Menstrual disorders are a common problem in women’s obstetrics and gynecology. To understand why menstrual disorders occur, it is important to start with the normal menstrual cycle. A woman’s period is a sign of her sexual maturity, and each month, the uterus prepares itself in advance for pregnancy. The endometrium has a functional layer (the bottom part of the picture), which begins to grow each month under the influence of estrogen from the ovaries, and grows to a certain thickness by the middle of the menstrual period, preparing the uterus for the implantation of a possible fertilized egg on the uterus. In the second half of the menstrual cycle thereafter, the so-called luteal phase occurs, in which the ovaries secrete progesterone, which supports the development of a possible fertilized egg, and, if there is no implantation of an embryo on the uterus, then the The prepared endometrium then begins to shed, forming menstruation. The cyclic changes in the endometrium, as described above, are regulated by the hormones secreted by the ovaries. Before ovulation, the ovaries predominantly secrete estrogen (yellow line in the diagram), which supports the growth of the endometrium, and after ovulation, a corpus luteum is formed, which secretes progesterone (orange line in the diagram). Progesterone raises the body’s temperature during the second half of menstruation, the red line seen in the diagram. The hormonal cycling of the ovaries is regulated by a higher center, the pituitary gland in the brain, which periodically secretes FSH (follicle stimulating hormone, green line in the figure) and LH (luteinizing hormone, blue line in the figure). And again, the pituitary gland is governed by its superiors, which are the hypothalamus, and the hypothalamus is the center of the brain, where thinking and mental factors can be factors that affect the hypothalamus. Understanding this vertical axis of hypothalamus – pituitary gland – ovaries – endometrium, one can know how normal menstruation comes about and understand what may be going on at the time of menstrual disturbances. time what may be going on. It is normal that it takes some time to establish the regularity of menstruation after entering puberty, and it usually takes 2-3 years after menarche to establish its regularity. When you are pregnant, the fertilized egg is implanted in the endometrium, which requires progesterone support from the corpus luteum of the ovary at the beginning, and then hCG (chorionic gonadotropin) secreted by the chorionic villi after the villi have grown to support the corpus luteum’s growth and secretion of progesterone, which is when the menstrual cycle does not occur. The uterus will continue to support the development of the fetus. If there is no pregnancy and menstruation is delayed, other more common is the external environment, such as weather, mental, emotional, diet, obesity, medication and other diseases in the body caused by the hypothalamus pituitary ovary function axis of the impact, such an effect is usually temporary, in addition to external causes or affect menstruation of the disease has been treated, usually the menstrual period can be resumed regularly, do not need to be too nervous. If menstruation does not occur for more than 3 months, the patient should be treated with medication. If the regularity of this axis is not established for a long period of time, it may be manifested as disorders of menstruation, or long menstrual cycles, or menstruation for many days at a time, which is also a pathological condition. In the long term, there is also the effect of overstimulation of the body by estrogen, which may increase the risk of endometrial cancer. So if there is a long-term disorder, medication is needed. For young fertile women, the focus is on adjusting the regularity of menstruation, and if fertility is a requirement, medication may be used to promote ovulation.