Why Is My Period Late? – Cleveland Clinic

There’s nothing like a late period to add some extra stress to your life. The most obvious culprit — pregnancy — is one possibility, but there are lots of other reasons.

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Ob/Gyn Erin Higgins, MD, explains why late periods happen and what to do if yours is MIA.

What is a “late” period?

Although a few people might have pinpoint predictability with periods, most have a little variation. So if your period is a day or two late, don’t panic.

“Your menstrual cycle is the length of time from day one of your period to day one of your next period,” Dr. Higgins says. “On average, these cycles are 24 to 38 days long.”

That means that a 28-day cycle one month and a 26-day cycle the next month is probably nothing to worry about. Your period might be considered late if:

• It’s been more than 38 days since your last period.
• You’re normally really regular, and your period is more than three days late.

Things that delay your period

A missed period is often the first sign of pregnancy, but there are other reasons for lateness, too. Here are some other factors that can delay your monthly flow:

Extreme diet and exercise

A healthy diet and regular exercise can do wonders for your health. But if you overdo it, you might say bye-bye to your periods, at least temporarily.

“Athletes who train really hard or who don’t get enough calories may stop menstruating,” Dr. Higgins says. “It’s the body’s way of telling you that it doesn’t have enough resources to support a pregnancy.”

When your periods stop due to weight loss, diet or exercise, you’re experiencing secondary amenorrhea. This means you previously had periods, but they have stopped. Secondary amenorrhea might happen to you if you:

• Eat an extreme, calorie-restricted diet.
• Have an eating disorder, such as anorexia or bulimia.
• Lose a lot of weight in a short amount of time.
• Undergo hardcore exercise training, such as for a marathon.

Polycystic ovary syndrome (PCOS)

PCOS is a hormonal imbalance that interferes with the release of an egg (ovulation). When you don’t ovulate, you usually don’t have a period. Many people with PCOS have irregular, late or missing periods. Other symptoms of PCOS include:

• Acne.
• Excess facial or body hair.
• Thinning hair.
• Weight gain or trouble losing weight.

Doctors diagnose PCOS by checking your symptoms and performing medical tests when needed. Medication and lifestyle changes can help manage the symptoms.

Stress

High levels of stress aren’t just a drain on your mental well-being. They can cause physical symptoms, too — and your periods could be in the line of fire.

“Minor, everyday stress usually won’t affect your period,” Dr. Higgins says. “But big-time stressors interfere with your body’s delicate hormone balance, which can ultimately make your period late.”

Some examples of major stress include:

• Death of a loved one.
• High school or college exams.
• Job loss.
• Major life events, such as a wedding.

Hormonal contraceptives

Hormonal birth control contains progestin or a combination of progestin and estrogen. These hormones stop ovulation and prevent pregnancy. Hormonal contraceptives include:

• Oral contraceptive (“the pill”): These are pills you take every day.
• Birth control patch: This is a sticker that you place on your skin and replace each week.
• Vaginal ring: You place this ring-shaped device in your vagina and change it once a month.
• Injectable contraceptive: This is a shot your doctor gives you every three months.
• Hormonal implant: This implant is a tiny rod-shaped device that a doctor places under the skin in your upper arm.
• Hormonal intrauterine device (IUD): This is a T-shaped device that your doctor places inside your uterus.

Some hormonal birth control causes a false period known as withdrawal bleeding. You’ll have this “period” when you have your hormone-free week with the pill, ring or patch. But if you keep taking the contraceptive without the hormone-free week, you might have some light spotting or no period at all.

“It’s OK to miss a period if you’re taking hormonal contraceptives continuously,” Dr. Higgins says. “But ask your doctor before trying it to be sure it’s safe for you.”

Thyroid conditions

Your thyroid gland is a butterfly-shaped gland at the base of your neck. And it’s one of the many hormonal mechanisms that help dictate your periods. If it’s overactive (hyperthyroidism) or underactive (hypothyroidism), you might have a late period.

“Thyroid problems are common, affecting more than 10% of women,” Dr. Higgins says. “They can cause irregular or missing periods and can be mistaken for menopause.”

Youth

It’s the rare young person who starts menstruating and immediately has a 28-day cycle every month. Usually, it takes a few years for things to settle down. That’s because preteens and teens have an immature hypothalamic-pituitary-ovarian (HPO) axis.

“The HPO axis is the hormonal system that regulates your ovulation and menstrual cycles,” Dr. Higgins says. “It takes a few years for the HPO axis to mature and regulate your periods.”

Typically, your period should even out and become more predictable in your late teens and 20s.

Perimenopause

Perimenopause is the transition from the reproductive years to menopause. This transition might take a year or two, or it could take several years. And during this time, your cycle might be all over the place. It could be 25 days one month and 29 the next.

“Irregular periods during perimenopause are OK,” Dr. Higgins says, “but if your periods are consistently getting heavier or closer together, see your doctor.”

The average age of menopause is 51, so perimenopause often begins in your 40s or 50s. Usually, perimenopause comes with other symptoms, too, such as:

• Hot flashes.
• Insomnia.
• Mood changes.
• Night sweats.
• Vaginal dryness.

Don’t ignore a missed period

If you keep track of your periods, you’ll probably know right away if something is amiss. Keep a period diary in your calendar or get an app designed for that purpose. Your period records can provide valuable information for you and your doctor.

“Doctors want to know details about your previous periods so we can determine if there’s an issue,” Dr. Higgins says. “An occasional late period is often the result of something minor, but if you frequently have late or irregular periods, check with your doctor to rule out other health conditions.”

Missed Periods (Causes, Symptoms, and Treatment)

Causes of a missed period

Often there is nothing to worry about when periods stop, and no serious cause. There are certain times when it is normal not to have periods. These include:

• Before puberty. Girls start to go through puberty from around the age of 9 years and their periods start a year or two later. Up until that point girls do not have periods.
• During pregnancy. If you are pregnant, your periods will normally stop until after the baby is born.
• During breastfeeding. If you are fully breastfeeding, you will normally not have a period until you stop. You may find you have a bleed if you drop a feed, or start to breastfeed less.
• After menopause. The menopause is the time in your life when your ovaries stop producing eggs and you stop having periods. The average menopause is around the age of 51. You will be classed as having gone through the menopause a year after your last period. However, it is extremely common for your periods to become less regular in the years leading up to the menopause. See the separate leaflet called Menopause (including HRT) for more details. 
• If you are using certain types of contraception. Some types of contraception may stop periods. They do not do so in all women; however, it is normal not to have periods (or to have very light periods) if you are using:

Stress

Stress affects the chemical messengers called hormones which are released from your brain. These hormones then go on to affect other hormones released from your ovaries which normally trigger your periods. Stress or a sudden shock can stop your periods in this way. Usually if this is the case, they resume naturally over some time.

How much stress can cause a late period?

Dr Sarah Jarvis MBE

Low body weight

Losing weight may result in periods stopping. This can occur if your body mass index (BMI) goes below 19. If you have an eating disorder called anorexia nervosa, losing too much weight can result in your periods stopping. It may also happen to athletes, gymnasts, long-distance runners and people who do an excessive amount of exercise.

What does weight have to do with missed periods?

Dr Sarah Jarvis MBE

Polycystic ovary syndrome (PCOS)

PCOS is a common condition which can cause periods to be very infrequent or sometimes stop altogether. Women with PCOS may have other symptoms such as difficulty losing weight, spots (acne) and too much body hair. See the separate leaflet called Polycystic Ovary Syndrome for more details.

Hormone problems

A number of conditions which affect hormone levels may cause missed periods. This includes:

• A condition where a hormone called prolactin is too high. This is called hyperprolactinaemia. The most common cause of this is a non-cancerous (benign) growth in the brain, called a prolactinoma.
• Conditions affecting a gland in your neck, called the thyroid gland. The thyroid gland produces hormones which may affect periods. If you are producing either too much hormone (hyperthyroidism) or too little (hypothyroidism), your periods may be affected.
• Congenital adrenal hyperplasia. This is a rare inherited condition where steroid hormones of the adrenal glands are not produced normally. There are different forms of this condition but some can lead to absent or infrequent periods.
• Another disorder of the steroid hormones, called Cushing’s syndrome. 

