Normogonadotropic menstrual function disorders in reproductive period

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Abstract

Objective. To analyze and summarize the available literature data regarding the normogonadotropic menstrual function disorders in the reproductive period for identification of pathogenetic approaches to treatment of menstrual function disorders, sterility, miscarriage and pathological processes associated with them.  Most of menstrual function disorders (76 %) are caused by functional hypothalamic disorders, changes in the rhythm and gonadotropic hormone secretion amplitude, which are not accompanied by an altered level of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) – normogonadotropic menstrual function disorders (NMFD).

Materials and methods. Systematic review of native and foreign literature.

Results. The clinical lecture presents the current data on physiology of reproductive system regulation, characteristics of menstrual function in norm and pathology; it defines  normogonadotropic disorders, demonstrates their clinical forms, hypothalamic dysfunction-forming mechanisms as well as  predetermining, trigger, contributory factors, which  form the normogonadotropic disorders; describes clinical features of patients with the above pathology as well as algorithms for therapeutic approaches in the form of “step-type” tactics: elimination of contributory factors, prevention of trigger mechanisms, basic adaptogenic and situational  therapy that leads to restoration of ovulation, realization of reproductive plans and improvement of the quality of life among such patients in more than 90 % of cases.

Conclusions. It was stated, taking into account the variety of mechanisms forming normogonadotropic menstrual function disorders, that treatment of such patients is a complex goal, which requires a detailed studying of female health status, forming a proper clinical diagnosis, developing personified medical programs for a long period of time.

About the authors

Е. А. Sandakova

E.A. Vagner Perm State Medical University

Email: zhoukovskaya@mail.ru

MD, PhD, Professor, Head of the Department of Obstetrics and Gynecology № 2

Russian Federation, Perm

I. G. Zhukovskaya

Izhevsk State Medical Academy

Author for correspondence.
Email: zhoukovskaya@mail.ru

MD, PhD, Associate Professor, Department of Obstetrics and Gynecology

Russian Federation, Izhevsk

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Supplementary files

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2. Fig. 1. The main levels of regulation of the reproductive system [4]

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3. Fig. 2. Stages of folliculogenesis development

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4. Fig. 3. Hierarchical nature of changes in the reproductive system

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5. Fig. 4. Clinical forms of normogonadotropic disorders of menstrual function

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6. Fig. 5. Mechanisms forming hypothalamic dysfunction [10, 23]

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7. Fig. 6. A "stepwise" therapy tactic for NSAIDs

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