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Клинические и эндокринные особенности менструального цикла женщин
Клинические и эндокринные особенности менструального цикла женщин
Ильясова Н.А., Бурлев В.А. Клинические и эндокринные особенности менструального цикла женщин. Гинекология. 2015; 17 (6): 17–21.
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Аннотация
Представленные данные литературы посвящены систематизации наиболее значимых факторов и механизмов в отображении клинических и гормональных особенностей менструального цикла (МЦ) во время естественного перехода к менопаузе. Возникновение «лютеинового внефазного явления» (luteal out-of-phase event или LOOP event) – следствие циклической стимуляции преантральных фолликулов, которые становятся чувствительными на стимуляцию фолликулостимулирующего гормона в определенные интервалы МЦ. Такие интервалы описывают как возвратные волны, возникающие в пределах одного МЦ у женщин менопаузального перехода. LOOP-феномен объясняет природу вариабельных эндокринных изменений в период перехода к менопаузе.
Ключевые слова: менструальная функция, менопаузальный переход, атипическая секреция эстрадиола.
Key words: menstrual cycle, menopausal transition, atypical estradiol secretion.
Ключевые слова: менструальная функция, менопаузальный переход, атипическая секреция эстрадиола.
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Key words: menstrual cycle, menopausal transition, atypical estradiol secretion.
Полный текст
Список литературы
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2. Hale GE, Hughes CL, Burger HG et al. Atypical estradiol secretion and ovulation patterns caused by luteal out-of-phase (LOOP) events underlying irregular ovulatory menstrual cycles in the menopausal transition. Menopause 2009; 16 (1): 50–9.
3. Dudley EC, Hopper JL, Taffe J et al. Using longitudinal data to define the perimenopause bymenstrual cycle characteristics. Climacteric 1998; 1 (1): 18–25.
4. Treloar AE, Boynton RE, Behn BG et al. Variation of the human menstrual cycle through reproductive life. International Journal of Fertility 1970; 12 (1 Pt. 2): 77–126.
5. Harlow SD, Cain K, Crawford S et al. Evaluation of four proposed bleeding criteria for the onset of late menopausal transition. J Clin Endocrinol Metab 2006; 91 (9): 3432–8.
6. Klein NA, Harper AJ, Houmard BS et al. Is the short follicular phase in older women secondary to advanced or accelerated dominant follicle development? J Clin Endocrinol Metab 2002; 87 (12): 5746–50.
7. Lenton EA, Landgren BM, Sexton L et al. Normal variation in the length of the follicular phase of the menstrual cycle: effect of chronological age. Br J Obstet Gynaecol 1984; 91 (7): 681–4.
8. Gorrindo T, Lu Y, Pincus S et al. Lifelong menstrual histories are typically erratic and trending: a taxonomy. Menopause 2007; 14 (1): 74–88.
9. Seltzer VL, Benjamin F, Deutsch S. Perimenopausal bleeding patterns andpathologic findings. J Am Med Women Assoc 1990; 45 (4): 132–4.
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16. Fraser IS, Critchley HOD, Munro MG et al. Can we achieve international agreement on t erminologies and definitions used to describe abnormalities of menstrual bleeding? Hum Reprod 2007; 22 (3): 635–43.
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21. Lynch KE, Mumford SL, Schliep KC et al. Assessment of anovulation in eumenorrheic women: comparison of ovulation detection algorithms. Fertil Steril 2014; 102 (2): 511–518.e2.
22. Hale GE, Zhao X, Hughes CL et al. Endocrine features of menstrual cycles in middle and late reproductive age and the menopausal transition classified according to the Staging of Reproductive Aging Workshop (STRAW) staging system. J Clin Endocrinol Metab 2007; 92: 3060–7.
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24. Burger H. The Menopausal Transition–Endocrinology. J Sex Med 2008; 5: 2266–73.
25. Robertson DM, Hale GE, Fraser IS et al. Changes in serum antimullerian hormone levels acrossthe ovulatory menstrual cycle in late reproductive age. Menopause 2011; 18 (5): 521–4.
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27. Wallace WHB, Kelsey TW. Human ovarian reserve from conception to the menopause. PLoS ONE 2010; 5 (1): e8772.
28. Monniaux D, Clément F, Dalbiès-Tran R et al. The ovarian reserve of primordial follicles and the dynamic reserve of antral growing follicles: What is the link? Biol Reprod 2014; 90 (4): 85.
