Under the pitipofunction of the ovaries implies a clinical term, which includes diseases that differ in pathogenesis and etiology. All of them possess similar signs of sexual underdevelopment. These include infertility, hypoplasia, amenorrhea, hypoastroy and hypotrophy of the uterus and ovaries.

There are many varieties of primary hypofunction. The main, primary, clinical form of such a disorder is premature climax. Usually it develops in women older than 35 years. In the etiology of the disease, the main role is played by various negative causes of disorder can become gene mutations, hereditary predisposition, autoimmune violations in the ovaries.

Ovarian hypofunction may occur against the background of normal generative and menstrual functions. It manifests itself in the form of tides to the head, amenorrhea, high sweating, fast fatigue, weakness, pain in the heart and head, reduce performance. During the occurrence of the disorder, it is determined: the reduced size of the uterus and the ovaries, the low concentration of prolactin and estrogen, the absence of follicles and yellow bodies, increased content Folliculizing and luteinizing hormones in the blood. This ovarian hypofunction has such treatment: the use of hormonal preparations (estrogen-gestagenic and estrogenic). Hormone therapy greatly improves the condition of such patients, so when this diagnosis, it is necessary to immediately begin treatment.

Isolated (secondary) ovarian hypofunction, organic and functional disorders of the functioning of the hypothalamic-pituitary system are important clinical forms This disorder. Despite the fact that in the ovaries there is a completely normal number of follicles, the process of ripening does not occur. For such a state, hypotrophy, primary or secondary amenorrhea, uterine hypoplasia and ovaries, hypooestroy. Such ovarian hypofunction usually leaks on the background normal content Folliculizing and luteinizing hormones in the blood.

There is still a polycystic ovarian syndrome. In such a disease, about 3% of young women suffer. Such a disorder is peculiar to the excessive development of androgens (in adrenal glands and ovaries), the failures in their peripheral metabolism. Along with these signs is determined increased quantity Luteenizing hormones, normal or reduced concentration Increased content in blood prolactin. Such ovarian hypofunction, symptoms: the development of pseudo-chroditism is characterized, for which hyperandrode, amenorrhea, infertility, anoinlation and severe acne are characterized.

Another reason, due to which the ovarian hypofunction may occur, may be virilizing tumor cells in the ovaries form an excess amount of testosterone, dehydroepiythrosterone and Androtandion, which are male sex hormones. Clinical manifestations Diseases are irregular scooty menstruation (Oligo-Poinsomera), acyclic uterine bleeding. This disease is peculiar to the manifestation of baldness, girsutism, voices, the formation of the physique of male type, the formation of pseudo-chroditism, the clitoris hypertrophy.

If there is hypofunction of ovaries, treatment is appointed after a comprehensive examination. When forming tumors, chemotherapy is carried out, irradiation and operational removal of the tumor. Hormonal disorders after a thorough examination are treated with various hormonal drugs.

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Syndrome of exhausted ovaries (Sia). The primary ovarian hypofunction of ovarian belongs to the so-called exhausted ovarian syndrome. For the characteristics of this pathological condition, many terms are proposed: "Premature climax", "premature menopause", "premature ovarian failure", etc. According to V. P. Kontnotnik, the term "depleted ovarian syndrome" is most appropriate, as it indicates ovarian genesis Diseases and irreversibility of the process.

Sia is a complex of pathological symptoms (amenorrhea, infertility, "tides" heat to the head, high sweating, etc.). It is a rather rare disease, precisely its frequency is not yet installed. Women arises in women younger than 37-38 years who had normal menstrual and generative functions in the past.

Etiology and pathogenesis

It has been established that in the occurrence of this disease, a variety of factors plays a role, with both environment and hereditary. More than 80% of patients identified the effect of adverse factors even during the period of intrauterine development, in pre-and puberty: toxicosis of pregnancy and extragenital pathology Mother, high infectious index in childhood. An analysis of the genealogical data showed that in 46% of the cases of relatives I and II degree of kinship had disorders of the menstrual function and relatively often early Climax (38-42 years). Apparently, against the background of an infallible genome, any exogenous effects (infections, intoxication, stress, etc.) can contribute to the atresia of the follicular apparatus of the ovaries. Sex chromatin ranges from 14 to 25%. Most patients have a normal female karyotype 46 / xx, a mosaic set of chromosomes is rarely detected.

One of the reasons for early depletion of the ovarian function can be gene mutations inherited or arising DE NOVO. The possibility of autoimmune violations is not excluded. Ultimately, the pathogenesis of the disease is associated with the pre- and postpubertal destruction of germinative ovarian cells.

Patanatomy

For these are characterized by hypoplastic ovaries. They are small sizes (1.5-2x0.5x1-1.5 cm), weighing no more than 1-2 g each. Such ovaries are correctly formed, they clearly differ cork or brain layers, but the number of priority follicles in the first layer is sharply reduced. These follicles usually grabs 5-15 years of reproductive life. Available primordial follicles are subject to normal growth and development. They reach the stage of mature grappa bubble and ovulate with the formation of most of the full yellow, and then white bodies.

