Irregular menstruation may indicate uterine fibroid or misuse of the pill

Before we start talking about menstruation, we have to clarify a few points. The menstrual cycles begin in adolescence, which is a milestone from late childhood to early adulthood, ending at menopause. In this text we will therefore talk about this reproductive period of the woman without considering pregnancy, postpartum, and breastfeeding, which deserve separate texts.

The brain is cyclically controlling the ovaries, which respond by producing hormones which, in turn , act on the uterus and other organs. There is, therefore, an axis: the brain, ovaries, and uterus, which harmonically coordinate menstrual cycles.

Menstruation is composed of blood along with the desquamation of the tissue surrounding the cavity of the uterus, which breaks off once that fertilization of the egg did not occur. We considered a normal menstruation with the following parameters: duration between two to seven days, interval every 21 to 35 days (in adolescents up to 45 days), an approximate volume of up to 80 ml per cycle, no more than a large absorbent per hour or buffer every two hours.

Failures considered normal up to 90 days after regular cycles, without gestation. Any change to plus or minus in quantity and / or range should be investigated when it persists for more than two consecutive cycles.

Any change to plus or minus in quantity and / or range should be investigated when it persists for more than two consecutive cycles.

The uterus is a muscular organ, very irrigated, with the capacity to grow up to 1,000 times to support a gestation, to contract, to expel the fetus and to return to the initial conditions for a new gestation. It depends on numerous hormones for its development and functioning. Because of this incredible capacity and potential, it may present some problems.

The causes of these abnormal bleeds can be divided into:

• Uterine Causes (structural): polyps, (non-uterine) causes: coagulopathies (change in coagulation), ovarian dysfunction (hormones), endometrial (infections), iatrogenic (medicines,
• We must remember that many bleeds do not have uterine origin, but from other parts such as: cervix, vagina, trauma, pregnancy, urinary tract infections , intestinal.
• We often find causes of SUA that overlap (associated) and we should investigate by exams: clinical, blood, hormones, ultrasound, among others, to be more accurate. in the diagnosis, treatment and follow-up of these patients.

The complaint of irregular menstruation after the use of the morning-after pill is very common. It causes a hormonal turbulence that is reflected in irregular bleeding. Parentheses: let's face it, there are women using these hormonal contraceptives for exception use as routine to avoid pregnancy ...

In addition to these changes, fibroids and polyps are common causes of intense, chronic bleeding and can lead to anemia .

Here's the hint: all bleeding beyond persistent normality should be investigated. It is the effect of some problem (not cause) and demonstrates that something is not going well.

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