29. Hansen KR, Craig LB, Zavy MT et al. Ovarian primordial and non-growing follicle counts according to the Stages of Reproductive Aging Workshop (STRAW) staging system. Menopause 2012; 19 (2): 164–71.
30. Landgren BM, Collins A, Csemiczky G et al. Menopause Transition: Annual Changes in Serum Hormonal Patterns over the Menstrual Cycle in Women during a Nine-Year Period Prior to Menopause. J Clin Endocrinol Metab 2004; 89 (6): 2763–9.
31. Landgren BM, Diczfalusy E. Hormonal effects of the 300 microgram norethisterone (NET) minipill. I. Daily steroid levels in 43 subjects during a pretreatment cycle and during the second month of NET administration. Contraception 1980; 21 (1): 87–113.
32. Краткое руководство по репродукции животных: крупный рогатый скот. Пер. с англ. Ч.1 и 2. Под ред. М.Пташинской. Пер. Н.Ю.Давыдова. Минск: Позитив-центр, 2012. / Kratkoe rukovodstvo po reproduktsii zhivotnykh: krupnyi rogatyi skot. Per. s angl. Ch.1 i 2. Pod red. M.Ptashinskoi. Per. N.Iu.Davydova. Minsk: Pozitiv-tsentr, 2012. [in Russian]
33. Derry PS, Derry GN. Menstruation, Perimenopause, and Chaos Theory. Perspectives in Biol and Med 2012; 55 (1): 26–42.
34. Еськов В.М., Еськов В.В., Джумагалиева Л.Б. и др. Медицина и теория хаоса в описании единичного и случайного. Вестн. новых медицинских технологий. 2014; 21 (3): 27–34. / Es'kov V.M., Es'kov V.V., Dzhumagalieva L.B. i dr. Meditsina i teoriia khaosa v opisanii edinichnogo i sluchainogo. Vestn. novykh meditsinskikh tekhnologii. 2014; 21 (3): 27–34. [in Russian]
35. Адайкин В.А., Добрынина И.Ю., Добрынин Ю.В. и др. Использование методов теории хаоса и синергетики в современной клинической кибернетике. Сибирский мед. журн. 2006; 8: 38 / Adaikin V.A., Dobrynina I.Iu., Dobrynin Iu.V. i dr. Ispol'zovanie metodov teorii khaosa i sinergetiki v sovremennoi klinicheskoi kibernetike. Sibirskii med. zhurn. 2006; 8: 38 [in Russian]
36. Ватамова С.Н., Гараева Г.Р., Козупица Г.С. и др. Теория хаоса-самоорганизации в описании функциональных систем организма человека. Вестн. новых медицинских технологий. 2014; 21 (2): 15–20. / Vatamova S.N., Garaeva G.R., Kozupitsa G.S. i dr. Teoriia khaosa-samoorganizatsii v opisanii funktsional'nykh sistem organizma cheloveka. Vestn. novykh meditsinskikh tekhnologii. 2014; 21 (2): 15–20. [in Russian]
37. Womenʼs Health and Menopause: a comprehensive approach. NIH Publication 2002; 2: 3284.
2. Hale GE, Hughes CL, Burger HG et al. Atypical estradiol secretion and ovulation patterns caused by luteal out-of-phase (LOOP) events underlying irregular ovulatory menstrual cycles in the menopausal transition. Menopause 2009; 16 (1): 50–9.
3. Dudley EC, Hopper JL, Taffe J et al. Using longitudinal data to define the perimenopause bymenstrual cycle characteristics. Climacteric 1998; 1 (1): 18–25.
4. Treloar AE, Boynton RE, Behn BG et al. Variation of the human menstrual cycle through reproductive life. International Journal of Fertility 1970; 12 (1 Pt. 2): 77–126.
5. Harlow SD, Cain K, Crawford S et al. Evaluation of four proposed bleeding criteria for the onset of late menopausal transition. J Clin Endocrinol Metab 2006; 91 (9): 3432–8.
6. Klein NA, Harper AJ, Houmard BS et al. Is the short follicular phase in older women secondary to advanced or accelerated dominant follicle development? J Clin Endocrinol Metab 2002; 87 (12): 5746–50.
7. Lenton EA, Landgren BM, Sexton L et al. Normal variation in the length of the follicular phase of the menstrual cycle: effect of chronological age. Br J Obstet Gynaecol 1984; 91 (7): 681–4.
8. Gorrindo T, Lu Y, Pincus S et al. Lifelong menstrual histories are typically erratic and trending: a taxonomy. Menopause 2007; 14 (1): 74–88.
