Dysfunction of the ovaries

Ovarian dysfunction is a failure of the ovarian function responsible for the formation of pituitary hormones, due to the emergence of foci of inflammation or an unstable state in the endocrine system. Hormonal dysfunction of the ovaries is characterized by a number of manifestations of pathological conditions. It is characterized by a failure of the normal cycle in two types: lengthening( more than 40 days) and shortening( less than 21 days) in tandem with hemorrhages occurring in the middle of the cycle( DMC).Bleeding from the uterus, not included in the period of menstruation, is the visiting card of this pathology.

Dysfunction of the ovaries of the reproductive period, with the ambiguity of the cycle of menstruation, can pour out into such a complication as anovulation( absence of appearance of the egg).The consequences of ovarian dysfunction lead to excessive irritability, malaise, headache, depression, nausea leading to vomiting, pains in the lower abdomen, manifested in a week or even two before the release of mestinal blood.

In tandem with dysfunction of the ovaries, it is possible to meet such female diseases as endometriosis or myomatous nodes on the uterus, as well as mastopathy. Such companions are more susceptible to women, whose age has crossed through the fourth decade. The cause of the imbalance of the cycle of menstruation can be the presence of pregnancy, entrenched outside the uterus or the presence of tumor-like formations of the pelvic organs. Symptoms of ovarian dysfunction may subside, but this phenomenon is of a short-term nature. Ignoring the manifestations of the disease leads to serious complications.

Causes of ovarian dysfunction

There are many causes of ovarian dysfunction. After all, in fact, this is a failure, or rather the failure to perform the functions assigned to this body. And any diligent worker is debugged a functioning system, does not shirk his duties just like that. Factors affecting the occurrence of dysfunction of the ovaries of reproductive age, may be the formation of inflammatory foci in the organs of the sexual system of women. Ovaries, uterus and uterine appendages( fallopian tubes) can acquire inflammatory processes under the names of oophoritis, endometritis or adnexitis, depending on localization. The culprits for the onset of infectious inflammation can be circumstances that are not dependent on women, such as a cold, the introduction of a pathogenic organism through blood or lymph flows from other organs, severe hypothermia. However, to harm yourself in this situation, and the mistress of the body, not complying with the rules of local hygiene of the genital organs or violating the technique of irrigation of the vagina.

Hormonal dysfunction of the ovaries can occur if the endocrine system is malfunctioning. Diseases of the thyroid gland, pathology of the adrenal cortex or diabetes mellitus may accompany a woman from birth, and may have acquired character. The consequences of ovarian dysfunction can lead to obesity.

Various pathologies of the ovaries and uterus, up to oncological, can cause a malfunction in the work of this body. Cancer of the body and cervix can manifest as bleeding in ovarian dysfunction.

Exhaustion of the nervous system, emotional and physical overstrain, as well as non-observance of healthy sleep and adequate rest can lead to interruptions in the work of the ovaries.

Premature termination of pregnancy in an artificial or spontaneous way, causes the hormonal background to change sharply. Such a change subsequently follows in a persistent violation of the functions of the ovaries, and in the future to infertility.

If a contraceptive like the intrauterine device is not properly installed, then in addition to a sudden pregnancy, a woman may experience dysfunction of the ovaries.

External factors, such as flights, from one climate to another, damage to radiation and exposure to harmful factors, may be involved in the occurrence of this problem.

Symptoms and signs of ovarian dysfunction

For the work and regulation of the ovaries meet three children living in the pituitary gland, or rather in its anterior lobe. The first is a follicle-stimulating hormone. Its name said for itself. This hormone is responsible for the acquisition, growth and maturation of follicles in the ovaries. The second is luteinizing hormone. He responds not for anything else, as for cyclicity. Thanks to him, a woman can calculate when she should not wear white trousers. The third hormone is called prolactin. This brave soldier is responsible for the beautiful decollete and the arrival of milk after delivery. With the birth of a baby, a pituitary in the name of prolactin, unfolds a party in the blood of a woman. Its amount is colossally increasing, which leads to the appearance of food for the baby. While the party continues, ovulation does not occur. This is the focus of the lack of pregnancy for mothers who support breastfeeding. It is clear that its increase before the onset of pregnancy is a pathology, and leads to a lack of release of the egg. If three of our guys, in the right proportion at a certain stage of the menstrual cycle, do their work, then ovulation occurs.

