Frequent menstruation - two or three times a month: what to do? 203

Causes of menstrual irregularities after 40 years

The menstrual cycle is divided into 2 phases: follicular and luteal.
During the first half of the cycle, the egg matures; this phase ends with ovulation and the release of the germ cell from the follicle. The onset of menstruation is the beginning of the follicular phase. When the follicle ruptures and the egg is released, the luteal phase begins, at which time the corpus luteum is formed under the influence of hormones that prepare the body for pregnancy. Along with this, the following processes occur:

• the remaining follicles stop developing intensively;
• the internal uterine layer of the endometrium begins to grow, to which, in the event of fertilization, the egg should attach, the vascular network in this layer intensively develops;
• the ducts of the mammary glands increase;
• To prevent rejection of a fertilized egg, the body's protective properties are reduced.

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If fertilization does not occur, the corpus luteum dies and critical days begin. New regulations should begin no earlier than after 28-32 days; in rare cases, this range may vary between 21-35 days. If a second period appears within a month, you should know exactly the reasons for these processes in order to understand whether this is a pathology that requires the attention of a specialist, or a norm that should not cause concern.

Hormonal changes begin at different ages for every woman. But on average, changes in reproductive function begin precisely at the age of 40–45. Therefore, frequent periods after 45 years, dizziness, migraines, first hot flashes, changes in the nature of bleeding during menstruation are typical signs of the onset of menopause.

Menstruation at this age twice a month only means that much less female hormones are produced, reproductive function decreases, and menopause occurs. It is at this age that problems with conception may appear: due to a decrease in the concentration of hormones and a decrease in the number of mature eggs, it can be difficult for a woman to become pregnant and bear a child.

Hormonal balance is the main factor responsible for women's reproductive health. Normal concentrations and ratios of sex hormones ensure the possibility of conceiving and bearing a child, and the regularity of menstruation.

Early onset of menopause (at about 40 years of age) is most often caused by hormonal imbalance. The production of estrogen and progesterone gradually decreases, the menstrual cycle is disrupted, general health worsens, and bleeding may occur, including between normal menstruation.

The frequency of the cycle is also affected by the presence of female diseases, such as:

• colpitis;
• vulvitis;
• bartholinitis;
• adnexitis;
• bacterial vaginosis;
• candidiasis;
• obstruction of pipes;
• inflammation of the ovary or uterus.

Diseases of the female genital area not only worsen health and manifest themselves with pronounced symptoms, but also cause long-term consequences - anatomical changes in the female body. Most often we are talking about adhesions or obstruction of the tubes, which impair blood flow in the soft tissues, reduce the likelihood of fertilization of the egg, and affect the ovulation process.

Changes in the menstrual cycle also appear - periods become very painful, irregular, appear in the middle of the cycle, the volume of discharge increases or, on the contrary, decreases.

Tumors

Depending on the aggressiveness, tumors of the female reproductive system are divided into benign and malignant:

1. Benign ones include uterine fibroids, cysts, ovarian tumors, serous cystoma, mucinous benign tumor, cystadenoma, Brenner tumor, stromal cell and germ cell tumors. Such neoplasms do not pose a great danger, but in most cases they are removed, since the risk of degeneration into a malignant neoplasm increases. The diagnosis is often made by biopsy, which additionally allows one to exclude cancer. The most common types of tumors developing in the female reproductive system are uterine fibroids and ovarian cystomas.
2. Malignant tumors (cancer) require mandatory high-quality diagnosis and treatment, since such a condition is dangerous not only for the health, but also for the life of a woman. Cancer of the vagina, ovary, uterus, cervix, and labia often develops asymptomatically or has signs of another disease. The development of oncology can be detected with a sharp change in the nature of menstruation, the appearance of pain in the abdomen and lower back, severe bleeding, frequent unreasonable increases in temperature, external changes, constant fatigue, weight loss of more than 10% over the past six months.

Menstruation for the second time in a month: main reasons

Sometimes repeated menstruation within a month is caused by functional or physiological conditions:

1. Taking any hormonal contraceptives. Such drugs impose a new hormonal background on the body, which you need to get used to. The result is unscheduled menstrual-like discharge. Usually, with further use over several cycles, bleeding does not recur.
2. Intrauterine device. It is regarded by the body as a foreign body. The uterus constantly contracts to expel the spiral, which can cause bleeding, sometimes quite profusely.
3. Sometimes an earlier onset of menstruation occurs after surgical curettage. A peculiar reaction of the body to the removal of the endometrium.
4. Physical and emotional stress, previous colds, and sudden climate change can cause premature menstruation.
5. Normally, menstruation may occur for the second time in a month if the cycle lasts 21-28 days, and the first day of the last menstruation fell on the first day. Then the next cycle will begin in the same month.
6. Ovulation may be accompanied by spotting, often mistaken for repeated regula. This happens in the middle of the cycle on days 11-15.
7. During pregnancy, implantation of the fertilized egg into the uterine wall can cause bleeding. This is possible two weeks after the previous menstruation.

