Hormonal imbalance in women: symptoms, signs. Delayed menstruation and amenorrhea. Tests in the absence of menstruation Tests for hormones if there is no menstruation

Most reactions in the body involve hormones. Is no exception. The volume of these substances in the blood is not the same at each of its stages, but must have certain values. Controlling them is important, because hormones during menstruation affect not only reproductive capabilities, but also the general condition of the female reproductive system, as well as the psychological one. An imbalance of these substances can cause many diseases of different organs and systems.

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How does the hormonal system work?

Hormones enter the bloodstream through the endocrine glands. It is worth saying that the balance of these active substances depends on the woman’s age, the stage of the menstrual cycle, and general health criteria. The background picture of a teenage girl should normally differ from that of a 45-year-old.

A woman’s reproductive function is ensured by a system that includes the hypothalamus, pituitary gland and ovaries. Its first part is located in the brain and produces hormones designed to control the endocrine glands. The hypothalamus is located in close proximity to the pituitary gland and controls its functioning, producing liberins and statins. The former stimulate the production of the necessary hormones, the latter slow it down when necessary. But the hypothalamus does not release liberins and statins voluntarily; to maintain a balance between stimulating and inhibiting the production of active substances, it receives information from all parts of the body.

The above makes the hormonal system very complex. Violations in any of its sections affect the functioning of all the others. And a malfunction of, for example, the thyroid gland will entail the same in the woman’s reproductive system.

Hormones throughout the cycle

Hormone levels and menstruation have a direct connection. The main ones are follicle-stimulating and luteinizing. Both are produced by the pituitary gland and cause the ovaries to produce other substances - estrogen and progesterone. The latter push the uterus and mammary glands to prepare for possible fertilization and subsequent development of the embryo.
The menstrual cycle is divided into three stages:

Follicular, which exists before the release of the egg;
, characterized by its ripening;
Luteal, occurring after the release of the egg.

Follicular stage

Calculated from the first day of menstruation. It is during this period of time that the uterine cavity is liberated from the upper layer of the endometrium and the dominant follicle is isolated. At the beginning of the stage, the uterine lining is full of blood vessels and nutrients intended for the embryo. Female hormones during menstruation at this stage determine the growth of the endometrium, thickening and release. At this point, estrogen and progesterone are reduced to lower values, due to which its upper layer is rejected.

At the same time, the level of follicle-stimulating hormone rises. With full health, its quantity and the size of the cavity in which the egg then matures increase throughout the entire initial phase of the cycle. Both the size of FSH and the follicle acquire the greatest significance two weeks after the first day of menstruation. The latter produces a large amount of estrogen, which stimulates the development of cells of the new endometrial layer. The follicular stage is the longest in the cycle. It becomes shorter as the woman approaches.

Despite the increased size of the follicle, it does not yet emerge from the ovary. For this to happen, luteinizing hormone must enter the process.

Ovulatory stage

The maturation of the egg is accompanied by an increased level of LH. It is he who adjusts the divergence of the follicle shell and its exit. Ovulation takes from 16 to 32 hours and ends with the release of the egg. Even after this, for 12-24 hours, the amount of LH is as high as ever. It makes fertilization more likely in the presence of sperm. A similar effect of hormones on menstruation ensures childbearing.

Luteal stage

Its countdown begins after ovulation, the stage lasts approximately 14 days. The final one is the last one before the next menstruation. At the beginning of the luteal period, the ruptured follicle closes, thus forming the corpus luteum, that is, a set of cells that produce progesterone. The task of these hormones during menstruation is to prepare the uterus for the possible attachment of a fertilized egg to its wall. It is this that causes the endometrium to grow and accumulate nutrients. Thanks to him, the number rises if conception has occurred. Progesterone, as well as estrogen, prepare the breasts for future feeding of the baby, expanding the ducts of the mammary glands. Because of this, before menstruation it becomes more sensitive to the point of pain.

In the absence of fertilization, the corpus luteum disappears 13-14 days after ovulation. That is, hormones decrease quantitatively before menstruation. This is how the body approaches another menstrual cycle, saving resources, preparing for a new probable attempt to fertilize an egg.

If conception occurs, another hormone comes into play - human chorionic gonadotropin. This is an undoubted criterion for pregnancy, since only the fetal membrane is capable of producing it.

The only group of active substances that increases quantitatively before menstruation is androgens. It is easy to understand which hormone increases before menstruation by a particularly good appetite during this period and the appearance of acne on the skin.

Why do analysis?

If you know what important role active substances play in a woman’s body, it would be logical to assume that a hormone analysis is very informative. It can identify ailments such as:

Infertility;

For any difficulties with childbearing, this study is one of the first to be prescribed. Many diseases not related to the sexual sphere can also be diagnosed by the amount of hormones.
It is necessary to know their healthy concentration at different time periods of the cycle in order to make a diagnosis. Of course, assessing and choosing treatment is a matter for a specialist, but it would not be harmful for any woman to understand which hormones during menstruation and in addition to them should decrease and increase, as evidenced by irregularities, when and how to submit the material in order to have a result that corresponds to reality.

Analysis algorithm

Hormones are very sensitive to external influences. Stress and hypothermia can distort the picture. Therefore, this test must be taken outside of infections and other listed circumstances. There are some other details of preparation for manipulation:

It must be taken on an empty stomach, that is, in the morning. Food can distort the picture;
The day before the procedure, avoid alcohol, smoking and sex;
The use of medications is taken into account, and not only those containing hormones.

Time to analyze

If you need to find out the concentration of female active substances, then the stage of the menstrual cycle matters. Blood for hormones during menstruation is allowed for analysis when it is necessary to determine the level of:

Estradiol;
Progesterone;
Testosterone;
DHA-S;
DEA sulfate;
Prolactin.

Tests for the listed substances will be accurate if done on days 2-5 of menstruation.

Women are also interested in what hormones to take after menstruation, since this is also possible and sometimes even necessary. Experts include such studies:

FSH. It is also determined on days 19-21 of the cycle;
LG. The same time frames as FSH will do;
Progesterone. Its amount can also be detected on days 21-22 of the cycle or days 6-8 after ovulation;
Prolactin. The period of time for taking the test is similar to progesterone.