9. Seltzer VL, Benjamin F, Deutsch S. Perimenopausal bleeding patterns andpathologic findings. J Am Med Women Assoc 1990; 45 (4): 132–4.
10. Mansfield PK, Carey M, Anderson A et al. Staging the menopausal transition: data from the TREMIN Research Program on Women’s Health. Womens Health Issues 2004; 14 (6): 220–6.
11. Thomas F, Renaud F, Benefice E et al. International variability of ages at menarche and menopause: patterns and main determinants. Hum Biol 2001; 73 (2): 271–90.
12. ASRM Practice Committee Menopausal Transition. Fertil Steril 2008; 90 (Suppl. 3): S61–S65.
13. Soules MR, Sherman S, Parrott E et al. Executive summary: Stages of Reproductive Aging Workshop [STRAW]. Fertil Steril 2001; 76: 874–8.
14. Jairajpuri ZS, Rana S, Jetley S. Atypical uterine bleeding-Histopathological audit of endometrium. A study of 638 cases. Al Ameen J Med Sci 2013; 6 (1): 21–8.
15. Harlow S, Gass M, Hall J et al. Executive summary of the Stages of Reproductive Aging Workshop+10: addressing the unfinished agenda of staging reproductive aging. Fertil Steril 2012; 97 (4): 843–51.
16. Fraser IS, Critchley HOD, Munro MG et al. Can we achieve international agreement on t erminologies and definitions used to describe abnormalities of menstrual bleeding? Hum Reprod 2007; 22 (3): 635–43.
17. Здоровье женщин и менопауза. Пер. с англ. М.: ГЭОТАР-МЕД, 2004; с. 354. / Zdorov'e zhenshchin i menopauza. Per. s angl. M.: GEОTAR-MED, 2004; s. 354. [in Russian]
18. Taylor SM, Kinney AM, Kline JK. Menopausal transition: predicting time to menopause for women 44 years or older from simple questions on menstrual variability. Menopause 2004; 11 (1): 40–8.
19. Paramsothy P, Harlow SD, Elliott MR et al. Classifying menopause stage by menstrual calendars and annual interviews: need for improved questionnaires Menopause. J North Am Menopause Soc 2013; 20 (7): 727–35.
20. Hale GE, Manconi F, Luscombe G et al. Quantitative Measurements of menstrual blood loss in ovulatory and anovulatory cycles in middle- and late-reproductive age and the menopausal transition. Obstet Gynecol 2010; 115 (2–1): 249–56.
21. Lynch KE, Mumford SL, Schliep KC et al. Assessment of anovulation in eumenorrheic women: comparison of ovulation detection algorithms. Fertil Steril 2014; 102 (2): 511–518.e2.
22. Hale GE, Zhao X, Hughes CL et al. Endocrine features of menstrual cycles in middle and late reproductive age and the menopausal transition classified according to the Staging of Reproductive Aging Workshop (STRAW) staging system. J Clin Endocrinol Metab 2007; 92: 3060–7.
23. Robertson DM, Hale GE, Fraser IS et al. A proposed classification system for menstrual cycles in the menopause transition based on changes in serum hormone profiles. Menopause. J North Am Menopause Soc 2008; 15 (6): 1139–44.
24. Burger H. The Menopausal Transition–Endocrinology. J Sex Med 2008; 5: 2266–73.
25. Robertson DM, Hale GE, Fraser IS et al. Changes in serum antimullerian hormone levels acrossthe ovulatory menstrual cycle in late reproductive age. Menopause 2011; 18 (5): 521–4.
26. Robertson DM, Hale GE, Fraser IS et al. A proposed classification system for menstrual cycles in the menopause transition based on changes in serum hormone profiles. Menopause 2008; 15 (6): 1139–44.
27. Wallace WHB, Kelsey TW. Human ovarian reserve from conception to the menopause. PLoS ONE 2010; 5 (1): e8772.
28. Monniaux D, Clément F, Dalbiès-Tran R et al. The ovarian reserve of primordial follicles and the dynamic reserve of antral growing follicles: What is the link? Biol Reprod 2014; 90 (4): 85.
29. Hansen KR, Craig LB, Zavy MT et al. Ovarian primordial and non-growing follicle counts according to the Stages of Reproductive Aging Workshop (STRAW) staging system. Menopause 2012; 19 (2): 164–71.
