Hormonal Imbalances Imbalance Treatment Delhi Causes India Men Women Symptoms Female Diagnosis Investigation Specialist Why tests Permanent cure Best senior Experienced India New Noida best qualified Indian East West North South Central Gurgaon Gurugram Faridabad Ghaziabad

Home Consult Us Doctor's Panel Contact Us Site Map
Thyroid Male Hormone Disorders

Less Facial Hair

Short Height Obesity Female Hormone Disorders Diabetes
         
Dr Roy's TV Interviews Dr Roy giving Lectures Print Media Presence Testimonials Awards & Achievements

For consultation & treatment (by appointment / or online) click How to Consult Us
   (Last Updated on: )


|| Small Breast || Female Hormone Deficiency || Unwanted Hair || Milk Secretion || 
|| Early Breast Development || Menstrual Irregularity || Infertility || PC OD || Excess Menstrual Bleeding ||
 || Premature Ovarian Failure || Premenstrual Syndrome || Menopause || Hormone Replacement Therapy ||


Menstrual Irregularity

Introduction & Normal Physiology of Menstruation

Absent Periods (Amenorroea)
Late Periods (Oligomenorroea)

Introduction: Menses irregularity may be complete absence of menstruation which is called amenorrhea or there may be delayed menstruation which is called oligomenorrhoea.

Normal Physiology of Menstruation: In normal female there are lacs of immature egg (ovarian) follicle lying in dormant state in the ovary. During the normal menstrual cycle on third day of cycle approximately 30 egg follicles starts maturing finally one of them will mature to full stage to form mature egg. When all the hormones are normal then one out of all maturing egg follicle is selected for further maturation & rest all shrink & atrophy. Finally this selected egg follicle passes through various stages of development & finally matures into a completely developed egg called ovum. Then egg is released out of the ovary (i.e. ovulation). Once the ovum is released ovary starts secreting progesterone for next 10 days. This progesterone hormone leads to strengthening of walls of blood vessel of endometrium. After 10 days of egg release i.e. ovulation, the production of progesterone hormone from ovary ceases. Thus the sudden deficiency of progesterone hormone leads to weakening of the linings of endometrial blood vessels which ultimately shrink & stop supplying blood to endometrium i.e. inner uterine lining. Thus in nut shell the production of estrogen from ovary lads to formation of inner lining of the uterus during menstrual cycle, where as production of progesterone from ovary after the ovulation leads to maintenance of this uterine lining. The menstrual bleeding occurs due to shedding of uterine inner lining i.e. endometrium due to disruption of its blood supply because of sudden deficiency of progesterone because of stoppage of its production from ovary. Thus if no ovulation occurs, there will not be any cyclical exposure of progesterone resulting in absence of regular menstrual bleeding. 
For detail information about causes, investigation & treatment click following links:


Amenorrhoea (means absence of period)
Late Periods (Oligomenorroea)


Amenorrhoea 

Amenorrhoea term is used when there is total absence of menses. 
Absence of period can occur due to any of the following hormone disorder as estradiol, pituitary hormone LH, FSH, Prolactin & Thyroid hormone, T3, T4, TSH etc due to any of the below mentioned causes. 

Causes of Amenorrhoea are:


1.Ovarian failure (hypergonadotropic hypogonadism): Gonadal agenesis, Gonadal dysgenesis, Turner syndrome 45, X, Mosaicism, Pure gonadal dysgenesis, 46, XX, 46,XX (Swyer syndrome), Ovarian enzymatic deficiency as 17a-Hydroxylase deficiency, 17, 20-Lyase deficiency, Premature Ovarian failure : Idiopathic premature menopause, injury, mumps oophoritis, radiation, chemotherapy, Resistant ovary (Savage syndrome), Autoimmune disease, Galactosemia. 

2. Absence of ovulation: Polycystic ovarian syndrome (PCOS or PCOD),Hyperthecosis, Adrenal disease : Cushing syndrome, adult-onset adrenal hyperplasia, Thyroid disease : Hypothyroidism, hyperthyroidism, Ovarian tumors : Granulosa-theca cell tumors, Brenner tumors, cystic teratomas, mucinous/serous cystadenomas, Krukenberg tumors. 

3. Hypothalmic Pituitary Abnormality leading to absence of estrogen production (hypogonadotropic hypogonadism). Craniopharyngioma, Germinoma, Hamartoma, Hand Schuller Christan disease, Teratoma, Endodermal, sinus tumors, metastatic carcinoma, Infection and other disorders : Tuberculosis, Syphilis, Encephalitis/meningitis, sarcoidosis, kallmann syndrome, idiopathic hypogonadotropic hypogonadism, Chronic debilitating disease, 
Pituitary Other hormone-screening pituitary tumors (ACTH, thyrotropin-stimulating hormone, growth hormone), non-functional tumors (craniophyaryngioma), Metastatic carinoma, Space-occupying lesions : Empty sella syndrome, Arterial aneuysm, Necrosis : Sheehan syndrome, Panhypopituitarism, Inflammatory /infiltrative : Sarcoidosis, Hemachoromatosis. 