Genetic problems

Genes are the building blocks of our cells and give us our individual characteristics. Genetic conditions are those which are inherited from our parents or due to abnormal genes. In rare cases, abnormal genes can be a cause of not having periods. In most of these, there will be primary amenorrhoea (ie periods never start). One example of this is Turner syndrome. In this condition, girls tend to be short, have particular features and have ovaries which do not work properly. They often do not start periods when other girls of their age do. See the separate leaflet called Turner Syndrome for more details.

Other genetic conditions may cause differences in genitals and female organs. For example, in a condition called androgen resistance syndrome, the child has female genitals outside but no female organs on the inside. With no ovaries or womb (uterus), these children will not have periods.

Occasionally babies do not develop normally in the womb before birth and may be born with problems which will prevent periods. For example, rarely a girl may be born without a vagina, or with a blockage in the vagina. Sometimes the first time this is apparent is when she does not start to have periods as expected.

Early menopause

The average time for women’s periods to stop in the UK is at the age of 51. However, there is quite a wide range. If periods stop before the age of 40, this is very early and is said to be premature menopause. If periods stop between 40 and 45 years of age, it is called early menopause. At the menopause, periods stop and there are usually other symptoms of menopause such as hot flushes.

Medicines and medical treatment

As discussed above, a number of contraceptive treatments can stop you having periods. Other medicines can affect periods too. Examples are some medicines for schizophrenia (antipsychotic medicines), an anti-sickness medicine called metoclopramide and strong painkillers called opiates.

A number of operations may result in absent periods. For example, after a hysterectomy you will not have periods. A hysterectomy is an operation where the womb is removed. As the blood during a period comes from the womb, you will never have periods again afterwards. Another operation (called endometrial ablation), which is sometimes done for heavy periods, also causes periods to stop. In this operation the lining of the womb is removed. This is not usually permanent and periods start again in time.

Treatments for cancer, such as radiotherapy or chemotherapy, can also damage the ovaries and result in absent periods. Recreational drugs such as heroin may also cause periods to stop.

Getting back to normal after stopping contraception

When you have been on the combined oral contraceptive (COC) pill or an injection form of contraception, it can take a while for your periods to restart once you stop the contraception. It can take a few months for your body’s own cycle to restart and it can take several months before you have a period.

What should I do if I have not started my period?

Girls start their periods at a very variable age. So it may be that your friends have been having periods for a while but you have not. Usually this will be normal variation and nothing to worry about. Ask your doctor’s advice if:

• You are 16 years old or older and still have no periods.
• You are 14 years old or older and have not developed breasts or pubic hair and do not have periods.
• You have a pain in your tummy every month but no bleeding.
• You can feel a lump in the lower part of your tummy.
• You have had sex without using contraception (ie if there is any chance you could be pregnant).
• You have lost weight or have symptoms of anorexia nervosa. (See the separate leaflet called Anorexia Nervosa for more details.)
• You feel unwell in yourself in any other way.

What should I do if I have missed my period?

Don’t panic! In most cases there is nothing serious going on. The most important thing to do is to do a pregnancy test if there is any chance at all you could be pregnant. If you otherwise feel well in yourself, and you are not pregnant, then the chances are your periods will start up again in due course.

You should consult a doctor if:

• You have not had a period for three months and your periods were previously regular.
• You have not had a period for 6-9 months but your periods have always been infrequent.
• You could be pregnant.
• You wish to become pregnant.
• You have hot flushes or night sweats and are under the age of 45.
• You have lost weight or your BMI is 19 or less.
• You or someone close to you is concerned about your eating or weight.
• You have milk leaking from your breasts and are not breastfeeding.
• You feel unwell in yourself (for example, headaches, changes in your vision, have lost or gained weight).
• You have not had a period for six months after stopping the contraceptive pill (or 12 months after the last contraceptive injection).
• You are worried about your lack of periods.

Will I need any tests for a missed period?

If you go to see a doctor about your periods stopping, first of all the doctor will ask you some questions. For example, the doctor will want to know:

• If you have ever had periods and whether they were regular.
• How long you have not had periods for.
• If you have recently been using any contraception.
• If you are on any medication or have any other medical conditions.
• If you have recently lost weight.
• If you are under any stress.
• If there is any chance you could be pregnant.
• If you have any other symptoms, such as hot flushes or milk leaking from your breasts. (Hot flushes may suggest an early menopause; milk leaking from your breasts suggests high levels of the hormone prolactin, discussed above.) The doctor may also ask about signs of pregnancy such as morning sickness or tender breasts.

Your doctor may then wish to examine you. The doctor may want to check your weight and height and then work out your BMI. They may also want to feel your tummy. They may want to look for signs of possible causes. (For example, excess body hair suggesting PCOS, or a lump in the neck suggesting a problem with the thyroid gland.) In some cases an internal examination may be needed.

Whether further tests are needed will depend on what has been discovered from talking to you and examining you. You may not need any tests at all. Tests which may be needed include:

• A pregnancy test (usually checked from a sample of urine).
• Blood tests. These are done to check out a number of possible causes. They may be done to check hormone levels (such as thyroid hormones and prolactin as discussed above, or the levels of hormones coming from the ovary). Occasionally tests for gene abnormalities may be needed.
• An ultrasound scan. (This may be needed to check your internal organs are normal, especially if you and your doctor wish to avoid an internal examination. This might be the case, for example, in young girls who have not started their periods.)

How are absent periods treated?

This depends on the cause. In many cases no treatment is needed. See the specific leaflets about the various causes for information on how each is treated.

Are there any complications of missed periods?

In the short term, there are no complications of missing a few periods. However, if it goes on for a longer time, it may cause some problems.

Infertility

Women who are not having periods may not be producing eggs from their ovaries (ovulating). This would mean they would not be able to become pregnant naturally. For some women this may be an issue. However, for many causes, there is treatment to help with this, so discuss it with your doctor if you want to become pregnant. See the separate leaflet called Infertility for more details.

Weak bones (osteoporosis)

When the absent periods are combined with low levels of the female hormone oestrogen, there may be a risk of bones weakening. Oestrogen helps keep bones strong, and they start to weaken after menopause. If they become excessively weak and break (fracture) easily, this is called osteoporosis. This only applies to women who have not had a period for a long time (a year or more). It is particularly a risk for women whose periods have stopped due to early menopause, weight loss, anorexia nervosa or excessive exercise.

Heart disease

It is suspected that low oestrogen levels also put a woman at risk of heart disease. Also women with PCOS are more likely to develop risk factors for heart disease, such as high blood pressure, high cholesterol levels, and diabetes. A healthy diet is particularly important for women with PCOS to reduce the risk.

Irregular periods

Other patterns of periods which are different to normal may also occur, as follows.

Infrequent periods

Having periods less often than normal is called oligomenorrhoea. The causes of this are much the same as the causes of absent periods discussed above. The most common cause is PCOS.

Erratic periods

For some women, periods don’t happen regularly but seem to come at unexpected times. Some months the gap between periods may be shorter than 28 days and other months it may be longer. This is common in teenage girls starting their periods and may go on for a few years as hormones settle down. It is also common in women as they approach the menopause. Often no cause is found and doctors put it down to a condition called ‘dysfunctional uterine bleeding’. This means no abnormality has been found to account for it and there is nothing to worry about. If bleeding is heavy, or the erratic cycle is a problem, there are treatments which can help, so contact your doctor.

Bleeding between periods

There are many causes for bleeding between periods. It is common in the first 2-3 months after starting the combined oral contraceptive (COC) pill.

In all other circumstances, contact your doctor if you have bleeding between your periods or bleeding after sex. You will need an examination and possibly some tests to find out the cause.

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.  

‘I’m 4 Days Late, Am I Pregnant?’ Plus Other Explanations

For many women, pregnancy is a celebrated event and an important time in their lives.

It is natural for these women to expect good news after a missed period and perhaps a positive home pregnancy test! However, women who do not want to fall pregnant might experience anxiety about irregular periods.

So, if your period is four days late and you are worried you might be pregnant, this article can offer some advice. As a matter of fact, pregnancy is not the only cause of missed periods. Factors like stress, excess workload, medical conditions like Polycystic Ovary Syndrome (PCOS), thyroid disease, and hormone changes are all frequently linked with a common symptom: an irregular period. You can read this article to further explore these factors and try to determine the cause of your late period. Of course, it goes without saying that any concerns over your health should always be discussed with a doctor too.