30. Landgren BM, Collins A, Csemiczky G et al. Menopause Transition: Annual Changes in Serum Hormonal Patterns over the Menstrual Cycle in Women during a Nine-Year Period Prior to Menopause. J Clin Endocrinol Metab 2004; 89 (6): 2763–9.
31. Landgren BM, Diczfalusy E. Hormonal effects of the 300 microgram norethisterone (NET) minipill. I. Daily steroid levels in 43 subjects during a pretreatment cycle and during the second month of NET administration. Contraception 1980; 21 (1): 87–113.
32. Kratkoe rukovodstvo po reproduktsii zhivotnykh: krupnyi rogatyi skot. Per. s angl. Ch.1 i 2. Pod red. M.Ptashinskoi. Per. N.Iu.Davydova. Minsk: Pozitiv-tsentr, 2012. [in Russian]
33. Derry PS, Derry GN. Menstruation, Perimenopause, and Chaos Theory. Perspectives in Biol and Med 2012; 55 (1): 26–42.
34. Es'kov V.M., Es'kov V.V., Dzhumagalieva L.B. i dr. Meditsina i teoriia khaosa v opisanii edinichnogo i sluchainogo. Vestn. novykh meditsinskikh tekhnologii. 2014; 21 (3): 27–34. [in Russian]
35. Adaikin V.A., Dobrynina I.Iu., Dobrynin Iu.V. i dr. Ispol'zovanie metodov teorii khaosa i sinergetiki v sovremennoi klinicheskoi kibernetike. Sibirskii med. zhurn. 2006; 8: 38 [in Russian]
36. Vatamova S.N., Garaeva G.R., Kozupitsa G.S. i dr. Teoriia khaosa-samoorganizatsii v opisanii funktsional'nykh sistem organizma cheloveka. Vestn. novykh meditsinskikh tekhnologii. 2014; 21 (2): 15–20. [in Russian]
37. Womenʼs Health and Menopause: a comprehensive approach. NIH Publication 2002; 2: 3284.
2. Hale GE, Hughes CL, Burger HG et al. Atypical estradiol secretion and ovulation patterns caused by luteal out-of-phase (LOOP) events underlying irregular ovulatory menstrual cycles in the menopausal transition. Menopause 2009; 16 (1): 50–9.
3. Dudley EC, Hopper JL, Taffe J et al. Using longitudinal data to define the perimenopause bymenstrual cycle characteristics. Climacteric 1998; 1 (1): 18–25.
4. Treloar AE, Boynton RE, Behn BG et al. Variation of the human menstrual cycle through reproductive life. International Journal of Fertility 1970; 12 (1 Pt. 2): 77–126.
5. Harlow SD, Cain K, Crawford S et al. Evaluation of four proposed bleeding criteria for the onset of late menopausal transition. J Clin Endocrinol Metab 2006; 91 (9): 3432–8.
6. Klein NA, Harper AJ, Houmard BS et al. Is the short follicular phase in older women secondary to advanced or accelerated dominant follicle development? J Clin Endocrinol Metab 2002; 87 (12): 5746–50.
7. Lenton EA, Landgren BM, Sexton L et al. Normal variation in the length of the follicular phase of the menstrual cycle: effect of chronological age. Br J Obstet Gynaecol 1984; 91 (7): 681–4.
8. Gorrindo T, Lu Y, Pincus S et al. Lifelong menstrual histories are typically erratic and trending: a taxonomy. Menopause 2007; 14 (1): 74–88.
9. Seltzer VL, Benjamin F, Deutsch S. Perimenopausal bleeding patterns andpathologic findings. J Am Med Women Assoc 1990; 45 (4): 132–4.
10. Mansfield PK, Carey M, Anderson A et al. Staging the menopausal transition: data from the TREMIN Research Program on Women’s Health. Womens Health Issues 2004; 14 (6): 220–6.
11. Thomas F, Renaud F, Benefice E et al. International variability of ages at menarche and menopause: patterns and main determinants. Hum Biol 2001; 73 (2): 271–90.
12. ASRM Practice Committee Menopausal Transition. Fertil Steril 2008; 90 (Suppl. 3): S61–S65.
13. Soules MR, Sherman S, Parrott E et al. Executive summary: Stages of Reproductive Aging Workshop [STRAW]. Fertil Steril 2001; 76: 874–8.
14. Jairajpuri ZS, Rana S, Jetley S. Atypical uterine bleeding-Histopathological audit of endometrium. A study of 638 cases. Al Ameen J Med Sci 2013; 6 (1): 21–8.
