Causes, symptoms and treatment of premature ovarian failure syndrome. What to do if you have been diagnosed with ovarian failure syndrome

early menopause or, as it is also called, ovarian wasting syndrome is an endocrine pathology that manifests itself as secondary amenorrhea, infertility and vegetative-vascular disorders. It is worth noting that women younger than 38 years old who had normal menstrual and reproductive function in the past face this disease. Good afternoon, dear readers. You have reached the author's blog of the endocrinologist Dilyara Lebedeva "Hormones are normal!".

Women care more about their youth and beauty than men, and every woman strives to maintain her attractiveness as long as possible. What makes a woman a real woman? They play a key role in maintaining women's health and beauty, they give the skin a velvety look, and hair - shine and silkiness, protect against bone fractures and myocardial infarction. The fact is that estrogens are the most powerful antioxidant substances, and oxidative stress, as you know, is one of the leading theories of human aging.

That is why, with the onset of early menopause, a woman begins to change rapidly and, by no means, for the better. With a decrease in the concentration of estrogens in the body, degenerative processes begin to occur, aimed at aging the body. But ovarian failure syndrome can be eliminated by prescribing drugs, but more on that later, at the end of the article.

What causes early menopause?

According to experts, the main cause of ovarian failure syndrome are chromosomal mutations and autoimmune disorders. The manifestations of these disorders are considered to be underdeveloped ovaries with a deficiency of follicles, a primary lesion of the central nervous system and the hypothalamus region, and destruction of germ cells.

The occurrence of early menopause is associated with various factors, as a result of which the gonadal tissue is replaced by connective tissue. We are talking about radiation, various medicines, starvation, the influenza virus, etc. Quite often, the influence of adverse factors was detected in fetal development (comorbidities of the mother, gestosis and toxicosis). Severe stressful situations and infectious diseases contribute to the emergence of this disease.

How to know that early menopause has begun?

Characterized by a violation of the menstrual cycle up to amenorrhea (absence of menstruation). For persistent amenorrhea in this disease, vegetative-vascular manifestations are characteristic.

We are talking about such typical signs of menopause as hot flashes, increased sweating, weakness, headache, etc. Amenorrhea is the cause of the development of progressive atrophic processes in the organs of the reproductive system and in the mammary gland. As a rule, patients with the presence of this disease have the correct physique. Obesity is not typical for ovarian failure syndrome.

Diagnosis of the disease

The basis for the diagnosis of early menopause is the anamnesis data and clinical signs are characteristic. The timeliness of the onset of menstruation and the absence of menstrual and reproductive disorders for 10-20 years are noted.

A decrease in ovarian function contributes to a pronounced persistent hypoestrogenism. Evidence of this is the negative symptom of the pupil, the monophasic nature of the basal temperature, and the decrease in the karyopyknotic index. A sharp decrease in ovarian function can be detected using hormonal studies. At the same time, there is a decrease in the level of estradiol and an increase in the content of gonadotropic hormones (LH and FSH).

Conducting a gynecological examination and additional diagnostic methods helps to detect the reduced size of the uterus and ovaries. Ultrasound examination reveals a thinned uterine mucosa. Also, the absence of follicles in the ovary indicates the syndrome of ovarian exhaustion.

To study in depth the state of the ovaries, hormonal tests are used. A test with estrogens and combined schemes are being carried out. In this case, it is possible to clarify the nature of amenorrhea.

Treatment of ovarian failure syndrome

The fight against these syndromes is the prevention and treatment of conditions accompanied by hypoestrogenism.

Infertility is considered an indication for the use of assisted reproductive technologies. First of all, we are talking about in vitro fertilization (IVF). It should be noted that it does not make sense to stimulate the depleted ovarian follicular apparatus.

Includes hormone replacement therapy. For this purpose, estrogen preparations, such as proginova, are used. The scheme and mode of administration is decided individually with each woman, followed by monitoring the effectiveness of treatment.