Follicles that have not reached the stage of mature grapha blades are subjected to as in physiological conditions, cystic, and then fibrous atresia. By the period of completion of the reproductive function of the ovaries in them, the sterile bark with atrophic intermediate cloth is found, since the fates of its cells and follicles are connected. The disappearance of the latter is accompanied by a sharp decrease in the number of cells in the intermediate tissue.

Clinical picture

As a rule, Menarche in patients with Sia occurs in a timely manner, menstrual and generative functions are not violated for 12-20 years. The disease begins either with amenorrhea, or from oligo-substare, which is ongoing from 6 months to 3 years. After 1 -2 months after the cessation of menstruation, "tides" of heat to the head appear, then weakness, headaches, fast fatigue, heart pain, reduced performance.

Violations fat ExchangeAs a rule, it is not observed. All patients with the right physique. Anthropometry reveals a female phenotype. Milk gland hypoplasia are not observed. In the gynecological examination, a sharp hypoplasic of the uterus is detected, a decrease in the estrogenic reaction of the mucous membranes, the absence of the symptom of the "pupil".

Diagnosis

When studying the ovarian function, its sharp decline is revealed: the symptom of "pupil" is always negative, colpocytological study (CI) within 0-10%, in the survey of mucus (IP) there are basal and parabaznal cells of the vaginal epithelium. Rectal monophasic temperature.

With pneumatic relief or ultrasound scanning, they are detected sharply reduced in the sizes of the uterus and ovaries. These data can be confirmed by laparoscopy, in which small wrinkled eggs are found yellowish, yellow bodies are missing, the follicles do not shine. With histological examination of biops of ovarian follicles are not detected.

Hormonal research shows low (usually lower than in the early follicular phase) level of estrogen. When determining the gonadotropic hormones, a noticeable increase in FSH was noted, the content of which is 3 times higher than ovulatory and 15 times the basal level of this hormone in healthy women of the same age. The LG content in patients with Sia is approaching it during the period of ovulatory peak and 4 times higher than the level of basal secretion of the luteinizing hormone. The level of prolactin is reduced by 2 times compared with its content in healthy women.

The progesterone sample in all patients is negative, which reflects the insufficient estrogen stimulation of the endometrium. Against the background of the estrogen-gestagne sample, all patients have an improvement in the well-being and the emergence of the menstrual-like reaction in 3-5 days after its end. These data indicate a pronounced hypofunction of the ovaries and the preservation of the sensitivity and functional activity of the endometrium.

Sample with clomiphene (100 mg for 5 days) does not lead to stimulation of the ovarian function. With the introduction of MCG (menopausal human gonadotropin) or xg (chorionic gonadotropin), activation is also not observed.

To clarify the backup capabilities of the hypothalamic-pituitary system, a sample is carried out with LG-RG (100 μg in / c). Under the introduction of LG-WG, an increase is noted. increased levels FSH and LH, which indicates the preservation of the backup capabilities of the hypothalamic-pituitary system at Sia.

During the study of the nature of the electric activity of the brain in patients with Sia, the reduction of the SS rhythm is noted. Some of them have violations characteristic of the pathology of hypothalamic nuclei on EEG. When analyzing radiographs of pronounced changes, the skull and the Turkish saddle is not detected.

Sample with estrogen allows you to clarify the pathogenetic mechanisms of violation of the secretion of gonadotropic hormones. Its results indicate the safety and functioning of feedback mechanisms between hypothalamic-pituitary structures and sex steroids, since after the introduction of estrogen, a regular decrease in the level of gonadotropins is noted. With the introduction of estrogen, the nature of the character of the electric activity of the brain is observed even with a fairly long flow of the disease. In some patients, according to the same authors, the depletion of the ovarian function can be a consequence of the increased neurogormonal activity of hypothalamic structures producing LH-WG. Its reason is obviously the insensitivity of the re-adjacent mechanisms to estrogen, on the one hand, and to the gonadotropic hormones - on the other.

According to G. P. Root, in patients with primary-ovarian failure, along with an increase in gonadotropic hormones, a reduced level of dopamine (yes) in the blood and slightly increased - serotonin (ST) was revealed. The coefficient of yes / st is equal to 1.

Thus, the diagnosis of this is based on the emergence of amenorrhea in women of reproductive age, infertility, "tides" heat to the head, high sweating. One of the main diagnostic criteria is a significant increase in the level of gonadotropins, especially FSH, a sharp decrease in the content of estrogen, a decrease in the size of the uterus and the ovaries and the absence of follicle in them. Progesterone and stimulating sample ovaries with clomiphene, MCG and hg are negative. A distinctive feature of the disease is to improve general status patients against therapy with estrogen drugs.

Differential diagnosis

Sia should be differentiated with diseases having similar symptoms. To eliminate the pituitary tumor, the main methods are craniography, as well as an ophthalmic and neurological examination.

