Ovarian failure: causes, symptoms and treatment
Ovaries — the most important organs of the female reproductive system. Starting from adolescence, they actively operate to the menopause. Failure of gonadal function critically affects your overall health and the health of women.
The work of the ovaries is regulated by the hypothalamic-pituitary complex by hormones. It is a complex multistep mechanism, and the breach at any stage can to break it. There are primary and secondary insufficiency of ovarian function: primary connected with the pathology of the bodies themselves, and secondary — with failures in work of endocrine regulatory systems. Secondary ovarian failure in most cases is the result of serious diseases of the anterior pituitary or hypothalamus.
The primary failure of the ovaries
The disease has many names: the depletion of gonadal, dysgenesis of the ovaries, hypogonadism, also known as premature menopause. Its essence is that young reproductively active women show signs characteristic of the postmenopausal period.
With age, the stock of oocytes in the gonads laid down in the embryonic period of development, coming to an end. This natural depletion, which occurs after menopause ends the reproductive period in a woman’s life, is declining ovarian function. It happens, however, that this event happens much earlier than expected.
The ovaries of young women sometimes cease to function properly, stops cyclic maturation of follicles. The disease can be caused by different factors. Of course, you cannot get pregnant. Failure of the ovaries — one of the main causes of female infertility (endocrine infertility).
It is possible to distinguish several varieties of primary ovarian insufficiency:
- The syndrome of premature exhaustion of the sex glands. Pathology caused by genetic disorders, aggressive environmental factors (exposure) and traumatic effects on the ovaries (e.g., during operation). When the disease is reduced or depleted the number of active follicles.
- Syndrome resistant gonads. Unlike the previous pathology in resistant ovaries is a sufficient number of follicles that could potentially Mature and ovulate. The problem is that the gonads are immune to the action of hormones. The pituitary gland sends a signal to the follicles to develop, but they for some reason do not perform it. The development of the disease leads to stable cessation of ovarian function.
- Dysgenesis of the gonads. This term includes several genetic disorders associated with disruption of the structure of the ovaries.
Premature failure of function of sexual glands is not uncommon. So, every tenth case of amenorrhea due to this pathology.
The causes of pathology
- congenital genetic disorders (including hereditary), pathology of pregnancy (hormonal imbalance, inflammatory diseases of the mother, the bearing of a girl);
- autoimmune processes such as autoimmune thyroiditis, rheumatoid arthritis, in which the body produces antibodies to the tissues of the sex glands;
- the influence of aggressive external factors (radiation, chemical substances, including drugs, radiation therapy, chemotherapy);
- injury ovarian damage during surgical interventions;
- chronic inflammatory processes in the reproductive system, tuberculosis of the genital glands.
The symptoms of ovarian insufficiency
Ovarian disease occurs on the background of the broken hormonal background of the organism and may be accompanied by characteristic symptoms of menopause caused by decreased estrogen levels.
- In case of primary failure of the organ marked increase in the level of follicle stimulating hormone (FSH), the secondary, on the contrary, there is a fall in FSH and LH (luteinizing hormone responsible for ovulation of the follicle).
- Decreases the production of estrogens abnormal ovaries.
- Failure of gonadal function manifested by violation of menstrual cycle, absence of menstruation (amenorrhea).
- Excessive sweating and hot flashes.
- Decrease in sexual desire, mood swings, sleep disturbances, irritability, depression.
- Dryness of the mucous membranes of the external genitalia.
Congenital hypofunction of sexual glands leads to delayed puberty in girls. There is underdevelopment sexual glands, the unstable cycle, oligomenorrhea or amenorrhea.
In severe cases, the disease is accompanied by serious lesions of the reproductive system.
Despite the large amount of literature devoted to the insufficient function of sexual glands, diagnosis of this condition causes significant problems for professionals. Based on mere complaints of the patient it is impossible to determine the problem. It is important to determine the cause of the disease, for this purpose, a number of studies:
- ultrasound examination of the ovaries allows you to visualize the structure of organs, to assess the activity of the follicles;
- karyotyping is performed to identify the major genetic disorders (a genetic disorder have the typical symptoms so that they can diagnose or at least suspect);
- detection of autoantibodies (antibodies produced by the body to its own tissues) sexual glands;
- a blood test for hormone levels.
Uninformative are methods such as biopsy and laparoscopic diagnosis. The presence of follicles in the ovary, which can be discovered in the course of these studies does not ensure their normal development and maturation.
The diagnosis of premature failure of the sex glands put women under 40 years of age, who for 4 months or longer there is a violation of ovarian function, and rates of hormones are abnormal.
The treatment of the disease
Half a century ago endocrine disruption of ovarian function was considered as an incurable disease. It is known, however, that some patients with resistant ovary syndrome sometimes have spontaneous ovulation of follicles. 5-10% of women suffering from premature failure of the sex glands, able to become pregnant even many years after the detection of the disease.
It is impossible to say when it will overcome the critical threshold, after which restoring the function of the ovaries will be impossible. Also, unfortunately, cannot be reliably predicted at what point there may come ovulation.
Treatment is aimed at restoration of normal endocrine and genetic status. The main method of hormonal therapy that is designed to compensate the lack of estrogen in the body of the patient. Additionally the prevention of osteoporosis, which is a common complication of the disease, preparations of calcium and vitamin D.
Stimulation of ovulation medical methods in most cases does not bring positive results.
Diseases of the sexual sphere, diagnosed infertility is a significant challenge for women. The management of these patients requires the doctor’s high professional competence and tact.
Hypofunction of the ovaries and ECO
Women suffering from depleted syndrome or resistant ovary can get pregnant using the procedure of in vitro fertilization (IVF), in which a fertilized donor egg is placed in the uterine cavity.
First there is the preparatory hormonal therapy drugs estradiol, progesterone, and progestins.
The effectiveness of IVF depends on age, health status, women and technology the procedure.
Ovarian hypofunction is a complex pathology that requires careful attention and adequate treatment. In many cases, the disease is not incurable, possible spontaneous bursts of activity of the sex glands, during which the patient can become pregnant.