15. Harlow S, Gass M, Hall J et al. Executive summary of the Stages of Reproductive Aging Workshop+10: addressing the unfinished agenda of staging reproductive aging. Fertil Steril 2012; 97 (4): 843–51.
16. Fraser IS, Critchley HOD, Munro MG et al. Can we achieve international agreement on t erminologies and definitions used to describe abnormalities of menstrual bleeding? Hum Reprod 2007; 22 (3): 635–43.
17. Здоровье женщин и менопауза. Пер. с англ. М.: ГЭОТАР-МЕД, 2004; с. 354. / Zdorov'e zhenshchin i menopauza. Per. s angl. M.: GEОTAR-MED, 2004; s. 354. [in Russian]
18. Taylor SM, Kinney AM, Kline JK. Menopausal transition: predicting time to menopause for women 44 years or older from simple questions on menstrual variability. Menopause 2004; 11 (1): 40–8.
19. Paramsothy P, Harlow SD, Elliott MR et al. Classifying menopause stage by menstrual calendars and annual interviews: need for improved questionnaires Menopause. J North Am Menopause Soc 2013; 20 (7): 727–35.
20. Hale GE, Manconi F, Luscombe G et al. Quantitative Measurements of menstrual blood loss in ovulatory and anovulatory cycles in middle- and late-reproductive age and the menopausal transition. Obstet Gynecol 2010; 115 (2–1): 249–56.
21. Lynch KE, Mumford SL, Schliep KC et al. Assessment of anovulation in eumenorrheic women: comparison of ovulation detection algorithms. Fertil Steril 2014; 102 (2): 511–518.e2.
22. Hale GE, Zhao X, Hughes CL et al. Endocrine features of menstrual cycles in middle and late reproductive age and the menopausal transition classified according to the Staging of Reproductive Aging Workshop (STRAW) staging system. J Clin Endocrinol Metab 2007; 92: 3060–7.
23. Robertson DM, Hale GE, Fraser IS et al. A proposed classification system for menstrual cycles in the menopause transition based on changes in serum hormone profiles. Menopause. J North Am Menopause Soc 2008; 15 (6): 1139–44.
24. Burger H. The Menopausal Transition–Endocrinology. J Sex Med 2008; 5: 2266–73.
25. Robertson DM, Hale GE, Fraser IS et al. Changes in serum antimullerian hormone levels acrossthe ovulatory menstrual cycle in late reproductive age. Menopause 2011; 18 (5): 521–4.
26. Robertson DM, Hale GE, Fraser IS et al. A proposed classification system for menstrual cycles in the menopause transition based on changes in serum hormone profiles. Menopause 2008; 15 (6): 1139–44.
27. Wallace WHB, Kelsey TW. Human ovarian reserve from conception to the menopause. PLoS ONE 2010; 5 (1): e8772.
28. Monniaux D, Clément F, Dalbiès-Tran R et al. The ovarian reserve of primordial follicles and the dynamic reserve of antral growing follicles: What is the link? Biol Reprod 2014; 90 (4): 85.
29. Hansen KR, Craig LB, Zavy MT et al. Ovarian primordial and non-growing follicle counts according to the Stages of Reproductive Aging Workshop (STRAW) staging system. Menopause 2012; 19 (2): 164–71.
30. Landgren BM, Collins A, Csemiczky G et al. Menopause Transition: Annual Changes in Serum Hormonal Patterns over the Menstrual Cycle in Women during a Nine-Year Period Prior to Menopause. J Clin Endocrinol Metab 2004; 89 (6): 2763–9.
31. Landgren BM, Diczfalusy E. Hormonal effects of the 300 microgram norethisterone (NET) minipill. I. Daily steroid levels in 43 subjects during a pretreatment cycle and during the second month of NET administration. Contraception 1980; 21 (1): 87–113.