For more, you can also read about whether [implantation bleeding can be heavy] or whether [you can be pregnant and still have your period].

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My Period Is 4 Days Late: Am I Pregnant?

To answer this, we must understand what a period is and why it stops during gestation. Women have a pair of ovaries that produce a mature egg each month under the influence of hormones, estrogen, and progesterone. This is known as the process of ovulation. In pregnancy, these hormones are also responsible for creating a soft lining inside the uterus. However, if pregnancy doesn’t occur, then this extra lining is shed out in the form of blood at a certain point in our menstrual cycle.

Considering this cycle, it is natural to assume that a late period or missed period is a sign of pregnancy. For most women, the logical next line of action after experiencing a missed period is to take a pregnancy test. A positive result in this test will show if you are pregnant, but you may also experience other early signs of pregnancy like nausea, (also known as morning sickness), fatigue, selective hunger, unexplained cramps in the pelvic region, increased moodiness, or irritability and tender or sore breasts.

If you are experiencing any or all of these symptoms you could be pregnant, but without a positive pregnancy test result, this cannot be confirmed.

Will A Pregnancy Test Work 4 Days After A Missed Period?

A pregnancy test works on the principle of detecting a hormone in your urine called human chorionic gonadotrophin. This hormone is produced as a result of the implantation of the embryo in early pregnancy. The production of this hormone usually starts one week after zygote formation.

Most doctors and medical professionals suggest that the best or most accurate pregnancy test result is obtained on the first day of a missed period, and during the morning when urine is moderately concentrated. Human chorionic gonadotrophin can be easily detected at this time. You can also wait until day five or six of a missed period to take a pregnancy test. This will eliminate the chance of false-negative pregnancy test results to a large extent. Also, since many women experience irregular menstrual cycles, it is generally suggested to take a test two weeks after unprotected sex to be sure.

So, in a nutshell, yes, a pregnancy test will work after four days of a missed period and it should be an accurate test since levels of human chorionic gonadotrophins will be high during this time if you are pregnant. However, it is worth noting that if your test reveals a negative result but you continue to experience early pregnancy symptoms, you should request a clinical pregnancy test from your doctor to rule out any confusion.

Generally, a false negative result occurs when we take the test too early or don’t follow the instructions correctly. A false positive (very rare) is generally due to the presence of particular drugs in your urine, including, sometimes, fertility drugs.

Other Reasons For A Late Period

The human body is a wonder in its own right where thousands of metabolic reactions are occurring at the same time. Considering this it is no surprise that there is a wide range of reasons why a woman’s period may be late. When your period is late, it can be concerning, but remember that it is normal for girls in early puberty to experience irregular cycles or periods since their body is adapting to these new changes. However, a late period in adult women might signify something else. Let’s understand the possible other reasons for a late period.

Polycystic Ovary Syndrome (PCOS)

One of the most common causes of a late period is this endocrine disorder. The World Health Organization predicts that this disorder has affected 116 million women worldwide since 2012. It is a complex genetic disorder suffered by women. Women suffering from PCOS experience a hormonal imbalance that makes them produce more male hormones, collectively known as androgens. These androgens develop certain male characters in such females as excess facial or body hair, weight gain, or irregular periods. The exact cause of this disorder is unknown. It is advisable to visit a doctor if you believe that you might be suffering from PCOS as this disorder has potential long-term effects on women’s fertility and requires appropriate treatment.

Taking Birth Control

The most popular and common form of birth control for women is the hormonal pill that is taken to prevent pregnancy after unprotected sex. These pills cause hormonal changes that affect ovulation and therefore can cause a late period. Other health effects of these hormonal pills can include spotting in between your cycle or period and mood swings. If your particular type of birth control is causing a difficult menstrual cycle, you should visit your health care provider or doctor to explore alternatives.

Stress

Stress affects the regular functioning of the brain and therefore, under stressful circumstances, the glands required to produce the hormones needed to regulate your menstrual cycle can be affected, initiating a hormonal imbalance is initiated. This can lead to late cycles. If you are overly stressed, regular meditation can sometimes help, and do not delay seeking help from a professional if required.

Menopause

The menopause is a natural part of a woman’s life cycle that marks the end of their fertility. This usually occurs when a woman is in her late 40s or 50s, but this differs for every woman. Common symptoms you may experience include an uneven period or late period, mood swings, hot flushes, and night sweats. If you are experiencing these symptoms and are concerned that it is happening before the normal age range, you may have perimenopause and should contact your doctor for advice and information.

Other Medical Factors

If you are diagnosed with medical issues including thyroid problems, endometriosis, or uterine fibroids, it can be relatively common to have an irregular menstrual cycle. If you have gained or lost a considerable amount of weight recently, then this can be a reason why your period is late too. Again, it is advisable to seek treatment from a doctor if you think you might be suffering from any of these conditions.

In a nutshell, a late period is normal during early puberty and can also be a sign of pregnancy for some, but it may also indicate potential health issues if it persists. There is no need to worry straight away if your period is late, but please keep an eye out for any of the symptoms listed above, contact a doctor if you have any concerns, and take a test to rule pregnancy out.

If you found this article helpful, then why not take a look at our guide to [how long after IUD removal you can get pregnant] or this [ovulation after miscarriage calculator]?

12 reasons why you’ve got period symptoms but no period

You’ve been seriously bloated, moody and tired. You’ve got monster cramps, and your face is as pimply as a 17-year-old boy’s. In other words, you’re suffering from all of the classic signs of your monthly flow – but your period is totally MIA.

First: Don’t freak. It turns out, there are tons of reasons you’ve got those tell-tale period symptoms, but no period.

“Hormonal changes related to ovulation can affect some of the same pathways in your brain that might be affected by other medical conditions, causing mood swings that feel similar to your period but aren’t related to ovulation or menses,” says Dr Chailee Moss, an obstetrician and gynaecologist at Johns Hopkins Medicine. What’s more, some physical abnormalities in your uterus and ovaries can also cause cramping that feels like PMS, she adds.

While skipping a period every now and then is usually nothing to worry about, if you have a fever, significant nausea or vomiting, or pain that you can’t control with simple OTC medications or that doesn’t improve within a week, check in with your doctor right away.

Otherwise, it’s time to see your doctor if you skip more than three cycles in a row, suggests Chicago-based obstetrician and gynaecologist Dr Jessica Shepherd – here’s what might be going on down there.

1. Anovulation

Every once in a while, your body goes through all of the hormonal changes associated with PMS, but if you didn’t actually release an egg that month, you won’t actually get your period. Known as anovulation, it’s more common than one might think. “Ten to 18% of all regular cycles are anovulatory,” Dr Shepherd adds. In case you’re wondering, yes, that stat can make getting pregnant tricky!

Read more: 6 times your period blood looks different — and what it means about your health

2. Pregnancy

If you’ve had unprotected sex in the last month, were a bit lax about taking your pill, or rely on the pullout method for birth control, it’s worth taking a pregnancy test. Many of the symptoms of early pregnancy, including breast tenderness, mood swings, fatigue and cramping, are the same ones that you were already experiencing month to month before and during your period.

Think there’s a chance you could be pregnant? Take an at-home pregnancy test on the day that you expect your period. If it comes back negative, wait three to four days and try again. “One to two days can make a difference in a positive pregnancy test,” says Dr Moss.

3. Thyroid conditions

Your thyroid, a small butterfly-shaped gland in your neck, regulates many of your body’s functions, including your metabolism and menstrual cycles. If your thyroid gets out of whack, your cycles can become irregular, says Dr Shepherd. The result: You may you go a long stretch without having your period while still experiencing period-like symptoms, says Dr Moss.

Because your thyroid regulates your brain function, mood swings that you thought were PMS may be related to your neurologic function, she explains. And spotting or cramping may occur because the lining of your uterus has built up but hasn’t shed because you’re not ovulating.

Be sure to check in with your doctor if you’re experiencing other symptoms of a thyroid condition, including sudden unexplained weight loss or gain, shaking, heart palpitations or significant fatigue.

Read more: 5 alternatives to pads and tampons you should think about trying

4. Hormonal birth control

One very common side effect of hormonal IUDs is skipped periods. That’s because one of the ways the device prevents pregnancy is by thinning out the endometrial lining so there’s nothing to shed come that time of the month.

