The sexual menstrual pathologies and disorders in adolescents

The sexual pathologies in adolescence, disorders, menstrual irregularities in adolescents: irregular menstrual cycles

The term menstrual disorders refers to any of a number of conditions that are related to the menstrual cycle. Menstruation is the shedding of the lining of the uterus (the endometrium) each month, also referred to as the menstrual period. Menstrual periods usually last for five to seven days.

The adolescents usually undergo of diverse pathological upheavals in the puberty and adolescence -
In case of menstruation slightly prolonged, reduced intervals and sporadically increased menstruations, that nevertheless do not repel of important form on the values of hemoglobin, usually it is enough with clarifying to the patient or to the mother of in question patient only of a transitory upheaval that usually sends spontaneously.

It is advised to wait for about three months before applying to treatment some, and in this time interval they are possible to be adopted reconstitute measures (iron) and to be advised to the patient who follows a diet appropriate (rich foods in proteins and vitamins).

- If the menstruations very are prolonged and frequent, the values of hemoglobin fall, so that the general measures of character unspecific are insufficient.
The election treatment is the hormonal one.
The therapeutic principle consists of causing, by means of the administration during about 10 days of hormonal preparing, the halting of the hemorrhage.
This treatment must take place during several months, since otherwise relapses can take place.
Inasmuch as it concerns to the inhibitor use of the ovulation (that are to administer from 5º day of the cycle as if it was a contraceptive treatment, in the girls in pubertal age it is necessary to have much well-taken care of.
In effect, in a phase of the development in which is to be a balance between hípofísaria and ovarian activity, this treatment can alter this so sensible process through the artificial suppression of the ovulation.
If the hormonal treatment fails, is probable that it is not true dysfunctional metrorrhagia, but of the first signs of a disease of the blood. In case of metrorrhagia profuse and prolonged, with very short intervals in which the values of hemoglobin descend below the 9 g %, the hospitalization necessity prevails.

Amenorrhea

Adolescents frequently experience irregular menstrual bleeding patterns, which can include several consecutive months of amenorrhea. Amenorrhea-except that occurring before puberty, during pregnancy or early lactation, and after menopause-is pathologic. Amenorrhea may be caused by anatomic abnormalities; hypothalamic, pituitary, or other endocrine dysfunction; ovarian failure; or genetic defects

Secondary amenorrhea.

With the term of secondary amenorrhea the menstruation absence is defined during a more or less long period (more than 6 months).
This form of amenorrhea can as much be physiological as pathological. – Physiological Amenorrhea.
In case of long amenorrheics periods, in the following year to the one of menarche, it is possible to be hoped, without preoccupations and following treatment some, to that the menstruation reappears of spontaneous form. Generally, in the first 6 months or even later, the spontaneous regulation of the cycle takes place. Anyway, before a girl who suffers secondary amenorrhea is necessary to always exclude the possibility from a gestation. -

Pathological Amenorrhea.

It is necessary to clarify the diagnosis whenever the secondary amenorrhea attends accompanied of one of the following conditions. Virílización: it is necessary to think about the existence of ovarian tumors, syndrome of Stein Leventhal or tumors of the suprarrenal crust.

Galactorrhea (raised of milk): before anything it is necessary to exclude a possible pregnancy and next to make a x-ray of the Turkish chair (skull) and a valuation of the prolactose to exclude a tumor hipofísarío. In addition, it is necessary to verify if the patient used contraceptives, psícotropos fenotíacins or other drugs.
In case of amenorrhoea of neurógen or psychogenic origin the psycotherapy prevails, with which in numerous cases a spontaneous reappearance of the menstruations is obtained. -

Premenstrual Tension.

The premenstrual syndrome does not have much importance in the girls. The symptoms begin immediately after the ovulation and increase of intensity until the appearance of the menstrual flow, the girls refer the suffering of hemicranias, nervousness, increase of weight due to the water retention and pain breasts. In most of the cases it is enough with a good control, not being due to overvalue the symptoms.

Algomenorrhea.

The regular menstruations that appear of painful form during the adolescence (dismenorrhea of the adolescent) are dismenorrheas primary, dysfunctional almost always, that does not respond to no organic cause. 2 or 3 years happen after menarche in girls with a already two-phase cycle. The concomitantes dismenorrheas to the first menstruation are very little frequent.
The origin of the primary dismenorrhea is not very clear. They often talk about like main the neurovegetativos factors, that do not have any determining meaning nevertheless.
A hormonal component cannot be excluded, since these girls always present/display two-phase cycles.
The dismenorrhea can even consider a sign of which the ovulation has taken place. It is very possible that one is angiospasms of the uterine musculature, that cause painful contractions ísquemícs. Anomalies of position of the immature and still hipoplasic uterus can cause painful contractures upheavals of the uterine irrigation and.
Although 25% of these girls do not require treatment some, this one can be problematic in more from a case.
As preventive measure in any case is indicated the explanation about the physiology and the function of the menstruation.

Oligomenorrhea

Oligomenorrhea is the term used to describe infrequent or light menstrual menstruation in a woman with previously normal periods cycles; are known as oligomenorrhea. It is very common in early postmencharchal period and not usually worrisome. But any woman with regularly established periods can develop oligomenorrhea.
When girls first menstruate they often do not have regular cycles for a few years. In some women periods may occur every three weeks and in others, every five weeks.
Flow also varies and can be heavy or light. Women should be concerned when periods come less than 21 days or more than 2 to 3 months apart, or if they last more than eight to ten days. Such events may indicate ovulation problems.

Dysmenorrhea

It is the cyclic menstruation pain in the lower abdomen usually associated with other gastrointestinal and neurological symptoms. It may be associated with pathology (secondary dysmenorrhea) or may be idiopathic in origin (primary dysmenorrhea-more prevalent). Dysmenorrhea is a common disorder that affects approximately 50% of menstruating women 10 .The pain is thought to result from uterine contractions and ischemia, probably mediated by prostaglandins produced in secretory endometrium; therefore, primary dysmenorrhea is almost always associated with ovulatory cycles and usually appears within 1-2 years of menarche, when ovulatory cycles are established. This common disorder usually starts during adolescence and tends to decrease with age and after pregnancy. Some women experience mild to moderate lower abdominal pain during mid-cycle (the 13th – 15th day of the cycle), some times there is blood spotting also. This is because of the release of the ovum into peritoneal cavity and no treatment is required for this Mittelschmerz syndrome

Adolescent has to prepare to for presentation of first menstruation, because she must to know that she is a physiological process, that will normally condition all its life while the sexual maturity lasts, without special upheavals and pain.
Although in some cases he attends himself spontaneous remission, is not due for that reason to neglect the treatment in the puberty, because otherwise the picture is considered irremediable and been left form in psique of the patient.
Only in serious, resistant cases to the mentioned treatment, one resorts to a hormonal therapy. In case of secondary dismenorrhea, the treatment will have to fight the base disease, being the gynecologist the one in charge to establish it.
In the young people operations like the expansion of the neck of the uterus under narcosis or the resección of likeable, the so habitual ones in other times are almost never indicated.

Tags: adolescent, anatomy, female anatomy