Everything that happens around us primarily affects the cerebral cortex and is transmitted further down the chain, so over the past 9 years, in the clinical practice of our doctors, cases of stress amenorrhea (absence of menstruation) have significantly increased. But stress for the body is not always shelling, being in a bomb shelter or losing loved ones, the state of the endocrine system is also affected by, for example, lack of sleep.
Our capabilities in the treatment of diseases of the endocrine system in gynecology
To find out the cause of a reproductive disease, the gynecologist-endocrinologist must first talk with the patient about the peculiarities of her life, previous diseases, family history, etc. You should spend at least half an hour on the first meeting, and preferably an hour. And after that, you can order an examination: first of all, an ultrasound of the pelvis, mammary glands, and thyroid gland. All this can be done on site at the VIRTUS Institute, because we have specialist doctors and the necessary equipment.
It is very important to take into account the day of the cycle: usually the examination is scheduled for the 5-9th day from the start of menstruation. Thus, a woman on the first day of menstruation can call and make an appointment for a week, come to the doctor and get a full examination in one day.
The next step is to examine the level of hormones in the first (day 3-5) and second (day 21-23) phases of the menstrual cycle. If the cycle is longer or shorter than 28-30 days, the examination dates will vary. With the results of hormone level analysis and ultrasound, the patient comes for a second consultation, during which the doctor offers a treatment plan. Sometimes additional research is needed: for example, when a woman has a high level of prolactin. In 20-30% of cases, it may be associated with changes in the pituitary gland, in particular the formation of a micro- or macroadenoma, and then magnetic resonance imaging of the head, preferably with contrast, is necessary. But you should not do any examinations before consulting a gynecologist: this is an unnecessary waste of time and money.
Usually, 1-2 months after the start of treatment, depending on the diagnosis, a control ultrasound and an analysis of the level of hormones (individual types or a complete package) are prescribed.
Treatment of diseases of the endocrine system in gynecology
Irregular menstrual cycles, whether they are too long, too short, or delayed, are often treated with the standard regimen of birth control pills. But there are many causes of cycle disorders, so such therapy is appropriate in about 30% of cases. Before prescribing treatment, it is not enough just to pass a general blood test, liver tests and do an ultrasound. A gynecologist must know diseases of the endocrine system, understand the chain of endocrine function of the reproductive system. The cause of problems with menstruation can be hypothyroidism or hyperthyroidism (insufficient or excessive function of the thyroid gland), and therefore the patient should be referred for an analysis of thyroid hormones and prolactin. Prolactin is one of the stress hormones, and at high levels it can trigger amenorrhea. Increased production of prolactin causes not only stress – it is enough to work a night shift or go to bed late, because the release of hormones in people is subject to daylight. It is also important that the chain of functions of a woman’s reproductive system is not designed for the number of periods she has. After all, menstruation is a pregnancy that did not occur, and during the life of our ancestors, a woman had 50-60 menstruations, not 500-600, as today.
Thus, the first task of a gynecologist-endocrinologist is to understand where the deviation from the norm occurs and what provokes it.