Based on the narrative of three pituitary adolescents working for the benefit of the ovaries, it can be judged that the first sign of dysfunction of the ovaries is a disruption in the regularity of the cycle of menstruation. If the inhabitants of the pituitary gland fail, then the egg does not go to the scene at the right time. The absence of an egg's performance leads to a lack of progesterone, which is also called the "pregnancy hormone" and an overabundance of estrogens.

Symptom of ovarian dysfunction, as mentioned above, is a malfunctioning cycle of menstruation. Disorders occur both in cyclicity and as menstruation. Allocations are abundant or, conversely, meager. However, bleeding with ovarian dysfunction can occur in the middle of the cycle, and not apply to menstruation.

For clarity of the picture, it is worth remembering what are the parameters of a normal cycle of menstruation. Its duration varies from 21 to 35 days, inclusive of the genital tract last at least 3 and not more than 7 days. Blood loss is small 50-100 ml for the whole period of bleeding. Menstrual blood is dark red, can have small, slimey clots. This period passes without changes in the somatic state of the woman. She should not feel pain, weakness, blurred vision, dizziness, loss of consciousness. During menstruation, you should not forget about the rules of local intimate hygiene. Normally, there should not be a smell. The gasket needs to be changed every 2-4 hours. Tampons should be used only in extreme cases, since they are traumatic for the cervix. Deviations from the parameters set by the mother by nature, serve as a signal for a call to a highly qualified specialist.

As serious irregularities occur in the process of preparation and release of the egg into the light, it is often observed the termination of pregnancy on a short term. In large numbers, women with ovarian dysfunction experience a lack of pregnancy.

Pain syndrome, during the menstrual cycle or a week before, accompanies women with dysfunction. In the middle of the cycle, on the dates of the supposed egg tour, a woman can also feel minor pain in the lower abdomen.

Acyclic uterine bleeding is one of the brightest signs of a failure in optimal ovarian function. They occur with increased frequency - the length of the break is less than 20-22 days, or with a lower frequency - the length of the break is more than 38-40 days. As a rule, they are massive up to 100-150 ml of blood and last at least a week.

Excessive irritability, malaise, headache, and even depression for a week - two before the "red days of the calendar", are not a norm option and are the reason for the visit to the doctor.

But of course the most alarming and alarming symptom is the absence of menstruation at all. Many rejoice at this coincidence and postpone the trip to the doctor, but we must remember that not everything that is convenient is correct.

Ovarian dysfunction and pregnancy

The idea of ​​pregnancy for ovarian dysfunction needs to be approached with all the intelligence and ingenuity. You need to restore the cycle, and sometimes the very existence of ovulation. Treatment and preparation takes place under the watchful eye of a gynecologist-endocrinologist.

In order to arrange touring an egg in the body of a woman who wants to know motherhood, a course of direct stimulants of ovulation is prescribed. Drugs are hormonal, their dose is calculated individually, it is increased only if necessary and very carefully. The launch of ovulation is controlled by biochemical blood counts and clinical data.

Using the ultrasound method of diagnosis, the doctor observes the speed and prospects for the acquisition and maturation of the follicle. When he reaches a size of 1.8 cm, the desired degree of maturity, as well as thickening of the layer lining the uterus to 8-10 mm, conclude that everything is ready to start ovulation. In the amount of 10 000 IU intramuscularly injected human chorionic gonadotropin, which releases an egg on the scene.