Taking estrogen preparations up to the age of physiological menopause (50-55 years), you can prolong youth and health for women who are doomed to early aging. The life of such women is practically no different from the life of healthy compatriots, although only a few decades ago it was simply impossible for them to maintain women's health, since hormonal drugs appeared not so long ago.

Often, in women with normal reproductive function and regular menstruation, already in middle age (up to 40 years), ovarian activity is attenuated, which clinically includes secondary amenorrhea, vegetative vascular disorders, and loss of fertility. Such a complex of symptoms is combined into the concept of ovarian failure syndrome (OSI). The prevalence of pathology is about 2%, and among cases of amenorrhea (cessation of menstruation) - 10%.

In gynecology, premature ovarian failure is often referred to as early menopause, or premature menopause. For a number of reasons, a woman's ovaries stop their natural activity at an atypical age for this, and the pathological processes are irreversible. Without proper treatment, which does not restore ovarian function, but compensates for disturbed hormonal levels, ovarian failure leads to early aging of the female reproductive system and the whole body.

Ovarian exhaustion at an early age: what are the causes

Premature cessation of the activity of hormone-producing organs in a woman can occur under the influence of a number of factors. There are several theories that pre-existing ovarian failure develops. The causes of this condition are more often associated with hereditary predisposition and the presence of the so-called "three X chromosome syndrome" - a consequence of gene mutations, teratogenic effects even in the prenatal period. Initially, in some women with this chromosomal anomaly, the ovaries are small, there is an underdevelopment of the follicular apparatus. At the same time, the researchers note that the function of the pituitary and hypothalamus in terms of hormone production is completely preserved, but it can increase sharply against the background of a decrease in hormone secretion by the ovaries. Among all cases of SIA, a hereditary history with amenorrhea, early menopause, late onset of the first menstruation is recorded in 25% of pathologies.

According to another theory, on the contrary, ovarian depletion is a lesion of the reproductive system against the background of increased production of gonadotropins. At the same time, damage to the centers of regulation in the parts of the brain of one degree or another is noted. Ovarian wasting syndrome can develop due to autoimmune reactions, when a woman has specific complexes of autoantibodies that attack the tissues of her own ovaries. Other possible causes of follicular atresia (in combination with a defective genome):

• intoxication, poisoning;
• exposure to ionizing radiation;
• infectious diseases (rubella, mumps, influenza) with a severe course, suffered in childhood;
• stress;
• metabolic disorders, in particular, galactosemia;
• malnutrition;
• autoimmune diseases of other hormone-producing organs;
• operations performed on the ovaries (resection for cysts, cystoadenomas).

The occurrence of amenorrhea in premature ovarian failure syndrome is associated with the cessation of the production of female hormones, in connection with which hypergonadotropia develops - an increase in the production of gonadotropins. It is these substances that cause the appearance of secondary amenorrhea.

Classification: SIA forms

By origin, the following forms of ovarian failure syndrome are distinguished:

1. Primary, or idiopathic. In this case, genomic abnormalities are to blame, which cause premature ovarian failure by the age of 33-38.
2. Secondary. Against the background of a hereditary predisposition, the appearance of pathology is provoked by various autoimmune, somatic, infectious diseases, stress, operations, etc.

Clinical picture of the disease

Symptoms of ovarian failure syndrome in most cases appear at 35-38 years of age. The clinical picture is characteristic of that in other forms of estrogen deficiency:

• hypomenstrual syndrome (rare periods, or oligomenorrhea), which can last 6-36 months;
• amenorrhea (abrupt cessation of menstruation);
• the appearance of tides inherent in menopause (usually 2 months after the development of amenorrhea);
• headache;
• dizziness;
• high fatigue;
• irritability;
• sweating;
• arrhythmia;
• insomnia;
• weakness;
• vascular dysfunction;
• infertility.

In general, the symptoms of pathology can vary in women, as is the case with normal menopause. But all of them are associated with the cessation of the ovaries, against which many reactions and metabolic processes change. Most often, after the onset of the first menstruation and before the onset of various deviations in the menstrual cycle, at least 12-20 years pass.

