Menstural disorders, neuroendocrine syndromes - kumar vikash Bukovinian state medical University,ukraine

1. MENSTURAL DISORDERS,
NEUROENDOCRINE
SYNDROMES
KUMAR VIKASH
GROUP- 55

4. Introduction
 Menstrual disorders and abnormal uterine bleeding
(AUB) are among the most frequent gynecologic
complaints.
 Menstrual disorders frequently affect the quality of life of
adolescents and young adult women and can be indicators of
serious underlying problems.

5. Normal Menstrual Cycle
 The normal menstrual cycle is a tightly coordinated cycle of
stimulatory and inhibitory effects that results in the release
of a single mature oocyte from a pool of hundreds of
thousands of primordial oocytes.

7. Classification of menstrual disorders
1. Amenorrhea
 Primary amenorrhea: Lack of sexual development ; Delayed sexual
development (infantilism) ; Without delay in sexual development-
malformations of the uterus: aplasia of the vagina and uterus.
 Secondary amenorrhea
2. Hyperprolactinemia
3. Dysfunctional bleeding
 Ovulatory bleeding
 Anovulatory bleeding

8. 4. Neuroendocrine syndromes
premenstrual syndrome; menopausal syndrome; polycystic (sclerocystic) ovary
syndrome, Sheehan's syndrome.
Certain medications can cause menstrual periods to stop,
including some types of: • Antipsychotics • Cancer chemotherapy •
Antidepressants • Blood pressure drugs • Allergy medications

9. Amenorrhea
 absence of menses in adult women within 6 months.
Amenorrhea is not any dependent disease, but a
symptom of many diseases, causing disorders of
menstrual function regulation on different levels.

10. Forms of amenorrhea:
 Primary amenorrhea is the absence of menstrual function from puberty age.
 Secondary amenorrhea is the suppression of menstrual function in woman who has
menstruated before.
 Physiological amenorrhea is absence of menses before puberty period, during
pregnancy and lactation, in menopause period.
 pathological amenorrhea can be provoked by many causes, especially by general
state changes, most frequently by endocrine diseases.
There are different forms of pathological amenorrhea: hypothalamic , pituitary,
ovarian and uterine ones according to the level of menstrual function regulation
disturbance.

11.  False amenorrhea —absence of menstrual blood excretion because of cyclic
changes presence in organism. False amenorrhea is a clinical sign of genital
organs development abnormalities — thresia of hymen or vagina, when blood,
having no exit, is accumulated in vagina, uterus and uterine tubes.
 True amenorrhea - absence of cyclic changes in women's organism , most
frequently associated with acute insufficiency of sexual hormones.

13. DYSFUNCTIONAL UTERINE BLEEDING

14.  A dysfunctional uterine bleeding (DUB) is the bleeding, not associated with
organic diseases of women's genitals, interrupted pregnancy or systemic
diseases of the organism.
 Classification of dysfunctional uterine bleeding according to
pathogeneses:
I. Ovulative (two-phased) :
• hypoestrogen
• hypogestagen
• hyperestrogen
II. Anovulative (monophased) :
• hypoestrogen
• hyperestrogen

15.  According to patient's age:
juvenile,
reproductive age
climacteric,
menopausal bleeding.
According to onset time:
cyclic
non-cyclic

16. Evaluation

20. NEUROENDOCRINE SYNDROME
 Pre-menstural syndrome
 Polycystic ovarian syndrom
 Amenorrhea
 PCOD
 Sheehans syndrome
 Post castration syndrome
 Ashermans syndrome
 others

21. Polycystic ovarian syndrom
 PCOS is also known as Stein-Levental syndrome.
Structural changes of the ovaries:
-Ovaries are enlarged in size 2-6 times on both
sides.
-Hyperplasia of stroma and theca cells.
-Presence of big amount of follicles with cystic
changes and atresia.
Ovarian capsule is thick

25. Diagnostics

26. TREATMENT