Update: October 2018
The ovaries are very tender organs that are the first to respond to
any deviation from the norm in the female body, so often
the initial sign of a disease is a rhythm disorder
menstruation and childbearing function.
As a rule, women do not associate shifts in the menstrual cycle with
developing serious pathology that can lead to such
irreversible effects, such as infertility. Hormonal
ovarian dysfunction is one of the symptoms of many serious
Communication of the menstrual cycle and ovarian dysfunction
As you know, the normal duration of the menstrual cycle
makes 21 – 35 days, menstrual bleeding lasts 3 – 7
days, and the total menstrual blood loss reaches 50 – 100 ml.
Any deviation from this norm is considered a violation.
menstrual cycle and should be carefully examined,
especially if such deviations are repeated repeatedly.
But the representatives of the weaker sex, even a slight lengthening
or shortening of the cycle is attributed to its individual physiological
features and not in a hurry to the doctor. But there is no smoke without fire, and
if there are deviations from the norm, then there is a reason for this, and
often very, very serious.
Under the ovarian dysfunction understand this pathology, when
the function of the formation of hormones in these organs is disturbed, which leads
to the disorder of the menstrual cycle, and, as a result, to the violation
reproductive function. This pathology does not apply to
independent diseases, but only constitutes a syndrome,
which may be one of the many manifestations of gynecological and
Ovarian dysfunction: causes
Since the ovaries are part of a complex system
hypothalamus-pituitary-adrenal ovaries, their regulation depends on
proper operation of the listed organs, that is, any failure to
some level will lead to the development of dysfunction. Ovarian dysfunction
due to numerous reasons:
Decrease or increase in hypothalamic production
releasing factors and pituitary FSH, LH and prolactin – a hormone,
responsible for the production of milk. This may be due
pituitary tumors or mental illness.
Diseases of other organs of the endocrine system
This group includes diabetes, bark pathology
adrenal glands, thyroid disease and obesity. All listed
diseases develop with the failure of the production of certain
General extragenital diseases
Severe pathology of the hepatobiliary system, anemia and
malignant blood diseases, decompensated
cardiovascular failure, severe kidney disease.
Disorders at the level of the ovaries
This group includes diseases of both the ovaries themselves and
other organs of the reproductive system.
- First of all, it is inflammation of the ovaries,
appendages and uterus.
- Secondly, all cysts, benign and malignant
ovarian and uterine tumors.
- Third, endometriosis of both the ovaries and the rest of the genital
organs. As well as scleropoleic and premature syndrome
- These can be long-term and / or significant stresses.
psycho-emotional overstrain, climate change and taking some
лекарств, увtreatment загаром, физическое истощение и анорексия.
- This group also includes radiation damage to the ovaries,
personal hygiene disregard
douching and their excessive frequency, irrational mode of work and
- Included in this group is an incorrect establishment.
intrauterine device, injuries and surgery on the ovaries or other
pelvic organs, premature termination of pregnancy
(especially the first), both artificial and spontaneous.
Clinical manifestations of ovarian dysfunction syndrome
If ovarian dysfunction occurs, all symptoms can be divided.
into several groups:
These symptoms include unstable pressure (something that rises
This is reduced), a violation of the condition of the hair and nails (brittle and dull
hair, splitting nails with specks and transverse stripes),
unaesthetic appearance (oily skin, acne),
psycho-emotional lability, especially manifested on the eve
menstruation (irritability, tearfulness, aggressiveness),
lethargy and weakness, excessive weight gain.
There is a change in the nature of the cycle. The duration of it
either lengthens and becomes more than 35 days, or decreases
(less than 21). Each menstruation delay is accompanied by long
bleeding, over a week, or frequent menstrual bleeding
lead to a decrease in hemoglobin and the development of anemia that
manifested by weakness, pallor, dizziness. Is changing and
the volume of menstrual blood loss, it increases, either
join acyclic spotting. Themselves
menstruation becomes painful, the woman on the eve of their concern
unpleasant spasmodic sensations below belly (about 5 – 7
days) In the end, amenorrhea can develop when menstruation
absent for 6 months or more.
The frequency of anovulatory cycles increases significantly, which is connected
with deficiencies in the production of FSH and LH (the process of maturation is disturbed
follicles and their ruptures for the release of the egg).
Accordingly, a woman has infertility. If
pregnancy is due to hormonal dysfunction of the ovaries
often interrupted (miscarriage).
All listed признаки в той или иной мере проявляются у
each patient with this pathology, but, as a rule, takes place
one group of the most pronounced symptoms.
Many methods are used to diagnose this pathology.
analyzes. At the initial appointment, the doctor carefully collects a history and
complaints and conducts a primary gynecological examination, during
which it is already possible to suspect a gross and overt pathology (tumors,
cysts). After that, a number of general clinical care is appointed.