And, while they don’t typically nix your flow altogether, birth control pills can result in super-light flows or spotting. So you might feel period symptoms like breast tenderness even without a heavy, full-blown period, says Dr Shepherd.

5. Stress

Stress is a surprisingly common reason for missing your period. “Stress increases your cortisol levels, which affects your hormone balance,” says Dr Shepherd – including the hormones that regulate your ovaries and uterine lining.

Exams, the death of a family member and divorce are all big-time stress-inducing events that can cause periods to go awry. But these life-changing biggies aren’t the only reasons you might be feeling the effects of stress.

“Some people don’t realise they’re so stressed, but once they talk about it they realise they are going through something,” says Dr Shepherd. If you think stress is messing with your periods, talk to your doctor; therapy, exercise, yoga and meditation can all help get your stress under control and your periods back on track.

Read more: 5 period symptoms that might signal a serious health problem

6. PCOS

Frequent skipped periods can be caused by polycystic ovarian syndrome (PCOS). “PCOS is a condition in which a patient has an excess of androgens, which are chemicals in the body that affect ovary function, hair growth, weight gain and sensitivity to insulin,” says Dr Moss.

PCOS can result in anovulatory cycles and irregular spotting. It commonly causes cysts to grow on the ovaries, which, if they rupture or cause the ovary to twist, can cause pelvic pain that feels a lot like period cramps.

Up to 20% of women worldwide are affected by PCOS, and it’s more common among women who are overweight or have a mom or sister with by the condition, Dr Moss says. If you think you might be suffering from PCOS, check in with your doctor. While there is no cure, birth control and other medications can help keep symptoms under wraps and get your periods back on track.

7. Uterine polyps

You might associate polyps with your colon, but the same small benign tumors can grow in your uterus. “It’s an overgrowth of lining of the uterus,” says Dr Moss. Polyps in your uterus can cause cramping and period-like discomfort, even when you’re not on your period.

Because polyps can make it harder to get pregnant, and because there is a small risk they may develop into uterine cancer down the line, your doctor will likely want to remove them, most often with a relatively simple procedure known as a hysteroscopy. During a hysteroscopy, a doctor inserts a long tube up through the vagina and into the uterus. The doctor is able to use the scope to both see and cut out the polyps.

Read more: 11 signs your PMS is actually premenstrual dysphoric disorder

8. Ovarian cysts

Every month, your ovaries make several cysts in preparation for ovulation, but only one cyst releases an egg. Although the others usually dissipate on their own by the time you get your period, sometimes one cyst (or more) sticks around.

Cysts can also occur if you have an anovulatory cycle (such as with PCOS). Ovarian cysts often cause no symptoms at all, although they can sometimes trigger period-like pain when you’re not on your period. So if you’re experiencing irregular cramping, talk with your doctor.

“Cysts in and of themselves aren’t usually a problem,” says Dr Moss. “But if they get particularly large, they can cause the ovary to twist, which is painful and requires an emergency procedure to save your ovary.”

9. Gynaecological infections

Some sexually transmitted infections like gonorrhoea and chlamydia can result in a condition known as pelvic inflammatory disease, which can cause significant discomfort that feels like period cramping when you’re not expecting your period. UTIs can also cause period-similar pelvic pain, says Dr Moss.

Whatever your down-there infection, a round of antibiotics should help clear it up. So keep an eye out for red-flag symptoms including fever, significant nausea or vomiting, or pain that doesn’t go away with OTC pain relievers.

Read more: The surprising reason you’re getting side pains once a month

10. Mittelschmerz

If you’ve got PMS-like cramping, bloating, and breast tenderness but no period, one reason may be that it’s not quite time for your period yet – but it’s coming.

German for “middle pain”, mittelschmerz happens about half-way through your menstrual cycle – around day 14 or the time they ovulate, says Dr Nicole Scott, an obstetrician and gynaecologist at IU Health. It’s a totally normal experience – affecting about 20% of women – and it doesn’t mean anything is wrong, she says. Since it’s just your ovaries doing their thing, there’s not much you can do to prevent it and the symptoms should go away within a day or two but if it’s extremely painful or comes with any sign of infection, call your doctor, she adds.

11. Exercising too much

Hitting the gym on the regular is one of the best things you can do to help deal with PMS, but working out too hard or too often can actually mess up your cycle and in some cases make you miss your period all together, Dr Scott says.

All the physical stress, especially if you lose a lot of body fat, can make your period go AWOL and cause abnormal fluctuations in your hormone levels. These fluctuations can cause moodiness, irregular spotting, acne and other PMS-like symptoms. If you miss your period for three cycles or more in a row, talk to your doctor.

12. Ovarian cancer

Ovarian cancer is relatively rare, affecting only about 22 000 women a year in the US, but it’s one of the deadliest cancers for women, killing about 14 000 women a year. A big part of this is because it often shows no, or very subtle, symptoms, Dr Scott says.

Missing your period isn’t the most common symptom of ovarian cancer – those are abdominal bloating, urinary problems, weight loss and pain – but it is a possible symptom, according to the American Cancer Society. So if you’ve missed your period for three months or more or you have other concerning symptoms, call your doctor immediately.

^{This article was originally published on www.womenshealthmag.com}

^{Image credit: iStock} 

15 Early Pregnancy Symptoms Before Missed Period

When you are eager to get pregnant, you could be closely tracking your ovulation and mating with your partner accordingly. And, you may want to know the result as soon as possible, rather than wait until you miss your period. But can you know if you are pregnant even before you missed your period?

A missed period could be the first major sign of pregnancy. But only a pregnancy test, a blood test, or an ultrasound scan may confirm your pregnancy. Although some changes begin to happen even before you miss your period, they are not accurate and may not necessarily confirm the pregnancy.

In this MomJunction post, we tell you how pregnancy symptoms vary from PMS symptoms, the possible symptoms of pregnancy before a missed period, and whether you can rely on them to confirm pregnancy.

PMS Symptoms vs. Pregnancy Symptoms

PMS (pre-menstrual syndrome) and pregnancy symptoms are quite similar, but some of them (such as basal body temperature, darkening areolas, nausea, food aversions on cravings) may become more pronounced and severe in pregnancy. Taking a pregnancy test could be the best way to figure out if these are signs of conception or the effects of PMS  (1).

Early Symptoms Of Pregnancy Before Missed Period

While a missed period is a prominent sign of pregnancy, there could be other bodily symptoms you experience before your period is due. Keep reading to know more about them.

1. Implantation bleeding and cramping

If you have unprotected sex during your fertile window, there is a chance that you might get pregnant. Implantation takes place when the fertilized egg attaches to the lining of the uterus. If that happens, you may experience implantation bleeding around the same time your period is due (2).

Implantation bleeding is light, and you may notice just a few drops of blood in your panty or while wiping your vagina. Therefore, you may or may not notice it.

2. Basal body temperature

Basal body temperature is considered to be an indicator of ovulation. A week or so before ovulation, your basal body temperature may be around 97 to 98°F, which is the average in the pre-ovulation state (3). One to two days after ovulation, your BBT usually increases by 0.5 to 1°F and decreases after your period ends. Most women tend to feel warmer during pregnancy, but there is no evidence to suggest that this is due to high basal body temperature.

The changes in the basal body temperature are subtle and not easy to measure. Moreover, you need to track it through the month, which makes it a less practical indicator of ovulation or pregnancy.

3. Sore, tender, and heavy breasts

When you conceive, hormonal changes in the body could result in tender or swollen breasts with veins around the breast becoming visible, darkening of the areola, and tingling of the breasts. These changes may occur as early as one to two weeks after conception.

These symptoms may be similar to those of PMS but may be severe if you’re pregnant. If your period is late and you notice breast changes along with other symptoms, take a pregnancy test to be sure (4).

4. Fatigue

Fatigue without reason may also be an early symptom of pregnancy. A spike in the levels of progesterone hormone could make you tired and sleepy all the time (5). Additionally, as the body begins to produce more blood to support your fetus’ growth, you may feel exhausted, especially if you don’t get enough minerals, vitamins, iron, and fluids in your diet.

If you’ve been planning to conceive, talk to your doctor and take prenatal vitamins, avoid caffeine and associated products, and sleep well to fight fatigue. Note that fatigue could also be due to other health issues such as anemia, hypothyroidism, etc., and may not be the sole indicator of pregnancy.