Unlike women with Sia, in patients with hypogonadotropic hypogonadism are noted low level Gonadotropins, lack of vasomotor disorders. When using funds that stimulate the function of the ovaries (gonadotropins, clomiphene), its activation is noted, which is not observed in patients with Sia. With laparoscopy, the ovaries are small, but shine follicles; They are also found in histological examination of ovarian biopsy.
This should be differentiated with resistant or refractory ovaries syndrome, which is also characterized by primary or secondary amenorrhea, infertility, normal development of secondary sexual signs, hypergronadotropic state, moderate hypo estroy.

Syndrome is rare. Morphologically, the syndrome of ovarian ovaries is hypoplastic, although correctly formed: clearly distinguishable with cortical and brain layer; In the cortex, a sufficient amount of prioritial follicles and single small greeted follicles with 1-2 rows of granules cells. Hanging and atrethic follicles, yellow and white bodies are practically not found. The intermediate fabric contains more cells than, for example, with hypogonadotropic hypogonadism.

Investigate the autoimmune nature of the disease to form antibodies to receptors for gonadotropins. The idiopathic form of primary ovarian failure with a high level of FSH and the presence of follicles in the ovary is described.

Clinical picture of heterogenne

Treatment is in substitution therapy by sex hormones. With initial or long amenorrhea, it should be started with estrogenization. Microfollins of 0.05 mg per day by courses on 21 days with seven-day breaks. As a rule, after the first course there comes a menstrual-like reaction. After 2-3 courses of microfollin or other estrogen, you can switch to combined estrogen-gestagne preparations of biseekurin type (Nonon, Riguevidon, Ovidon).

Vegetative symptoms ("tides" of heat, sweating) quickly fasten, improving overall well-being. Treatment should be made minimal doses that have a positive effect. According to V. P. Khotnotnik, usually enough 1/4 tablets of these drugs, should not be achieved by a menstrual-like reaction, but only strive to reduce the severity of vegetary-sized disorders. Treatment should be carried out until the age of natural menopause.

Vitaminotherapy courses are shown in the spring months. Treatment of patients with primary ovarian failure is a kind of prevention of atherosclerosis, myocardial infarction, osteoporosis.

Prevention is to prevent the effects of such adverse factors as pregnancy toxicosis and extragationalital pathology in mothers, infectious diseases in childhood. We are interested in genetic factors.

N.T. Starkov

Description:

Ovarian hypofunction is a collective concept that includes various pathological conditions, due to many reasons, but manifested by ovarian failure. At the same time, due to the insufficient level of genital steroid hormones, there may be belated sexual maturation with amenorrhea or hymenstrual syndrome, or with the development of pathology in a degenerate period - secondary with the phenomena of premature sexual wiping (early climax).

Symptoms:

The clinical picture of the ovarian deficiency, & nbsp & nbsp arising before the period of puberty, is characterized by a delay. Later and insufficiently develop primary and secondary sexual signs. The pitipofunction of the ovaries that arose in a childbearing age is manifested by hypotrophic changes in the genitals and fading the secondary sexual signs. Neuropsychiatric, vegetative and endocrine and metabolic disorders can appear.

Depending on the severity of symptoms, three degrees of ovarian hypofunction can be clinically distinguished. With a light degree of ovarian deficiency in girls, there are slightly underdeveloped secondary sexual signs, mammary hypoplasia. The uterus is relatively developed with proliferating endometrial, but is not sufficient to the correct transformation. Menstrual function in patients violated (amenorrhea, hymanstrual syndrome, juvenile uterine). Scamp of ovarian middle degree The severity of the rods is characterized by a pronounced underdevelopment of primary and secondary sexual signs: external genital organs, the vagina and the uterus are sharply underdeveloped, low-heated propagation, dairy glands infantile. Menstruation is missing.

With severe form of ovarian hypofunction during puberty, the genitals are hypoplastic. The uterus is small, dense, with non-functioning endometrial, much smaller sizes compared to age norm, with hyper-, ante or retroflexia. The mucous membrane of the outer genital organs and the vagina is sharply atrophichnaya, shiny, pale pink. Solutions and dairy glands are almost absent.

The clinical picture of the deficiency of the ovaries, developed in a half-grade age, also depends on the degree of expression of pathology. In light cases of ovarian hypofunction, there is only secondary amenorrhea with a fairly developed uterus and proliferating endometrial. With a more severe degree of severity of the ovarian deficiency with amenorrhea, vegetual and psychoneurological symptoms are noted, as in the pathological course of the menopausal period.

The uterus is small, dense, with atrophic endometrial. Usually, with hypofunction of the ovaries of the childbearing period, a light flow with amenorrheans is initially noted, passing into a difficult form, as the next stage of the disease.

Causes of occurrence:

The causes of the science hypofunction are diverse. Congenital ovarian hypoplasia binds to exposure harmful factors During the period of intrauterine development. Acute and chronic infections (korea, vapotitis, etc.), different kinds irradiations, as well as alimentary factors (insufficient nutrition, no vitamins) can lead to ovarian pituitary. The influence of harmful factors can manifest itself damage to both the ovaries and other structures of the generative system.

