Delayed menstruation

　　1. Side effects of drugs

　　Long-term use of oral contraceptives can also cause menstrual delay. It has also been found that the new generation of gastrointestinal motility drugs domperidone, also known as metoclopramide, may also cause this. Since domperidone is not easily permeable through the blood-brain barrier, it is believed that it has no inhibitory effect on central dopamine receptors. The suppression of central dopamine receptors leads to a decrease in the amount of releasing factors entering the anterior pituitary gland from the hypothalamus, resulting in a decrease in the secretion of gonadotropins and adrenocorticotropic hormones by the anterior pituitary gland, leading to amenorrhea and delayed ovulation.

　　2. Pregnancy

　　For women of childbearing age who have had sexual intercourse, when their menstrual period is delayed, they often suspect themselves, whether it is an abnormal menstrual period or pregnancy. This is a common phenomenon in daily life. How to exclude pregnancy and how to determine whether it is a menstrual disease is the first problem to be clarified. First, determine whether it is pregnancy. If the menstrual cycle has always been normal without any signs of delay, and there are some symptoms of pregnancy, then on the fifth day after the delay of the menstrual period (or from the fifth day of the menstrual period), a pregnancy test strip should be used to test the urine. If it is positive, it should be accompanied by a gynecological pelvic examination; if the cervix shows a purple-blue change, the uterine body is full or enlarged, and there may be symptoms such as breast tenderness and nausea, it can be diagnosed as pregnancy. Of course, a pregnancy can also be quickly determined by an ultrasound.

　　3. Surgical causes

　　(1) The menstrual period after surgical or medical abortion is determined by the degree of recovery of the endometrial wall, and it may cause delayed menstruation to a great extent.

　　(2) Cervical adhesion caused by uterine cavity surgery can lead to blood stasis, thus delaying menstruation.

　　4. Premature ovarian failure

　　Premature ovarian failure is caused by abnormal ovarian function. It often manifests as delayed menstruation, oligomenorrhea, amenorrhea, and infertility. It can also appear with symptoms similar to menopause, such as vaginal dryness, sexual difficulties, hot flashes, and insomnia.

　　If the menstrual period is delayed only 1-2 times and there are no other accompanying symptoms, it does not belong to the category of menstrual diseases. If the interval between menstrual cycles is 35 days or more, it is called oligomenorrhea. If the menstrual period stops for more than 3 cycles, it is called amenorrhea. Since no ovulation occurs after amenorrhea, it can also lead to problems such as osteoporosis and endometrial hyperplasia, which must be paid attention to. It is necessary to undergo a comprehensive examination at the hospital immediately.

　　5. Long-term exposure to harmful rays, chemotherapy drugs, and other factors may also cause early ovarian failure and delayed menstruation. Pay attention to ovarian protection. For women over 40 years old, if menstruation is delayed and other endometrial lesions are excluded, it is often due to the gradual decline in ovarian function, and no special treatment is needed in clinical practice.

　　6. Endocrine disorders

　　Endocrine disorders often accompany menstrual disorders, and endocrine disorders can have a significant impact on the secretion of ovarian hormones, such as polycystic ovary syndrome and early ovarian failure due to endocrine causes, which can lead to delayed menstruation. It is necessary to check in a timely manner and receive treatment as soon as an abnormality is found.

　　7. Other factors

　　Such psychological factors as mental tension, pressure, and environmental changes, as well as diseases that affect endocrine function, can all cause delayed menstruation. For example:

　　(1) Irregular lifestyle: According to research, cold stimulation during the menstrual period of women can cause excessive constriction of blood vessels in the pelvic cavity, which can lead to oligomenorrhea or amenorrhea. Therefore, women should have a regular daily life, avoid overwork, especially during the menstrual period, to prevent cold and dampness.

　　(2) Abnormal emotions: Long-term mental depression, being upset, or suffering from major mental stimulation and psychological trauma can all lead to menstrual disorders, dysmenorrhea, or amenorrhea. This is because menstruation is formed after the ovary secretes hormones that stimulate the endometrium, and the secretion of ovarian hormones is controlled by the pituitary gland and the hypothalamus. Therefore, any abnormal function of the ovary, pituitary gland, or hypothalamus will affect menstruation.

　　(3) Excessive dieting: Studies by experts show that a girl's fat should account for at least 17% of her body weight before the first menstruation, and at least 22% of her body weight to maintain a normal menstrual cycle. Excessive dieting, due to insufficient energy intake, causes a large amount of fat and protein to be consumed, resulting in significant estrogen synthesis impairment and deficiency, affecting the onset of menstruation, and even oligomenorrhea or amenorrhea. Therefore, women who pursue a slim figure should not diet blindly.

　　(4) Excessive dieting: Some women, in order to achieve a significant weight loss effect, not only control their diet but also take various weight loss drugs, which can also cause delayed menstruation.