4. Prolactinomas & Hyperprolactinemia

5. Defect in uterus or vagina: Labial agglutination/fusion, Imperforate hymen, transverse vaginal septum, Cervical agenesis isolated, Cervical stenosis iatrogenic, vaginal agenesis isolated, Mullerian agenesis (Mayer-Rokitansky-Kuster-Hauser syndrome), Complete androgen resistance testicular feminization), Endrometrial hypoplasia or aplasia congenital, Asherman syndrome (uterine synechiae), small hypoplastic uterus etc. 

Investigations & Diagnosis:


For diagnosis of cause of absent menses we do following tests.
Complete hormone profile: LH, FSH, total testosterone, free testosterone, Prolactin, Androstenidione, SHBG, 17 HYDROXYPROGESTERONE, DHEAS, Estradiol, Progesterone
Suppression & Stimulation Tests, 
Karyotype
Genetic testing
Pro. Challenge test 
Hystero-salpingography for uterus & tube status 
Laproscopy
High Resolution Ultrasound

Treatment:-Treatment of specific diseases. Once the cause for Amenorrhoea is found then treatment started. Abnormalities of the thyroid gland, pituitary and abnormalities in the adrenal glands can be treated by appropriate medicines. Normally patient starts getting normal menstrual cycle (period) in three to six month time. The various drugs which are required are as follows: 
a) Clomiphene
b) Gonadotropin Therapy
c) HCG Therapy
d) Hmg therapy
e) Metformin
f) Glitazones
g) Tamoxifene
h) Letrozole
i) Medroxyprogesterone
i) Desgestrol
j) Megestrol
k) Norethisterone
l) Hydroxyprogesterone
m) Oral E & P Combination Pill

Late Periods (Oligomenorroea)

Late periods are called oligomenorrea & this is a common problem during reproductive years in female. Menstrual irregularity can occur due to any of the following hormone disorder as estradiol, pituitary hormone LH, FSH, Prolactin & Thyroid hormone, T3, T4, TSH etc due to any of the below mentioned causes.

What are causes of menstrual irregularity?

- Abnormal function of the hypothalamus. Decreased secretion of Gonadotropin results in menstrual irregularity ; This problem can occur due to Craniopharyngioma, Germinoma, Hamartoma, Hand Schuller Christan disease, Teratoma, Endodermal, sinus tumors, metastatic carcinoma, Infection and other disorders : Tuberculosis, Syphilis, Encephalitis/meningitis, sarcoidosis, kallmann syndrome, idiopathic hypogonadotropic hypogonadism, Chronic debilitating disease, 

- Abnormal functions of the pituitary gland results in abnormal secretion of some hormones such as prolactin, LH, FSH leading ro high prolactin or low FH, FSH. Other hormone-screening pituitary tumors (ACTH, thyrotropin-stimulating hormone, growth hormone), non-functional tumors (craniophyaryngioma), Metastatic carinoma, Space-occupying lesions : Empty sella syndrome, Arterial aneuysm, Necrosis : Sheehan syndrome, Panhypopituitarism, Inflammatory /infiltrative : Sarcoidosis, Hemachoromatosis. 

- High values of prolactin hormone called hyperprolactinemia due to prolactinoma, idiopathic hyperprolactinemia or due to other causes is an important cause of disturbed periods.

- Abnormal functions of the ovaries: Decreased function of the ovaries results in increased blood level of follicle Stimulating Hormone, Failure of ovaries before the age of 35 years is called premature ovarian failure. Aproximately 5% women have stoppage of period by 35 years. Causes of disturbed ovarian function are Polycystic ovarian syndrome (PCOS or PCOD),Hyperthecosis, Adrenal disease : Cushing syndrome, adult-onset adrenal hyperplasia, Thyroid disease : Hypothyroidism, hyperthyroidism, Ovarian tumors : Granulosa-theca cell tumors, Brenner tumors, cystic teratomas, mucinous/serous cystadenomas, Krukenberg tumors. , Gonadal dysgenesis, Turner syndrome 45, X, Mosaicism, Pure gonadal dysgenesis, 46, XX, 46,XX (Swyer syndrome), Ovarian enzymatic deficiency as 17a-Hydroxylase deficiency, 17, 20-Lyase deficiency, Premature Ovarian failure : Idiopathic premature menopause, injury, mumps oophoritis, radiation, chemotherapy, Resistant ovary (Savage syndrome), Autoimmune disease, Galactosemia. 

