Treatment of menstrual disorders abroad
Menstrual cycle represents physiologic cyclic changes of the female endocrine profile. Menstrual cycle includes the functional activity of the reproductive organs associated with the release of a mature ovum from the ovary. Menstrual disorders are common in women of a reproductive age.
Causes of menstrual disorders
Menstrual disorder is a pluricausal condition which means it is caused by a whole number of factors.
Depending on the cause, there are several basic kinds of menstrual disorders:
- Central disorders arise after central endocrine glands change their functional activity (hypothalamus, pituitary, subcortical structures damage).
- Peripheral disorders are determined by the various diseases of reproductive glands and other reproductive system structures like infectious inflammation, polycystic ovary, and uterine tumours etc.
- Endocrine disorders include such disorders as an increased or decreased function of internal secretion organs, mainly the thyroid gland (thyrotoxicosis, hypothyroidism).
- Genetic abnormalities refers to the the genetic abnormalities of the endocrine glands and the reproductive organs of congenital origin that lead to menstrual irregularities and infertility in women.
Symptoms of menstrual disorders
Several types of menstrual disorders are differentiated depending on the prevailing clinical signs:
- Algodismenorrhea (painful menstruation) is the most common clinical menstrual disorder making up more than 30% of all the cases. This type is peculiar with the aching or cramping pain in the lower abdomen of various intensities accompanied by a general malaise. This condition may last from a few hours up to 1-2 days.
- Dysmenorrhea (untimely menstruation) is characterized by premature menstrual bleedings or its delay.
- Amenorrhea (absence of menstruation) is often a result of genetic abnormalities or endocrine disorders leading to the complete absence of menstruation. It is associated with female infertility, which develops due to a dysfunction of the egg maturation process.
- Hypomenclural syndrome means that menstruation duration is not disrupted, but discharge from the vagina is meager.
- Oligomenorrhea is characterized by a decrease in the duration of menstruation and often combined with obesity.
- Polymenorrhea is a prolonged menstruation of 7 days and more.
- Metrorrhagia (uterine bleedings) is manifested by bleeding from the vagina in between the menstruation cycle. Pathology is sometimes not a result of endocrine profile changes, but a consequence of liver problems or coagulation blood system issues.
Diagnostics of menstrual disorders
In modern European hospitals a comprehensive diagnosis is carried out to identify causes of menstrual disorders and essence of reproductive system changes. Comprehensive diagnosis includes the following techniques:
- Ultrasound of reproductive organs, abdominal cavity, thyroid gland
- Colposcopy which is an examination of the vagina and cervix using an optical device called colposcope
- Laboratory exclusion or confirmation of various infections, including diseases transmitted sexually
- Microscopy and bacteriological culture of the smear from the vagina and cervix
- Biopsy of the uterine cervix whereby a tissue sample is taken for a histological microscopic examination
- PAP test-microscopic examination of the smear to exclude precancerous conditions and malformations
- Laboratory determination of various hormones level in the blood
Choice of the technique is done individually for each woman. A doctor bares in mind her age, presence of concomitant somatic pathology and the nature of menstrual disorders.
Treatment of menstrual disorders abroad
Therapy scheme is prescribed by a doctor after comprehensive diagnostics. There are several types of treatment that are possibly used depending on a pathological condition:
- Conservative therapy (antibiotics, hormonal medicines)
- Physical impact techniques on the mucous membrane of the cervix in case of some malformations (cryodestruction, laser therapy, methods of radio wave surgery)
- Hysteroresectoscopy (endoscopic surgical methods for the malformations removal from the uterus)
- Laparoscopic cauterization of the ovaries is used for polycystic ovary treatment
There exists a single treatment scheme. Menstrual disorders mean a wide group of symptoms evidencing various diseases. Besides, not all of them include reproductive organs issues. These can be issues with the liver, thyroid gland, brain, hematopoiesis system. Thus, therapy is selected based on the underlying disease.
If the only goal of treatment is to get pregnant, a woman is prescribed a treatment for ovulation stimulation. Conception is possible to achieve within a few cycles. If conservative treatment of infertility doesn’t bring any effect, then in vitro fertilization is performed
Prognosis for menstrual disorders
Life and work capacity prognosis is normally favourable for menstrual disorders. The majority of diseases respond very well to treatment.
Prognosis for the reproductive function depends on the number of factors such as; the underlying disease, degree of its severity, a woman’s age. They are able to restore female fertility before the age of 35. If infertility still remains, IVF is performed. Chances to get pregnant differ depending on the way they provide IVF. German hospitals provide 45% chance to conceive and give birth to a baby from the first try. While in developing countries, this chance does not go over 30%.
Presence of a genetic abnormality makes the prognosis for the reproductive function unfavourable. In this case, absolute infertility is usually confirmed. In some women with genetic and chromosomal abnormalities, pregnancy can be achieved by using IVF with donor oocytes.