Testosterone, DEA-sulfate, DHA-S can be checked at any stage of the menstrual cycle. A woman’s health is influenced by many more hormones that do not directly affect menstruation, but have an effect on other organs. This feature can affect a woman’s ability to bear children, so the analysis examines them too. It's about

Cortisol;
Ketosteroids.

Their meanings are important if pregnancy is planned.

Norm of analysis

They are determined by what day of menstruation the hormones are taken, because their quantity, as already mentioned, should normally be different at different stages of the cycle. In full health, the indicators look like this:

FSH. In the follicular phase, the indicator reaches 4-10 U/l, during ovulation - 10-25 U/l, in the luteal period 2-8. In surviving women, FSH is 18-150 U/l;
LG. In the follicular period it is 1.1-11.6 mU/ml, during ovulation - 17-77, in the luteal period the maximum value is 14.7. When using oral contraceptives, the value is 8 mIU/ml or less, and after menopause it is 11.3-39.8;
Progesterone. This indicator in the follicular segment has a value of 0.3-1.6 μg/l, during ovulation - 0.7-1.6, in the luteal period - 4.7-8 μg/l. After menopause - 0.06-1.3. During pregnancy, this figure increases starting from the 8th week;
Prolactin. The usual value ranges from 4.5-33 ng/ml in the follicular period, during ovulation it is 6.3-49, in the luteal phase - from 4.9 to 40 ng/ml. After conception and throughout the entire lactation period, prolactin increases from 500 to 10,000 mIU/l;
Estrogens. These hormones normally range from 5 to 53 pg/ml in the follicular part, 90-299 in the ovulatory part, and 11-116 pg/ml in the luteal part. During menopause it decreases to 5-46;
Testosterone. The numbers of the free indicator differ not according to the stages of the menstrual cycle, but according to the age criterion. However, there is total testosterone, which is 0.26-1.3 pg/ml;
DHA-S. The indicator ranges from 2.5 to 11.6 µmol per day;
DEA sulfate. Normal levels in women should not rise above 80-560 mcg/dL.

What does a hormone imbalance mean and what does it lead to?

As a rule, a noticeable difference in indicators from the norm signals trouble in the body. If hormones affecting menstruation are calculated, then it relates mostly to the reproductive sphere:

FSH increases with oncological diseases of the pituitary gland and insufficiency of ovarian function. Alcoholism may also be the cause. The hormone decreases with sclerocystic ovaries and excess weight;
LG. Problems with the pituitary gland and obesity can reduce the volume. An increase threatens those who have changes in the structure of the ovaries or brain tumors;
Prolactin. Affects the synthesis of progesterone by the corpus luteum, suppresses FSH during pregnancy, and participates in metabolic processes. Prolactin also supports milk production. If there is excess or deficiency of the hormone, the development of the follicle is disrupted, which prevents ovulation. Excess prolactin is observed in tumors, hypothyroidism, disorders of the ovaries or pituitary gland (also the culprit of deficiency), autoimmune problems;
Estrogens. Outside of pregnancy, estradiol plays a major role in the cycle. Estriol is responsible for the “interesting position”. The first is produced by the follicle, the corpus luteum, to regulate the cycle and maturation of the egg. Elevated estrogen levels indicate tumors of the ovaries or adrenal glands. It is also observed in obese women, since adipose tissue is also capable of producing them. A decrease in estrogen does not allow ovulation, therefore it can cause cycle failure and infertility;
Progesterone. Its increased values occur with neoplasms of the ovaries or adrenal glands. A decrease in the indicator is provoked by constant inflammation of the reproductive organs, and this entails scanty periods, failure to ovulate, problems while expecting a baby or infertility;
Testosterone. Another male element, the excess of which causes early spontaneous abortion. These hormones during menstruation in excessive quantities disrupt ovulation. This is a consequence of diseases of the adrenal glands or ovaries;
Androgens. These are male hormones, and their excess provokes disruption of the ovaries, excess body hair, and infertility. And too low a level reduces sexual appetite.

What to do if there is no menstruation

It happens not only due to the “fault” of pregnancy, but also in pathological conditions that do not manifest themselves in any other way. The most harmless reason for this is long-term use of birth control pills. In this case, it is permissible to wait up to six months for menstruation.

If this reason is excluded, you will have to find out the real reason with a specialist. A woman may have a question: how to take hormones correctly if there is no period? After all, many of them need to be done at a certain stage of the cycle. The specialist will recommend an analysis regardless of this, that is, on any day convenient for the patient. He will need to know the level:

Prolactin.

A woman’s excess hair, excess weight, stretch marks on the skin, or a diagnosis of polycystic ovary syndrome make it advisable to also count

Free testosterone;
Progesterone;
Insulin;
Estradiol;
Cortisone.

And yet, if a problem arises, how to take hormones if you don’t have your period, the first test should be for hCG. It is likely that pregnancy is the culprit for their absence.

How to return menstruation with hormones

It is advisable to use medications if you know which substances are missing to restore a full cycle. When menstruation is delayed, hormones force the body to consistently reproduce all its stages, if chosen correctly. Therefore, before starting treatment, you should wait for the test results. After all, if there is an excess of progesterone, then additional doses will aggravate the situation. In a cycle, it is not so much the volume of hormones that is important, but the ratio. Therefore, drugs based on them should be selected by a gynecologist based on the interpretation of the analysis.

Hormones that cause menstruation are found in the following medications:

. This drug contains progesterone. The artificially synthesized substance is similar to that produced by the female body, but despite this it can cause allergies. Has some contraindications;
. Its basis is estrogens and gestagens. Arbitrary use is fraught with severe bleeding. The drug also has many contraindications and can cause intolerance;
Utrozhestan. The active substance is progesterone. The product also does not tolerate uncontrolled use, because it can cause the growth of mammary tumors, allergies, and asthma attacks;
(Puregon, Menogon). These drugs stimulate the release of FSH and LH. They are used not just to restore the cycle, but with the goal of getting pregnant. Their independent use can provoke “fatigue” of the ovaries and excessive growth of the endometrium.

Oral contraceptives are also suitable for inducing menstruation, but this is also under the guidance of a specialist.

It is possible that the cause of the delay was not a deficiency or excess of the mentioned hormones, but a malfunction in the functioning of the organs that produce them. Then treatment should not be limited to taking these pills, it should be aimed at combating the underlying disease. And it may not concern the reproductive sphere, but affect, for example, the endocrine system or the brain.

