Patient's question:
Here is the English translation of your text, with the original line breaks preserved and all Chinese text translated into English:"Recently, my menstrual cycle has shortened to about 24 days, and my physical condition weakens during menstruation. Even slight fatigue during my period causes heavy bleeding. How can I restore my cycle to the previous 30-day average? I’m afraid this will lead to an early menopause if it continues. (I had functional uterine bleeding 6-7 years ago, which was later cured. After that, I had a severe cold after swimming in the sea, which shortened my cycle and also caused abdominal pain.)
First follow-up question: Oh, thank you for the detailed answer.
For the past ten years since my first menstrual period, my cycle has been around 29 days. But in recent years, it suddenly shortened. I’m wondering what will happen if this continues into middle and old age."
Doctor's answer:
Menstruation is vaginal bleeding caused by the cyclical shedding of the endometrium due to the periodic changes in ovarian hormones. After puberty, the ovaries gradually develop under the stimulation of gonadotropin hormones secreted by the hypothalamus-pituitary axis. Under the action of pituitary follicle-stimulating hormone (FSH), follicles gradually grow, mature, and secrete large amounts of estrogen. Under the influence of estrogen, the endometrium proliferates and thickens, exhibiting a proliferative phase change. Under the action of luteinizing hormone (LH), mature follicles rupture and release ova. After ovulation, the follicle forms a corpus luteum, and luteal cells secrete progesterone. Under the combined action of estrogen and progesterone, the endometrium further proliferates and exhibits a secretory phase change due to the secretion of glandular epithelial cells. If the ovum is not fertilized, the corpus luteum begins to atrophy, with an average lifespan of 14 days. After the corpus luteum atrophies, the levels of estrogen and progesterone in the ovaries rapidly decline, causing the endometrium to lose support and atrophy. Due to ischemia and necrosis, the endometrium detaches, resulting in vaginal bleeding, which is commonly referred to as the onset of menstruation.The first occurrence of menstruation is called menarche. The age of menarche is mostly between 13 and 15 years old, and its timing is influenced by various internal and external factors, such as climate, individual constitution, and nutritional status. The first day of bleeding marks the beginning of the menstrual cycle, and the interval between two consecutive first days of menstruation is called the menstrual cycle. Therefore, the calculation of the menstrual cycle should include the time of menstruation. Some women only calculate the time after menstruation is clean, which may lead to the misconception that the menstrual cycle is shortened. Clinically, some women often complain of abnormal menstruation, experiencing two menstrual periods in a month. In fact, if calculated carefully, there are typically menstrual periods at the beginning and end of the month.