Late period? Here are potential reasons beyond pregnancy | Omaha

Question:

I’m supposed to get my period and I haven’t been this late before. Could I be pregnant? What are symptoms of early pregnancy? When should I see a doctor?

Answered by OB-GYN Karen Carlson, MD:

There are many reasons why a woman’s period can be late, ranging from common hormonal imbalances to stress to pregnancy. Additionally, it is quite common to have late cycles both right after a teen begins having periods and when a woman is about to end or near menopause. A menstrual cycle is considered normal if it ranges between 21 and 35 days. Many women have times during their reproductive years when they have late or irregular periods. In fact, this is the most common reason that women seek care from a gynecologist. Stress, low or high body weight, excessive exercise, use of birth control, chronic diseases, early menopause, and other hormonal problems are just some examples that may cause periods to be late. Let’s take a look at some of these in more detail. 

When we feel stressed, our body produces stress hormones from the adrenal gland. These hormones can inhibit the production of sex hormones from the ovary, which are essential to maintain regular menstrual cycles. Additionally, too much exercise, for example with long and frequent running sessions or intense weightlifting, can also decrease estrogen levels and make periods late or sometimes stop altogether. Many forms of birth control, including pills, patches, NuvaRing, progesterone IUDs, shots and arm implants, especially near the beginning of use, can make periods irregular or late. 

More concerning causes of late periods include chronic diseases and hormonal problems. Diabetes, thyroid disease, polycystic ovarian syndrome, celiac disease and pituitary tumors are common diseases and hormonal problems that can cause irregular or late menses (blood and other matter discharged from the uterus at menstruation). When periods are late, many women will have some mild symptoms similar to early pregnancy, including mild uterine cramping. The breasts may feel heavier and fuller or be tender to the touch. Nausea, constipation, mood swings, dizziness and fatigue may be experienced. These symptoms are caused by increasing levels of the hormone progesterone, and they occur in both early pregnancy and the premenstrual portion of the cycle. Because of this similarity, when a period is late for other reasons, a woman may still have some early symptoms of pregnancy, due to the higher levels of progesterone. It is reasonable to take a home urine pregnancy test with a late period to differentiate. 

Many women have a time in their reproductive years when their periods are late or irregular. It is time to call a doctor if you have a positive pregnancy test, if the abnormal bleeding pattern continues for three consecutive months, or if there is no menstrual bleeding for three months in a row.

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How Late Can a Period Be Before You Know You’re Pregnant?

Home » Eugene OR How Late Can a Period Be

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Is a late period a sign of pregnancy? If you usually have regular periods and your period is overdue by less than three days, you may be pregnant and your period might be considered delinquent. Late periods can result from a variety of factors, such as lifestyle modifications and medical problems.

If you notice that your menstruation is running late! Book your next appointment with Dr. Beyerlein, Gynecologist, and Obstetrician. Contact us or visit us online to book your next appointment. We are located at 10 Coburg Rd STE 100, Eugene, OR 97401.

Table of Contents:

What is a late period?
How many days late can a period be before worrying about pregnancy?
Is there a possibility of getting pregnant just after my period has finished?
What are the symptoms of ovulation?
How early can I know my symptoms of pregnancy?

What is a late period?

The majority of people have a little variation in their periods, although a few people may have pinpoint predictability. You should not worry if your period is a couple of days late. One month you may have a 28-day cycle, and the next month you may have a 26-day cycle. It’s possible that your period is late if it has been more than 38 days since your last period or if your cycle is very consistent and your period is more than three days late.

The first sign of pregnancy is usually a missed period, but there are other reasons for lateness. These include stress, extreme diet or exercise, hormonal contraceptives, and various health conditions. It is important to seek care in order to discover the cause of a late period as it may indicate serious health concerns of pregnancy.

How many days late can a period be before worrying about pregnancy?

Keep track of your period over several months to see if there are any changes in your cycle. As a result, you’ll be able to determine what a “normal” menstrual cycle looks like for you. In most cases, if your period hasn’t started within seven days of when you expect it (most pregnancy tests will also be accurate by this point) it’s considered late.

Is there a possibility of getting pregnant just after my period has finished?

It’s possible to become pregnant shortly after your period, but it’s not very likely. During or just after your period, you can conceive (get pregnant) if you have sex without using contraception. Getting pregnant is also possible if you have never had a period before, during your first period, or after your first-time having sex.

No safe time of the month exists when you can have sex without contraception without risking pregnancy. It is most likely that you will conceive during times of your menstrual cycle when you are most fertile.

What are the symptoms of ovulation?