Frequent periods can be caused by physiological conditions accompanied by hormonal imbalances. These include:

• the period of puberty, when the cycle is just being established;
• in premenopause, ovarian function declines;
• postpartum period for 1 year.

Contraception can cause menstrual irregularities

Pathological

When a woman notices her period for the second time in a month, the reasons may be serious. These are diseases of the reproductive, endocrine, hematopoietic systems:

• Myoma. Although this is a benign formation of the uterus, it can reach large sizes and disrupt the functions of the female genital organs. There is always a danger of a tumor degenerating into a malignant one.
• Endometriosis. The second most common cause of uterine bleeding. Repeated blood loss is characteristic (they can be insignificant, spotting, brown) on the same days of the cycle. For example, after the end of menstruation, blood appears again after 3-4 days.
• Endometrial hyperplasia. Overgrowth of the uterine mucosa often leads to repeated bleeding of varying severity.
• Polyps. Variants of benign tumor. Due to their shape, they can be damaged, twisted, pinched, causing bleeding.
• Cervical erosion . Erosion often bleeds after mechanical contact: sexual intercourse, installation of a diaphragm, douching, examination by a gynecologist. Usually the blood loss is not profuse and is not accompanied by pain.
• Inflammatory processes of the genital organs . Long-term inflammation in the pelvic organs leads to menstrual irregularities. Both early onset of menstruation and its delay are possible.
• Spontaneous termination of pregnancy in the early stages. Miscarriage, as well as interrupted ectopic pregnancy, cause menstrual-like bleeding.
• Bleeding disorders , vasculitis can cause prolonged, frequent periods.
• Endocrinological diseases lead to an imbalance of hormones in the body and, as a result, disruption of the menstrual cycle. This often affects patients with diabetes mellitus and thyroid pathologies.

Video about menstrual irregularities

https://youtu.be/SZSG7Bvr1s4

Pathological conditions

Violations can be caused by various factors, the most serious of which are pathological conditions. Ovarian pathology affects not only the abundance of discharge, but also its frequency. This process may involve various types of damage and malignant neoplasms.

Often the problem is hidden in the corpus luteum. The lack of the main female hormone progesterone is not able to maintain the cycle at a normal level. As a result, violations occur. However, in most cases, due to low progesterone levels, discharge may not be present for a long time.

If your periods are too heavy and this happens more than once in one cycle, the possibility of developing polyps cannot be ruled out. A chronic inflammatory process can lead to damage in the uterine cavity, which provokes frequent discharge.

Often, constant menstruation is not associated with the functioning of the ovaries and the entire genitourinary system of a woman. This process can be affected by abortion or curettage of the uterine cavity. During the removal of the embryo, mechanical damage can occur, as a result of which discharge is recorded for a long time. If they are abundant, this indicates serious damage or involvement in the process of inflammation.

The operated ovary may bleed. As a result of surgical intervention, dysfunction of the system develops. This leads to irregular menstruation.

Dysfunctional uterine bleeding is a consequence of a pathological process. People with bleeding disorders fall into this category. Any damage to the uterus provokes bleeding of varying intensity.

If menstruation occurs frequently, but no surgical interventions have been performed, most likely the woman has developed a pathological process.

Treatment and diagnosis of cycle failures

Not only women’s health in general, but also the timely onset of menopause, as well as the ability to become pregnant during menopause if a woman is planning to conceive, depends on the effectiveness of treatment and prevention.

Before determining therapy, a mandatory diagnosis of diseases that may become a probable cause of a failure in the cycle is carried out. With heavy menstruation, the first drug prescribed to a woman will be a hemostatic agent. Other medications are selected depending on the diagnostic results.

For appropriate treatment, you must contact a gynecologist. At the first stage, a diagnosis of the disease will be carried out, which includes:

• taking an anamnesis to determine the time of onset of changes in the menstrual cycle;
• gynecological examination, palpation of all accessible pelvic organs;
• strokes;
• oncocytology (smear), especially when identifying pathological foci on the cervix;
• ruling out a possible pregnancy by performing a routine home test or blood test for hCG levels;
• study of endocrine status - determination of the level of estrogen, progesterone, pituitary hormones, prolactin, if necessary, study of the function of the thyroid gland, adrenal glands;
• Ultrasound – abdominal and transvaginal sensors are more often used;
• histological examination of endometrial particles after preliminary curettage of the uterine cavity - according to indications.

Treatment of heavy menstruation, when menstruation occurs twice a month, is prescribed in accordance with the detected causes of hormonal cycle disorders. This may include:

• the use of hemostatic drugs for heavy bleeding;
• elimination of hormonal disorders;
• treatment of concomitant diseases – STDs, anemia;
• review of therapy used to combat underlying diseases (for example, taking hormonal drugs);
• the use of drugs to stimulate ovarian function, physiotherapeutic methods, herbal and vitamin therapy;
• the use of complex methods of infertility therapy (if conception is desired).