32. Краткое руководство по репродукции животных: крупный рогатый скот. Пер. с англ. Ч.1 и 2. Под ред. М.Пташинской. Пер. Н.Ю.Давыдова. Минск: Позитив-центр, 2012. / Kratkoe rukovodstvo po reproduktsii zhivotnykh: krupnyi rogatyi skot. Per. s angl. Ch.1 i 2. Pod red. M.Ptashinskoi. Per. N.Iu.Davydova. Minsk: Pozitiv-tsentr, 2012. [in Russian]
33. Derry PS, Derry GN. Menstruation, Perimenopause, and Chaos Theory. Perspectives in Biol and Med 2012; 55 (1): 26–42.
34. Еськов В.М., Еськов В.В., Джумагалиева Л.Б. и др. Медицина и теория хаоса в описании единичного и случайного. Вестн. новых медицинских технологий. 2014; 21 (3): 27–34. / Es'kov V.M., Es'kov V.V., Dzhumagalieva L.B. i dr. Meditsina i teoriia khaosa v opisanii edinichnogo i sluchainogo. Vestn. novykh meditsinskikh tekhnologii. 2014; 21 (3): 27–34. [in Russian]
35. Адайкин В.А., Добрынина И.Ю., Добрынин Ю.В. и др. Использование методов теории хаоса и синергетики в современной клинической кибернетике. Сибирский мед. журн. 2006; 8: 38 / Adaikin V.A., Dobrynina I.Iu., Dobrynin Iu.V. i dr. Ispol'zovanie metodov teorii khaosa i sinergetiki v sovremennoi klinicheskoi kibernetike. Sibirskii med. zhurn. 2006; 8: 38 [in Russian]
36. Ватамова С.Н., Гараева Г.Р., Козупица Г.С. и др. Теория хаоса-самоорганизации в описании функциональных систем организма человека. Вестн. новых медицинских технологий. 2014; 21 (2): 15–20. / Vatamova S.N., Garaeva G.R., Kozupitsa G.S. i dr. Teoriia khaosa-samoorganizatsii v opisanii funktsional'nykh sistem organizma cheloveka. Vestn. novykh meditsinskikh tekhnologii. 2014; 21 (2): 15–20. [in Russian]
37. Womenʼs Health and Menopause: a comprehensive approach. NIH Publication 2002; 2: 3284.
________________________________________________
2. Hale GE, Hughes CL, Burger HG et al. Atypical estradiol secretion and ovulation patterns caused by luteal out-of-phase (LOOP) events underlying irregular ovulatory menstrual cycles in the menopausal transition. Menopause 2009; 16 (1): 50–9.
3. Dudley EC, Hopper JL, Taffe J et al. Using longitudinal data to define the perimenopause bymenstrual cycle characteristics. Climacteric 1998; 1 (1): 18–25.
4. Treloar AE, Boynton RE, Behn BG et al. Variation of the human menstrual cycle through reproductive life. International Journal of Fertility 1970; 12 (1 Pt. 2): 77–126.
5. Harlow SD, Cain K, Crawford S et al. Evaluation of four proposed bleeding criteria for the onset of late menopausal transition. J Clin Endocrinol Metab 2006; 91 (9): 3432–8.
6. Klein NA, Harper AJ, Houmard BS et al. Is the short follicular phase in older women secondary to advanced or accelerated dominant follicle development? J Clin Endocrinol Metab 2002; 87 (12): 5746–50.
7. Lenton EA, Landgren BM, Sexton L et al. Normal variation in the length of the follicular phase of the menstrual cycle: effect of chronological age. Br J Obstet Gynaecol 1984; 91 (7): 681–4.
8. Gorrindo T, Lu Y, Pincus S et al. Lifelong menstrual histories are typically erratic and trending: a taxonomy. Menopause 2007; 14 (1): 74–88.
9. Seltzer VL, Benjamin F, Deutsch S. Perimenopausal bleeding patterns andpathologic findings. J Am Med Women Assoc 1990; 45 (4): 132–4.
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Авторы
Н.А.Ильясова*, В.А.Бурлев
ФГБУ Научный центр акушерства, гинекологии и перинатологии им. акад. В.И.Кулакова Минздрава России. 117997, Россия, Москва, ул. Академика Опарина, д. 4
*natalia_ilyasova@mail.ru
V.I.Kulakov Research Center for Obstetrics, Gynecology and Perinatology of the Ministry of Health of the Russian Federation. 117997, Russian Federation, Moscow, ul. Akademika Oparina, d. 4
*natalia_ilyasova@mail.ru
ФГБУ Научный центр акушерства, гинекологии и перинатологии им. акад. В.И.Кулакова Минздрава России. 117997, Россия, Москва, ул. Академика Опарина, д. 4
*natalia_ilyasova@mail.ru
________________________________________________
V.I.Kulakov Research Center for Obstetrics, Gynecology and Perinatology of the Ministry of Health of the Russian Federation. 117997, Russian Federation, Moscow, ul. Akademika Oparina, d. 4
*natalia_ilyasova@mail.ru
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