At the beginning of the course of the disease, during a gynecological examination, the doctor, as a rule, notes the correct physique of a woman, the normal shape of the mammary glands, and the absence of pathological discharge from the nipples. The genital organs also have the correct structure, but the size of the cervix and uterus is usually somewhat reduced. If a woman did not have a history of chronic inflammatory diseases, the fallopian tubes are well passable. The size of the ovaries is always reduced, weight - no more than 1-2 grams, they have a dense structure, but the outer layers (cortical, cerebral) have retained differentiation.

The number of follicles is also sharply reduced in a woman with the initial stage of SIA, but the remaining ones continue their natural growth, maturation and functioning. The dominant follicle ovulates normally, after which the corpus luteum forms. Gradually, the number of follicles in the cortical layer decreases, and then they completely stop forming.

As it exists (after 3-6 years), ovarian failure syndrome causes atrophic changes in the mammary glands, vaginal dryness up to atrophic colpitis, signs of osteoporosis, urination disorders, deposition of adipose tissue on the abdomen, thighs.

Consequences and complications: why SIA is dangerous

Ovarian exhaustion syndrome inevitably leads to early aging of the body and infertility. At a relatively young age, a woman may be disturbed by heart disease - arrhythmias, coronary artery disease, and the risk of myocardial infarction increases. The fragility of bones increases, since against the background of a decrease in the absorption of calcium, the content of this element in the bone tissue decreases (osteoporosis develops). And, of course, because of the early onset of menopause, the quality of sexual relations decreases, often a woman falls into depression, and her performance deteriorates.

SIA and pregnancy

With the development of pathology, the opportunity to give birth to a child becomes elusive. In some patients with early ovarian failure syndrome, pregnancy is possible due to the cyclic existence of the pathology. For this, special replacement therapy is carried out (gestagens plus estrogens), after which the follicle matures, ovulation is restored and conception occurs. According to statistics, up to ¼ of women are able to become pregnant when favorable conditions are created. For the vast majority of women, the only chance to conceive is IVF using donor oocytes.

Diagnostic measures for SIA

It is worth consulting a doctor for any violations of the menstrual cycle, especially with a decrease in the amount of menstrual blood, a decrease in menstruation, and the cessation of menstruation. The program for diagnosing ovarian failure syndrome is as follows:

1. Metrosalpingography. The small size of the uterus, the thinning of its mucous layer are recorded.
2. Ultrasound of the pelvic organs. Allows you to fix a decrease in the size of the uterus up to 2-3 cm long, 1.7-2 cm in diameter, a decrease in the size of the ovaries to 28 * 17 mm or less. In the structure of the ovaries, small follicles are often visualized.
3. Blood tests for hormones. An increase in the level of FSH, LH, a sharp decrease in the level of estradiol, a slight drop in the prolactin level are detected.
4. Electroencephalography. Often, functional pathologies of the hypothalamus are found, which are completely corrected by medication later.
5. Laparoscopy with ovarian biopsy. The ovaries are dense, wrinkled, small in size, yellow in color. Sometimes the cortical layer is transformed into connective tissue (if the patient already has no follicles). When studying the biopsy, atrophy of the ovarian tissues is diagnosed.
6. Densitometry. There is a decrease in the density of bone tissue.
7. The study of the lipid spectrum of blood. A pathological increase in triglycerides is often found.

Hormonal tests are of great importance in the diagnosis of SIA. Among them are used:

1. Progesterone. Patients do not experience menstruation after testing.
2. Progestogen, estrogen. A menstrual-like reaction occurs if these tests are carried out in a cyclic mode.
3. Dexamethasone. After the introduction of the drug in the blood, the cortisol index quickly falls (a sign of low adrenal activity).
4. Clomiphenic. Basal temperature, estradiol levels do not increase, that is, the sample is considered negative.