5. Nausea

Nausea or morning sickness is a classic sign of pregnancy that you may be able to notice in the early stages. It could become prominent in the initial weeks around the missed period, even before your pregnancy is confirmed. You may feel dizzy, weak, and feel like throwing up at times.

You may feel nauseous at any time of the day, but early mornings could be the worse, which is why it is referred to as morning sickness. About 50 to 80% of women experience morning nausea, but the severity may vary (5). The condition may be worse in your first pregnancy but may subside with the eventual ones.

This symptom may start anytime between two and eight weeks after conception.

6. Bloating and feeling of tightness

You may feel your tummy is protruded, and your pants may get tight. A heavy or bloated feeling in the stomach is a common symptom of pregnancy before missed periods (6).

Bloating could be followed by farts and burps because of the progesterone hormone, which retards your digestion (5). However, bloating could happen due to other indigestion issues too.

7. Food aversions

You may start disliking the foods you once loved and even become averse to them, so much so that their smell or taste might make you nauseous (5). Aversion to foods could be common early in the pregnancy when nausea and vomiting are present. Some may get their appetite back by the second or third trimesters, but others may have to deal with it through the pregnancy.

While the suggested cause of food aversion is an increase in the progesterone levels, there is no substantial evidence to support the theory.

8. Dizziness

Dizziness and lightheadedness could also come early on in pregnancy, due to a change in the blood volume and pressure when the blood vessels dilate early in the pregnancy (7).

9. Mood swings

Feeling moody? It could be due to the hormonal changes after conception. The variations in the hormone levels may affect the neurotransmitters of the brain, resulting in enhanced emotions from spells of weeping to sudden anger outbursts (8). However, it is difficult to relate mood swings to pregnancy as women have mood swings before their period as well.

10. Constipation

An increase in progesterone levels might affect your digestive system. Your bowel movements may get harder as the hormones cause the food to pass slowly through the digestive system. If you develop constipation before your period is due, and you’ve had unprotected sex during the fertile period, you may have to take a home pregnancy test (7).

11. Headaches and backaches

Low blood sugar levels may cause headaches, as the brain cells try to cope up with the lower levels of sugar supply. If you have frequent headaches, then it could mean that the female sex hormones like estrogen and progesterone are preparing the womb for the baby (9).

You could also experience lower back pain as your ligaments loosen up, and your body prepares to carry the weight of the baby (7). Implantation cramping, bloating, and constipation may also cause backaches during early pregnancy. Your sleeping positions could also be a cause of back pain.

If the pain is unbearable, go to a doctor for a proper diagnosis. Avoid taking over-the-counter painkillers, as self-medication can be harmful if you’re pregnant.

12. Drooling

Drooling is not a common symptom, but some women may produce excess saliva (referred to as ‘Ptyalism gravidarum’) if they are experiencing nausea or vomiting.

A couple of case studies reported excess salivation in pregnant women during the first trimester of pregnancies. However, further studies are needed to decide if this is an early pregnancy symptom (10).

13. Thirst

Women may also feel thirsty in the early stages of pregnancy (11), which could be due to an increase in blood volume or excessive urination. You may drink more water, and that may cause frequent urination, which in turn could make you feel thirsty again!

14. Urge to pee

An increased urge to pee is a typical pregnancy symptom that you may experience during the first few weeks. This could be due to the excess production of the blood, owing to the many hormonal changes that occur after conception (4). The kidneys work to filter more blood, filling up the bladder, and making you pee frequently.

15. Shortness of breath

You may begin having shortness of breath in the first few weeks of pregnancy since your body requires more oxygen and blood to share with the growing fetus. It may continue throughout the pregnancy as the baby grows, and the need for oxygen and nutrients increases (12). Having an exercise routine, sitting in a proper posture, taking slow deep breaths, wearing loose clothes, etc., could help in regulating your breathing.

Some of these pregnancy symptoms are similar to those of PMS and may be ignored by most women. Also, a few others could be due to other medical conditions and should be checked by a doctor.

Are These Symptoms Reliable Enough To Confirm Pregnancy?

The symptoms we mentioned above are only possible indicators and not definitive signs that confirm a pregnancy. So even if you experience one or more of these symptoms, it may not always necessarily mean that you are pregnant. They are only the indicators of a possible pregnancy. Your pregnancy can be confirmed when a pregnancy test shows a positive result.

How Soon Can You Experience Pregnancy Symptoms Before A Missed Period?

You may start experiencing pregnancy symptoms around a week and a half before your period is due, or 12 to 15 days after ovulation (or conception, as it happens around ovulation time) (13). However, the onset of symptoms differs from one woman to another. Some women experience symptoms such as nausea, tender breasts, fatigue, sleepiness, and bloating within a week of conception.

Symptoms such as increased frequency of urination will usually occur around the time your period is due. Symptoms such as vaginal discharge, changes in the areola, and elevated body temperature appear eventually and can only be detected on close examination.

What Can Be The Other Causes For A Delayed Period?

Your period could be delayed due to many reasons other than pregnancy. They could be hormonal changes, excessive weight gain or weight loss, eating disorders (anorexia or bulimia), stress, polycystic ovary syndrome, travel, thyroid, birth control pills, or drug use (14).

So, it is possible to miss your period and not be pregnant.

Is It Possible To Be Pregnant And Get Your Period?

You are unlikely to get your period if you are pregnant. But as mentioned before, you may notice light bleeding or spotting in the early stages, also referred to as implantation bleeding. Sometimes, bleeding could be due to an infection, miscarriage, placental issues, or an ectopic pregnancy.

How Long Should You Wait To Take A Home Pregnancy Test?

Ideally, you should wait for one to two weeks from the time of ovulation to take a home pregnancy test (13). But you might get an accurate result if you wait until a week after your missed period. Home pregnancy tests detect hCG, which could peak during this period.

Right from the day you have sex during the ovulation period, your body is in the process of developing a new life inside you. While signs and symptoms before a missed period could indicate pregnancy, only a test may give you precise results.

If you are experiencing one or more of the early pregnancy symptoms and you think you could be pregnant, even though your pregnancy test result is negative, consult your doctor about it. Sometimes home pregnancy tests taken too early or late may also give a false negative. A doctor may suggest blood tests at a specific time for correct diagnosis.

Have you experienced any of these symptoms when you were trying to get pregnant? How did you confirm your pregnancy? Tell us about it in the comment section below.

References:

MomJunction’s articles are written after analyzing the research works of expert authors and institutions. Our references consist of resources established by authorities in their respective fields. You can learn more about the authenticity of the information we present in our editorial policy.The following two tabs change content below.Dr. Sangeeta Agrawal worked in Royal London, St. Bartholomew’s, North Middlesex and Barnet General hospitals in London. Currently, she runs her own clinic in Mumbai. She is also attached to Bhatia Hospital, Breach Candy Hospital, Wockhardt Hospital, and Global Hospital. Her areas of expertise include obstetrics and gynecology, involving teenage care, antenatal, intrapartum, post-natal care, painless labor, fertility control, menopause… moreRebecca is a pregnancy writer and editor with a passion for delivering research-based and engaging content in areas of fertility, pregnancy, birth, and post-pregnancy. She has been into health and wellness writing since 2010. She received her graduate degree in Biotechnology and Genetics from Loyola Academy, Osmania University and obtained a certification in ‘Nutrition and Lifestyle in Pregnancy’ from Ludwig… more

Calculator: Is My Menstrual Period Late?

Missing a period, especially if you always had regular menstrual periods, is a significant event, so naturally, the next question that follows is, “Am I pregnant?” Pregnant women have no menstrual period. But not every woman who misses her period is pregnant.

Understand the science of your body

Get personalized insights when you log your symptoms and track your cycle in the Obie app.

Download Now!

Do you think you’re pretty knowledgeable about getting pregnant? Take our new fertility quiz and see what you score!

Could you be pregnant?

If you missed your period, answer these 4 questions:

1. Am I trying to get pregnant?
2. Have I had sex during my fertile days?
3. Have I not used contraception?
4. Did I ovulate?

If you answered “yes” to all questions, there is a high chance that you are pregnant. But only a positive pregnancy test will confirm your suspicion.   

When will a pregnancy test appear positive?

If you are trying to get pregnant and you miss a period, you are naturally excited, yet there is no way to know for sure until you take a pregnancy test. However, there are several symptoms that are suggestive of pregnancy, including breast tenderness, nausea, and bloating. Keep in mind, these can also be premenstrual signs.