　　(5) Psychological stress: Heavy work tasks, excessive tension, and low mood are all reasons for delayed menstruation. Pressure in daily life will inevitably affect a woman's menstruation, so it is necessary to regulate emotions and maintain an optimistic positive attitude.

　　(6) Thyroid dysfunction: Many women have thyroid abnormalities, such as hyperthyroidism or hypothyroidism, which can lead to a decrease in menstrual blood volume and delayed menstruation.

　　(7) Deficiency of vitamin E: Vitamin E is rich in various cooking oils. Excessive light diet can cause a deficiency of vitamin E, leading to abnormal menstrual cycle, so it is particularly important to supplement vitamin E at this time.

　　(8) Irregular menstruation: Various factors such as diet and lifestyle can lead to irregular menstruation. Delayed menstruation is also a type of irregular menstruation. For example, as middle-aged women's reproductive function gradually declines, hormone secretion is紊乱, menstrual cycle disorder occurs, followed by delayed menstruation.

　　The normal menstrual cycle of women consists of four parts: follicular phase, ovulatory phase, luteal phase, and menstrual phase. Although taking hormones can delay the onset of menstruation, it may also disrupt the endocrine rhythm within the body, cause endocrine disorders, affect ovulation, and cause irregular menstrual periods. The delayed menstruation usually has a large amount of menstrual blood, does not stop, and lasts a long time, which is also harmful to the body. Using drugs to change the cycle will lead to menstrual disorders. Unmarried women, especially some female students, may cause a decrease in menstrual blood volume or even amenorrhea by taking birth control pills to delay the menstrual period, which is very harmful. Therefore, if there are special circumstances and it is necessary to delay the onset of menstruation with drugs, it should be done under the guidance of a gynecologist in the hospital, and should not be bought at a pharmacy and taken arbitrarily. If there are side effects after taking the medicine, please go to the hospital for treatment immediately. In addition, eating tonic foods such as longan and ejiao before menstruation may also slightly delay the menstrual period, causing abdominal distension and pain, and a decrease in menstrual blood volume, so women should not eat these foods before menstruation either.

　　The relationship between irregular menstruation and infertility

　　There is an inevitable relationship between irregular menstruation and the occurrence of female infertility. It does not mean that it will directly lead to a decrease in female fertility, but because it is a manifestation of some gynecological diseases, and these diseases are exactly one of the important reasons for the decrease in female fertility. For example, when women have endometritis, endometriosis, cervicitis, salpingitis, abnormal ovarian function, or endocrine system disorder, various degrees of menstrual abnormalities will occur. If active preventive measures are not taken at this time, it will greatly affect pregnancy to a large extent. Because these diseases are common gynecological diseases that cause a decrease in female fertility, they should be paid attention to.

　　1. Qi stagnation:

　　Menstruation: Menstruation is delayed, the amount of menstrual blood is less, the color is normal or dark red with clots, and the discharge is not smooth.

　　The whole body: depressed spirit, or abdominal distension and pain, or breast distension, chest and hypochondriac pain, the tongue quality may be slightly dark, and the tongue fur may be thin and yellow.

　　2. Phlegm obstruction:

　　Menstruation: Menstruation is delayed, the color of the menstrual blood is light and sticky, and there is a lot of leukorrhea before and after menstruation.

　　The whole body: obesity, dizziness, palpitations, stuffy and bloated epigastrium, nausea, cough with a lot of phlegm, poor appetite and eating less, tongue body is fat, with teeth marks, white greasy fur.

　　3. Blood deficiency:

　　Menstruation: Delayed, less menstrual blood, pale color, thin quality

　　Overall: pale or pale complexion, dizziness and blurred vision, palpitations and insomnia, even hidden pain in the lower abdomen, continuous and pleasant to rub, pale lips and tongue, thin white fur.

　　4. Kidney deficiency:

　　Menstruation: Delayed period, less menstrual blood and thin quality, dark or faint menstrual color.

　　Overall: lumbar sacral pain, frequent night urination, increased leukorrhea, thin and pale quality, or dizziness and tinnitus, pale tongue, thin white fur.

　　1. Maintain a cheerful spirit, avoid mental stimulation and emotional fluctuations. Some women may experience symptoms such as lower abdominal distension, backache, breast tenderness, mild diarrhea, fatigue, drowsiness, emotional instability, irritability, or depression during the menstrual period, which are all normal and do not require excessive tension.

　　2. Pay attention to hygiene and prevent infection. Pay attention to the cleanliness of the external genitalia. Absolutely do not have sexual intercourse during the menstrual period. Pay attention to keeping warm, avoiding cold stimulation. Avoid overwork. Those with excessive menstrual bleeding should avoid eating brown sugar.

　　3. Underwear should be soft, cotton, well-ventilated, and breathable. Change them frequently, and dry the underwear in the sun.