The pathogenesis of this disease depends on the nature of the damaging agent, the term and the duration of its impact. It can lead to morphological disorders of ovaries (sclerosation, cell infiltration, fibrosis and scarring), as well as the pathology of enzyme systems of steroidogenesis. In the morphological damage to the ovaries, the latter changes and may violate functional state receptor apparatus and their sensitivity to gonadotropins. Perhaps this is how the syndrome of "resistant ovaries" is developing.

Depending on the degree of damage to the ovaries, more or less pronounced failure of products of sex steroid hormones is developing. This leads to a sexual and somatic infantilism with hypoplasia of the genital organs and their mucous membrane, and consequently, to a violation of the perception of hormonal influences. Other reproductive system organs are already involved in the process and a certain symptom complex of ovarian failure is developing.

Treatment:

For treatment prescribe:

The treatment of ovarian hypofunction depends on the time of its occurrence (before or after puberty) and severity.

With a pronounced hypofunction of the ovaries that arose before the period of puberty, the treatment is carried out in stages:

I Stage - Therapy is aimed at stimulating the ripening of genital organs of the girl;

II Stage - treatment involves the creation of the cyclic functioning of the reproductive system with cyclic transformation of endometrial;

III stage is carried out if necessary to perform a generative function;

The IV stage is aimed at rehabilitation and prevention of disease recurrences.

At the stage after establishing a complete diagnosis in the form and severity of the disease, measures are carried out aimed at eliminating pathological and harmful factors (treatment of extragenital diseases, chronic infections, household and professional adverse effects), normalization of the day and alternation of labor and recreation, mental and physical Loads, Organization of rational nutrition using a complex of vitamins and an increase in the immunoreactivity of the body.

At this stage, natural and informed physiotherapeutic factors and LFC are widely used, especially in order to improve the blood supply to the small pelvis organs. Physiotherapy procedures should not be very intense. It is not recommended to use such powerful impacts as mud, paraffin and ozokerito-abs. From hormonal funds, only estrogenic compounds of 16-20 days of 10-12-day breaks for 2-3 months are used to increase the size and proper functioning of the genitals. Increase in the sizes of the uterus, the appearance of the symptom of the "pupil", an increase in the cariopic nodule according to the data cytological studies are the basis for the purpose of cyclic hormone therapy.

It should be remembered that here hormonal therapy is not a substitution, but activating. Therefore, hormonal drugs are prescribed in small doses with a gradual decline in the 2nd and 3rd months. Folliculin is used to 2000-3000 units per day, ethinyl estradiol (microfallines) of 0.25-0.05 mg / day. At the stage stage, all measures of stage continue, but instead of estrogenic compounds, cyclic hormone therapy is carried out in order to induce cyclic changes in the reproductive system and the appearance of cyclic bleeding.

Estrogenous compounds are prescribed (ethinyl estradiol at 0.05 mg / day) for 1 b - 18 days, and then gestagens (progesterone 5 mg intramuscularly or pregnin at 30 mg under day per day) for 8-10 days, and then through 8-10 days a new course begins. The second or third month hormonal agents can be used in a day.

In total, cyclic hormone therapy in order to activate the reproductive system is carried out within 2-3 months, after 2-4 months, it is repeated, and so if necessary in the same manner within 1 year. All treatment is carried out under the control of tests of functional diagnostics, hormonal research and ultrasound. Ripening of follicles and the appearance of ovulatory cycles are the criteria for the effectiveness of the therapy. With an easy degree of ovarian failure, cyclic hormonal therapy can immediately be held preliminary application estrogen.

Treatment of ovarian hypofunction arising reproductive period, in many respects similar to the above, but has its own characteristics. At the stage of the stage, all measures are carried out to eliminate harmful factors and a stuffing nature. Cyclic hormone therapy (II stage) imitates the menstrual cycle that women had before. The harder the form of the disease, the greater the dose of hormones (folliculin of 10,000 units, progesterone 10 mg / day). Cyclic hormone therapy courses last 2-3 months with 2-4-month breaks. The latter are necessary, since after the abolition of hormones, the neurohumoral system of regulating the reproductive function is activated.

Treatment on the III and IV stages is carried out equally for women with primary and secondary pitipofing of ovaries. The III stage of treatment for ovulation stimulation to perform reproductive functions in women is carried out as such a need arises after efficiency at the II stage of therapy. Ovulation stimulation in such cases is carried out by clomiphene and other means according to traditional schemes without the use of gonad of outcropping hormones, since the gonadotropic function of the pituitary gland in the pitipofunction of the ovaries is significantly increased. The IV stage of treatment of such patients providing for the prevention of recurrence of the disease is carried out by reconsiderization with a regular dynamic survey and conducting corrective activities throughout life.