Ovarian exhaustion syndrome is differentiated from organic lesions, including pituitary tumors, resistant ovary syndrome, and tuberculosis of the reproductive system. For this purpose, MRI, CT of the head, craniography, fundus examination, etc. may be recommended.

SIA treatment

Therapeutic tactics include measures to prevent complications of estrogen deficiency. In most cases, replacement treatment of ovarian failure syndrome is indicated until the age when menopause begins due to natural causes. This will help prevent violations of the urinary system, osteoporosis of bones, metabolic pathologies. The complex of therapy includes estrogen preparations containing estadiol, estrone, estriol and their derivatives in various forms, as well as gestagens (progesterone).

The average dosage of estradiol is 70-80 mg, estriol - 130-160 mg, estrone - 50-60 mg. They take medications for 14 days, and in the second phase of the cycle, the required dosage of gestagens (natural or synthetic) is added to the course for 10-13 days. In women, the symptoms of menopause quickly pass, menstrual-like bleeding is observed. Another option for hormone replacement therapy is taking COCs in the contraceptive regimen (Marvelon, Novinet, Regulon), which is usually prescribed to young patients.

The form of application of hormone therapy drugs - tablets, injections, plasters, local remedies, implants. Estrogen-containing ointments, suppositories are especially effective for atrophic colpitis. Among the drugs used:

• Klymen;
• Femoston;
• Klimara;
• Proginova;
• Klimonorm.

Additionally, to relieve symptoms, general strengthening of the body, stimulating effects on metabolism, the following medications and procedures are recommended:

• exercise therapy, massage;
• reflexology;
• radon, iodine-bromine baths;
• hydromassage;
• sedatives (Persen, Novo-Passit);
• vitamin and mineral complexes;
• phytoestrogens (Remens, Altera Plus);
• angioprotectors.

Often, a woman is additionally assigned consultations of a urologist, endocrinologist, mammologist, psychotherapist. Along with traditional treatment, it is useful to use folk remedies therapy, as well as eat more food containing phytoestrogens - soy products, ginger, rye, wheat germ, nuts, rice.

Traditional treatments for ovarian failure syndrome include taking foods rich in lecithin and vitamin E (hazelnuts, peanuts, legumes, cauliflower). You can also drink infusions and decoctions of sedative herbs. For example, take 10 gr. valerian root, chamomile flowers, peppermint leaf. Brew a spoonful of collection with a glass of water, after insisting, drink 100 ml each. morning, evening for a month.

Prevention of SIA

In the presence of a genetic abnormality in the structure of chromosomes, preventive measures may be ineffective. The best way to prevent wasted ovary syndrome in a daughter is to take precautions by the mother during gestation, that is, to exclude teratogenic factors. In addition, the pathogenic influence of infections, stress and other risk factors in early childhood should be prevented.

Women in their reproductive years should follow these rules:

• timely treatment of ovarian pathologies;
• good nutrition, avoidance of starvation;
• high-quality therapy of severe viral diseases;
• prevention of poisoning, drug overdoses, the effects of radiation;
• control of the level of stress, physical, mental stress;
• taking hormonal drugs only according to the doctor's recommendations;
• regular visits to the gynecologist.

These measures, of course, are not specific to the prevention of ovarian failure syndrome, but will help prevent too early menopause if there is a tendency to pathology.

Many women, having turned to a gynecologist because of the inability to conceive a child for a long time, find out that they have been diagnosed with ovarian failure syndrome. Some panic, believing that this is a sentence and they will not have children, but with the right therapy, there is hope.

Ovarian exhaustion syndrome (OIS) is not a separate disease, but a combination of symptoms of dysfunction of the female body. It has been established that even with the normal functioning of the reproductive system, patients aged 18 to 42 years are at risk of developing SIJ.
According to statistics, the disease affects 7-15% of the female population. In the gynecological reference book, emaciated ovary syndrome has a number of other names: premature ovarian failure, impoverishment of the ovarian follicular apparatus, early menopause, premature menopause. International code (ICB) No. 10 E28.
You should not think that the pathology concerns only the reproductive system and is fraught only with the absence of children in the future. With the progression of the syndrome, the patient automatically falls into the risk zone for developing osteoporosis, type 2 diabetes, high cholesterol and heart problems. The disease will also affect the appearance: premature aging of the body, deterioration in appearance (oily skin, thin hair, overweight).