How many weeks am I pregnant from my last period?

Wondering how many weeks pregnant you are right now? Well, you first must know when your last period was in order to find out how many weeks you are right now. Calculating an accurate due date is an important first step in pregnancy. The calculation of the estimated due date (EDD) is based on the day of the date of ovulation and fertilization. The EDD can be calculated by adding 266 days to the day of ovulation/fertilization.

What is the last menstrual period (LMP)?

The LMP is the date of the first day of the last menstrual period you had before conceiving. It is the first day that your last menstrual cycle begins when you see bright red blood, not just a little brown spotting. You should keep track of your LMP each month, either with an online calculator or just by recording it on a calendar each month. That is the date you use when entering the LMP on an online period calculator.

Whether you are trying to get pregnant or not trying to get pregnant, keeping track of your menstrual periods is vital. Besides pregnancy, missing a menstrual period could also be a sign of other issues like missed ovulation.

Why would I have a late period?

Having a late menstrual period is among the first signs and symptoms of pregnancy. Other early pregnancy signs include breast tenderness, nausea, fatigue, and frequent urination.

Just enter the first day of your last menstrual period and the average number of days of your menstrual cycle above to calculate whether your next menstrual period is late or see if you might be pregnant!

Read More:
Pregnancy Symptoms: Early Signs You May Be Pregnant
Pregnancy symptoms Calculator
Due Date Calculator

Burn center – frostbite

Details about the treatment of frostbite

If you have a question to our doctor about the treatment of diseases, you can call 8 (812) 748-23-48 or ask a question to the surgeon online.

Frostbite occurs due to a sufficiently long exposure to cold on the limbs (mainly on the fingers), on the open parts of the face (nose, cheeks, ears). First, the blood circulation of the skin is disturbed, then the deeper tissues, then the necrosis of the skin and subcutaneous tissues occurs.

The dynamics of the process is represented by three periods:

1. Pre-reactive, characterized by a significant decrease in the temperature of the affected tissues. The blood flow slows down; hemoconcentration occurs. Complete freezing of a limb, glaciation is possible.
2. Early jet. It begins after warming up the limb – acute inflammatory reactions on the 5th day. There is a restoration of tissue temperature, edema develops. The process is accompanied by local blood coagulation in the vessels with the formation of blood clots, which impede, then stop the blood flow.For 2-7 days, due to intoxication, the body temperature rises. Dry necrosis of the fingers often occurs, and demarcation zones are formed.
3. Late jet period. Necrosis is characteristic (mainly with deep frostbite). Purulent-septic infectious lesions join.

Allocate; superficial (I-II degrees) and deep (III-IV degrees) frostbite.

Symptoms:

I degree frostbite: the skin is pale, cold. After warming, the pains are stitching, burning, itching, the skin is hyperemic, edematous.Subsequently, peeling.

Frostbite II degree: blisters with a transparent liquid form on the skin (for 2-3 days). Necrosis of the surface layers occurs. Epithelialization at the 2nd week.

Frostbite III degree: blisters with bloody fluid, the bottom of the blisters is blue-crimson. Superficial necrosis of the skin, sometimes subcutaneous tissue, wet necrosis is possible. Later, granulations develop, plastic defects are required, and scarring is possible.

IV degree frostbite: necrosis of soft tissues, bones, joints.Mummification or wet gangrene. Necrectomy, amputation required.

Medical care in the pre-reactive period: Elimination of the effect of cold. In case of significant frostbite, for example, of the foot – before entering or before bringing the victim into the room – a heat-insulating bandage should be applied to the frostbite zone, an immobilizing splint should be applied (Kramer or from improvised means). In the hospital, treatment is aimed at the fastest and most complete restoration of adequate blood flow in the affected segments.To do this, use infusion therapy, drugs that improve blood rheology and tissue perfusion, vasodilators, vitamins. Sometimes they resort to intra-arterial drug administration.

In the reactive period, medical assistance is largely similar, but the outcome of treatment is usually worse. By this time, irreversible changes in tissues had already taken place. There are signs of demarcation of necrosis – the formation of a demarcation line. Gangrene develops.

The outcome of treatment depends on the depth of tissue freezing and the timeliness and adequacy of therapy.The main principle of a favorable outcome is early referral to specialized hospital care in the pre-reactive period.

OGBUZ “Dermatovenerologic dispensary”

SYPHILIS TODAY

In the twentieth century, with the advent of antibiotics, the situation somewhat changed for the better, although syphilis is still considered one of the most common sexually transmitted diseases. Nevertheless, at the end of the twentieth century, Russia was experiencing a real epidemic of syphilis.Here are just some of the numbers. In 1989, its incidence was 4.3 cases per 100,000 people. And the numbers that seem unrealistic are so terrible: by 1997 (that is, in less than 10 years), the incidence of syphilis had increased 70 times (277.3 cases per 100,000 population). At the same time, it is necessary to add to them those cases of syphilis that have not been officially registered. Venereologists believe that, taking into account unregistered cases, the incidence of syphilis was then 2-3 times higher.In addition, do not forget that the average statistics are calculated based on the total population of the country, including infants and the elderly. Naturally, among the sexually active part of the inhabitants of Russia, the incidence of syphilis is even higher. Men and women contract syphilis equally often. Now the wave of morbidity is gradually decreasing, but the “sick generation” of the mid-90s can still give birth to sick children, so it is too early to talk about stabilization of the situation.

Treponema pale

Syphilis is a venereal disease caused by treponema pallidum, previously called pallidum spirochete.In shape, pale treponema is spiral and under a microscope resembles a corkscrew. if we continue the analogy with a corkscrew, it seems to be screwed into a crack in the skin or mucous membrane. Pale treponema is extremely mobile, therefore, at the slightest opportunity to penetrate the body, it does it very quickly. Each treponema pallidum is divided into several parts during reproduction. Having penetrated the human body, pale treponemas begin to multiply, affecting the internal organs and tissues through which they quickly spread.At the same time, they still live and multiply on mucous membranes, and are easily transmitted through sexual intercourse or, in especially difficult cases, through close household contact (through a common towel or dish, for example). This is why syphilis is so contagious and spreads at a tremendous rate.

It is also important to know that the body does not develop a stable immunity to pale treponema, therefore, re-infection is possible even after a complete cure, for example, in a couple where both partners were ill, and only one was treated.
The danger of treponema lies in the fact that they feel great not only inside the human body, but also in an external humid environment, where they can wait in the wings for several days. Therefore, they can easily live for several hours, for example, on the dishes used by a person with syphilis, and from it, under favorable circumstances, “move” to the new “owner”. They are practically insensitive to cooling. Even after the death of a patient with syphilis, pale treponemas can remain vital for quite a long time, up to 96 hours.Freezing also does not deprive them of their vitality – according to experiments, pale treponema remained viable after spending a year at a temperature of -78 ° C. However, when dry, under the influence of disinfectants, acids and alkalis, treponemas quickly die. High temperature has a detrimental effect on them: at a temperature of 55 ° C, treponemes die within 15 minutes. When boiled, treponema dies instantly.

Syphilis is chronic, without appropriate treatment for many years, decades.It is characterized by damage not only to the skin, but also to the mucous membranes, internal organs, large vessels, musculoskeletal and nervous systems.

From the moment of infection, syphilis is a common infectious disease and is characterized by an undulating course with a change in periods of exacerbation.

During the period of exacerbation of syphilis, active manifestations of the disease are observed on the mucous membranes, skin, and internal organs.

During the latency period, clinical signs of syphilis are not observed on visual examination, however, serological blood tests remain sharply positive.The latent and “erased” course of syphilis is facilitated by the independent use of antibiotics, including for other diseases, for example, “colds”, sore throats ..

Syphilis symptoms . Typically, syphilis occurs in four periods, each of which is characterized by certain symptoms. Syphilis is sometimes referred to as the “monkey disease” because its symptoms of syphilis can be similar to those of many other diseases. There are cases when the patient was examined by many doctors of different specialties, until he was offered to take a blood test for syphilis.The analysis gave positive results, and only after that it became clear that the symptoms that the patient attributed to diabetes, gastritis or cancer problems were in fact caused by syphilis.