Each month, one of the ovaries releases an egg that is mature. During ovulation, a woman is most fertile. Around day 14 of the average 28-day cycle, counting from the first day of one period to the first day of the next, ovulation typically occurs.

Since cycles may last anywhere from 23 to 35 days, and even your own cycle and ovulation time may vary slightly from month to month, there’s a wide range of normal.

Symptoms of ovulation include the cervix softening and opening, slight pain or mild cramps in the lower abdomen, cervical mucus growing thinner and clearer, and your basal body temperature fluctuating. Additionally, sex drive may also increase, the vagina or vulva may appear swollen, and light spotting can occur.

How early can I know my symptoms of pregnancy?

Depending on the person and the pregnancy, early pregnancy signs vary. You may not notice any symptoms at all or feel changes in your body before you realize you’re pregnant. A missed period, frequent urination, tender breasts, fatigue, and morning sickness are all symptoms of early pregnancy.

Depending on how soon you become pregnant, you might feel pregnant within a few days or weeks after you take a positive pregnancy test. Symptoms of pregnancy vary from person to person and even from pregnancy to pregnancy. It is possible to feel pregnant before you miss your period. Approximately one week before missing a period, some people report feeling pregnancy symptoms.

Individuals in Eugene, OR, experiencing a late period who wish to find out why can seek care at Dr. Richard Beyerlein’s health clinic for all OBGYN services. Contact us through our website to book your next appointment today. We serve patients from Eugene OR, Springfield OR, Coburg OR, Creswell OR, Cottage Grove OR, Lowell OR, and Junction City OR.

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Suite 100 Eugene, OR 97401

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Mental disorders of late age

Mental disorders of late age are diseases that occur in presenile (presenile, involutional) and senile age. Since there are large differences in the definition of the concept of “late age”, in psychiatry, the involutionary period is usually understood as the age from 45 to 55 years, and patients older than 60 years are referred to the old age (V. M. Bleikher, I. V. Kruk “Explanatory Dictionary psychiatric terms”, 1995), which is at odds with the WHO classification, according to which patients from 60 to 74 years old are considered elderly, and persons from 75 to 90 years old are classified as old age.

The increase in life expectancy has led to a change in the age structure of the population, manifested in an increase in the proportion of elderly and senile patients and, accordingly, elderly patients who manifest certain somatic disorders, as well as severe mental disorders.

Gerontological mental disorders:

Mental disorders of late age are usually divided into diseases of “organic” origin, which arise on the basis of a certain destructive process and lead to dementia (dementia), and “functional” (reversible and, as a rule, not leading to gross dementia) disorders.

The treatment of affective (manifested by such disorders as depression or manic states) and delusional (manifested mainly by delirium) senile psychoses does not differ from the psychopharmacotherapy of similar conditions in other mental illnesses. At the European Medical Center, we use combined treatment with antipsychotics and antidepressants – depending on the patient’s condition, treatment can be started with the use of antipsychotics and, upon reaching a decrease in the patient’s anxiety-delusional arousal, it is possible to add antidepressant drugs.

If a patient with affective and affective-delusional senile (senile) psychosis is insensitive to psychotropic drugs, it is possible to prescribe the so-called electroconvulsive therapy (ECT), if there are no contraindications. Since ECT is ineffective in delusional forms of senile psychosis, treatment with antipsychotics is used.

Psychopharmacological treatment of mental disorders of late age is carried out in a multidisciplinary hospital of the European Medical Center, where patients are provided with comprehensive support and treatment – a complete physical examination is carried out, round-the-clock monitoring of the patient’s condition during therapy is provided and complications are prevented.

Parkinson’s disease is a degenerative-atrophic disease of the brain that manifests itself at a later age and is often accompanied by mental disorders. The most effective treatment for movement disorders currently used to treat Parkinson’s disease is L-DOPA, but the drug has side effects (approximately 50% of patients may experience mental disorders such as confusion, psychomotor agitation with anxiety, agitation, drowsiness, increased depression ). The appointment of L-DOPA follows after a thorough assessment of the mental state of the patient and treatment begins with small doses, which are gradually increased. If psychotic disorders occur, along with a gradual decrease in doses of antiparkinsonian drugs (up to temporary cancellation) and detoxification therapy, it is possible to prescribe small doses of psychotropic drugs.

Alzheimer’s disease – an atrophic brain disease that manifests itself mainly in presenile age, which leads to dementia and is accompanied by disorders of higher nervous activity. The prognosis of this disease is unfavorable, and today there are no proven effective methods of its treatment. In the later stages of the process, patients, as a rule, need to be hospitalized in psychiatric hospitals or placed in neuropsychiatric boarding schools.

