Experts reveal that dark menstrual blood does not mean irregular menstruation

There are many reasons for irregular menstruation. It may be caused by neuroendocrine disorders, organic diseases, drugs, bad habits and other factors. The hazards of irregular menstruation caused by different reasons are also different. It is necessary to determine the cause first and then treat it symptomatically. Some women often ask whether dark menstrual blood indicates irregular menstruation. In fact, the color of menstrual blood has little to do with irregular menstruation.

Li Li, chief physician of the Department of Gynecology at Guangdong Provincial Women and Children's Health Care Hospital, introduced that menstruation is actually the cyclical shedding of the endometrium under the action of estrogen secreted by the ovaries (as shown in the figure below). Normal menstruation includes normal menstrual cycle, normal menstrual period, normal menstrual volume and normal physiological reactions. Any abnormality in the above factors is considered menstrual abnormality. The menstrual cycle refers to the time from the first day of this menstruation to the first day of the next menstruation. The normal range of menstrual cycle is 21 to 35 days, and the most normal is 28 days. A menstrual cycle longer than 35 days or shorter than 21 days is considered abnormal. Menstrual period refers to the time from the first day of bleeding to the end of bleeding. A normal menstrual period is 2 to 7 days. If it is too long or too short, you need to consider whether there is a possible disease problem.

Li Li reminded that blood volume is a particularly subjective factor and is difficult to judge, but surveys show that the average blood volume for Chinese women per cycle is 50-60ml, and more than 80ml is considered excessive menstruation.

Proliferative phase Secretory phase Menstrual phase

Some patients are always worried about the dark color of their menstrual blood. Is it a sign of irregular menstruation? Li Li pointed out that the color of menstrual blood, which we usually think is very important, is not actually a factor in determining whether menstruation is normal or not. If the amount of bleeding is large and the blood stays in the vagina for a short time, the color will be reddish; if the amount of bleeding is small and the blood stays in the vagina for a long time, it will naturally turn black (because the blood contains a lot of iron, which will turn black under the influence of the acidic environment of the vagina). Therefore, from the perspective of Western medicine, the color of menstrual blood does not have much significance.

What are the causes of menstrual disorders?

1. Caused by neuroendocrine dysfunction: mainly due to unstable or defective function of the hypothalamus-pituitary-ovarian axis. The cyclical changes of ovarian hormones are controlled by the higher-level command system, namely the pituitary gland in the brain, which secretes FSH (follicle-stimulating hormone) and LH (luteinizing hormone) to regulate ovarian hormones; the pituitary gland has its superior, which we call the hypothalamus. Just like the relationship between the central government, the provincial government and the local government, menstruation is controlled and regulated by the hypothalamus-pituitary-ovarian axis. Functional defects of this axis may lead to menstrual disorders.

2. Caused by organic diseases or drugs: Certain organic diseases such as endometrial hyperplasia, adenomyosis, submucosal uterine fibroids, cervical lesions, and abnormal development of reproductive organs can lead to irregular uterine bleeding; local inflammation of the reproductive organs, other endocrine dysfunctions such as thyroid and adrenal cortex dysfunction, diabetes, Sheehan's disease, etc.; liver diseases; blood diseases; those who use drugs for the treatment of mental illness, endocrine preparations or use intrauterine contraceptive devices may all experience irregular menstruation. Certain occupations, such as long-distance runners, are prone to amenorrhea. In addition, some abnormal bleeding during pregnancy is often mistaken for menstrual irregularities.

3. Bad habits: Many bad habits may also lead to menstrual disorders, such as abnormal emotions, unlimited dieting, addiction to smoking and drinking, etc.

Don’t underestimate seemingly minor illnesses: What are the dangers of irregular menstruation?

1. Long-term excessive menstruation and irregular uterine bleeding can lead to hemorrhagic anemia, dizziness due to bleeding, fatigue, panic, palpitations, shortness of breath and other phenomena.

2. Menstrual irregularities caused by organic diseases such as uterine fibroids, endometrial polyps, etc., if not treated in time, will lead to worsening of the condition.

3. Dysfunction of one or more links in the hypothalamus-pituitary-ovarian axis will lead to anovulation, which is one of the pathophysiological bases of menstrual disorders and one of the causes of infertility. Some patients can ovulate but have insufficient ovarian luteal function, which can also cause infertility.

4. Irregular menstruation affects women's physical and mental health, and may cause abnormal phenomena such as skin pigmentation, roughness, dullness, decreased energy, and even irritability.

The occurrence of menstruation is the result of the combined action of many factors. Once menstruation becomes abnormal, you must consider the possibility of disease.

How to treat menstrual disorders?

Since the causes of irregular menstruation are multifaceted, individualized treatment should be given according to the different causes. For menstrual disorders diagnosed as caused by neuroendocrine dysfunction, different treatment plans should be adopted according to the severity of the disease and the specific circumstances of the patient.

1. For organic lesions such as uterine fibroids, endometrial polyps, etc., surgical treatment should be performed targeting the primary disease.

2. Periodic disorder: Different treatment plans can be adopted according to different ages. For adolescent girls with menstrual disorders, estrogen and progesterone can be used to simulate ovarian function, that is, artificial cycle treatment, which has a very good effect; while for women of childbearing age and menopause, menstrual disorders must rule out lesions in the vagina, cervix, uterus, ovaries, etc. After excluding organic lesions, treatment should be carried out according to different causes.

3. Infertility: Different ovulation-inducing drugs can be selected according to the patient's condition to improve ovarian function or replace part of the function of the pituitary gland and hypothalamus.

4. Bleeding and anemia: Due to long menstrual periods and heavy menstrual flow, in addition to general hemostatic measures, hormones or curettage may be used to stop bleeding as appropriate.

How to prevent menstrual disorders

In terms of prevention, Li Li suggested that women should pay attention to the regulation of emotions, diet, daily life and many other aspects. The relationship between emotions and diseases has gradually been paid attention to by people in recent years. For menstrual disorders, positive and optimistic emotions have a positive effect on the occurrence, development and prognosis of the disease. In terms of daily life regulation, traditional medicine pays great attention to diet. As the saying goes, "food supplements are worse than medicine supplements." Patients can regulate menstruation with food supplements according to their own conditions. In addition, people with abnormal weight, whether they are too fat or too thin, are prone to menstrual disorders. Therefore, normal nutrition, exercise, and maintaining a proper weight are very important prerequisites for maintaining a normal menstrual cycle for women. At the same time, female friends should pay attention to hygiene during menstruation, avoid strenuous exercise, keep warm during menstruation, and get enough sleep. Only in this way can they coexist peacefully with "Aunt Flo" and have health and beauty.