The forecast depends on the severity of the ovarian failure, the timing of its occurrence and effectiveness of the treatment measures. Often, in the first stage of treatment, menstruation appear, even without hormone therapy, which indicates a favorable forecast. With secondary amenorrhea, women after 30 years often have a long time to conduct hormonal therapy. The induction of the spontaneous menstrual function is more likely to implement. In such situations, tactics are carried out as climacteric syndromeWhen synthetic estrogen-gestagenic preparations are long used with the substitution.

The pitipofunction of the ovaries in women is a whole complex of pathological conditions caused by a violation of the functionality of the ovaries. These bodies do not provide a normal menstrual cycle, as there is a decrease in the production of appropriate. In this case, the follicles are poorly ripen, the yellow body is not formed. Ovulation practically does not occur.

A woman is able to determine the pitipofing of the ovaries itself, since the violation is manifested by long disorders menstrual cycle. However, it is not worth confused by this pathology with the natural focus of the reproductive system during the occurrence of menopause. Moderate hypofunction occurs in women aged 40 years.

Naturally, the ovarian hypofunction does not appear by itself. It is provoked by certain reasons. Pathology is primary or secondary. In the first case, it is a congenital, provoked disruption of intrauterine development due to the transfer of infectious or inflammatory diseases by the mother. As for the secondary hypofunction, the violation occurs under the influence of such factors:

• psycho-emotional disorders;
• serious infections;
• sharp reduction in estrogen levels, as well as violations of the functionality of the endocrine system;
• problems with metabolism;
• genetic susceptibility;
• infectious or inflammatory pathologies of the reproductive system ();
• syndron chronic fatigue or exhaustion of the body;
• chemotherapeutic treatment;
• structural changes in the tissues of appendages;
• irregular nutrition, compliance with excessively strict diets, sharp weight loss;
• uncontrolled application of hormonal contraceptives;
• diseases of the hypothalamic-pituitary zone due to mental or mechanical injury.

Also develop a violation may be due to chronic adhesitis. Causes of ovarian hypofunction must be found out necessarily, otherwise the treatment of the pathological state will be useless.

Symptoms and signs

Ovarian hypofunction is characterized by certain symptoms:

1. Disruption of the menstrual cycle: primary or secondary amenorrhea, oligomenogenia. From how strong an endocrine imbalance is depends on the severity of symptoms.
2. If a woman still managed to get pregnant in a natural way or with the help of Eco, then due to the lack of hormones there is a high risk of spontaneous interruption. The future mother becomes difficult to enter the baby and have to be under constant control of doctors.
3. No ovulation.
4. Atrophy of the mucous membranes of internal genital organs. Endometrial functionality is significantly reduced.
5. The inverse development of the genital organs (with a long flow of the pathological process).
6. Psychegetative disorders (such as women on the background of Klimaks).
7. Osteoporosis. The patient at the same time becomes prone to fractures that do not arise due to injury.

It should be noted that the secondary form of pathology has more vivid manifestations, therefore it is not difficult to determine it.

The degree of development of pathology

The treatment of ovarian hypofunction depends on how difficult the patient's condition is, and how long it develops.

Degree of development	Features
	The size of the uterus remains the same. As for the endometrium, it is formed correctly, but is characterized by partial underdevelopment. Secondary sexual sites for hypofunction of a lightly present, but there is a decrease in the mammary glands. Menstrual cycle is not broken, but bleeding scant
	In this case, the external and internal genitals are not developed, as it should be. Menstruation is completely absent
Heavy	It is infrequent, as a woman against the background of problems with the reproductive function and, if there are other symptoms, appeals to the doctor sooner. Characterized by the absence of secondary sexual signs, primary amenorrhea

It is possible to completely eliminate the problem only if the pituitary is not congenital and not running. Otherwise, it is not possible to fully restore or resume the work of the reproductive system.

Diagnostic features

In the presence of or other diseases of the reproductive system, its hypofunction can develop.

Diagnostics is carried out not only to confirm the diagnosis. Experts learn how functional ovaries are, refine the area of \u200b\u200bthe defeat. It is important to accurately establish the causes of such a state. For this, these studies are held:

1. Gynecological examination of patients, as well as the analysis of the general state.
2. Determining the level of progesterone, estrogen, prolactin and other hormones. These analyzes are carried out in certain phases of the menstrual cycle (if it is not broken).
3. Pharmacological sample. It is needed to determine how much ovarian tissue is sensitive to drugs.
4. Ultrasound. It will allow you to know the thickness of the endometrium, the size and the degree of functionality of the internal genital organs.
5. X-ray skull (if secondary pituitary is observed).
6. MRI pituitary.

These studies will allow the cause of the appearance of a pathological condition and to choose the right therapy, which includes not only steroid drugs.

Stages of treatment

The patient needs to remember immediately that the therapy will be long. Sometimes it is held until the commencement of the menopausal period. There are several stages of treatment:

1. First. For women of reproductive age, it is necessary in order to eliminate the negative factors causing hypofunction. If pathology develops in girls who have not yet reached puberty, then the stimulation of this process is carried out. In cyclic mode, the patient will have to take estrogens. Most often, such therapy lasts about 3 months. It is also necessary to remove external factors that violate the functionality of the reproductive system of the girl.
2. Second. It begins only when a positive reaction to estrogen treatment is observed. When the ovarian hypofunction, treatment at this stage is to restore cyclical changes in them.
3. The third. It is necessary for the patients who decided to become pregnant.
4. Fourth. Women's rehabilitation is carried out, as well as prevention of hypofunction relapses. Most often, such therapy lasts until the onset of natural menopause.