Senile dementia is the most characteristic mental illness of senile age with a progressive breakdown of mental activity, culminating in most cases in total dementia (decrease in all intellectual functions). Some foreign psychiatrists consider senile dementia, a kind of completion of the physiological process of aging of the brain, inevitable in old age. With physiological aging, there is also a decrease in the level of mental activity, reminiscent of the initial symptoms of senile dementia. Proper care and symptomatic therapy are important for the fate of such patients – at the initial stage of the disease, patients are recommended to be left in their usual home environment (if their condition allows). Transfer to an unusual (including hospital) environment can cause an aggravation of the course of the disease. Patients are hospitalized only for special indications (helplessness, lack of care, danger to themselves and others).

There are no convincing data indicating the effectiveness of the treatment of senile dementia with nootropic drugs, and therefore such therapy can be recommended only in the initial stages of the disease, as well as in the combination of senile dementia with cerebral atherosclerosis. Psychotropic drugs in very small doses are indicated only when the patient is very agitated, persistent insomnia or psychotic disorders.

Compression syndrome – causes, symptoms, diagnosis and treatment

Positional Compression Syndrome is a complex of symptoms that occur when soft tissues are injured caused by prolonged compression by one’s own body weight. It develops in the absence of primary damage and is most often associated with the unconscious state of the patient. The syndrome is characterized by purple spots, abrasions and superficial necrosis of the affected area of ​​the body, signs of kidney dysfunction. Diagnosis includes a thorough history taking and examination of the patient, blood and urine tests, ultrasound and radiography of the affected area. Treatment involves extracorporeal detoxification methods, infusion therapy, symptomatic drugs.

General information

The disease was first described in 1754 in Vienna during the autopsy of the bodies of those who died during a fire. The true frequency of positional compression syndrome (SPS) has not been established. This is due to the difficulties of its diagnosis during the initial examination and the hushing up by the victims of the conditions of the injury, if it appeared as a result of severe alcohol or drug intoxication. The severity of the immediate and long-term consequences of SPS require practitioners to improve care protocols and develop more effective methods of treatment.

Positional compression syndrome

Causes

Positional compression syndrome is defined by many authors as a compression injury. Most cases of SPS are associated with the unconscious state of the victim, due to which the person is not able to control the position of his body and can be in an uncomfortable position for hours. The reasons for this condition are:

• The use of surfactants. The most common cause of pathology is considered to be excessive intake of alcohol or its surrogates, which cause deep intoxication and loss of consciousness. SPS also develops with drug intoxication, especially with the introduction of opiates, tranquilizers and other substances with a strong sedative effect.
• Intoxication. Poisoning with loss of consciousness is characteristic of inhalation of carbon monoxide and exhaust gases. This situation happens during a fire, a long stay in an unventilated garage. Much less often, the cause of positional compression is intoxication with nitro dyes and other toxic substances.
• Traumatic brain injury. Severe brain damage is accompanied by prolonged loss of consciousness. If a person is not helped in time, he falls in an uncomfortable position and stays in it for a long time.

Pathogenesis

General and local changes are distinguished in the mechanism of SPS development. General disorders are caused by the action of the etiological factor of the disease, which leads to acid-base imbalance, deterioration of microcirculation, hypothermia of the body. These causes are superimposed on an unconscious or comatose state, causing severe local changes in the affected tissues.

The key point of pathogenesis is the deterioration of tissue blood supply, which causes the formation of myoglobin. Normally, it is found only intracellularly, the largest amounts of pigment are found in skeletal and cardiac muscles. With positional compression syndrome, myoglobinemia and myoglobinuria occur. Excess pigment accumulates in the renal tubules and clogs them, causing acute renal failure.

Positional compression syndrome

Classification

In practical traumatology and resuscitation, 5 periods of the disease are distinguished: acute, early, intermediate, late and the stage of long-term results. They are important for predicting possible symptoms and their timely treatment in order to prevent the development of complications of SPS. Of great importance for practitioners is the classification by severity, according to which the syndrome is divided into 3 degrees:

• Light. Occurs when small areas of the body are affected: forearms, lower legs, head. With mild severity, the time of positional compression does not exceed 6 hours.
• Medium. Develops when extensive areas of the body are affected: thighs, upper or lower limb completely. The duration of compression increases to 6-10 hours.
• Heavy. Manifested with massive compression of one or more parts of the body. The compression time is 10-24 hours: the longer the compression syndrome lasts, the worse the prognosis for the patient.

