Dysfunction of ovaries
Dysfunction of ovaries – the disorder of hormonal function of ovaries owing to inflammatory process or endocrine frustration which is shown a number of pathological states. It is characterized by violations of a menstrual cycle: its excessive lengthening (more than 35 days), or the shortening (less than 21 day) which are followed by the subsequent dysfunctional uterine bleeding. Also it can be shown by simptomokompleks of a premenstrual syndrome. Can cause development of endometriosis, myoma of a uterus, mastopathy, cancer of mammary glands, infertility.
Dysfunction of ovaries
Dysfunction of ovaries is understood as the disorder of gormonoobrazuyushchy function of ovaries leading to lack of an ovulation and violation of a menstrual cycle. As displays of dysfunction of ovaries serve dysfunctional uterine bleedings, i.e. bleedings lasting over 7 days after a periods delay longer than 35 days, or the frequent, irregular, chaotic periods coming through different intervals of time (but less than 21 day).
The normal menstrual cycle lasts from 21 to 35 days with menstrual bleeding lasting 3-7 days. The physiological norm of blood loss at periods usually does not exceed 100-150 ml. Therefore, any deviations in rhythm, duration of a menstrual cycle and the volume of blood loss are regarded as display of dysfunction of ovaries.
Symptoms of dysfunction of ovaries
Regulation of activity of ovaries is carried out by hormones of a forward share of a hypophysis: lyuteiniziruyushchy (LG), follikulostimuliruyushchy (FSG) and Prolactinum. A certain ratio of these hormones at each stage of a menstrual cycle provides a normal yaichnikovy cycle during which there is an ovulation. Therefore dysfunctions of ovaries are the cornerstone the regulatory violations from gipotalamo-hypophysial system leading to an anovulyation (lack of an ovulation) in the course of a menstrual cycle.
At dysfunction of ovaries lack of an ovulation and phase of a yellow body causes various menstrual frustration connected with the insufficient level of progesterone and excess of estrogen. Can confirm dysfunction of ovaries:
- Irregular periods, their scarcity or, on the contrary, intensity, bleedings during the intermenstrual periods;
- Not incubation of pregnancy or infertility as a result of violation of processes of maturing of an ovum and an ovulation;
- The pulling, skhvatkoobrazny or dull aches in the bottom of a stomach and in a waist in premenstrual and menstrual days, and also in days of an estimated ovulation;
- Hard proceeding premenstrual syndrome which is shown slackness, tearfulness apathy, or, on the contrary, irritability;
- Acyclic (dysfunctional) uterine bleedings: frequent (with a break less than 21 day), rare (with a break over 35 days), plentiful (with blood loss more than 150 ml), long (more than a week);
- Amenorey – not approach of periods in time more than 6 months.
Thus, each of symptoms of dysfunction of ovaries separately is a serious reason for consultation of the gynecologist and inspection as leads to infertility and not incubation of a fruit. Besides, dysfunction of ovaries can testify to malignant tumoral diseases, extra-uterine pregnancy, and also be an incitement to development, in particular at women 40 years, myomas of a uterus, endometriosis, mastopathy, a breast cancer are more senior.
Reasons of dysfunction of ovaries
As the reasons of dysfunction of ovaries serve the factors leading to violation of hormonal function of ovaries and a menstrual cycle:
- (Ooforit) inflammatory processes in ovaries, appendages (salpingooforit or adneksit) and a uterus – (the endometritis, tservitsit). These diseases can result from non-compliance with hygiene of genitals, a drift of activators with a blood-groove and a lymph flow from other abdominal organs and intestines, overcooling, cold, violation of the correct technology of syringing of a vagina.
- Diseases of ovaries and uterus (tumor of ovaries, , endometriosis, uterus fibromyoma, cancer of a neck and body of a uterus).
- Existence of the accompanying endocrine frustration as acquired, and congenital: obesity, diabetes, diseases of a thyroid gland and adrenal glands. The hormonal imbalance caused in an organism by these diseases affects also the reproductive sphere, causing dysfunction of ovaries.
- Nerve strain and exhaustion as a result of stresses, physical and psychological overfatigue, an irrational work-rest schedule.
- Spontaneous and abortion. Medical abortion or miniabortion at the first pregnancy when reorganization of the organism aimed at incubation of pregnancy, sharply breaks is especially dangerous. It can cause the steady dysfunction of ovaries in the future threatening with infertility.
- The wrong arrangement in a cavity of a uterus of an intrauterine spiral. Statement of an intrauterine spiral is carried out strictly in the absence of contraindications with the subsequent regular control inspections.
- External factors: change of climate, excessive insolation, beam damages, reception of some medicines.
Sometimes there is enough even a single violation of a menstrual cycle in order that persistent dysfunction of ovaries developed.