Pathogenesis

What is the reason for the decline in reproductive function in these young women? So far, there is no one exact theory that explains the process of premature ovarian failure.
There are 2 groups of causes leading to the pathological process in the ovaries.

1. Leading factors:
   • chromosomal abnormalities;
   • hormonal changes;
   • hereditary factor in the female line. In adolescence, these girls have late and unstable menstruation, and ultrasound can diagnose small ovaries, underdevelopment of the genital organs, immature follicles;
   • imbalance of the autoimmune system. In this case, antibodies are produced that destroy cells, thereby impoverishing ovarian tissue;
   • disruption of the pituitary and hypothalamus;
   • primary lesion of the CNS.
2. secondary factors:
   • intrauterine infection of the fetus;
   • toxicosis or extragenital pathology in a pregnant mother;
   • infections: Streptococcus, measles, mumps, Staphylococcus, rubella;
   • hypothyroidism;
   • hyperemia of the nervous system;
   • poor nutrition or starvation;
   • lack of nutrients;
   • stress, nervousness, depression;
   • abuse of alcohol, nicotine, drugs,
   • long-term use of hormone-containing drugs;
   • radioactive or chemical exposure.

There is an unconfirmed theory that the ovarian reserve decreases due to the psychological mood of the woman. Ppsychosomatics is explained by the reluctance of a woman to have children because of fears (psychological violence, war, fear of poverty, etc.).

SIA is a complex of pathological symptoms and a multifactorial disease. The exact cause of occurrence has not been established, but genetic factors are of some importance, and environmental factors play a dominant role.

Clinical picture

As a rule, the disease develops gradually. Initially, a woman has amenorrhea or oligomenorrhea. After that, secondary signs begin to torment: “hot flashes” of heat to the head, weakness, fatigue, headache, fatigue, pain in the heart. Do not underestimate the manifestations of pathology!
Syndrome of early exhaustion of the ovaries is detected only when contacting a doctor.
Symptoms of SIA:

• increased sweating;
• irregular menstruation (ovarian function is sharply reduced and ovulation does not occur);
• an excess of androgens. High levels of “male hormones” in the body that can be seen visually: excess hair on the face and body, oily skin, acne.
• thinning or hair loss;
• overweight;
• enlargement of the ovaries;
• infertility;
• fatigue, constant weakness;
• pain in the lower abdomen;
• hot flashes (sudden intense heat all over the body with profuse sweating);
• sleep problems;
• constant headache.

If a woman has several signs of an illness, then you should not waste time and self-medicate. It is necessary to contact the clinic for a consultation, because only a qualified specialist will be able to establish the correct diagnosis.

Diagnosis of ovarian failure syndrome

To accurately determine the pathology, you must first contact a gynecologist. The doctor will first of all take an anamnesis, listen to complaints, conduct a physical examination on a gynecological chair (assessment of the size and condition of the cervix, uterus and ovaries. During palpation, the doctor cannot always accurately determine the changes, therefore a comprehensive examination is prescribed:

• determination of fasting blood levels of progesterone, prolactin, estradiol, FSH, LH;
• hysterosalpingography (helps to establish a decrease in the size of the uterus, ovaries and endometrium);
• Ultrasound of the pelvic organs;
• laparoscopy.

Premature ovarian failure syndrome must be differentiated from diseases that have similar symptoms. In some cases, when there is doubt about the correctness of the diagnosis, the patient is prescribed specific hormonal tests with estrogen and progesterone.