"Persuasion" of the ovum by hormonal therapy is carried out for three cycles of menstruation. The next three cycles use a synthetic preparation of progesterone - the "pregnancy hormone" from 16-25 days. The control is performed by measuring the basal temperature( should become hotter), and of course the ultrasound machine.

Ovarian dysfunction is not a verdict for a woman. Current gynecology in 90% of cases solves the problem of malfunctioning cycle of menstruation and improves the regularity, and sometimes the very existence of ovulation. Pregnancy comes and wears out, however its conducting should be spent with predilection from the earliest terms. If necessary, with periodic monitoring of the hormonal background.

To a modern woman, it is preferable to monitor your gynecological status so that later on you will not have problems with the appearance of offspring. Preventing and preventing gynecological diseases is the leading goal of the modern community of obstetrician-gynecologists. After all, the symptomatology of ovarian dysfunction does not cause much inconvenience, and the treatment of this disease is not involved.

Dysfunction of the ovaries does not threaten life, but it is threatened with cancer, which can be missed, amid ambiguous bloody discharge. Yes, and in mastopathy or uterine myoma few pleasant moments. Visit to your doctor every six months, the delivery of preventive tests, such as a smear on the purity of the vagina and oncocytology from the cervix, as well as general blood and urine tests, will help prevent the development of the disease.

Diagnosis of ovarian dysfunction

For the first time to suspect a malfunction of the normal operation of the ovaries, a obstetrician-gynecologist can visit a planned( once every six months) examination in a female consultation while collecting an anamnesis. Or the reception can be unplanned, at the initiative of the patient, as she found signs of a disease that bother her. The gynecologist, within the women's consultation, should rule out the presence of a pathology related to surgery, such as the presence of tumors or an ectopic pregnancy. Then the most appropriate and correct is the referral of a woman to a consultation with a gynecologist - an endocrinologist.

At the first meeting, the doctor will ask in detail about the complaints that worry the patient, and also do not be surprised that the doctor will want to know about other diseases, since childhood. It will be necessary to talk about surgical interventions, if any, and provide, if possible, extracts from the histories of the disease. Honestly tell us about your obstetrical and gynecological status: whether there were pregnancies, childbirth or abortions. Also, before going to the gynecologist, a woman should take up intimate hygiene, as she will be examined in her armchair. You need to have a disposable diaper with you.

Such, at first glance, interrogation, is very important and is called the collection of an anamnesis of the disease. A set of information received and a gynecological examination in the mirrors, will become an assistant in the formulation of the preliminary diagnosis. Further, the attending physician will draw up a survey plan, for setting a more accurate - clinical diagnosis.

It should be remembered that this pathology has an endocrine character, so ultrasound will include not only examination of the pelvic organs, but also a thorough examination of the adrenal and thyroid glands. It should be understood that ultrasound is not an absolute source of diagnosis, and its results should be evaluated in conjunction with the indicators of other surveys. And only a gynecologist can end up diagnosing, but not a doctor of functional diagnostics.

Also taken is sowing on the growth of bacterial flora from the vagina. This analysis helps to exclude the factor of the local inflammatory process. The results of inoculation are studied under a high-sensitivity microscope.

In the laboratory, a woman will give PCR - tests for many sexual infections. The sex partner, if any, will also have to pass tests for diseases that are transmitted through sexual contact.

One of the most expensive, but at the same time, the most important is the analysis of the content of the sex hormones in the blood and urine of a woman. These are the three inhabitants of the pituitary gland plus progesterone and estrogens. The delivery of these hormones takes place at a certain time of the cycle, so you should not try to hand them yourself. The doctor will carefully explain which day of the female cycle exactly and which hormone will need to be tested.