The importance of hormones during menstruation is difficult to overestimate. And yet, sometimes to normalize their balance it is enough not to worry about nonsense, eat normally, rest on time and regularly see a gynecologist.

Before using any medications, you should consult a specialist doctor; there are contraindications.

The main “female” hormones are estrogens, progesterone, luteinizing hormone and follicle-stimulating hormone. In addition, doctors often prescribe a test to determine prolactin levels.

What tests need to be taken to study the content of female hormones?

During a gynecological examination, doctors often write out a referral to study the level of sex hormones, and for good reason. The fact is that most diseases of the female reproductive system are either caused by hormonal imbalance or provoke its occurrence, so it is necessary to find out what the level of sex hormones is. But many women do not know what tests need to be taken for female hormones and when. Regardless of what the doctor prescribed, it would be desirable and useful to understand this issue yourself.

Hormones are amazing substances on which everything depends. Literally everything. We want to eat or, we feel attraction or dislike for someone, we get scared, we are happy, we get pleasure from chocolate or our favorite music... The mother experiences a surge of tenderness for the newly born child, the couple, hugging, forgets about the quarrel... What is it: feelings and desires ? Undoubtedly. But a person’s feelings and desires are controlled by hormones, and every emotion, need, desire is simply a combination of several of them. Biochemistry - everything is simple here.

In the human body, these substances are produced by the endocrine glands. These include the following anatomical structures:

hypothalamus;
pituitary;
pineal gland;
thyroid;
adrenal glands;
ovaries in women, testes in men;
thyroid and parathyroid glands;
thymus;
paraganglia;
pancreas.

If we talk about sex hormones, and they are the topic of this article, then you should be interested in the ovaries. And also the hypothalamus, pituitary gland and adrenal glands, since they also take part in secretion.

Female hormones include estrogen, progesterone, follicle-stimulating hormone, luteinizing hormone, and prolactin. They each regulate the functioning of the reproductive system in their own way. And the gynecologist wants to find out their level, who issues a referral for analysis.

Estrogens

They can be called hormones of femininity. Why in plural? Because under this name three female sex hormones are combined:

estradiol;
estrone;
estriol.

Estrogens ensure the development and growth of reproductive organs, the formation of secondary sexual characteristics, a feminine figure, and the manifestation of sexuality. In addition, they regulate the menstrual cycle, stimulating the maturation of the egg - their highest level is observed just before ovulation.

After the oocyte is released, estrogen levels decrease to increase with the start of a new cycle.

All three hormones are produced by the ovarian follicles and, to a lesser extent, by the adrenal cortex. A small amount of estrogens is produced by adipose tissue. And the pituitary gland and hypothalamus regulate synthesis. However, these two glands control the production of all hormones.

If a woman has it, it can manifest itself with the following symptoms:

irritability, mood swings;
headache;
weight gain;
decreased libido;
bone fragility;
sleep disorders;
decreased skin elasticity;
amenorrhea.

But excess hormones also harm the body. Women can also gain weight, suffer from irritability and insomnia, and headaches. Possible nausea, engorgement and hair loss, the appearance of acne, swelling. Naturally, the menstrual cycle will also be disrupted.

If a woman experiences the above symptoms, she should have her estrogen levels tested. It can be performed on any day of the cycle, preferably on an empty stomach, like many other tests. There are no specific preparation requirements.

Reduced production of these hormones is observed with a strict diet, insufficient body weight, and excessive physical activity. As for diseases, these are diseases of the pituitary gland and hypothalamus, dysfunction or hypoplasia of the ovaries, hypofunction of the adrenal cortex.

An increase in estrogen in the blood can indicate disorders such as tumors, polycystic ovary syndrome, neoplasms of the adrenal cortex, cirrhosis of the liver, and some diseases of the uterus. In addition, such an imbalance can be caused by taking OCs and dietary features.

Follicle stimulating hormone

As mentioned above, the entire first phase of the cycle occurs under the influence of this substance. Active production of FSH is observed for a short time in newborns, then during puberty. In women of fertile age, FSH concentrations peak during ovulation.

When the hormone concentration decreases below normal, a woman may experience the following symptoms:

lack of ovulation;
scanty and irregular periods;
reduction, atrophy of the mammary glands;
atrophy of the external genitalia;
infertility.

If FSH is elevated, then this is manifested by bleeding that is not associated with menstruation, as well as the absence of menstruation.

A decrease in the level of follicle-stimulating hormone causes obesity, polycystic ovary syndrome, and less commonly, dysfunction of the hypothalamus.

An increase in FSH concentration is caused by ovarian dysfunction and tumor diseases of the pituitary gland.

Blood is donated for hormones either on days 3–8 or on days 19–21 of the menstrual cycle; this is done on an empty stomach.

Progesterone

This substance is called the pregnancy hormone, since it is its content in the body that determines whether a fertilized egg will attach to the wall of the uterus and whether a woman will be able to bear a child.

Progesterone begins to be actively produced by the corpus luteum, which forms after ovulation.

Its main function during this period is to prepare the uterus for implantation of the fertilized egg. Under the influence of progesterone, the tone of smooth muscles (organ walls) decreases and the mucous membrane loosens. If conception occurs, progesterone begins to be produced by the placenta.

In addition to its main function, this hormone is also responsible for the accumulation of subcutaneous fat by increasing appetite and increasing the absorption of nutrients from consumed foods (intestinal function slows down due to the same relaxation of smooth muscles).

If progesterone levels are too low, then the main problem that arises is miscarriage and infertility. The fertilized egg either cannot attach to the wall of the uterus, or the pregnancy fails a short time after conception.

In addition, there is a long cycle with painful and long menstruation, dizziness and headache, vaginal dryness, and mood changes.

If a woman has had miscarriages or has reason to suspect infertility, progesterone levels may need to be determined. When it is reduced, therapy is required.

There are many reasons why progesterone levels decrease. These include disorders of the thyroid gland, pituitary gland, and ovarian diseases, including infectious and inflammatory ones. Often, a decrease in progesterone production is associated with insufficiency of the corpus luteum, which, in turn, is provoked by increased physical activity.