- blood and urine sampling for general tests;
- a blood test for biochemical composition (first of all,
determination of glucose level);
- electrocardiography (to exclude cardiovascular
- Ultrasound of the pelvic organs (identification of the size of the ovaries, their
structure and follicular apparatus, determining ovulation in
- taking a smear on the vaginal microflora;
- determination of genital infections by PCR;
- basal temperature measurement (helps determine which
phase of the cycle there are violations);
- study of hormonal status (determination of levels
prolactin, FSH, LH, progesterone and estrogen).
If the situation requires it, then hormone tests are prescribed.
thyroid and adrenal glands (blood and urine), radiography
skull (the definition of pituitary tumors, the syndrome of “empty Turkish
saddles “and other pathologies), if necessary, MRI and CT of the head
the brain. An EEG of the brain is also assigned to confirm
local disorders in the medulla.
According to the testimony of a hysteroscopy with scraping cavity
uterus and obligatory histological examination of scrapings, in
difficult cases require diagnostic
Examination program for each patient with this syndrome
is selected and assigned individually, depending on
alleged cause of pathology.
Ovarian Dysfunction Treatment
If ovarian dysfunction is detected, a doctor is connected to the treatment.
gynecologist-endocrinologist. As a rule, patients with such a diagnosis
are admitted to hospital for emergency reasons, that is, with
выраженным кровотечением и treatment начинается с купирования
states. Held hemostasis can be 2 types – surgical and
symptomatic, which may also include hormonal
Surgical hemostasis or curettage of the uterus
It is performed only with bleeding that threatens a woman’s life (very
low hemoglobin, unconscious or profuse
- Separate curettage of the cavity and cervix, with
subsequent histological examination of the scraping.
- Further, until complete bleeding stops,
symptomatic, possibly with elements of hormones, therapy (dicine,
uterotonics, ascorbic acid, physiotherapy plus
combined oral contraceptives).
- The next stage of therapy is the prevention of bleeding. On
This stage of treatment is recommended to take progesterone drugs with 16
on 25 days of a cycle (norkolut either dufaston or urozhestan).
- At the same time, anemia is being treated (appointment
iron preparations: sorbifer-durules, ferretab, by
indications of blood transfusion of erythrocyte mass).
- At the end of taking progesterone drugs for
weeks, moderate or minor
menstrual bleeding whose first day is considered
on the first day of the menstrual cycle and in accordance with it are assigned
KOKI. This stage of treatment lasts 3–6 months or more with the aim of
recovery cycle and depending on the desire of the woman
get pregnant in the future.
After cupping bleeding, the woman is held in parallel.
treatment, направленное на ликвидацию причины дисфункции
- If she has genital and inflammatory infections
diseases, antibacterial and anti-inflammatory
therapy. After a course of antibiotics, the menstrual cycle and
ovulation restored independently, without appointment
- When diagnosed extragenital pathology is carried out
Correction of identified diseases (selection of a sugar treatment regimen
diabetes, thyroid disease, etc.)
- In case of ovarian dysfunction due to exposure
external factors are recommended adherence to emotional and
mental rest, nutrition correction, dosed physical
load, vitamin phase of the cycle and dietary supplements.
- Ovarian dysfunction, причиной которой явились опухоли и кисты
ovarian, uterine myoma and endometriosis and other gynecological
diseases treated depending on the situation (delete
tumors / cysts, hormone therapy).
Важно помнить, что женщинам, которые прошли treatment по поводу
this pathology, install intrauterine device
Ovarian dysfunction: planning a pregnancy
Particularly worried about the patient question: “When ovarian dysfunction
can you get pregnant? Of course, you can get pregnant and even worth
try. Но следует помнить, что treatment длительное, которое
starts with restoring the rhythm of the menstrual cycle and
In the case of a restored menstrual cycle, but with a persistent
Anovulation is performed by stimulating it with anti-estrogen hormones.
drugs (pergonal, clostilbegit, humegon) that are necessary
принимать с 5 по 9 дни цикла (всего 5 days) When a woman
accepts ovulation-stimulating drugs, the doctor prescribes
the passage of ultrasound to control the speed and degree of maturation
follicle and increase the thickness of the uterine lining. Ultrasound control in
each cycle is carried out repeatedly (2 – 3 times), and
stimulation is carried out for three months.
When the main follicle reaches the required size (18 mm) and
endometrial thickenings up to 8 – 10 mm; administration of chorionic
gonadotropin in the dosage of 10,000 IU. This hormone stimulates
transition of the follicular phase to the luteal phase and provokes a rupture
follicle and the “release” of a mature egg. Then throughout
three more monthly cycles are assigned progesterone
drugs (16 – 25 days).
Track the onset of ovulation on the basal schedule
temperature, ultrasound data (follicle size and mucosal thickness
uterus) at this stage only once a month.
After the normal menstrual cycle is restored
and persistent ovulation, a woman can easily get pregnant and endure
baby A similar treatment regimen for ovarian dysfunction is practically
90% restores the menstrual cycle and ovulation, and,
therefore solves the problem of infertility.