The doctor will want to look at a snapshot of your brain. To exclude formations in the pituitary zone, more serious methods of investigation may fall into the survey plan. The MRI study is based on the measurement of the response of the nuclei of a hydrogen molecule to the effect on tissues by electromagnetic waves in a constant magnetic field. There are several methods of MRI, an obstetrician-gynecologist will tell you which one to pass to you. Layered examination of the pituitary gland in the brain by computer tomography may also be required. In case of detection of pituitary formations, additional tests will be prescribed.

Electroencephalography of the brain is performed to avoid disturbances in the patency of electrical oscillations over a complex web of neurons. The procedure is absolutely painless, although it looks intimidating. On the scalp are attached from 19 to 256 electrodes with a special gel. The time of the procedure depends on the volume of the study.

At the discretion of a gynecologist, a study is made using a special microscope - a hysteroscope. The walls of the uterus are examined and a small piece of the cervix is ​​taken for a thorough examination at the cellular level. Either scraping of two zones is applied: the mucous coating of the cervical canal and the coating inside the uterus. The obtained biological material is sent for histological examination to the laboratory.

The examination plan is selected individually for each patient individually, and it is not necessary that all of the above will be prescribed, when confirming the diagnosis of ovarian dysfunction. Success in diagnosis, and most importantly adjusting the disorder of ovarian function, depends on the degree of symptomatology in a woman. Timely attention to the malfunctions of the cycle of menstruation, referral to a doctor and appointment of a survey plan, and further treatment, is the key to a positive result. In case of chronic course of the process to prevent serious complications, it is recommended to visit the gynecologist - endocrinologist 2 times, even if there is no negative dynamics in the state.

Treatment of ovarian dysfunction

When the final diagnosis of ovarian dysfunction, the gynecologist endocrinologist appoints a treatment plan. The tasks that arise before the tandem of the doctor and the patient are to eradicate the causes of this pathological condition, restore the normal concentration of hormones responsible for regulating the cycle of menstruation and ovulation, as well as the prevention of emergency conditions such as bleeding. Treatment of ovarian dysfunction is carried out in a hospital or at home, depending on the severity of the disease.

Treatment of women with uterine bleeding is divided into 2 stages. The first is to perform haemostatic therapy during the loss of blood, and the second is to take preventive measures that prevent the recurrence of bleeding and restore the normal functioning of the hormones responsible for the regular cycle of menstruation. Hemostatic therapy includes a number of mandatory activities. First, it is a curative protective regime, restriction of motor activity, bed rest, normalized diet. The second is non-hormonal haemostatic drugs. Introduction uterotonicheskih solutions such as Oxytocin, starting with 5 units. From 2 to 4 times a day, increasing the contractility of the uterine musculature. Vitaminotherapy( ascorbic acid, B vitamins) is prescribed to raise the general immunity status. To increase the activity of myometrium, co-carboxylase is administered at a dosage of 50-100 mg within the muscle 1 p / day. To improve blood clotting, use Methylergometrine, in a dose of 250-500 mg 2 or 3 times a day. Also, a complex of reflex phyto-physiotherapy is prescribed. There are several methods of reflexology, such as acupuncture or electro-puncture. Phytotherapy consists in the appointment of ready-made hemostatic herbs, widely distributed in pharmacies. Physiotherapy includes electrical stimulation of the cervix, electrophoresis with calcium ions in the collar and endonasal zones, electrophoresis of the endonasal area with vitamin B. If the complex of these measures does not give an effect, then go to the third point of hemostatic therapy - hormonal hemostatic therapy.

For indication of hormonal hemostatic therapy, there are indications and contraindications, they will be described in detail by the attending physician. In the absence of contraindications, the drugs of general choice are contraceptives of combined composition - estrogenic and gestagenically monophasic with low dosage. On the first day, 1 to 3 tablets are given every 3 hours. After reducing bleeding, leave only a maintenance dose of hormonal contraceptives( 1 tablet per day).The total duration of the course is from 5 to 20 days, depending on the dynamics. The course dose should not exceed 10 tablets.

