Ovarian hypofunction or ovarian failure is a complex of changes in the female body, which occurs when the ovaries work to reduce the production of hormones and participate in the menstrual cycle.
Ovarian hypofunction is not a diagnosis or disease, it is a syndrome that occurs in conjunction with other manifestations (or in isolation) and gives characteristic signs depending on the time of occurrence – during puberty or during reproductive maturity.
There are two types of ovarian hypofunction:
- primary disorders arising in utero and associated with ovarian hypoplasia,
- secondary, resulting from various metabolic disorders and hormonal balance, disorders of the influence of regulatory organs – the hypothalamus and pituitary gland.
Manifestations of ovarian hypofunction depend on the time when failure occurs. Manifestations can occur before puberty or after its onset.
Symptoms in the reproductive period
If ovarian hypofunction occurs during the reproductive period, manifestations will be as follows:
- in mild degrees of damage, the uterus is of normal size, the endometrium is sufficient,
- menstruation scanty, painful, may disappear ( secondary amenorrhea ),
- with the progression of the symptoms of menopause with the absence of menstruation,
- manifest mental disorders
- tides, pressure fluctuations,
- the uterus is reduced in size,
- dryness and atrophy of the vaginal mucosa occurs,
- the endometrium is atrophied,
- Infertility occurs.
Symptoms of congenital insufficiency
Hypofunction of the ovaries of a congenital or early acquired nature is manifested by other symptoms:
- delayed puberty in girls after 15-17 years,
- late and insufficiently pronounced development of the mammary glands,
- a complex of disorders associated with menstrual function ( primary amenorrhea or oligomenorrhea ).
By severity can be divided into three degrees of symptoms.
With a slight degree of ovarian hypofunction, the following occur:
- slight underdevelopment of secondary sexual characteristics (weak pubic hair and underarms),
- underdevelopment of the mammary glands,
- the uterus is infantile, its size is reduced, the endometrium is formed, but thinned.
- menstruation is, but they are irregular, painful; there may be intermenstrual bleeding or long delays).
With a moderate degree of ovarian hypofunction, the manifestations are more distinct:
- the genital area is visually underdeveloped,
- the uterus and vagina dramatically reduced in size,
- female hair distribution is poorly defined or absent,
- the mammary glands are quite sharply underdeveloped,
- menstruation is absent.
In severe cases:
- pronounced hypoplasia of the uterus and genitals (they are dense, reduced in size),
- the uterus may have an abnormal position
- mammary glands are not developed,
- body hair is not available,
- external genitals are completely childish,
- vaginal mucosa is atrophic,
- there is no menstruation.
The basis of the diagnosis is an indication of a weak development of secondary sexual characteristics, absence of menstruation, a disproportionate physique, and masculine features are revealed.
The basis of diagnosis:
- Ultrasound of the uterus and appendages,
- plotting basal temperatures
- determining the level of ovarian hormones,
- determination of the level of pituitary and hypothalamic hormones,
- if necessary, conduct functional hormonal tests,
Gynecologists and endocrinologists are engaged in the diagnosis and treatment of ovarian hypofunction. Methods of treatment depend on the type of hypofunction and the time of its occurrence, as well as the severity of the process.
With secondary hypofunction
treatment is aimed at eliminating the causes affecting the ovaries, otherwise the principles of treatment are similar to the treatment of primary ovarian hypofunction.
When primary ovarian hypofunction
and underdevelopment of sexual characteristics requires a set of measures:
- normalization of the regime and power,
- treatment of concomitant pathologies,
- therapeutic exercises and therapy aimed at normalizing blood circulation in the small pelvis,
- hormone replacement therapy in order to properly form and function of the genital organs (estrogen is prescribed for several cycles).
As the formation of the correct structure of the genitals requires a transition to cyclic hormone therapy in order to activate the ovary and the formation of a normal menstrual cycle. Assign folliculin and microfollin in gradually decreasing doses. As genital organs are formed, estrogens are prescribed in combination with progestogens (progesterone).
Therapy is carried out 2-3 months in a row with a break for adaptation. If necessary, repeat the course of therapy.
In order to give birth to children, stimulation therapy is carried out after the effectiveness of cyclic therapy, it is carried out according to special schemes developed individually.
With timely initiated therapy of ovarian hypofunction, all changes are quickly eliminated, a woman can have children and lead a normal life.
The ovaries are one of the main reproductive organs of a woman, they produce hormones, make it possible to mature eggs, which allows a woman to bear and bear children.
Decreased ovarian function causes impaired reproductive function. However, the sex hormones produced by the ovary affect not only the reproductive functions, but also many types of metabolism and the work of the internal organs and skin. With their insufficiency, one way or another, the whole body suffers, early wilting of beauty and a violation of the woman’s health are noted.
There are many reasons for the decline in ovarian function, and they depend on the type of pathology.
The main causes of primary hypofunction consider:
- the impact of adverse factors during intrauterine insertion and ovarian formation (pregnancy pathology),
- hormonal imbalance of the mother’s body during the bearing of the future girl,
- previous infections during pregnancy ( rubella, measles ),
- chromosomal abnormalities,
- hereditary diseases.
The main causes of secondary ovarian hypofunction are even more diverse:
- severe exhaustion, anorexia nervosa (when a woman weighs less than 45 kg, menstruation can stop completely)
- nutritional deficiency of fats, as a source of synthesis of sex hormones,
- vitamin deficiency
- stresses, nervous shocks,
- genital tuberculosis,
- chronic, including infectious, inflammatory processes in the field of appendages,
- head injuries with damage to the brain stem and the pituitary or hypothalamus zone,
- circulatory disorders in the area of the cerebral arteries,
- Sheechen syndrome (acute necrosis of part of the pituitary gland),
- chemotherapy, radiation.
As a result of exposure to harmful factors during pregnancy, the anatomically correct ovaries are disturbed, they become functionally defective, as a result their hormone-producing function is reduced. This leads to disruption of the formation of secondary sexual characteristics and puberty.
When various negative factors affect the ovaries after puberty, scarring, hardening (replacement by connective tissue), cystic degeneration of the ovaries with weakening of their functional activity can form . There may be a change in the receptor apparatus of the ovaries to signals from the governing organs of the hypothalamus and pituitary, forming the syndrome of resistant ovaries.
As a result, the production of sex hormones suffers, which leads to disruption of the formation of secondary sexual characteristics, and if the damage occurred at reproductive age, it leads to early climax and aging.