It is also important to get rid of inflammatory processes or other diseases of reproductive organs, such as chronic adhesitis. Without clarifying the reasons to eliminate their consequences will not work.

Hormonal therapy also has its own characteristics. First it is carried out by monopreparations, and only then introduced combined tools. In the future, if the effectiveness of treatment is good, the dosage of drugs decreases to avoid side effects.

Non-immune therapy

Naturally, without hormonal treatment It is impossible to do without, however, it is necessary to use other methods of therapy:

1. Physiotherapeutic procedures. They helps to stimulate the development of genital organs. You should use those procedures that contribute to improved blood circulation.
2. Medical physical education.
3. Vitamin therapy. Such a treatment method is needed during the active formation of cyclic changes in the ovaries. The patient will have to take vitamins C, E, foliic acid, magnesium and zinc.
4. Folk methods. There are various gynecological fees that are used to enhance education and ripening. Also, folk remedies reduce the severity of signs. Popular is the collection, which contains a boring uterus. It has long been considered the "female" grass. Rhodiola pink, lesion, red brush, rosehip, mistletoe, licorice, AIRA helps well. Pretty popular is the collection "Scarlet flower".

Gypofunction is a complex multifaceted problem. Any patient may suffer, regardless of age. Timely treatment Pathology can get rid of the majority of its forms.

Can a woman have children with hypofunction

The ovaries are an organ without which pregnancy is impossible. It is the formation and ripening of eggs. All other processes that occur in the reproductive system are aimed at preserving and developing pregnancy, creating favorable conditions.

When hypofunction, the hormone level changes, so the functionality of the organs is reduced, fertility (the ability to conceive) is deteriorating. Women can develop infertility associated with the absence of a menstrual cycle, thinning of the endometrium layer. Even if pregnancy and comes, it will be extremely difficult to carry it out. It all depends on how strong the changes of the organs of the woman are. In this case, the patient will need supporting therapy before the onset of natural menopause.

Gynecological fees do not always help draw changes in the organs. In this case, the woman will have to go through the procedure of artificial fertilization with constant supervision of doctors. However, the result will be only if the patient has no primary amenorrhea with a fair decrease in the reproductive system organs. Here the chances of pregnancy are close to zero.

Gypofunction is a serious problem, to deal with which it is necessary not only with hormonal drugs, but also by applying folk fees. It is also important to turn to a specialist in time if there are signs of the menstrual cycle, while the problem has not come too far.

Ovarian hypofunction is a set of changes in women's bodyIn which the authority cannot perform its task. In this state, the development of key hormones is reduced, which leads to various violations in reproductive sphere. In adolescence, the pitipofing of the ovaries is the cause of the delay of sexual development, in a mature - infertility and early climax. Without treatment, pathology provokes a failure in the work of the whole organism and threatens the development of serious complications.

What is ovarian hypofunction: basic concepts

The pitipofunction of ovarian is not a separate disease, but only syndrome, indicating certain problems in the reproductive sphere. This condition accompanies with various diseases - and gynecological, and somatic. In the diagnosis, much attention is paid to the search for the cause of the failure of the ovaries. Knowing why the problem arose, you can choose the optimal tactics of treatment and cope with complications.

The basis of the ovarian hypofunction is a decrease in the production of genital hormones: first of all - estrogen, as well as progestins and androgen. The lack of estrogen leads to a violation of the work of the whole organism. This hormone is not only responsible for feminization (the development of reproductive organs and the formation of secondary sexual signs), but also participates in many links of metabolism. Estrogen affects the processes occurring in bone tissue, regulates the production of important proteins, blood coagulation and synthesis of fats. The lack of this substance disrupts the work of the heart and vessels, lungs and kidneys, skin and bone-muscular system. Gypooestroy leads to a rapid fading of a woman and significantly undermines her health in pretty early age.

It is important to know: the physiological hypophunction of ovarian occurs at the age of 40-45 years and precedes the arrival of Klimaks. In case of early decrease in the production of hormones, they talk about pathology.

Classification: primary and secondary pituitary

The following varieties of pathology are distinguished:

• Primary hypofunction is an innate state associated with damage to the intrauterine organ. The first signs of the disease are manifested in adolescence.
• Secondary hypofunction - acquired state. Pathology arises against the background of various gynecological and endocrine diseases And is the result of hormonal failure.

It is not always possible to figure out the exact reason for reducing the production of sex hormones. In the formation of primary failure of the ovaries, the value is attached to the following points:

• The impact of adverse factors at the stage of bookmarking reproductive organs (8-10th week) and differentiation (20-22th week). Special attention is paid to radiation irradiation, infectious diseases and the use of drugs.
• Hormonal disorders in the body of a woman who has a baby.
• Infectious and autoimmune diseases transferred at an early age.
• Hereditary chromosomal anomalies.