With excess progesterone, intestinal function is primarily disrupted: constipation, bloating, and flatulence appear. Weight increases, women get tired faster, become irritable, and complain of migraines and headaches. In addition, hormonal imbalance is manifested by greasiness of the skin, acne, pressure surges may bother you, depression of mood, and drowsiness may occur. In a word, almost all the symptoms of pregnancy.

For what reasons can progesterone increase? These are various tumors of the ovaries and adrenal glands, cirrhosis of the liver.

How to submit? There are no special requirements, like other hormone tests, it is taken on an empty stomach. Be sure to take it on days 19–21 of the menstrual cycle.

Luteinizing hormone

This active substance is produced by the pituitary gland when the concentration of estrogen increases. Together with FSH, luteinizing hormone stimulates the release of a mature egg from the follicle.

With a decrease or increase in LH levels, there is an absence of menstruation or scanty, short bleeding, decreased libido, infertility, and miscarriages. In adolescence, low LH levels manifest as delayed growth and sexual development.

As a rule, the cause of a decrease in LH levels is congenital genetic pathologies and developmental disorders, but obesity, bad habits, taking certain medications, stress, and surgery can also trigger this. Naturally, LH levels decrease during pregnancy, this is the norm.

Prolonged physical activity, stress, disorders of the pituitary gland, polycystic disease, and ovarian depletion can increase the concentration of this hormone.

On what day should I go to give myself up if I was sent for analysis? This is usually done on days 3–8 or 19–21.

Prolactin

What hormones should I take if there is not enough milk after childbirth? Or, on the contrary, milk is released, albeit in small quantities, but there was no birth, and there is no pregnancy. In this case, you need to examine the level of prolactin - it is responsible for milk production. In addition, prolactin ensures the onset of orgasm and reduces pain sensitivity.

The hormone is produced by the pituitary gland, in addition, it is also synthesized by the embryo, since protection from the effects of the maternal immune system may be required, and prolactin provides it.

You need to donate female hormones, or rather, blood for their analysis, if you suspect either an increase or decrease in prolactin levels.

In the first case, the woman does not ovulate, and therefore infertility is diagnosed. Miscarriages may occur, and amenorrhea is a common symptom. There is secretion of milk from the nipples, hirsutism, frigidity, the functioning of the thyroid gland is disrupted, and osteoporosis develops.

Reasons for increased prolactin: disorders of the pituitary gland, hypothyroidism, autoimmune diseases, prolactinoma, polycystic ovary syndrome, liver cirrhosis, renal failure, vitamin B6 deficiency.

Lack of prolactin is manifested by the absence or small amount of milk after childbirth, early miscarriages, cycle disorders, hirsutism, edema, migraines. The reason for the decrease in this hormone can be diseases of the pituitary gland, head injury (traumatic brain injury), post-term pregnancy, and excessive bleeding.

In any case, a hormone test needs to be done so that it does not take a long time to identify the cause of the symptoms. The procedure is carried out on any day, phases 1 and 2 of the cycle, as usual, on an empty stomach.

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The influence and changes of hormones in different phases of the menstrual cycle

The phases of the menstrual cycle and hormones are closely interrelated, and in each of them in the female body the ratio between hormones will be different.

Any correlation violations between one or another active substance will cause pathological conditions.

A cycle represents changes that occur over equal periods of time. A woman's normal menstrual cycle is clearly divided into phases.

Female hormonal system

At the initial stage, the pituitary gland, located at the base of the brain, begins to produce FSH - follicle-stimulating hormone. It stimulates the ovaries to produce an egg.

The pituitary gland and hypothalamus are important organs that regulate the activity of the hormonal system. The functioning of the ovaries and the normal hormonal regulation of the menstrual cycle depend on their coordinated work.

The formation of estrogen biological structures is carried out from their precursors - testosterone and androstenedione.

The female body converts them into estradiol, which at the cellular level is transformed into estrol and estriol.

Female sex hormones affect the functioning of such organs as the mammary glands, the uterus (including its mucous membrane), and the fallopian tubes.

During pregnancy, their work is restructured in such a way that they begin to provide for the needs of the embryo.

Features of a normal menstrual cycle are the uninterrupted functioning of all internal secretion organs.

Thanks to the activity of the pituitary gland, follicle-stimulating and luteinizing hormones (FSH, LH, respectively) are formed.

These hormones determine whether an egg will be released from the ovarian follicles and whether it will be viable.

The condition of the uterine mucosa determines whether it can accept a fertilized cell (zygote) and ensure its normal development.

Hormones throughout the menstrual cycle

There are several types of female sex hormones, which determine the normal course of the cycle and the course of pregnancy.

Estrogen hormones include estrone, estradiol, estriol. They are responsible for the presence and expression of secondary female sexual characteristics and the normal function of the female reproductive system.

All types of estrogens are involved in the regulation of the menstrual cycle.

Their effect extends not only to the genitals, but to the entire body.

The strength and stability of bone tissue depends on the level of hormones, since they contribute to the retention of calcium and phosphorus in the body.

Any hormonal fluctuations during menstrual cycle disorders contribute to the fact that this tissue will be fragile and will not be able to support the functioning of the musculoskeletal system.

Estradiol in some cases poses some danger to a woman’s body, since an increase in the amount of this hormone leads to the fact that oncological processes can begin in the cells of the reproductive system.

Changes in hormonal levels associated with excessive estradiol activity contribute to the fact that menstrual function becomes irregular and disturbances may appear:

endometriosis;
fibroadenoma;
mastopathy;
polycystic disease;
myoma.

For a woman, a decrease in antitumor immunity is dangerous, that is, a decrease in the body’s ability to resist changes that cause cancer.

Another hormone that plays a large role in the hormonal regulation of the menstrual cycle is progesterone. It begins to form only if the follicle has matured and burst, i.e., a corpus luteum has formed in its place.

It is an estrogen antagonist and is produced for fertilization and egg implantation.

An imbalance of hormones during menstruation is reflected in the following way:

menstrual cyclicity disorders occur;
headaches and pain in the mammary glands appear;
premenstrual syndrome appears.

Disturbances in the hormonal balance provoke a change in a woman’s mood, she becomes more irritable, and also prone to colds.

Other chronic pathologies may worsen.

Menstrual first phase of the cycle

At the beginning of each menstrual cycle, the body prepares for the possibility of pregnancy. The cycle can be divided into several phases.