Therapy

Treatment for the diagnosis of premature ovarian failure is prescribed by a gynecologist-endocrinologist. A woman has a depletion of the ovarian follicular apparatus, therefore, stimulating ovarian function is not advisable.
Treatment in the first place should be directed to hormonal correction with the help of estrogen. The patient is prescribed drugs containing progesterone and estradiol: Estrinorm, Duphaston, Inoklim, Femoston, Microfollin, Norkolut, Angelik, Proginova, Divina, Ovariamin.
The course of treatment is usually 2-4 weeks. But this does not mean that the woman is completely cured. Therapy is carried out until the age of natural menopause.
Breaks, drug regimens and the frequency of repeated courses are individually prescribed.

ethnoscience

Treatment with folk remedies for a disease helps only at an early stage of development of dysfunction. Recommended strong remedies: decoction of Matryona, collection of Father George, collection of mother Seraphim, red brush, upland uterus. Take herbal preparations according to the instructions after the permission of the doctor.
The patient may be prescribed a rehabilitation course of therapy: massage, acupuncture, hirudotherapy, physiotherapy exercises.
Many recommend homeopathy. Among dietary supplements, Kudesan, Ovarium Compositum are especially popular.

• be sure to take, in agreement with the doctor, sedative, sedative and vitamin complexes;
• conduct an annual examination of the pelvic organs (ultrasound), take at least minimal tests;
• adhere to the principles of a healthy diet and lifestyle;
• take medications only after consulting a gynecologist (this applies to hormones, contraceptives);
• prevention and timely treatment of viral infections;
• lose weight with excess weight and stick to a diet;
• visiting a doctor at least once a year.

Forecast

The chance for a woman to restore her reproductive function and menstrual cycle is minimal. Conducted therapeutic actions aimed at stimulating ovarian function, as a rule, are considered ineffective. In rare cases (less than 5-8%) in patients after complex treatment and careful implementation of all recommendations, spontaneous restoration of ovulation and even the onset of natural pregnancy are noted.

Early ovarian failure syndrome and pregnancy

One of the signs of the disease is the absence of conception for a long time. Sometimes timely and competent treatment restores the reproductive function of a woman, which leads to a long-awaited pregnancy. If hormone replacement therapy did not help restore reproductive function, the patient may be advised to use it.
As practice shows, women diagnosed with premature ovarian failure syndrome are recommended the IVF procedure (in vitro fertilization). With several unsuccessful attempts, IVF is used with a donor egg (the donor material is fertilized with sperm, and the resulting embryo is transferred to the patient).
A woman can choose donor material at the clinic for a fee or use material from close people (mother, sister). As a rule, such material is genetically more similar to the patient, which increases the success of the procedure and reduces the psychological stress for the woman. Agree, bearing a child with a sister's egg is psychologically much more comfortable than with a stranger's egg. Moreover, with such a donation, the risk of poor genetic heredity is reduced.

Video: Ovarian Depletion Syndrome

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Dysfunction of hormone-producing organs, aggravated heredity, infectious diseases and surgery are recognized as the main causes of early menopause, a vivid manifestation of which is ovarian exhaustion. The treatment of this pathology is based on the use of synthetic hormones, phytocomplexes and physiotherapy aimed at restoring fertility and eliminating the unpleasant symptoms of menopause.

Factors that cause ovarian failure

Depleted ovary syndrome is diagnosed in 2% of women of late reproductive age (35-45 years), in whose body the maturation of follicles and the synthesis of sex hormones stop. The development of the pathological process in young women is not excluded. Even at the time of intrauterine development, a certain number of primordial follicles are laid in the female body, which are activated only in the puberty period under the action of hypothalamic hormones.

With each menstrual cycle, the follicular reserve gradually decreases. The complete extinction of ovarian function, as a rule, occurs after 50 years and indicates a further inability of a woman to reproduce offspring. This menopause is a natural physiological process that cannot be avoided. However, there are situations when the depletion of the follicular apparatus occurs prematurely: the ovaries stop synthesizing their own hormones.

