Irregular menstruation and a growing belly

Irregular menstruation is just a symptom. The treatment should be determined first. The cause of the abnormality should be determined. All aspects of the reproductive endocrine axis must be in normal condition. Irregular menstruation will cause the lower abdomen to grow larger. If there is a problem in any link, the corresponding hormone levels will also change. Advice for women with menstrual irregularities must include checking hormone levels and ovarian function. Six electrochemiluminescent hormones (best done on the third to fifth day of menstruation) and four-dimensional color Doppler ultrasound.

Reflects the condition of the uterus, ovaries and pelvic cavity.

2. Cytological examination

Exfoliated cytology examination to check ovarian function and rule out cervical malignancy.

3. Biopsy

Determine the nature of the lesion and is mostly used for the diagnosis of tumors.

4. Endocrine assay

Currently, hormones secreted by the hypothalamus, ovary, thyroid and adrenal cortex, such as follicle-stimulating hormone, luteinizing hormone, prolactin, estrogen, progesterone, testosterone, triiodothyronine, tetraiodothyronine, and thyroid-stimulating hormone, can be measured. Simple methods commonly used in clinical practice to understand ovarian function include vaginal smear, cervical mucus, basal body temperature and endometrial biopsy.

Hysteriodized oil contrast can be used to understand the condition of the uterine cavity and whether there are submucosal fibroids or polyps. Anteroposterior and lateral sections of the sella turcica can be used to determine whether there is a pituitary tumor.

6. Hysteroscopy or laparoscopy

Observe the lesions of the uterine cavity and pelvic organs.

7. Others

Perform liver, kidney function and blood system examinations as appropriate. Chromosome examination should be performed when necessary.

Diagnosis

The diagnosis is mainly based on medical history, physical examination and auxiliary examinations. During the diagnosis process, it is important to exclude bleeding caused by systemic or female genital pathological causes, such as blood diseases, liver and kidney failure, thyroid dysfunction, pregnancy and related diseases, reproductive tract injury, infection and tumors.

1. Treat the cause

For pathological causes, corresponding treatment is needed according to the specific cause.

2. Stop bleeding and correct anemia

It is caused by long menstrual period and heavy menstrual flow. In addition to general hemostatic measures, hormones or curettage may be used to stop bleeding as appropriate. Give oral blood-enriching drugs or infusion treatment.

3. Adjustment cycle

Estrogen and progesterone alone or in combination can be used for cyclical treatment, or traditional Chinese medicine can be used for treatment.

4. Infertility

Dysfunction of one or more links in the hypothalamus-pituitary-ovarian axis causes anovulation, which is one of the pathophysiological bases of menstrual disorders and one of the causes of infertility. It is a problem that many patients urgently need to solve. Some patients may ovulate but have insufficient luteal function, which can also cause infertility. Different treatments are selected according to the patient's condition to improve ovarian function or replace part of the function of the pituitary gland and hypothalamus.