The total duration of one cycle in the body is 4 weeks (28 days).

For some women, the norm may decrease to 21 days or exceed this number, reaching up to 35 days.

Permissible deviations cannot exceed 3 days, because otherwise we can talk about the instability of the cycle and the fact that pathological processes develop in the body.

If any deviations in cyclicity and discrepancies in the normal duration of each phase appear, the woman should immediately consult a doctor.

The first day of the menstrual cycle is the first day of menstruation.

Its normal duration is from 3 to 7 days. If pain appears at this time, it will be most noticeable in the initial days.

The pain is caused by the fact that the hormones of the first phase lead to increased rejection of the mucous membrane that formed earlier.

Follicular or proliferative

At the second stage, bleeding stops. Proliferation begins when the pituitary gland begins to produce follicle-stimulating hormone, or FSH.

Follicular phase hormones, in particular FSH, promote the active production of follicles, which are vesicles filled with clear liquid. Each follicle contains an immature egg.

The main task of FSH is to stimulate egg maturation in the middle of the cycle.

When the follicular phase begins, the hormone level must exactly correspond to the ratio between FSH and estrogen.

At the beginning of menstruation, the amount of estrogen is small, but with each subsequent day its content increases.

As follicles form, one becomes dominant and leaves the ovary with the egg.

Estrogen contributes to the rapid saturation of the endometrium with blood in this menstrual phase.

This is necessary so that after fertilization the egg is fixed in the endometrial layer.

At this time, a small amount of thin mucus is secreted in the genitals, which, unlike other secretions, is sticky.

In such an environment, sperm can move quickly and remain viable for several days.

Ovulatory

During the periovulatory period, the amount of estrogen increases.

Immediately before the release of the egg in the middle of the menstrual cycle, the content of luteinizing hormone increases, and ovulation (the release of the oocyte from the follicle) occurs.

You can confirm ovulation using an ovulation test, which is easy to do even at home.

The time at which the oocyte is released depends on how well the hormones responsible for ovulation work. This may occur on different days in each menstrual cycle.

Sometimes there may be minor pain during the release of the oocyte. This is normal, as is the absence of any pain.

A sure sign of oocyte release is an increase in basal temperature.

Luteal or corpus luteum phase

The menstrual cycle and hormones are closely related; after the oocyte leaves the follicle, it begins to move towards the uterus.

Remains viable for 24 hours, and sometimes up to 5 days. Therefore, the few days before and after ovulation are considered the most favorable for fertilization.

After ovulation, the activity of the follicle begins to change, it secretes another hormone - progesterone.

The production of the substance is initiated by luteinizing hormone. This menstrual phase of the cycle is also called the luteal, or corpus luteum phase.

Thanks to progesterone, the upcoming preparation of the uterine mucosa (endometrium) for the implantation of a fertilized oocyte (zygote) begins. During this same menstrual phase, estrogen production begins.

Just before your period, you may experience signs of premenstrual tension (also called premenstrual syndrome).

Some women experience lower abdominal pain, irritability, or depression.

If fertilization does not occur during this menstrual phase of the cycle, the amount of progesterone and estrogen decreases.

A low amount of these substances in the blood leads to the fact that the excess mucous mass begins to shrink and separate. This is how menstruation begins.

When pregnancy occurs, the body changes menstrual activity and produces another hormone - human chorionic gonadotropin.

It maintains high follicle activity and progesterone and estrogen continue to be produced in sufficient quantities. These hormones are necessary to prevent rejection of the fertilized oocyte.

If fertilization of the egg has occurred, the next menstrual cycle does not occur. The corpus luteum continues to produce estrogen and progesterone until a full-fledged placenta is formed.

The activity of these hormones is combined with the activity of human chorionic gonadotropin. The normal course of pregnancy will depend on the healthy state of the placenta.

Description of the phases of the menstrual cycle by day, and when to take hormone tests?

The activity of a woman’s reproductive system can be described by day:

The first 4-5 days are menstruation. Blood is released (about 100 cm³), the first phase of the menstrual cycle continues.
Over the next 6-14 days, the body prepares for a possible pregnancy.

This manifests itself in an increase in the amount of FSH produced in the follicles, which affects the production of estrogen.

In this phase of the cycle, the growth of the epithelial layer of the endometrium begins. Its duration can vary from 7 to 21 days.

On days 14-15, the ovulatory phase of the menstrual cycle begins.

At this time, the most estrogen is produced, causing the follicle to rupture. These days are the most favorable in terms of fertility.

A woman can determine the moment of ovulation by measuring her basal temperature - it will be slightly elevated.

On day 17, phase 2 of the menstrual cycle begins. The duration of the second phase of the cycle is from 12 to 16 days. During this period, the uterus prepares to receive a fertilized egg.

If all these phenomena occur differently, then the woman develops menstrual irregularities.

You need to know what tests are recommended to take in case of hormonal imbalance to determine your health status.

The following tests must be taken if your period is late:

The following studies are also possible:

performing a home pregnancy test;
Ultrasound of the uterus and abdominal organs, ultrasound using a vaginal sensor;
in doubtful cases, the patient is referred for magnetic resonance imaging.

All of these examinations must be carried out in accordance with the rules for preparing for them.

The menstrual cycle is a complex process, and each woman is individual.

If a woman knows all its subtleties, then she will be able to promptly detect the presence of unfavorable changes in the body, begin their treatment, thereby preventing dangerous gynecological pathologies.

What hormone tests should be taken during menopause?

Menopausal syndrome

Around the age of 45, a woman’s sex hormones begin to reduce menstrual function. They stop the production of elements and substances that carry out cyclic changes in the uterus, endometrium, and subsequently completely end reproductive age.

The lack of the necessary consistency of menstruation also occurs with various pathologies of the genital organs and endocrine system that require treatment, physical exhaustion and pregnancy, and therefore is not entirely an indicator of the onset of menopause.