The depletion of the follicular reserve is most often due to a genetic factor, the so-called 3-chromosome syndrome, which appeared under the influence of gene mutations in the prenatal period of embryo development. The abnormal structure of the ovaries leads to their premature aging.

An equally popular theory of premature decline in ovarian reserve is recognized as hormonal dysfunction. Increased production of gonadotropins triggers the mechanism of damage to the reproductive system, when autoimmune antibodies destroy their own ovarian tissue, reducing the supply of full-fledged follicles.

The fading of ovarian function earlier than the age norm can be caused by other reasons:

• infectious diseases;
• chronic diseases of the endocrine, nervous, excretory system;
• surgical intervention in the organs of the reproductive sphere (resection of the ovaries, removal of cysts, tumors);
• intoxication of the body with drugs and toxic substances;
• diseases suffered by a woman during pregnancy;
• stressful situations;
• high physical and mental stress;
• rigid diets, starvation;
• violation of metabolic processes in the body;
• autoimmune diseases;
• negative impact of ionizing radiation.

When is treatment needed?

Ovarian exhaustion syndrome has characteristic symptoms: external age-related changes and an abnormal structure of the paired organ, diagnosed during its study.

The following signs may indicate lazy (exhausted) ovaries:

• lack of ovulation despite regular sex life without the use of contraceptives;
• flushes of heat;
• increased sweating;
• dizziness, headaches;
• cardiopalmus;
• jumps in blood pressure;
• swelling of the limbs;
• darkening in the eyes when changing the position of the body;
• thyroid dysfunction;
• decreased physical activity;
• memory impairment;
• hair loss, thinning hair;
• changes in the structure of the skin, hair, nails;
• the appearance of wrinkles on the face and neck;
• hyperpigmentation of certain areas of the skin;
• psycho-emotional instability;
• male-type fat deposition;
• underdevelopment of secondary sexual characteristics;
• frequent, unproductive urination;
• decrease in sexual desire;
• occurrence of cardiovascular disease.

In a laboratory blood test, ovarian exhaustion is indicated by:

• low levels of estrogen, progesterone, estradiol, prolactin, prostaglandins;
• high concentration of follicle-stimulating and luteinizing hormones, triglycerides.

Signs of depletion (aging) of the ovaries can also be confirmed using instrumental diagnostics:

1. Electroencephalography determines brain activity, reveals dysfunction of the hypothalamus, the presence of diseases of the central nervous system that affect the functioning of the ovaries.
2. With the help of metrosalpingography, it is possible to detect a decrease in the size of the body of the uterus, narrowing of its neck, thinning of the endometrium.
3. Ultrasound examination of the pelvic organs determines the reduction of the ovaries, the underdevelopment of the follicular reserve, the absence of maturing follicles, the presence of any neoplasms.
4. Laparoscopy of the ovaries followed by a biopsy is aimed at examining the connective tissue, the outer layer, and the structure of the organ. As a result of a cytological study, the replacement of the ovarian tissue with connective tissue, the absence of full-fledged follicles, is confirmed.

Treatment

Ovarian depletion, regardless of the cause of the development of the pathological process, requires treatment aimed at restoring the balance of sex hormones and eliminating the unpleasant symptoms of early menopause.

The fading of ovarian function requires an integrated approach to treatment. The main role is played by hormone replacement therapy, which prevents estrogen deficiency. Early (before natural menopause) ovarian wasting involves the use of drugs containing estradiol, estriol or estrone for 2 weeks. The second stage of treatment requires the use of progestogens of natural or synthetic origin.

Hormone replacement therapy is the mainstay of treatment for young women who are planning a pregnancy. Treatment with combined oral contraceptives stops premature ovarian failure, osteoporosis, early atherosclerosis, stroke, restores the work of the endocrine, urinary, nervous system, activates metabolic processes in the body.

Synthetic analogues of hormones are used in the form of:

• tablets;
• candles;
• ointments, gel;
• plasters;
• implants.

