancy due to the fact that in the early stages it is accompanied by signs of interruption (bloody discharge pain in the lower abdomen). A woman perceives these symptoms as painful menstruation with a violation of the menstrual cycle. At the same time, they assure the doctor that menstruation was every month, but more abundant and painful.

Some women who have already conceived have bleeding, which they may confuse with the so-called “menstruation”. For example, in the case when the placenta is located in the lower part of the uterus and covers its internal pharynx (this should be interpreted as a threat of abortion). Such patients require closer attention and careful monitoring.

After childbirth, women forget that ovulation can occur before the first menstruation even in the presence of active lactation, therefore, fertilization is possible. In addition, if the fair sex did not start taking birth control pills in the first 5 days of the cycle, missed taking them, or had vomiting and diarrhea, then the pill could not be absorbed. As a result, follicle growth and ovulation are triggered. In such cases, additional contraception is needed.

During menopause, ovulation can occur at any time. During this period, a woman feels mood swings, dizziness, nausea and a regular weight gain. At this time, it is necessary to visit a gynecologist more often and use contraception, since the fact of an unplanned pregnancy is not excluded.

The second type is characterized by the following

Many young girls may show a symptom of physiological denial of their pregnancy, because they do not want a child, are emotionally unprepared to cope with this situation and are afraid of their parents (girls are afraid of the publicity of their sexual contacts) and consequences of pregnancy. A married woman may experience the same problems because of infidelity to her husband. Fatigue they attribute to overwork or sleep problems. Mentally ill women who, in principle, do not know and do not understand what is happening to them, may also not know about their pregnancy.

If you experience any unusual symptoms such as weight gain, missing or unusual menstruation, we recommend that you contact your doctor.

Make an appointment with a gynecologist

For more details, consult a qualified specialist at the Semeynaya clinic.

To find out prices for a gynecological appointment or other questions, follow the link below:

Endometriosis: symptoms and treatment

Approximately 25 – 40% of female infertility is due to this disease. This pathology can become a significant obstacle, preventing the fertilized egg from remaining in the uterine cavity or leading to miscarriages. Moreover, endometriosis can affect the entire female body, leading to disruption of the functioning of many internal organs and systems.

Endometriosis is a disease of the female reproductive system, in which the tissue of the inner lining of the uterus (endometrium) begins to penetrate into the underlying structures (myometrium), neighboring organs (fallopian tubes, ovaries, bladder) and even affecting distant parts of the body (lungs, liver and etc. ). At the same time, endometrial foci outside the uterus are also subject to the menstrual cycle, periodically contributing to the development of bleeding. The initial manifestations of the pathology are manifested by painful, profuse and prolonged menstruation.

Why does endometriosis develop and its classification? There are many genetic, immune and other, less common theories. The following is considered the most reliable.

There are two main forms of endometriosis, different in their causes and manifestations:

• Genital. It affects the internal genital organs: uterus, fallopian tubes, ovaries, vagina. Due to the presence of a chronic inflammatory process (endometritis of any nature), abortion, injury, the presence of an intrauterine device or spontaneously, endometrial cells begin to grow into the muscular layer of the uterus. Two of its subspecies are also distinguished:
• External genital. It affects only the ovaries and the peritoneum of the small pelvis.
• Internal genital (adenomyosis or endometriosis of the uterus). Grows into the muscle layer, leading to an increase in the body of the uterus. Often associated with myoma.
• Extragenital. Foci of endometriosis occur in the pelvic organs, abdominal cavity, lungs, intestines, skin, etc. During menstruation, blood with rejected endometrial cells for various reasons first enters the fallopian tubes, and then into the abdominal cavity. On the surface of the peritoneum, endometrial cells take root, gradually increase in number, menstruate and, in the future, spread further throughout the body.

Cases of a combination of genital and extragenital endometriosis are known.

There are 4 stages of development of this pathology, based on the prevalence and depth of the foci:

• Stage I – Foci of small size, superficial (affect only the mucous membrane of the uterus) – minimal endometriosis.
• Stage II – Some lesions penetrate the muscle membrane – mild endometriosis.
• Stage III – deep, transmural (through the entire wall of the uterus) foci of endometriosis appear. Small endometrioid ovarian cysts develop.
• Stage IV – there are many deep foci, cysts reach significant sizes. Foci of endometriosis grow into neighboring organs (vagina, rectum, bladder), adhesions develop in the small pelvis – severe endometriosis.

How the disease manifests itself

Depending on the form of the disease (genital, extragenital) and the stage of the process, the manifestations may be different. And if in the extragenital form the symptoms depend on the affected organs, then genital endometriosis has a number of characteristic features:0003

• Pain syndrome. Pain is felt in the pelvic area, it can either increase before the onset of menstruation or be constant (chronic pelvic pain). Often there is pain during intercourse. In stage IV disease, pain may occur during urination or defecation. In case of damage to other internal organs, pain can also occur in their area, which, as a rule, is cyclic in nature.
• Bleeding. In the initial stages of endometriosis, excessive bleeding develops only during menstruation. They become long, plentiful, at the end of which characteristic brown discharge may continue. In the later stages of the disease, an admixture of blood appears in the feces, urine. The extragenital form is capable of causing the discharge of bloody sputum, the occurrence of subcutaneous hemorrhages. These manifestations occur synchronously with the onset of menstruation.
  