Causes of secondary hypogonadism:

• Heavy infectious diseases.
• Autoimmune pathology.
• Tumors I. inflammatory processes brain.
• Card-brain injury with pituitary damage or hypothalamus.
• Blood circuit breeding.
• Inflammatory processes in the uterus.
• The consequences of chemotherapy or radiation irradiation.
• Weight deficit and strong exhaustion. It is known that when weighing 45 kg and less decreases the production of ovarian hormones.

Another classification is also applied in gynecological practice:

• Hypergonadotropic hypogonadism is a state at which the lack of ovarian hormones leads to an increase in the level of pituitary hormones and hypothalamus. The primary failure of the ovarian is hypergronadotropic.
• Hypogonadotropic hypogonadism is a condition in which the production of all hormones is reduced - both in the ovaries, and in the hypothalamic-pituitary system. It is noted in secondary dysfunction.
• Normogonadotropic hypogonadism is manifested by a violation of the rhythm of the secretion of pituitary and hypothalamus hormones. Occurs in endocrine pathology (diseases thyroid gland, adrenal glands).

Signs of ovarian hypofunction: how to recognize the disease

The manifestations of hypogonadism depend on the age of the woman and the form of the disease.

In adolescence

With congenital pathology or the development of hypofunction in an appropriate periodily, a complete cessation of the production of hormones, secondary sexual signs are absent. The first reliable symptom of the girl's ripening is considered an increase in the mammary glands - Telecom. This process is normal at the age of 9-12 years. It is necessary to worry my parents when the girl does not have a single sign of puberty - no congenital hypogonadism is not excluded.

With partial shortage of the ovary hormones, sexual delay is noted. Maturation begins later than the prescribed period or is slow pace. The appearance of secondary sexual signs (the growth of the mammary glands, the lobster and the axillary depression) lags behind 2-3 years and more. Menstruation come late (at the age of 15) or completely absent (primary amenorrhea). It happens that the interval between the emergence of the first signs of puberty and monthly is more than two years. All these symptoms should alert the girls's parents and become a reason for a visit to the doctor.

In reproductive age

In women, 18-45 years of ovarian hypofunction is manifested by such symptoms:

• Irregular menstruation: delay up to 7-14 days or more.
• Scarce periods (less than 3 days).
• Amenorrhea is the lack of menstruation of 6 months and more.
• Unbearable pregnancy - repeated spontaneous miscarriages.
• Infertility is the inability to conceive a child for 12 months of regular sex life without using any contraceptive means.

In the prelimacteric period: the pitipofing of the ovaries in women after 40 years

In addition to the disorders of the menstrual cycle at this age, there are vegetary changes, characteristic of Klimaks:

• The appearance of tides: a sudden feeling of heat spreading on face and body. Rays can be replaced with chills.
• Increased sweating.
• Vibrations of blood pressure.
• Sharp mood change, increased emotionality.
• Reduced libido.
• Dry vagina.
• Weakness and fast fatigue.

Norma Climax comes aged 45-50 years. During this period, there is a gradual extinction of the reproductive function and there is a decrease in the development of ovarian hormones. After 12 months from the last in the life of menstruation, they talk about the occurrence of menopause. Climax entails violations in the work of the heart and blood vessels, increases the likelihood of osteoporosis and other age-related changes. In hypofunction of ovarian and early menopause at the age of 40 years of age, these processes occur faster and significantly undermine the health of women.

Diagnostic scheme

A reason for a visit to the doctor:

• The delay in sexual development in a teenage girl (the absence or slow development of secondary sexual signs, menstruation).
• Disorders of the menstrual cycle in a woman of reproductive age: monthly delay, Amenorrhea.
• Infertility.
• Signs of Klimaks under the age of 45.

Each of these states it is possible to reduce the function of the ovaries. The following methods are helped to set the diagnosis:

Gynecological examination

When examining a teenage girl draws attention to the absence or underdevelopment of secondary sexual signs. The uterus and ovaries during the Bimanual study of infantile and also do not correspond to the age norm.

In the reproductive and prelimacteric period, the genitals are formed correctly on the female type. Perhaps a slight decrease in the sizes of the uterus and appendages. It is often noted by mammary hypoplasia.

Laboratory research

To estimate the hormonal profile, it is necessary to identify the concentration of such substances:

• Estrogens.
• Progesterone.
• Luteinizing hormone (LH).
• Follicle-stimulating hormone (FSH).
• Prolactin.

Test results help not only diagnose, but also determine the type of ovarian failure.

Ultrasound: Echo Drinks of ovarian hypofunction

Ultrasound examination in reproductive age is carried out on the 5-7th day of the cycle. According to ultrasound testimony, it is repeated in the middle of the cycle closer to possible ovulation. Teenagers with a delay in sexual development research is performed on any day. When evaluating the pelvis organs pay attention to such indicators:

• The dimensions of the uterus and ovaries.
• The presence of follicles in the ovaries, separation among them dominant (taking into account the phase of the menstrual cycle) and the signs of ambulance.
• Identification of tumors of appendages and other pathological changes.