Menopause is diagnosed by determining certain hormones in the blood. During this period, they must have a certain quantity and ratio, different from the previous one. Preventive studies on hormones during menopause will indicate the choice of treatment for the symptoms that appear:

Unexpected hot flashes to the upper body (shoulders, chest, face) from one to several dozen times a day.
Obsessive sweating, accompanied by copious drops of sweat and chills. Such symptoms cause noticeable discomfort. Sweating at night leads to nervous sleep, which leads to poor health and fatigue during the day.
Feelings of anxiety, headaches, nervousness, mood swings. Hormones control emotions, varying the mood from inspired to the exact opposite - broken and despondent.
Vaginal dryness, pain during sexual intercourse - a lack of estrogen affects the elasticity of the vaginal walls and the amount of natural lubrication of the mucous membranes.
Urinary incontinence with sudden movements, coughing, laughing. Muscle tissue loses its ability to provide proper tone, including the bladder.
Osteoporosis is a disease characterized by degenerative processes in the bones.

Tests for menopause

A hormonal blood test will help determine whether a woman is worried about the approach of menopause. During this period, tests for three female sex hormones are considered conclusive: follicle-stimulating hormone (FSH), luteinizing hormone (LH) and estradiol:

FSH is produced by the pituitary gland and is responsible for regulating the synthesis of estrogen in the ovaries.
Estradiol is the most active sex hormone (cholesterol derivative), stimulates endometrial cells to actively grow, reduces the resistance of the uterine vessels at the initial stage of pregnancy, and increases blood flow in it.
LH is responsible for several processes in the body: egg formation, ovulation, and stimulates the formation of the corpus luteum.

By passing these three hormone tests, you can definitely determine the presence of menopause and select hormone replacement therapy. If indicated, the doctor will also prescribe other reproductive function tests, blood tests for thyroid hormones, biochemistry, testosterone, prolactin, progesterone.

If the diagnosis is confirmed, then studies may be prescribed to determine the cause of the complicated course. For this purpose, an ultrasound scan of the thyroid gland and pelvic organs is performed. A smear is taken for cytology, osteodensitometry and mammography are performed.

Analyzes and studies can be carried out even when you feel normal, since this period is characterized by serious changes. They often lead to diseases that are best diagnosed as early as possible.

Basic requirements for donating blood for analysis

At the first symptoms of menopause, it is necessary to donate blood to determine the cause of the decline of ovarian function and, as a consequence, disruption of the menstrual cycle. In order for the test results to be as accurate as possible, you need to exclude the following a few days before the procedure:

physical exercise;
consumption of alcohol and cigarettes;
taking medications;
drinking strong tea and coffee;
sex.

Blood is taken on an empty stomach in the morning. Do not donate blood during menstruation. When menopause occurs, special attention should be paid to hormones; a blood test can tell about their more accurate condition.

When to take it

Hormonal tests are taken on a certain day of the menstrual cycle, otherwise the result will not be meaningful. Tests such as LH, FSH, estradiol, prolactin, and thyroid hormones must be performed on the fifth to seventh day. The last meal should be no earlier than 8-10 hours.

Another thing is donating blood for progesterone. This analysis is carried out only in the middle of the second half of the menstrual cycle. It is taken on an empty stomach, on the 22nd day. If menstrual function is not preserved, hormones can be taken any day.

Norms of indicators

After 35 years, ovarian function gradually slows down, and ovulations occur less frequently. Around the age of 45-50, it stops, the amount of estrogen decreases, which, in turn, leads to a decrease in progesterone levels. A decrease in the level of female sex hormones leads to the activation of the pituitary gland, the hormone produced by them, FSH, increases in the blood. High levels of FSH increase the production of LH. The levels of these hormones completely block ovulation, and the ovaries gradually lose sensitivity to sex hormones. There are no cyclic changes; menstruation stops.

The influence of hormones during menopause depends on the woman’s lifestyle, temperament, her daily diet, heredity and diseases, but the average indicators depend on the results of the tests obtained. The severity of climacteric syndrome depends on the ratio of FSH and LH in menopause; with low numbers (0.4-0.7), its manifestation is stronger.

Estradiol is one of the most active hormones produced in the female body. In addition to the production of eggs, it is also responsible for good mood and sleep, the condition of the skin and hair, and reduces the possibility of atherosclerosis. The level of estradiol in the blood significantly affects a woman’s well-being; its high level has a positive effect on the body.

Poor lifestyle and bad habits such as smoking, sedentary lifestyle, fatty, sugary foods and excessive alcohol consumption reduce the level of this hormone. Low estradiol content negatively affects the bone structure and mucous membrane of the body, resulting in frequent hot flashes and tachycardia. On an emotional background it affects in the form of depression, frigidity, apathy, severe irritability, headaches and chronic fatigue.

The normal value is considered to be between 6-82 ng/ml. Speaking about a high level of the hormone (more than 82 ng/mg), it is worth noting that its excessive increase indicates the presence of possible abnormalities in the body: improper functioning of the liver, a benign tumor in the female reproductive organs or breast, problems with the thyroid gland, persistence of the follicle, endometriosis , follicular ovarian cyst, obesity. This requires additional research.

Many reactions take place in the human body every day, some of them not without the participation of hormones. The most striking reaction in the body that occurs with the participation of hormones is menstruation. The composition of menstrual blood is not the same during each stage of the cycle, and must show certain values at each stage. A woman needs to pay special attention to controlling hormonal levels during menstruation, as not only the performance of the reproductive system, but also the general condition of the body depends on it. Any changes in hormonal levels can provoke the development of diseases of various organs and systems of the body.

The physical and psychological state of a woman depends on hormones

How does a woman's hormonal system work? Menstrual cycle and hormones. Necessary diagnostics. What causes hormonal imbalance during menstruation?

The endocrine glands, which are located throughout the body, ensure full access of hormones to the blood. The balance of hormones in each woman’s body is individual and depends on:

The woman's age.
Days in the menstrual cycle.
General health.

The normal level of hormones in the blood during adolescence differs sharply from the readings during the onset of premenopause. Hormones that are produced in the hypothalamus, pituitary gland and appendages play a major role in the reproductive function of a woman’s body. The hypothalamus and pituitary gland are located in special lobes of the brain and are responsible for the timely production of hormones by the glands.

The hypothalamus is located next to the pituitary gland and is responsible for the production of liberins and statins, responsible for the proper functioning of the pituitary gland. Liberins are responsible for catalyzing the production of hormones necessary for the body, statins provoke the cessation of excessive activity when necessary. These two types of hormones are not produced chaotically in the body, and the hypothalamus receives a signal from all body systems to produce them accurately.