Diagnosis of dysfunction of ovaries
The expert the gynecologist-endocrinologist is engaged in inspection and treatment of dysfunction of ovaries. At suspicion of dysfunction of ovaries the doctor, first of all, will exclude surgical pathology: extra-uterine pregnancy and tumoral processes, the analysis of a menstrual calendar of the woman will carry out, will listen to complaints, will perform gynecologic inspection and will make the plan of further diagnostics. The complex of diagnostic procedures directed on identification of the reasons of dysfunction of ovaries can include:
- Ultrasonic examinations of bodies of a small pelvis, ultrasonography of adrenal glands and thyroid gland;
- Microscopy and a vagina secret on flora, PTsR-diagnostics for an exception of sexually transmitted infections (candidiasis, ureaplasmosis, mycoplasmosis, clamidiosis, a trichomoniasis, etc.);
- Determination of level of content of sex hormones (Prolactinum, follikulostimuliruyushchy and lyuteiniziruyushchy hormones, progesterone, estrogen) in urine and blood;
- Blood test on the content of hormones of adrenal glands and a thyroid gland;
- Radiographic research of a skull, brain MPT and KT – for an exception of damages of a hypophysis;
- Brain EEG – for an exception of local pathological changes in it;
- Hysteroscopy with an aim biopsy of a neck of a uterus or a diagnostic scraping of a cavity and the channel of a neck of a uterus for the subsequent histologic research of pieces of endometrium;
The scheme of inspection of the patient having dysfunction of ovaries is formed individually in each concrete situation and not necessarily includes above and above the listed procedures. Success of correction of dysfunction of ovaries in many respects is defined by degree of expressiveness of frustration therefore any violations of a menstrual cycle have to guard the woman and force it to undergo diagnostics. Dynamic observation and inspection at the gynecologist-endocrinologist at least 2-4 times in a year, even in the absence of subjective changes in a state is recommended to patients with chronic dysfunction of ovaries in order to avoid serious complications.
Treatment of dysfunction of ovaries
The complex of medical actions at dysfunction of ovaries pursues the following aims: correction of medical emergencies (bleeding stop), elimination of the reason of dysfunction of ovaries, restoration of hormonal function of ovaries and normalization of a menstrual cycle. Treatment of dysfunction of ovaries can be performed permanently or on an outpatient basis (at the easy course of dysfunction of ovaries). At a stage of a stop of bleeding hormonal haemo static therapy is appointed, and in case of its inefficiency the separate scraping of a mucous membrane of a cavity of a uterus with the medical and diagnostic purpose is carried out. Depending on result of the histologic analysis further treatment is appointed.
Further treatment of dysfunction of ovaries depends on the reasons which caused a disease. At identification of chronic inflammatory processes carry out treatment of the infections which caused them including sexually transmitted. Correction of the endocrine violations which caused dysfunction of ovaries is carried out by purpose of hormonal therapy. For stimulation of immunity at dysfunction of ovaries purpose of vitamin complexes, homeopathic medicines, dietary supplements is shown. The importance in the general treatment of dysfunction of ovaries is allocated for normalization of the mode and a way of life, food and physical activity, and also physical therapy, reflexotherapy and the psychotherapeutic help.
For the purpose of further prevention of repeated uterine bleedings and restoration of a regular menstrual cycle at dysfunction of ovaries apply therapy by progesterone medicines from 16 to 26 day of a cycle. After this course within seven days the periods begin, and its beginning is regarded as the beginning of a new cycle. In the subsequent the hormonal combined contraceptives for normalization of a menstrual cycle are appointed. Installation of an intrauterine spiral (Naval Forces) is contraindicated to women at whom dysfunction of ovaries was observed earlier.
Dysfunction of ovaries and planning of pregnancy
Preparation and implementation of pregnancy at dysfunction of ovaries need to be carried out under control and by means of the gynecologist-endocrinologist. For this purpose it is necessary to complete a course of the therapy directed to restoration of an ovulyatorny menstrual cycle. At dysfunction of ovaries hormonal treatment by medicines of a horionichesky gonadotrophin, clomifene, a menotropin which are applied, since 5 in the afternoon of a menstrual cycle till the 9th day inclusive is for this purpose appointed.
During a course of reception of the appointed medicine by means of ultrasonography control the speed and extent of maturing of a follicle is fixed. At achievement the follicle of necessary degree of a maturity and the size of 18 mm and thickness of endometrium of 8-10 mm to the patient enters the horionichesky gonadotrophin of the person (HGP) causing an ovulation. Similar stimulation therapy is carried out usually during three more subsequent menstrual cycles. Then during three cycles progesterone medicines from 16 to 26 day of a menstrual cycle are applied. Control of approach of an ovulation is exercised by means of measurement basal (rectal temperature) and control ultrasonographies.
Methods of treatment of dysfunction of ovaries which are applied by modern gynecology in many cases allow to achieve stabilization of a menstrual cycle and regular approach of an ovulation. Thanks to it the woman can become pregnant and take out the child. If, despite treatment, pregnancy does not occur, consultation of a reproduktolog is necessary for the solution of a question of expediency of artificial insemination with the subsequent replanting of embryos in a uterus cavity. According to indications for EKO the donor ovum or a donor embryo can be used. Reproductive technologies also provide a cryopreservation of the embryos which did not undergo transfer in a uterus for their use in need of repeated EKO. At women with dysfunction of ovaries conducting pregnancy has to be carried out from early terms and with special attention.
The female reproductive system is a mirror in which the general health of an organism is reflected, and it the first reacts to the arising pathological states violation of menstrual and genital functions. Answer to a question: to treat or not to treat dysfunction of ovaries in case the general health at the same time suffers slightly – it is unambiguous: to treat and as soon as possible! Dysfunction of ovaries sometimes is terrible not so much the manifestations, how many the remote consequences among which the most frequent are infertility, mastopathy, uterus myoma, malignant new growths of a reproductive system and mammary glands, crushing endocrine defeats.