In case of copious bleeding, this scheme is used. COC is prescribed, for example, Marvelon 1 tablet every 1.5-2 hours under the tongue, ranging from 3 to 6 tablets in 24 hours. Dynamic control of the condition is carried out, and with decreasing secretions the final daily dose is determined. With scant excretions, 1 tablet maximum to 2 times a day.

Hemostasis with gestagenic preparations can be carried out only with discharge by the type of clotting. If the discharge is bright and their amount is increased, this is a contraindication to the use of COCs, since it can lead to increased symptoms and as a consequence - extensive blood loss. Usually appoint Dufaston 10 mg per day for 10 days.

The fourth item is surgical haemostasis, which consists of separate diagnostic curettage, which was mentioned above. However, it is performed only with extensive, non-stopping blood loss with a drop in hemoglobin and hematocrit and the absence of the expected positive effect of conservative methods of stopping blood loss. With extensive blood loss, anti-anemia therapy is performed. Its volume depends on the indicators of red blood tests and the total amount of lost blood circulating in the body of a woman. If the degree of anemia is light and hemoglobin is not lower than 100 grams per liter and the number of erythrocytes is at least 3 million or more, then the woman does not need to restore the volume of circulating blood by means of infusion therapy.

For the treatment of anemia, iron preparations such as Sorbifer, Ferlatum and others are prescribed 1 tablet 1 or 2 r / day. If blood loss reaches 700 ml, and hemoglobin levels fall below 100 grams per liter, but not less than 70 grams per liter, there are no blood transfusions. Only blood products are poured: cryoplasm, at the rate of 5 ml per 1 kg, albumin 5, 10, 20% in a dosage of 100 ml per day, and also to restore the volume of blood circulating in the body, crystalloid and colloidal solutions are poured. At severe degrees of blood loss, hemotransfusion, carried out by erythrocyte mass, eritrovzvesi are added to blood preparations. Continue to restore the volume of circulating blood solutions by means of infusion therapy. It should be calculated purely individually, to prevent a strong dilution of blood replacing the blood.

After relief of emergency conditions, treatment of ovarian dysfunction is aimed at eliminating the cause of its occurrence. Based on the results of the tests, they conclude. If there are foci of chronic infections, a specific treatment is carried out, aimed at destroying the pathogens that triggered this process. If there are diseases transmitted during sexual intercourse, then both partners are treated.

For prophylaxis of bleeding repeats, progesterone preparations such as Dufaston or Utrozhestan are prescribed from the 16th day of the cycle to the 25th inclusive. At the end of the course, during the week, menstruation begins, which is usually considered the beginning of the cycle. In the future, the woman is selected COCs for further regulation of the cycle of menstruation. Intrauterine spiral with ovarian dysfunction should not be established.

To stimulate ovulation use drugs that block estrogens. For example, Klomiphen tablets in a dosage of 50 mg 1 p / day from the 5 day cycle, for 5 days. After a month of treatment, in the absence of the expected effect, gradually increase the dose to 150 mg / day or extend the course to ten days. After Clomifene is withdrawn, the secretion of the hormone responsible for the release of FSH and LH is triggered, their active release occurs, thereby triggering the growth of a new number of follicles. Dynamics is monitored with the help of blood biochemistry. In women with ovarian dysfunction, pregnancy should be monitored more closely from early periods. If necessary, an analysis should be made for the hormonal status.

Ovarian dysfunction is one of the most common diseases in women of all ages. With the advent of the first menstruation, moms should explain to the girls how to correctly calculate the cycle and which menstruation should be normal. Maintaining the female calendar, listening to the malfunctions in your body and preventive visits of the obstetrician-gynecologist are the key to preventing the occurrence or complication of female diseases that affect reproductive function.

With dysfunction of the ovaries it is possible to become pregnant and to bear a healthy offspring. Let the path to the desired goal will not be easy, but timely diagnosis and treatment will pay off with the long-awaited two parallel stripes on the test, and in the future the most beautiful smile of your child.