Immaturity of hypothalmic pituitary ovarian system 

What are the laboratory tests for menstrual irregularity?
Recommend some of the following laboratory tests confirm the diagnosis :
- Hormone Tests: L.H., F.S.H., Prolactin, Estradiol (E2),
Increase in Male hormone as Testosterone, Free testosterone, DHEAS, Androstenidione, 17.0 H.P. SHBG
- Thyroid function tests, Excess or deficient functions of thyroid glands can either cause decreased menstruation or amenorrhea.
Ultrasonography of the pelvis region for ovarian size & uterus.
Some other tests may also be required depending on history & physical examination

What is the treatment for menstrual irregularity?
- Treatment of specific diseases. Abnormalities of the thyroid gland, pituitary and abnormalities in the adrenal glands can be treated by appropriate medicines.
- Progesterone withdrawal

- Hormone therapy. Hormone treatment is recommended for that particular hormone disorder which is detected during hormone investigation. The various hormone therapies are 
a) Clomiphene
b) Gonadotropin Therapy
c) HCG Therapy
d) Hmg therapy
e) Metformin
f) Glitazones
g) Tamoxifene
h) Letrozole
i) Medroxyprogesterone
i) Desgestrol
j) Megestrol
k) Norethisterone
l) Hydroxyprogesterone
m) Oral E & P Combination Pill
n) Metformin
o) Glitazones

For consultation & treatment (by appointment / or online) click How to Consult Us

                                                                                            

 

 

 

 

 

 

 


We get patients from all major cities in India & Abroad . In the following cities all the facilities for investigation & treatments including medicines are available as Delhi (North, South, East, Central, West, New Delhi). Hormonal Imbalances Imbalance Treatment Delhi Causes India Men Women Symptoms Female Diagnosis Investigation Specialist Why tests Permanent cure Best senior Experienced India New Noida best qualified Indian East West North South Central Gurgaon Gurugram Faridabad Ghaziabad To Different Communities like Hindustani, Hindustan, Hindu, Christian, Muslim, Sikh, Parsee. The other cities are NCR, National Capital Reagion in India, Indian, Hindustan, Ghaziabad, Faridabad, Noida, Gurgaon Gurugram, Meerut, Bombay, Chandigarh, Calcutta,  Simla, Jammu, Srinagar, Aligarh, Lucknow, Kanpur, Allahabad, Varanasi, Dehradun, Madras, Kolkatta, Nainital, Agra,  Jaipur, Bikaner, Jodhpur, Porbandar, Dwarka, Ahmedabad, Gandhi Nagar, Vadodara, Surat, Mumbai, Pune, Thane, Panaji, Nasik, Nagpur, Indore, Ujjain, Bhopal, Gwalior, Jabalpur,  Raipur, Hyderabad, Goa, Visakhapatnam, Bangalore, Banglore, Bangalooru, Mysore, Mangalore, Manipal, Chennai, Pondicherry, Madurai, Kanchipuram, Coimbatore, Kanyakumari, Ernakulam, Trivandrum, Darjeeling, Gangtok, Bhubaneswar, Puri, Guwahati, Shillong, Imphal, Kohima, Agartala, Patna, Ranchi.

|| Home || Contact Us || Thyroid & Thyrotoxicosis || Hypothyroidism  || Goitre (Enlarged Thyroid)||  || Diabetes || 
|| Symptoms of Diabetes  || Diabetes Tt  || Monitoring of Diabetes || in Diabetes || 
|| Short Height Causes || Short ht.Treat || Obesity Causes Treatment  || Male Horm. DIS. ||  
|| Less Beard & Moustaches  || Small Testis || Hypogonadism || Andropause|| Testosterone Deficiency || 
|| Absent Sex Development || Under Weight   || Gynecomastia (Breast Enlargement) || Breast Enlar Gement || 
|| Low Sprem Count  || Nil Sperm || Male Infertility ||SmallBreast || Menopause|| Facial Hair || Menstrual Irreg. ||
 || Fem.Horm Dis.|| Milk Secr./High Prolaction || Pituitary Gland || Clinic Map|| Online Enquiry || H. F.Causes ||
|| H. F. Diag || Dg || H. F. Tt ||

For consultation & treatment (by appointment / or online) click How to Consult Us

We provide treatment for : Scanty Periods Heavy Excess Bleeding Treatment Delhi Causes Diagnosis Investigation Specialist Why tests Permanent cure Best senior Experienced India New Noida best qualified Indian East West North South Central Gurgaon Gurugram Faridabad Ghaziabad Excess hormone therapy  is one of the very remarkable advancement in the last 5 years.  

 


Causes of Hair Fall || Investigations & Diagnosis || Treatment of Hair Problems||Contact us
  White Spots || Urticaria || Consult us at our centre | || Contact Dermatitis || Scar || Acne Pimple || Itching
Psoriasis || Eczema ||  Dry Skin || Oily Skin || Recurrent Infection  ||  Fungus Nail  || Enquiry Form 

Copyright 2001 All Right Reserved www.DiabetesThyroidHormone.com