The hormones in polycystic ovaries
Structural and functional pathology of the genital organs specific to each sex, as the female reproductive system differs significantly from that of men. The female body is subject to cyclic monthly rhythm, disruptions of which lead to the development of serious diseases. Among them, the polycystic ovarian syndrome is a dysfunction of the body, accompanied by cystic degeneration of ovarian follicles.
Women’s monthly cycle – the norm
Even in the womb of the female embryo there is a bookmark embryonic eggs. When it comes time of puberty, the beginnings of these in the ovarian follicles, aktiviziruyutsya and begin their development. Process on the part of the endocrine system strictly regulate the hormones.
At the beginning of the cycle has been the activity of several follicles, but after a few days already stands out dominant. It is necessary to him in the middle of the cycle to rupture, releasing the Mature egg into the fallopian tube. The output of reproductive cells from the ruptured follicular sheath is called ovulation. This event launches the second phase of the cycle, in the uterus Matures endothelial layer, ready to accept a fertilized egg, and ovarian follicle becomes a temporary endocrine gland — yellow body.
Hormonal regulation of the menstrual cycle
Between the humoral regulation of the first and second phases of the cycle there is a significant difference. In the first phase it is necessary to ensure active growth and maturation awakened within the follicle of the egg. This involved the estrogens — the so-called female hormones. When it comes to the time of ovulation, it comes in the «pregnancy hormones» progesterone and active substances that stimulate the rupture of the follicular sheath and the transformation of the follicle into the corpus luteum — the follicle-stimulating and luteinizing hormones.
Humoral regulation is a complex multistep process. If any stage fails, can disrupt the normal flow of cycles, for example, is not going to happen ovulation is his key point. As a consequence, does not occur phase does not change the hormonal course of the female body.
The development of polycystic ovaries
This is the mechanism of development of polycystic ovaries. For some reason ovulation occurs the oocyte, abnormal follicle continues to grow and degenerates, forming a cystic bladder, liquid-filled. If it’s not a one-time anomaly, a similar process will be repeated from cycle to cycle. Multiple follicular cysts of the ovaries such bunches of grapes, sex gland increases in size, its surface becomes uneven.
The disease affects one of the ovaries, or both on at once. In case of serious hormonal disorders pathology usually bilateral. Unilateral may be associated with the development in the ovary of the inflammatory process. If cystic degeneration has affected both glands cannot complete the reproductive function of women, as there is ovulation and fertilization of the egg. Pregnancy with bilateral polycystic impossible.
Causes polycystic degeneration of the ovaries
The main reason for the disease is hormonal imbalance in the female body, inadequate humoral regulation of the events of the monthly cycle.
- hyperandrogenism — excessive production of male hormones in the female body;
- disorders of secretion of follicle stimulating and luteinizing hormones responsible for the development and ovulation of follicles.
Hyperandrogenism can develop in response to an abnormal insulin resistance of tissues. In this state, the cells lose sensitivity to insulin. Trying to adjust the balance, the body increases its production, and also alters production of other active substances. This hormonal storm leads to damage of endocrine tissues and organs, the development of diseases. When polycystic follicular capsule thickens at the right time is not interrupted, ovulation does not occur. Starts pathological cystic development.
Factors affecting hormonal balance:
- reception female hormonal medicines and the use of oral contraceptives;
- metabolic disorders, diseases of the endocrine system, particularly thyroid, adrenal, complex pituitary — hypothalamus (in the polycystic in women is often detected type II diabetes (insensitivity to insulin), and obesity of different degree).
- abortion, complications during pregnancy;
- puberty body and menopause (during the primary polycystic disease in girls of 12-14 years can not return to normal menstrual cycle);
- a sharp change in climatic conditions, diet, associated, for example, moving to another climate zone;
- strong stress.
Observed more frequent diagnosis of ovarian cystic Mature nulliparous women. If the body realizes its reproductive function, hormonal changes, «calm down», becomes more healthy.
To trigger the development of pathology of the ovaries can reduce inflammation in the reproductive system. Its cause is usually the microbial infection is caused by the following factors:
- failure to comply with the woman personal hygiene, getting into the reproductive tract of contaminated particles;
- failure to observe sexual hygiene.
- infection with sexually transmitted infections;
- the spread of infectious agents to the blood stream from foci of inflammation in other organs (caries, tonsillitis).
A significant role of genetic factors in polycystic. In women with burdened heredity (various diseases of the ovaries and reproductive system in General) the higher the probability of anomalies.
Symptoms of polycystic ovaries
When polycystic disrupted the functioning of sexual glands and the entire monthly cycle, the symptoms a woman may see yourself:
- changing the nature of the menstrual bleeding to decrease the amount of blood;
- becoming rare periods (oligomenorrhea) or disappear altogether (amenorrhea);
- sometimes the pathology is accompanied nagging pain in the abdomen in the projection of the ovaries;
- for a long time a woman can not get pregnant.
Also expressed symptoms of hormonal imbalance:
- fatigue, chronic fatigue;
- irritability, mood swings, depression, of depression;
- metabolic disorders, obesity;
- hirsutism — active hair growth on the face and body of male type;
- the deterioration of the hair and skin, acne, blackheads.
Hormonal abnormalities in the polycystic contribute to the development of other pathologies, such as ovarian disease often accompanies fibrocystic mastopathy.
These symptoms are not specific and are unable to clearly indicate cystic degeneration of the sex glands. Moreover, they are often ignored by women. Mood swings, chest pain, pimples are perceived as signs of premenstrual syndrome (PMS) or puberty (in girls).
Often to the gynecologist diseased woman drawn only after long unsuccessful attempts to conceive a child.
Clinical diagnosis of polycystic ovarian pathology
When a woman presents with complaints to the gynecologist, it is important to diagnose polycystic and start his treatment. We must never confuse polycystic degeneration of the follicles multifollicular ovarian syndrome, which in most cases is a normal variant and not a threat to women’s health. In the structure multifollicular ovaries at the same time there are several (up to 7) active growing follicles, among which can not stand out dominant. This condition is normal for the first days of the cycle, it usually passes spontaneously in the stabilization of hormonal levels.
- Pathological changes of the ovaries the doctor may be detected in the gynecological examination. The study is conducted bimanual both hands — vaginal-abdominal. It allows diagnosing the change (increase) the size of the gonads and their structure. Such manipulations if polycystic can be accompanied by pain.
- In addition to a pelvic exam is mandatory medical history (is history). The patient should tell what the symptoms are and how long she was concerned about, and what medications and what dosages she was taking lately. The diagnostic value can have these external symptoms like obesity, hirsutism.
- To confirm the diagnosis an ultrasound examination is performed that detects changes in the ovaries typical for polycystic. Transvaginal ultrasound is performed using a special sensor. The image of the pathological follicles resembles a «string of pearls». Bodies symmetrically enlarged, have increased relative to the normal density and thicker as a result of hyperandrogenism capsule.
- In some cases, doing a diagnostic laparoscopy of the abdomen. This procedure is indicated in cases of suspected malignant tumors of the ovaries or of the uterus, ectopic pregnancy, ruptured ovarian cyst. Through microscopic punctures in the body cavity introduces a laparoscope manipulators and a video camera, if necessary, the surgeon can immediately make the removal of the tumor.
- Laboratory studies in the polycystic determine changes in hormonal composition of blood: concentrations of FSH and LH hormones, hyperandrogenism. In addition, the analysis on the level of lipids, sugar and resistance to insulin action.
- You need to check thyroid function.
- In addition, the patient undergoes a test to determine pregnancy.
It should be remembered that in some cases recurrent disease when is cystic hyperplasia of uterine endometrium.