In case of inconsistencies, echo-discovery normal indicators We can talk about the pitipofing of the ovaries.

Additional methods

To clarify the diagnosis and search for the causes of ovarian hypofunction, such methods are used:

• Computer and magnetic resonance tomography - to identify tumors of appendages and brain.
• Tests on thyroid hormones and adrenal glands.
• Laparoscopy is an endoscopic study of the pelvis organs. According to the testimony during the diagnostic operation, the ovarian biopsy is carried out.

Approaches to the treatment of ovarian hypofunction

The treatment of therapy in hypogonadism will depend on the cause, form of pathology, patient age, severity clinical symptoms and the presence of concomitant diseases.

Traditional methods of therapy for ovarian hypofunction

With primary hypogonadism in adolescent girls, treatment is aimed at stimulating the appendages and launch of normal puberty. For this purpose, such events are held:

1. Elimination of negative factors affecting the work of the ovaries. It is recommended to avoid physical and mental overvoltage, ensure balanced diet, treat the concomitant diseases.
2. Redean hormonal therapy. Prescribed preparations of female sex hormones according to an individual scheme. The dosage and duration of the reception are determined by the doctor, based on the severity of the disease.
3. As reproductive organs form formation, they are moving to cyclic hormone therapy until the normalization of the menstrual cycle. Estrogen and Gestagenov preparations are used. The course of treatment lasts 2-3 months, after which a break is made for 3-4 months, and then the cycle is repeated. Therapy goes under constant control of the level of hormones and ultrasound.
4. Physiotherapy I. physiotherapy To stimulate blood flow in the pelvis organs.

With a decrease in the function of ovaries in reproductive age, general fastening techniques, leafc and physiotics are also actively used. Cyclic hormonal therapy is carried out by drugs that stimulate the work of the gonad. The course of treatment lasts 2-3 months with a break for the same period.

The forecast directly depends on the severity of the state of the woman and the duration of the disease. A favorable feature is considered to be the emergence of menstruation for one or two cycles of therapy. In the young age of a positive effect, sometimes it is possible to achieve even without the use of hormones after the normalization of lifestyle. The older the woman, the harder it is to restore the function of the ovaries.

Treatment of ovarian hypofunction by folk remedies and methods of alternative medicine

Since gynecologists are far from always possible to achieve a quick effect, many women turn to the grandmother's recipes. Herbrays are going to run, and a tincture of a clean region, a boring uterus and a red brush are especially popular. Such remedies help to normalize the hormonal background and improve the operation of ovaries during light dysfunction, but do not cope with serious pathology (including innate).

Other funds are used in the treatment of hypogonadism:

• Homeopathy - the use of active substances in a low concentration. Doctors traditional medicine do not adhere to such tactics and believe that the effect of homeopathic preparations No more than from placebo.
• Hirudotherapy - applying leeches. The technique helps to improve blood flow in the pelvis organs, but practically does not affect the functioning of the ovaries.
• The use of miraculous Chinese phytootamphones and other similar means cannot seriously be considered as a full treatment of ovarian hypofunction.

Application folk remedies Perhaps only in coordination with the doctor and exclusively as auxiliary method of therapy.

How to get pregnant in the pitipofunction of the ovaries?

Infertility is one of the main problems arising in hypogonadism. If the ovaries do not work and adequate synthesis of hormones does not occur, ovulation becomes impossible. Follicles do not ripen, the egg does not go into abdominal cavity, fertilization does not happen. Before the occurrence of pregnancy, a woman has a long way to go:

1. Full examination at the gynecologist with the assessment of the hormonal profile and search for the causes of pathology.
2. Normalization of lifestyle: rejection of bad habits, rational nutrition, motor activity, lack of stress.
3. Replacement hormonal therapy with estrogen and progesterone drugs.
4. Stimulation of ovulation. To activate the operation of the ovaries, clomiphene and similar means are applied.

Even if a woman succeeds in getting pregnant against the background of hypogonadism, it is not always possible to endure the child. Estrogen lack prevents normal processes occurring in the uterus. Endometrium does not grow, and fruit egg Nowhere to attach. Implantation is interrupted, miscarriages occur. Often, miscarriages are repeated, which allows you to talk about the usual unbearably of pregnancy.

The pitipofunction of ovaries is a serious pathology, and it is necessary to fight with it proven and effective methods traditional medicine. You should not hope for recipes for a last century, conspiracies and other dubious techniques. The sooner the woman appeals to the doctor with her problem excitingly, the easier it would cope with the consequences of pathology and to preserve reproductive health.

Is it possible to cure the hypofunction of homeopathy ovarian? Elena, 34 years

Hello, Elena! The effectiveness of any homeopathic preparations is doubtful, and hardly similar means can cope with serious pathology. In the treatment of homeopathies, homeopathy is not applied.

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