Symptoms

In the clinical course of the positional compression syndrome, 5 periods are distinguished, which successively replace each other. In the first (acute) phase, intoxication, loss of consciousness and other signs are observed, depending on the specific etiological factor. Most patients develop a coma that lasts from several hours to several days. This period is characterized by various changes in the compressed tissues and throughout the body.

In the second (early) stage, symptoms of tissue damage appear. Most often, the upper and lower limbs are subject to compression. On examination, red-bluish spots on the skin are observed, occasionally they are covered with abrasions, small hematomas and areas of maceration. With prolonged compression, detachment of the epidermis is determined with the formation of vesicles that are filled with a cloudy or bloody liquid. Patients complain of pain, a feeling of fullness, numbness of the limb.

After the pressure is eliminated, blood begins to actively flow to the limb, which is externally manifested by edema. The tissues are sharply tense, the skin becomes pale and cold. Puffiness is accompanied by compression of the arteries, therefore, in the distal extremities, the vascular pulsation is sharply weakened or not detected at all. Such symptoms are complemented by a sharp limitation of mobility, which is associated with severe pain and swelling.

The early stage of positional compression is accompanied by endogenous intoxication. Immediately after leaving the coma, general malaise, lethargy, nausea and vomiting appear. Characterized by an increase in temperature to subfebrile values. Patients experience shortness of breath, deafness of heart tones, dry mouth. Damage to the kidneys and other organs with the development of multiple organ failure marks the transition to the third (intermediate) period of the disease.

The fourth (late) stage of the compression syndrome is characterized by a gradual restoration of the work of all organs and systems. It begins within 10-25 days after soft tissue injury. With successful treatment, SPS enters the fifth phase – the period of long-term results. It lasts from 3 months to 2 years, is characterized by late consequences on the part of the affected limb, kidneys and other organs.

Complications

The main problem of positional compression syndrome is acute renal failure, which is associated with massive myoglobinemia. The development of acute renal failure 3 times increases the likelihood of death in the victim and correlates with an unfavorable long-term prognosis. Of great importance are the complications of the underlying disease or intoxication, which caused compression of the soft tissues of the body.

Diagnostics

Examination of the patient is carried out by an intensive care physician or a traumatologist, depending on the prevailing symptoms. A detailed history taking comes to the fore: it is necessary to clarify the circumstances that preceded the injury, find out the exact position of the victim, exclude chemical addictions and other risk factors. The following methods are used to diagnose positional compression syndrome:

• Soft tissue ultrasound. Ultrasound diagnostics shows signs of damage to compressed muscles: blurring of the muscle pattern, absence of transverse striation, mosaic hypoechoic zones (foci of myolysis). To exclude venous causes of SPS, dopplerography of the vessels of the affected area is prescribed.
• Radiography. X-ray imaging is informative to exclude dislocations and fractures, which, in combination with external skin lesions, give a similar clinical picture. With positional compression syndrome, radiographic changes are absent.
• ECG. On the electrocardiogram, signs of hyperkalemia are determined: a change in the QT interval, an increase in T waves in the chest leads, single bigeminia and ventricular extrasystoles. The study is supplemented by ultrasound of the heart, in which pathological changes are not detected.
• Biochemical blood test. The main diagnostic sign is an increase in blood myoglobin above 1000 ng/ml, which correlates with a high risk of kidney damage. An increase in blood creatinine indicates the development of renal dysfunction, in combination with reduced glomerular filtration, the diagnosis is confirmed.
• Urinalysis. In SPS, urine has a specific gravity greater than 1015 and contains large amounts of myoglobin. Osmolarity is over 500 mosm/l, sodium level does not exceed 20 mmol/l. The ratio of osmolarity of urine and plasma is more than 1.1.

Differential diagnosis

When a patient with compression syndrome is admitted, a complex differential diagnosis is carried out between positional tissue compression and classic crush syndrome. Distinctive features of SPS are the absence of pain and traumatic shock, the lack of information about the patient getting under the rubble. Be sure to exclude venous thrombosis and thrombophlebitis, dislocation and fracture of the limb.

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Fasciotomy for SPS

Treatment of positional compression syndrome

In the prehospital stage, patients receive emergency care according to a generally accepted protocol. Medicines are prescribed to support cardiac activity and other vital functions. To eliminate the pain syndrome after the return of consciousness, injectable analgesics are used, according to indications – narcotic ones. The affected limb is tightly bandaged, it is immobilized and local hypothermia is carried out to prevent edema.

Further treatment is carried out in a hospital. Drug therapy includes infusion solutions, diuretics, extracorporeal detoxification (hemodialysis) for severe renal impairment. In case of poisoning with established poisons, specific antidotes are used.