  A rather rare manifestation of extragenital endometriosis is a bloody tear. The presence of this symptom gave rise to many myths and legends in ancient times and the Middle Ages.
• Dysmenorrhea. It is manifested by painful, prolonged and abundant cyclic discharge. Perhaps a combination with anemia that develops at the end of menstruation.
• Infertility. In connection with the changes that occur in the endometrium and ovaries, constant anemia due to bleeding, the onset and normal course of pregnancy becomes quite problematic.
• Adhesive disease. Due to the constant flow of menstrual blood into the abdominal cavity, especially in the pelvic area, adhesions gradually develop. They reduce the mobility of the internal organs, fallopian tubes, body of the uterus, which can further reduce the chance of pregnancy. In severe cases, acute or chronic intestinal obstruction may develop.
• Extragenital lesion. Perhaps this group of symptoms is the most diverse. This is due to the polymorphism of the symptoms inherent in the defeat of a particular organ. Signs of neoplasms of the liver, lungs, respiratory failure, jaundice, gastrointestinal bleeding, hematuria (blood in the urine), etc. may develop.

What threatens endometriosis

The development of complications of this pathology is closely related to its manifestations and symptoms. The most serious consequences of endometriosis are:

• Infertility.
• Adhesive disease.
• Anemia.
• Damage to the central nervous system.
• Malignancy of endometriosis foci.

If pregnancy still occurs against the background of endometriosis, its course may be complicated by the threat of miscarriage, improper attachment of the placenta, fetal hypoxia. Adhesions can lead to the development of an ectopic pregnancy.

Diagnosis

If the patient is concerned about abdominal pain and attempts to conceive are unsuccessful, the question arises as to the presence or absence of endometriosis.

What are the symptoms associated with endometriosis?

• painful menses
• painful intercourse
• chronic pelvic pain
• pain in the lumbosacral region
• painful urination
• painful defecation.

The study of the patient’s complaints, the history of her illness, gynecological examination are only the initial stages in the diagnosis of endometriosis. To clarify the diagnosis, ultrasound, computed tomography or MRI (magnetic resonance imaging) and other research methods are performed.

But the “gold standard” in the diagnosis of this pathology is laparoscopy with biopsy.

Treatment of endometriosis

Today, there are three main ways to treat endometriosis: medical, surgical and combined. Each method has its own positive and negative sides, scope. When choosing a treatment, the doctor is guided by the age, stage and form of the disease, planning a subsequent pregnancy.

Medical treatment

Conservative treatment is used if it is necessary to preserve the childbearing function of a woman at a young age or premenopause and in preparation for surgical treatment. When conducting drug therapy for endometriosis, treatment is carried out in two directions: elimination of pain syndrome (analgesics, NSAIDs) and suppression of the activity of pathological foci with the help of hormonal drugs. It should be clearly understood that conservative treatment of endometriosis without hormones is impossible.

Combined oral contraceptives (COCs) or progestins are given as first-line therapy.

To reduce the pain symptom, analgesics, non-steroidal anti-inflammatory drugs are prescribed.

Hormone therapy is aimed at suppressing the activity and reducing the size of endometrial lesions. The selection of a treatment regimen is based on the maximum reduction in the manifestation of side effects from drugs. The following means are most widely used:

• Progestins (gestagens). They are taken in a course of 6-8 months for any form and stage of endometriosis. Contribute to the normalization of the secretion of the endometrium, slow down its growth and reduce the amount of menstrual bleeding up to their complete absence. Dienogest, dydrogesterone, progesterone, norethisterone are used. Among the side effects may be the development of depression, intermenstrual bleeding, pain in the mammary glands.
• Monophasic COCs. Oral contraceptives completely block cyclic mechanisms in the female body, which prevents the growth and subsequent rejection of the endometrium, the development of menstrual bleeding. This leads to the complete or almost complete elimination of the manifestations of endometriosis. The use of COCs can cause headaches, depression, insomnia, high blood pressure, and reduce libido. Rigevidon, Novinet, Diane-35, Regulon and others are used.
• Gonadotropin-releasing hormone agonists, hormonal releasing systems: vaginal and transdermal combined hormonal contraceptives, subcutaneous and intramuscular progestin depots, levonorgestrel intrauterine releasing system (LNG-IUD) used when COCs and progestogens fail or before laparoscopic surgery for endometriosis .
• Gonadotropin-releasing hormone agonists are taken once a month and are the “big guns” in hormone therapy. Shown in III-IV stages of endometriosis. They block the production of specific releasing factors in the hypothalamus, which prevents further production of sex hormones according to the female cycle. These drugs can cause hot flashes, decreased libido, vaginal dryness, menopausal symptoms, osteoporosis, headaches, and muscle pain.

Surgical treatment

Currently, more and more preference is given to organ-preserving operations, excluding resection of the uterus and its appendages. This trend is due to the great progress in minimally invasive surgery over the past 10-15 years. The main goal of surgical treatment of endometriosis today is the removal of foci and the maximum restoration of the functionality of the female reproductive system.

Excision of endometrioid lesions where possible, especially deep endometrioid lesions, laparoscopic cystectomy of endometrioid cysts (endometriomas) is recommended. This avoids recurrence of symptoms and endometrioma.

A significant role in the course of the postoperative period, the possibility of complications is played by the level of professionalism of the operating doctor. The clinics “Mother and Child” employ world-famous specialists who have the techniques for conducting modern surgical interventions to remove endometriotic lesions.