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2024 | OriginalPaper | Hoofdstuk

17. The normal and abnormal menstrual cycle

Auteurs : Prof. dr. Joop S. E. Laven, Prof. dr. Nils C. B. Lambalk

Gepubliceerd in: Textbook of Obstetrics and Gynaecology

Uitgeverij: Bohn Stafleu van Loghum

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Summary

The regulation of the menstrual cycle in women is an intricate interplay between the hypothalamic, pituitary and gonadal hormones. Immediately following menarche, most menstrual cycles are anovulatory and, hence, the interval between menstruations is slightly irregular. After two to four years, most girls will have regular periods. However, a small number will continue to have irregular or even absent menses. Other women will develop irregular cycles later on in life if they gain too much weight. In others, the disappearance of menses might be associated with other disturbing symptoms. Anovulatory cycles are classified as having central, peripheral or combined causes. Apart from subfertility, anovulation is also associated with other short-term as well as long-term health issues such as hirsutism, obesity, metabolic syndrome, cardiovascular disease, osteoporosis and type 2 diabetes mellitus. Therefore, women with irregular menstrual cycles deserve proper medical attention, appropriate care and sufficient follow-up during their whole lifespan in order to prevent and timely treat some of the disturbing symptoms and health sequelae later on in life.
Bijlagen
Alleen toegankelijk voor geautoriseerde gebruikers
Woordenlijst
Amenorrhoea
No menses at all or interval exceeding 199 days.
Androgenic alopecia
Male type of scalp hair loss in women.
Anosmia
Loss of the sense of smell.
Anovulatory
Not having regular ovulations.
Hirsutism
Hair overgrowth.
Hormone replacement therapy (HRT)
Replacement of oestrogens and progestogens in order to replace the missing sex steroids.
Hypogonadotropic hypogonadism
Absent ovarian activity due to lack of central stimulation.
Kallmann syndrome
Anosmic hypogonadotropic hypogonadism.
Laparoscopic ovarian diathermy (LOD) (drilling)
Destruction of ovarian tissue using electro-cauterisation.
Menarche
First menstrual period ever Menopause Last menstrual period.
Normogonadotropic normo-oestrogenic anovulation
Combined central and peripheral cause of anovulation PCOS Polycystic ovary syndrome Hypergonadotropic hypogonadism Irresponsive ovary due to absence of follicles.
Oligomenorrhoea
Interval between menses exceeding 35.
Osteopenia
Low bone mineral density, T score between −1.0 and −2.5.
Osteoporosis
Decreased (too low) bone mineral density T score lower than −2.6.
PCOS
Polycystic ovarian syndrome.
POI
Primary ovarian insufficiency.
Polymenorrhoea
Interval being shorter than 21 days.
Literatuur
1.
go back to reference Amsterdam ESHRE/ASRM-Sponsored 3rd PCOS Consensus Workshop Group. Consensus on women’s health aspects of polycystic ovary syndrome (PCOS). Hum Reprod. 2012;27:14–24. Amsterdam ESHRE/ASRM-Sponsored 3rd PCOS Consensus Workshop Group. Consensus on women’s health aspects of polycystic ovary syndrome (PCOS). Hum Reprod. 2012;27:14–24.
2.
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3.
go back to reference Balen AH, Morley LC, Misso M, Franks S, Legro RS, Wijeyaratne CN, Stener-Victorin E, Fauser BC, Norman RJ, Teede H. The management of anovulatory infertility in women with polycystic ovary syndrome: an analysis of the evidence to support the development of global WHO guidance. Hum Reprod Update. 2016;22:687–708.CrossRefPubMed Balen AH, Morley LC, Misso M, Franks S, Legro RS, Wijeyaratne CN, Stener-Victorin E, Fauser BC, Norman RJ, Teede H. The management of anovulatory infertility in women with polycystic ovary syndrome: an analysis of the evidence to support the development of global WHO guidance. Hum Reprod Update. 2016;22:687–708.CrossRefPubMed
4.
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go back to reference Luisi S, Orlandini C, Regini C, Pizzo A, Vellucci F, Petraglia F. Premature ovarian insufficiency: from pathogenesis to clinical management. J Endocrinol Invest. 2015;38:597–603.CrossRefPubMed Luisi S, Orlandini C, Regini C, Pizzo A, Vellucci F, Petraglia F. Premature ovarian insufficiency: from pathogenesis to clinical management. J Endocrinol Invest. 2015;38:597–603.CrossRefPubMed
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go back to reference Meczekalski B, Katulski K, Czyzyk A, Podfigurna-Stopa A, Maciejewska-Jeske M. Functional hypothalamic amenorrhoea and its influence on women’s health. J Endocrinol Invest. 2014;37:1049–56.CrossRefPubMedPubMedCentral Meczekalski B, Katulski K, Czyzyk A, Podfigurna-Stopa A, Maciejewska-Jeske M. Functional hypothalamic amenorrhoea and its influence on women’s health. J Endocrinol Invest. 2014;37:1049–56.CrossRefPubMedPubMedCentral
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go back to reference Trofimova T, Lizneva D, Suturina L, Walker W, Chen YH, Azziz R, Layman LC. Genetic basis of eugonadal and hypogonadal female reproductive disorders. Best Pract Res Clin Obstet Gynaecol. 2017;44:3–14.CrossRefPubMed Trofimova T, Lizneva D, Suturina L, Walker W, Chen YH, Azziz R, Layman LC. Genetic basis of eugonadal and hypogonadal female reproductive disorders. Best Pract Res Clin Obstet Gynaecol. 2017;44:3–14.CrossRefPubMed
Metagegevens
Titel
The normal and abnormal menstrual cycle
Auteurs
Prof. dr. Joop S. E. Laven
Prof. dr. Nils C. B. Lambalk
Copyright
2024
Uitgeverij
Bohn Stafleu van Loghum
DOI
https://doi.org/10.1007/978-90-368-2994-6_17