The entire hormonal system is very complex to work with, and a disturbance in any of its parts provokes an imbalance in all other systems. Thus, a malfunction of the thyroid gland entails the onset of improper functioning of the organs of the reproductive system.

The hypothalamus is responsible for the correct production of hormones

Cycle and hormones

Hormonal levels are directly related to the menstrual cycle. The main hormones of the reproductive system, synthesized by the pituitary gland - FSH and LH, affect the functioning of the appendages. It is these hormones that cause the production of estrogens and progestins in the required quantities, causing the uterus to prepare for the possible onset of pregnancy.

The menstrual cycle is usually divided into three stages:

Follicular. This period marks the time before the egg is released from the epididymis.
Ovulatory. The period associated with the maturation of the egg.
Luteal. It is characterized by the release of the egg after ripening into the uterine cavity.

Follicular period

This period is usually counted from the onset of the first days of menstruation. During this period, the epithelium in the uterus separates and the dominant follicle matures. When this stage occurs, the uterine lining is dotted with blood vessels and filled with nutrients that are intended for the future embryo. Female hormones that are produced during this period affect the growth of the endometrium, its thickening and excretion. During this period, estrogen progesterone reduces its activity in production and shows the lowest levels in the blood. It is thanks to this drop in female sex hormones that the upper layer of the uterine epithelium is rejected and excreted.

Exactly under what processes does the FSH level increase? It continues to grow throughout the follicular stage, increasing the size of the uterus so that the egg can implant.

Follicle-stimulating hormone and the dominant follicle acquire their greatest significance two weeks after the start of menstruation. The dominant follicle provokes the growth of estrogen, increasing the rate of endometrial growth. The stage of follicular development in the cycle is the longest, and its length decreases during the onset of climate change. Despite the fact that the follicle increases in size, it does not leave the ovary, because for its exit it is necessary luteinizing hormone.

The diagram shows a dominant follicle, fallopian tube, immature follicles and the release of a mature egg

Ovulation stage

During the period of ovulation the level luteinizing the hormone that promotes the maturation of the egg in the appendages increases sharply. It is thanks to this hormone that the follicle membrane ruptures and the egg is released. The ovulation period takes from 16 to 48 hours and is characterized by the end of the release of the egg. After the cell exits, the level luteinizing The hormone maintains its highest peak for 24 hours. It is the correct level of this indicator in the blood that allows a woman to become pregnant.

Luteinizing period in the cycle

This period lasts about two weeks after ovulation. The final day of this stage is the day before menstruation of the next cycle.

At the beginning of a new stage, the follicle formed in the membrane closes, forming the corpus luteum. It is the corpus luteum that influences the production of progesterone.

Progesterone affects tissue and causes an increase in the endometrium in the uterine cavity, and the accumulation of nutrients, which contributes to the onset of the preparatory period for the attachment of the embryo.

All these changes cause an increase in basal temperature if conception occurs. It is progesterone and estrogen that contribute to the expansion of the ducts of the mammary glands, preparing the breasts for the future lactation period. What makes the breasts painful before the onset of a new cycle.

If conception does not occur, the corpus luteum dies 2 weeks after ovulation. During this period, hormone levels drop, preparing the body for a new chance of fertilization.

If conception occurs, then human chorionic gonadotropin grows in the body, which indicates the onset of pregnancy. Only the fetal membrane can produce this hormone.

The fertilized egg begins to produce human chorionic gonadotropin

Why is a hormone test necessary? What are the dangers of hormonal imbalances?

If a woman has no pathological diseases and no irregularities in her cycle, taking hormone tests is a preventive measure. Thanks to which you can see:

The presence of deviations from the norm and the influence of hormonal levels on a woman’s body.
The growth of pathological neoplasms in the reproductive system.
Dysfunction of reproductive organs.

For any changes in the cycle and problems associated with the reproductive function, the woman will be advised to undergo a series of hormonal tests. According to the data received, the doctor can prescribe treatment that will prevent the development of negative consequences.

Even a slight deviation from the norm in indicators can signal the presence of pathology in the body, which affects the body as a whole. If changes occur in hormones that affect the menstrual cycle, then reproductive dysfunction occurs:

FSH level. The level of follicle-stimulating hormone increases in the body if there is an oncological dysfunction of the pituitary gland, or insufficiency in the functioning of the appendages. An increase in follicle-stimulating hormone levels may be response the body to alcoholism or excess weight.
Luteinizing the hormone reduces its levels in the blood if a woman has abnormalities in the pituitary gland or obesity. And the increase luteinizing The hormone can be detected in women whose ovarian structure has abnormal changes or brain tumors.
Prolactin. It is produced in the body, affecting the level of progesterone, and can suppress follicle-stimulating hormone during pregnancy. These indicators influence metabolic processes in the body. Prolactin ensures proper milk production during lactation. With a deficiency or increased secretion of this hormone, the synthesis of follicles is disrupted, which can disrupt the ovulation process. An excess in the production of prolactin is observed with a disease such as hypothyroidism, or disruption of the appendages or the function of the pituitary gland.
Estrogen. The hormone estradiol has a great influence on the cycle. The hormone estrogen is produced by the follicle and affects the proper development of the egg and its release. An increased level of estradiol indicates the presence of pathological neoplasms of the adrenal glands or ovaries. High levels of estrogen in the blood are observed in underweight women, as the body receives additional amounts of estrogen from adipose tissue. An increase in estrogen levels reduces a woman’s ability to become pregnant, disrupts the cycle and causes infertility.
Progesterone. A high level of progesterone in the blood indicates the presence of unwanted tumors in the appendages or adrenal glands. A decrease in blood levels indicates an inflammatory process in the reproductive system. This hormone also affects the onset of ovulation.
Testosterone. Despite the fact that testosterone is a purely male hormone that is responsible for male strength, its excess in the body can cause premature termination of pregnancy. Increased production of testosterone during the menstrual cycle can affect ovulation, delaying the onset of menstruation for a long time. An increase in testosterone in the blood may indicate the presence of adrenal gland formation and a malfunction of the ovaries.
Androgens. This type of male hormones can cause disruptions in the reproductive system in the female body, increased hair growth, or cause infertility. And elevated androgen levels reduce libido

Women undergo hormone testing during menopause for various reasons. Some want to make sure that the process has begun, others have to do this to identify diseases of the reproductive system. Externally, menopause manifests itself as the absence of menstruation. However, the cycle may be disrupted for other reasons. Age restrictions are extended over several years – 45–50. Moreover, menopause may, for certain reasons, occur earlier or be delayed for several years. Consequently, hormone tests during menopause make it possible to find out for sure about the onset of menopause. Research is carried out not for the sake of interest, but to establish the woman’s condition. Based on the presence of hormones, we can predict what symptoms to expect and what diseases can be avoided.