　　4. Avoid eating cold, sour, and spicy刺激性 food, drink more water, and keep the bowels smooth. Those with blood heat should eat more fresh fruits and vegetables before the period and avoid eating刺激性食物 such as scallions, garlic, chives, and ginger. Those with deficiency of both Qi and blood should increase nutrition in their daily life, such as milk, eggs, soy milk, pork liver, spinach, pork, chicken, and mutton, and avoid eating cold fruits and vegetables.

　　Firstly, basic gynecological examination

　　1. Ovarian function examination:

　　(1) Endometrial biopsy; (2) Vaginal cell shedding examination; (3) Cervical mucus crystalline examination; (4) Serum E, P measurement; (5) Basal body temperature measurement.

　　2. Pituitary function examination:

　　(1) Direct measurement of blood LH, FSH levels, and PRL levels: If FSH > 40 IU/L suggests ovarian failure; if PRL > 25ug/L suggests hyperprolactinemia, if LH and FSH are at normal or low levels, further pituitary stimulation test is needed.

　　(2) Pituitary stimulation test: If the LH released 15-45 minutes after the injection of LHRH is more than three times the level before injection, it indicates that the pituitary responds well to exogenous LHRH, and the cause of amenorrhea is the hypothalamus. If the LH level does not increase or increases unclearly after injection, it indicates that the pituitary stimulation test is (       ), and the lesion is located in the pituitary. 3. sellar CT examination to determine whether there is a pituitary adenoma.

　　3. Chromosome examination to exclude sexual development abnormalities.

　　4. Ultrasound examination to determine whether the ovaries have polycystic changes.

　　Secondly, further examination

　　1. Laparoscopic examination to understand the status of the gonads, including maldevelopment, polycystic ovaries, and early ovarian failure, etc.

　　2. Magnetic resonance imaging examination for the removal of pituitary microadenoma.

　　The diet of patients with delayed menstruation should pay attention to the following points in their daily life:

　　1. Women with severe hemorrhage should consume high-fiber foods such as spinach, jujube, beetroot, and dried grapes to replenish blood.

　　2. Do not刻意 eat sweets. Such as drinks, cakes, brown sugar, candy. Prevent blood sugar instability and avoid exacerbating the discomfort of MC.

　　3. Consume desirable protein. Eat more high-protein foods such as meat, eggs, tofu, soybeans, etc. during lunch and dinner to supplement the nutrients and minerals lost during menstruation.

　　4. Avoid drinking drinks containing caffeine. Coffee, tea, and other drinks can increase anxiety and restlessness, and can be replaced with barley tea and mint tea. In addition, avoid eating food with too high or too low temperature changes.

　　5. Eat more high-fiber foods. Vegetables, fruits, whole grains, whole wheat bread, brown rice, and oatmeal contain more fiber, which can promote the release of sex hormones, increase the content of magnesium in the blood, and have a regulating effect on menstruation and calm the nerves.

　　Delayed menstruation, or blood cold and blood deficiency. Wearing cool clothes often can accumulate cold in the body, which can slow down blood circulation, cause Qi and blood stasis, and make menstruation easy to delay. Symptoms of blood cold include: dark red menstrual blood with a large amount, severe pain in the lower abdomen, pale complexion, cold limbs, and aversion to cold. In this case, you can eat ginger, brown sugar, and dates porridge. You can also eat eggs cooked with mugwort and ginger. The specific method is: 9 grams of mugwort, 15 grams of ginger, and two eggs, put them all in a pot of water and boil together, drink once a day for 3-5 days before menstruation.

　　Blood deficiency can also cause delayed menstruation, often accompanied by symptoms such as palpitations, dizziness, and yellowish complexion. Aconite can be eaten, but it is better to take it in winter, 3-9 grams a day, and 3 grams is enough in spring and summer. If there are symptoms such as poor digestion and cough with phlegm, stop taking it.

　　Treatment Method: Warm the meridians and dispel cold, harmonize the blood and regulate the menstrual cycle. The main points are the Ren meridian and the acupoints of the Foot Taiyin and Foot Yangming meridians.

　　Main Points: Qihai, Sanyinjiao, Guilai

　　Matching Points: For those with cold and实证, add uterus; for those with deficiency and cold, add Mingmen and Yaoyangguan.

　　Operation: Qihai and Sanyinjiao use the supplement method with a needle, and moxibustion can be used. Guilai uses the draining method. The matching points are operated according to the method of supplementing the deficiency and draining the excess, and moxibustion or warm needle moxibustion can be used.

　　The therapeutic meaning: Qihai can benefit the body temperature and Yang, and moxibustion can also warm the meridians and dispel cold. Sanyinjiao is the intersection point of the Liver, Spleen, and Kidney meridians, which can regulate and nourish the three Yin meridians and harmonize blood and regulate the menstrual cycle. Guilai is the acupoint of the Stomach Meridian of Foot Yangming, which can regulate Qi and blood and regulate the menstrual cycle.