Stages of syphilis: The incubation period, lasting 3-4 weeks, lasts from the moment treponema enters the patient’s body, that is, from the moment of infection, until the formation of a hard chancre. The duration of the incubation period can be longer or less than the average value: the range is from 10 to 80 days.The patient at this time is already a danger to others, he is contagious, although he himself may not yet know about his disease.

• PRIMARY SYPHILIS – stage of syphilis, characterized by the appearance of a hard chancre, which is an erosion or ulcer. The chancre diameter is 10-20 mm. The chancre is localized most often on the genitals: in the coronal groove, on the glans penis, the inner and outer sheets of the foreskin; less often – on the skin of the scrotum and pubis, on the labia majora or labia minora.Also, chancre can occur outside the genitals – most often the red border of the lips, nipples of the mammary gland, in the throat (on the tonsils).
  
  Regional lymph nodes also enlarge. If untreated, this period lasts about 2 months, at the end of the primary period, a number of patients develop general symptoms of syphilis, manifested by increasing weakness, decreased appetite, malaise, pain in muscles and joints (pale treponemas enter the bloodstream through the thoracic lymphatic duct).At this stage of syphilis, rashes appear on the skin of the trunk, on the mucous membrane of the mouth, indicating the transition of primary syphilis to secondary.
• SECONDARY SYPHILIS – the stage of the disease caused by the spread of treponema pallidum through the blood throughout the body. Secondary syphilis is manifested by various rashes on the skin and mucous membranes. The course of secondary syphilis is undulating: the period of active manifestations is replaced by a latent form of syphilis. Serological blood tests remain sharply positive during all periods of syphilis.
  Secondary syphilis lasts 3-4 years and is also characterized by an increase in several groups of lymph nodes and, sometimes, damage to the nervous system, a number of internal organs.
• TERTIARY SYPHILIS – the stage following secondary syphilis, which is characterized by irreversible lesions of the internal organs and the nervous system with the appearance of large ulcers in them – syphilitic gummas. Clinical signs of tertiary syphilis can appear many years later after a long asymptomatic course of the disease from the moment of infection with syphilis.The main reason influencing the formation of tertiary syphilis is the absence or inadequate treatment of patients with earlier forms of syphilis.
• HIDDEN SYPHILIS (syphilis latens) – syphilis, in which there are no signs of damage to the skin, mucous membranes and internal organs, but serological blood reactions to syphilis are positive. Early latent syphilis is latent syphilis, less than 2 years have passed since the moment of infection. Late latent syphilis – more than 2 years have passed since the infection.Most patients with this form of syphilis are detected during various preventive medical examinations, dispensary examinations.
• VISCERAL SYPHILIS – syphilis, in which internal organs are affected (heart, lungs, liver, brain, spinal cord, stomach, kidneys).

WAYS OF INFECTION WITH SYPHILIS

Household – syphilis, the infection of which occurs in everyday life: through dishes, towels, toothbrushes, etc.The most frequent route of infection with syphilis, more than 97%, is sexual , with various forms of sexual intercourse, including oral.

Rarely, infection with syphilis can occur through close household contact, in exceptional cases – through household items. Infection with syphilis is possible through the milk of a nursing woman with syphilis. There were no cases of syphilis infection through urine or sweat. In saliva, pale treponemas can be found only when there are rashes on the oral mucosa.
Syphilis can be contracted through the sperm of a patient in the absence of visible changes in the genitals. When donor blood is transfused, a patient with syphilis develops transfusion syphilis. Infection of medical workers is possible when examining patients with syphilis, carrying out medical procedures and manipulations, during an operation.

Recently Added Items – World Digital Library

Spell Heal

Manuscript “Zhu you ke” (“Healing with a spell”) according to legend was written by a Taoist priest named Zhang Zun and is of exceptional rarity.The work, also known as “Mi jue qi shu” (“Rare Book of Secrets”), consists of five unnumbered volumes, indicated by symbols: qian , yuan , heng , li and zhen … There is a footnote on the first volume of Qian which says that the original stone tablets entered the imperial collection in the 13th year of Kangxi (1656) as one part of Labor Shi san ke (Thirteen Ways of Healing ). The spell heal is the 13th of the Thirteen Ways.Perhaps the work was published before the beginning of the Qing dynasty. Volume “qian” contains a story about the source. It says that in the 28th year of the Chunxi reign (1188) of the Song dynasty, the governor of Ya Qi province was ordered to strengthen the bed of the Yellow River, where he found 58 stone tablets with incomprehensible words carved on them. Zhang Zun deciphered the inscriptions, and since then, the treatment of diseases has become more effective. During the Jingtai reign (1450–1456) of the Ming Dynasty, a physician named Xu Jinghui, a native of Linqing, Shandong Province, is said to have mastered 13 treatments and practiced them, leaving his home filled with patients.Zhang Zun, the author of the epilogue to the first volume labeled “qian,” wrote about the existence of another copy of a lower quality. That version was discovered in 1724, compiled and rewritten by Shan Chanfa, but the five volumes did not appear to match, and the methods of incantation and prohibition were different. Presumably, the book was copied from various sources. Spell healing was a recognized and respected profession. The doctor who heals with the spell used prayers, magical talismans or the imposition of prohibitions, as well as rituals to “transfer the spirit into the essence of qi .“These remedies could not only heal from pain and disease, but also stop babies crying at night, help women in childbirth, and heal wounds from accidents, and animal and insect bites. The methods promised results such as “to bring well-being to the house by filling a vase with water,” “to destroy rats with magical talismans,” and “to become a tiger by blowing on a feather.” The treatments described in the book were designed for adults and children. They covered topics such as heart rate, childbirth, eyes, flatulence, teeth and stomatitis, ears and nose, orthopedics, wounds and bone fractures, arrowhead injuries, witchcraft, and so on.

Alcohol withdrawal syndrome

Alcohol withdrawal syndrome is a complex of pathological symptoms that occur in alcoholics when they refuse to drink alcohol. It resembles a hangover in manifestations, but differs from it in a number of additional signs, including duration. It develops only in patients with stages 2 and 3 of alcoholism; in the absence of alcohol dependence, it is not observed. It is accompanied by sweating, palpitations, hand tremors, impaired coordination of movements, sleep and mood disorders.Transition to alcoholic delirium (delirium tremens) is possible. Treatment is infusion therapy.

Alcohol withdrawal syndrome

Alcohol withdrawal syndrome (withdrawal syndrome) is a complex of psychological, neurological, somatic and autonomic disorders that occurs after stopping alcohol intake. It develops only in people suffering from alcohol dependence. It occurs at the 2nd stage of alcoholism. Some of the manifestations of this syndrome are similar to the usual hangover, but with a hangover, a number of symptoms are absent, including an irresistible craving for alcohol.The hangover disappears within a few hours, the withdrawal syndrome lasts for several days.

The time period from the beginning of regular consumption of alcoholic beverages to the onset of alcohol withdrawal syndrome ranges from 2 to 15 years. There is a relationship between the time of onset of this condition, gender and age of patients. So, in young men and adolescents, signs of abstinence are observed as early as 1-3 years after the onset of alcohol abuse, and after 2-5 years, the disease becomes prolonged and pronounced.In women, this syndrome appears after about 3 years of regular drinking.

Pathogenesis of alcohol withdrawal syndrome

After entering the body, ethanol is broken down in several ways: with the participation of the enzyme alcohol dehydrogenase (mainly in the liver cells), with the help of the catalase enzyme (in all cells of the body) and with the participation of the microsomal ethanol-oxidizing system (in the liver cells). In all cases, acetaldehyde becomes an intermediate metabolic product – a highly toxic compound that has a negative effect on the functioning of all organs and causes hangover symptoms.

In a healthy person, alcohol is broken down primarily by alcohol dehydrogenase. With the regular use of alcohol, alternative variants of alcohol metabolism are activated (with the participation of catalase and the microsomal ethanol-oxidizing system). This leads to an increase in the amount of acetaldehyde in the blood, its accumulation in organs and tissues. Acetaldehyde, in turn, affects the synthesis and breakdown of dopamine (a chemical that interacts with nerve cells).

Long-term alcohol consumption leads to depletion of dopamine stores. In this case, alcohol itself combines with the receptors of nerve cells, making up for the resulting deficit. In the first stage of alcoholism, the patient in a sober state suffers from insufficient stimulation of the receptors due to a lack of dopamine and the absence of substituting alcohol for it. This is how mental dependence is formed. At the second stage of alcoholism, the picture changes: the cessation of alcohol intake entails a breakdown in compensation, in the body, not only decay, but also the synthesis of dopamine increases sharply.Dopamine levels increase, which leads to the appearance of autonomic reactions, which are the main signs of withdrawal symptoms.