Classification of hormones

Medical workers conditionally divided female sex hormones into 2 groups: estrogens, progestins. The main representative of the latter is progesterone. Each of them performs its own function and has a certain structure. Sex hormones are produced by the ovaries as a result of the influence of the pituitary gland, which is located in the brain. At the first stage of the menstrual cycle, FSH hormones are produced - follicle-stimulating hormones, which promote the formation of estrogens. The latter coordinate the development of the egg and the onset of ovulation. In the second phase of the cycle, LH hormones are produced - luteinizing hormones, which are responsible for the level of progesterones, maintaining pregnancy, and the onset of menstruation.

The role of estrogen

Estrogen is often used in the plural because there are several types. The ovaries begin producing estrogen at puberty. The first sign is breast growth and body formation. For an adult woman, a normal amount of this hormone is of great importance. Estrogen is responsible for the timely onset of the monthly cycle, its formation within 2 years after menarche. Hormones protect blood vessels from clogging, restore water-salt balance, renew cells, add elasticity to the skin, and strengthen bone tissue. During menopause, estrogen levels approach a minimum. As a result, women experience joint pain and fractures. Osteoporosis develops against the background of estrogen deficiency.

The role of progesterone

Considered a male hormone. Its active production begins from the moment the egg leaves the follicle. If this does not happen, the amount of progesterone remains at a minimum level. Gynecologists and endocrinology specialists say that a lack of progesterone is normal 2 years after menarche, during menopause. In other periods of life, this is a pathology and leads to improper functioning of the body and infertility.

Estrogens and progesterones in the right ratio are the key to women’s health and a regular menstrual cycle. During menopause, when pregnancy is not needed, estrogens are no longer produced in the required quantities. Cause imbalance and all sorts of health problems. Although this all happens as a result of the natural processes of menopause, various gynecological diseases arise that are associated with hormonal imbalance.

Tests for menopause

The most important tests that indicate the onset of menopause:

blood test for FSH level;
presence of the hormone estradiol;
LH blood test.

Follicle stimulating hormone coordinates the production of estrogen in sufficient quantities. While its level is high, the concentration of FSH in the blood is minimal. With the onset of menopause, FSH levels increase sharply. A reading greater than 20 honey/ml indicates menopause.

Estradiol is the main female hormone, belongs to the group of estrogens, but is converted by FSH to male hormones. Estradiol is responsible for the formation of female forms. If the analysis shows a level below 35, then menopause has arrived.

Luteinizing hormone changes throughout the monthly cycle. Its active increase is visible in the middle of the cycle, at the time of ovulation. During menopause, LH hormones are always at a high level. From 10 to 60 IU/l.

According to indications, the doctor prescribes determination of other hormones during menopause: progesterone, prolactin, testosterone, thyroid hormones. The absence of progesterone during menopause is considered normal. Tests for hormones during menopause make it possible to detect the presence of menopause and select effective hormonal therapy to improve well-being and prevent the development of diseases.

Rules for submitting material for research

It is recommended to carry out the analysis at the beginning of menopause. To determine your hormonal levels, find out the reasons for the delay in menstruation. You should prepare for the procedure in advance, as some factors may affect the accuracy of the results. A few days before taking hormone tests for menopause, you must:

eliminate excessive physical activity;
do not drink alcoholic beverages;
no smoking;
give up strong tea and coffee;
don't have sex;
do not take medications.

During the absence of menstruation, the analysis is carried out on any day. Blood should be donated on an empty stomach. Controlling hormones during menopause is very important. Because at this stage of the life cycle, women have an increased risk of developing gynecological diseases. Timely identified changes can prevent the negative consequences of menopause and reduce the likelihood of developing the disease during menopause.

When to take it

The onset of menopause occurs between the ages of 45 and 50 years. You can guess the beginning of the process by the absence of menstruation and symptoms:

Negative manifestations are caused by estrogen deficiency. If the above symptoms are present, it is necessary to conduct a hormone test during menopause. It should be borne in mind that menopause can occur much earlier than expected for certain reasons. Menopause is divided into several types:

Early. It occurs before 40 years of age. The situation is associated with ovarian depletion, infectious diseases of the genital organs, and heredity.
Artificial. Due to surgical intervention - removal of the ovaries.
Pathological. With strong manifestations of negative consequences. Hormonal therapy is required.

The importance of hormones during menopause

FSH levels increase significantly. This is due to the body’s attempts to stimulate the production of estrogen. The functions of the ovaries fade away gradually, the body needs to get used to the new conditions of existence. An important diagnostic point is the ratio of FSH and LH. The lower the coefficient, the more serious the symptoms of menopause. In general, the indicator varies at the level of 0.4–0.7.

Estradiol levels during menopause are significantly lower than in women of reproductive age. The indicator is influenced by multiple factors:

physical activity of a woman;
bad habits;
taking medications, especially antibiotics.

An increased level of estradiol during menopause indicates the presence of pathologies:

Estradiol causes constant fatigue, indigestion, swelling, weight gain, and tenderness of the mammary glands.

During menopause, hormonal levels can change several times. It is recommended to undergo periodic examination. A woman who knows the state of her body can choose therapy, proper nutrition, and reduce the symptoms of menopause in simple ways. If you consult a doctor for help in a timely manner, you can avoid the development of terrible diseases. Most of them make themselves felt precisely during menopause, with unstable hormonal levels. A specialist will be able to choose the right drug and eliminate serious negative consequences.

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Where to conduct hormonal testing

Currently, it is possible to find out the state of hormonal levels during menopause in public and private medical institutions. The choice is individual. In government institutions, the analysis may take a little longer than in private medical centers. But the cost for private owners is slightly higher. The average price for researching one indicator is 500–700 rubles.