Operative methods

Surgical methods for the treatment of gynecological female diseases are used for the following purposes:

• diagnostic and therapeutic curettage;
• removal of polyps, cysts, myomas, fibroids;
• resection of the ovary, removal of the fallopian tube;
• extirpation of the uterus or other organs.

All types of malignant neoplasms require intervention. In this case, in addition to removing the tumor itself, chemotherapy and/or radiation therapy is prescribed.

Any disruption of the menstrual cycle requires examination, and after 40 years the problem becomes especially relevant due to the increased risk of the formation of malignant and benign tumors.

If a woman has repeated periods during one menstrual cycle, she should first take a pregnancy test to rule out or confirm conception. If there are pathological symptoms, you should immediately seek medical help. Diagnosis of the pathology is made by a gynecologist; in some cases, consultation with other specialists (endocrinologist, psychotherapist) may be necessary.

Normal menstrual cycle

Menstruation, which does not occur twice in four weeks, but obeys the lunar calendar, indicates that all the mechanisms responsible for the birth of offspring are working without failures. The normal pause between bleeding should be 28-32 days.

By the way, menstruation can appear 2 times per cycle even in the case when the interval between adjacent menstrual bleeding in a representative of the fair half of humanity is 21-28 days. This is due to the individual characteristics of the body and is not considered a pathology. After all, given that a month is 30 days, and menstruation began, for example, on the 1st, bleeding can occur twice. This often happens to girls under 18 years of age.

But when the patient has not previously observed a similar phenomenon, and her menstruation begins again, her periods are heavy and scarlet, she should immediately contact a medical facility, since such a clinical picture may indicate a serious illness.

Repeated menstruation as an exception to the rule

If your period comes again in a month, this is not correct, it means there is a failure in the system and you need to find out the reasons. Failure in the menstrual cycle can be normal, or it can be a pathology that needs to be treated.

An exception to the rule is repeated menstruation in the following cases:

• Cycle disorders. Due to hormonal imbalances, menstruation can occur twice in one month; this may be due to taking medications, abortion, or childbirth.
• Taking oral contraception. Birth control pills can affect the menstrual cycle for the first 3 months from the start of use. If it continues further, you need to consult a doctor.
• Establishing a cycle. In young girls with the onset of their first menstruation, the menstrual cycle is unformed for 2 years and disruptions are possible.
• Climax. With the onset of menopause, hormonal levels change, which sometimes affects menstruation.
• Depression or stress. The result is hormonal imbalance.
• Sudden weight loss or weight gain leads to hormonal imbalances.
• Intrauterine device. Placed only by a gynecologist, it may not be suitable for a woman and repeated periods will begin, then it is necessary to change the method of contraception.
• Climate change, adaptation.

What to do if menstruation occurs twice a month?

You should contact your doctor for advice and referral for testing if you have any of the following symptoms:

• If menstruation comes for the second time in a month, the blood discharge is scarlet, and the color does not change for 4-5 days, this indicates bleeding of the uterus. Medical help should be sought immediately. The doctor should prescribe medications to stop the bleeding and determine the cause.
• When, 14 days after the end of menstruation, the next one begins and there is pain in the lower abdomen similar to contractions, you need to call an ambulance. These symptoms are similar to an ectopic pregnancy.
• Menstruation, unusual in color, volume and period of occurrence, is already a reason to consult a doctor for medical help.

Diseases that cause bleeding

In addition to the reasons described above, there are many pathologies that affect a woman’s internal organs and can cause blood to appear from the vagina. Let's look at the most serious and common ones.

1. Uterine fibroids. A tumor that is not malignant, but can develop to quite impressive sizes. At a certain stage of its growth, it causes disturbances in the production of sex hormones, which leads to repeated menstrual bleeding. Treatment of fibroids requires serious drug therapy and sometimes surgery.
2. Adenomyosis. This inflammatory process also affects the body's endocrine system, which is why menstrual blood appears several times during the reproductive cycle.
3. Inflammation of the ovaries, pathologies of the fallopian tubes, cervical erosion. These processes often cause both menstrual and intrauterine bleeding. The appearance of blood in such pathologies requires urgent medical intervention to avoid the risk of anemia.
4. Endometriosis and polyps. Such negative processes occur in the internal cavity of the uterus. Under certain circumstances, they can cause menstruation, because it consists of the remnants of the exfoliated endometrial layer.
5. Cancerous tumor of the uterus. The appearance of malignant tumors in the main reproductive organ of a woman causes bleeding and watery discharge from the vagina. Menstruation of this consistency requires an immediate visit to a gynecologist to undergo a thorough examination of the body.
6. Miscarriage. If for some reason the fertilized egg fails to implant in the uterine cavity, the body gets rid of it, that is, a miscarriage occurs. This process is accompanied by bleeding, which occurs regardless of the reproductive cycle.
7. Ectopic pregnancy. In the case when the development of the embryo began not in the uterus, but in the fallopian tube, bleeding from the vagina may appear, reminiscent of menstruation. By the way, this pathology is very dangerous for a woman’s reproductive system and requires immediate surgical intervention.
8. Poor blood clotting. May lead to recurrence of menstruation.