Changes in dopamine levels are associated with symptoms such as sleep disturbances, anxiety, irritability, and increased blood pressure. The severity of withdrawal symptoms directly depends on the level of dopamine. If its content is three times higher than the norm, the withdrawal syndrome turns into alcoholic delirium (delirium tremens). Along with the effect on the level of neurotransmitters, acetaldehyde negatively affects the ability of red blood cells to bind oxygen.Red blood cells deliver less oxygen to tissues, which leads to metabolic disorders and oxygen starvation of cells of various organs. Against the background of tissue hypoxia, somatic symptoms occur, characteristic of withdrawal symptoms.

The depth of the damage to the body during abstinence affects the duration of this condition. A typical hangover lasts only a few hours. Withdrawal lasts on average 2-5 days, the maximum symptomatology is usually observed on the third day, at the height of the breakdown of compensatory mechanisms due to the cessation of alcohol intake.In severe cases, residual withdrawal symptoms may persist for 2-3 weeks.

Symptoms and classification of alcohol withdrawal syndrome

There are several classifications of alcohol withdrawal syndrome, taking into account the severity, time of onset of certain symptoms, as well as clinical variants with a predominance of one or another symptomatology. At the 2nd stage of alcoholism, there are three degrees of severity of abstinence:

• 1 degree.It occurs during the transition from the first stage of alcoholism to the second. Appears with short-term binges (usually lasting no more than 2-3 days). Asthenic symptoms and disorders of the autonomic nervous system predominate. It is accompanied by palpitations, dry mouth and increased sweating.
• 2 degree. It is observed “in the midst of” the second stage of alcoholism. Appears after binges lasting 3-10 days. Neurological disorders and symptoms from the internal organs are added to autonomic disorders.It is accompanied by redness of the skin and whites of the eyes, palpitations, fluctuations in blood pressure, nausea and vomiting, a feeling of turbidity and heaviness in the head, gait disturbances, trembling of the hands, eyelids and tongue.
• 3 degree. Usually occurs during the transition from the second stage of alcoholism to the third. It is observed with binges lasting more than 7-10 days. Vegetative and somatic symptoms persist, but fade into the background. The clinical picture is mainly determined by mental disorders: sleep disorders, nightmares, anxiety, guilt, sad mood, irritation and aggression towards others.

At the third stage of alcoholism, the withdrawal syndrome becomes pronounced and includes all of the above symptoms. It should be borne in mind that the manifestations of abstinence can vary, the severity and predominance of certain symptoms depends not only on the stage of alcoholism, but also on the duration of a particular binge, the state of internal organs, etc. Unlike a hangover, withdrawal symptoms are always accompanied by an irresistible craving for alcohol, worse in the afternoon.

Taking into account the time of onset, two groups of withdrawal symptoms are distinguished. Early symptoms occur within 6 to 48 hours after stopping alcohol. If the patient resumes drinking alcohol, these symptoms may disappear completely or significantly soften. After refusing alcohol, the patient is restless, agitated, irritable. Increased heart rate, hand tremors, sweating, increased blood pressure, aversion to food, diarrhea, nausea and vomiting are noted. Reduced muscle tone.Disorders of memory, attention, judgment, etc. are revealed.

Late symptoms are observed within 2-4 days after stopping the use of alcoholic beverages. They mainly relate to mental disorders. Mental disorders occur against the background of aggravation of some of the early symptoms (palpitations, agitation, sweating, hand tremors). The patient’s condition is changing rapidly. Clouding, hallucinations, delusions, and seizures are possible. Delusions are formed from hallucinations and are usually paranoid in nature.Persecution delusions are most common.

As a rule, early symptoms precede late ones, but this pattern is not always observed. In mild cases, late symptoms may be absent. In some patients, late symptoms develop suddenly, against the background of a satisfactory general condition, in the absence or mild severity of early manifestations of withdrawal. Some late symptoms can be gradually reduced without turning into alcoholic delirium.With the appearance of all signs and the progression of late symptoms, delirium tremens develops. In some cases, the first manifestation of abstinence is an epileptic seizure, and other symptoms (including early ones) join later.

There are 4 variants of the course of alcohol withdrawal syndrome with a predominance of symptoms from various organs and systems. This division is of great clinical importance, since it allows one to establish which organs are most affected as a result of abstinence, and to choose the most effective therapy.This classification includes:

• Neurovegetative option. The most common variant of the course of withdrawal symptoms, the “basis” on which the rest of the manifestations are “built up”. Manifested by sleep disturbances, weakness, lack of appetite, rapid heart rate, fluctuations in blood pressure, hand tremors, facial swelling, increased sweating and dry mouth.
• Cerebral variant. Disorders from the autonomic nervous system are complemented by fainting, dizziness, intense headache, and increased sensitivity to sounds.Seizures are possible.
• Somatic (visceral) option. The clinical picture is formed due to pathological symptoms from the internal organs. Slight yellowness of the sclera, bloating, diarrhea, nausea, vomiting, shortness of breath, arrhythmia, pain in the epigastric region and the region of the heart are revealed.
• Psychopathological variant. Mental disorders predominate: anxiety, mood changes, fear, severe sleep disorders, short-term visual and auditory illusions, which can turn into hallucinations.Deteriorating orientation in space and time. Suicidal thoughts and suicidal attempts are possible.

Regardless of the variant of the course of abstinence, this condition is always accompanied by mental and mental disorders of the patient. During this period, all personality changes characteristic of alcoholism come to the fore, become “more prominent”, noticeable from the outside. Attention is drawn to the inertia and unproductiveness of the patient’s thinking. The patient perceives explanations and instructions poorly, often acts and responds inappropriately, in his answers and speeches there is no lightness and spontaneity characteristic of ordinary informal communication.Humor and irony are absent or oversimplified and coarse.

In young people, anxiety prevails, in the elderly – a decrease in mood. Patients feel hopelessness, suffer from feelings of guilt due to the inability to refrain from drinking alcohol and their actions committed in a state of intoxication. In some cases, panic attacks occur. Depression alternates with episodes of determination, caused by increased cravings for alcohol. In this state, patients, without remorse, deceive loved ones, open locks or run away from home through the balcony, beg for money from friends and strangers, commit thefts, etc.etc.

Treatment of alcohol withdrawal syndrome

Treatment of withdrawal symptoms is carried out by specialists in the field of narcology. Patients with mild withdrawal symptoms can get help from a narcologist at home or on an outpatient basis. The treatment regimen includes intravenous drip infusion of saline solutions, vitamin therapy, detoxification therapy (ingestion of activated carbon), means for restoring the functions of various organs and improving the activity of the nervous system.Patients are prescribed benzodiazepines – drugs that reduce anxiety, have a sedative, hypnotic and anticonvulsant effect and at the same time affect the autonomic nervous system, helping to eliminate autonomic disorders.

The indications for hospitalization are exhaustion, significant dehydration, severe hyperthermia, strong tremors of the limbs, eyelids and tongue, hallucinations, epileptic seizures and impaired consciousness. Inpatient treatment is necessary in the presence of somatic pathology, including gastrointestinal bleeding, respiratory failure, severe liver failure, pancreatitis, severe bronchitis and pneumonia.Patients are also hospitalized in the presence of mental disorders (schizophrenia, manic-depressive psychosis, alcoholic depression) and if there is a history of episodes of alcoholic psychosis.

The inpatient care program includes drug therapy (the outpatient treatment regimen is supplemented with antipsychotics, anticonvulsants, hypnotics, tranquilizers, nootropics, remedies for the correction of mental and somatic disorders), a special diet, plasmapheresis and other non-drug methods of therapy.Treatment is carried out after an appropriate examination. Patients are under the supervision of a narcologist.

Prognosis for alcohol withdrawal syndrome

In mild cases, all symptoms of withdrawal symptoms disappear without treatment in a period of up to 10 days, with treatment without hospitalization (at home or on an outpatient basis) – in a period of up to 5 days. The prognosis for severe withdrawal depends on the form of the disorder, the severity of mental disorders and the severity of somatic pathology.