Means that stimulate ovarian function

Early ovarian failure can be prevented if effective treatment is given. Before treating ovarian failure, it is necessary to undergo a comprehensive diagnosis of the body, determine the ratio of hormones, the presence of diseases that affect reproductive function. Correction of the hormonal background is possible only by the attending physician.

Uncontrolled intake of hormonal drugs, incorrect dose determination provokes the appearance of side effects in the form of deterioration in the functioning of the ovaries, thrombosis, deterioration of blood clotting, swelling of tissues, digestive problems, obesity, and increases the risk of developing oncology.

Depleted ovaries and pregnancy

Is it possible to get pregnant with depleted ovaries? The chance of successful conception exists subject to timely treatment with hormonal drugs. Depleted ovary syndrome is not a sentence at all. Pregnancy occurs in 60% of cases if the provoking factor is eliminated. However, it must be remembered that against the background of depleted ovaries, the risk of gestational diabetes, hypertension, preeclampsia, and weight gain increases. The presence of this pathology also affects the intrauterine development of the fetus, provokes a miscarriage, premature onset of labor.

The goal of hormone therapy is to stimulate ovulation:

1. First of all, the attending physician prescribes antiestrogenic drugs that help restore the natural menstrual cycle.
2. With genesis and habitual miscarriage, Duphaston is used for 3-6 months. With amenorrhea, Duphaston is used in combination with estrogens from the 11th to the 25th day of the menstrual cycle for 3 months. The same treatment regimen is followed with.
3. In the absence of a positive result of treatment, follicle-stimulating hormone preparations (Metrodin, Urofollitropin) are indicated to achieve "superovulation". The drug is taken for 2 or more menstrual cycles in agreement with the attending physician. To stimulate the growth of multiple follicles, the doctor may prescribe assisted reproductive techniques.

If, as a result of conservative treatment, pregnancy does not occur, resort to surgical intervention using laparoscopy. Wedge-shaped resection of the ovaries involves the removal of 2/3 of the organ. Medical statistics confirm the effectiveness of such treatment in most cases.

Hormone therapy, carried out in pregnant women, involves the use of drugs that cause normal secretory transformations in the endometrium, which contribute to the successful bearing of the fetus. From the 11th to the 25th day of the menstrual cycle, Duphaston is prescribed, adjusting the dose after a colpocytological study.

Hormone therapy is contraindicated in the lactation period, as it passes into breast milk. At the time of treatment, breastfeeding is stopped.

Traditional medicine

Alternative methods of treatment are included in complex therapy, but do not replace the classical scheme.

1. Depleted ovary syndrome involves treatment with the help of sedative fees and infusions. A positive effect on the nervous system of infusion of peppermint (1 tablespoon of dry raw material per 0.5 l of water), viburnum, cranberry and blackberry fruit drinks was noted.
2. Eliminates psycho-emotional instability freshly squeezed beetroot juice (100 ml), to which 1 tbsp. l. honey. The drug is taken 2 times a day, 50 ml.
3. Treatment with folk remedies includes the use of an egg-lemon suspension, which effectively fights the manifestations of early menopause due to the high content of lecithin. To prepare it, you need to grind lemons and eggshells with a blender in a ratio of 1: 1. The resulting mixture is infused for 3-4 weeks, and then consumed 3 times a day, 1 tbsp. spoon.
4. You can eliminate the symptoms of ovarian exhaustion with the help of. In 250 ml of water, brew 1 tbsp. a spoonful of dry grass and insist for 30-40 minutes. Infusion is taken up to 5 times a day for 1 tbsp. spoon before meals.
5. Infusions of wintergreen, ortilia lopsided, red brush, field yarutka, which are prepared in a similar way, have similar properties.
6. With depleted ovaries, the daily diet should include foods containing lecithin, folic acid, natural phytoestrogens, B vitamins. These include sprouted grains of wheat, rye, soybeans, lentils, beans, cauliflower, nuts, fish, egg yolks and others.
7. For the preparation of herbal tea with phytoestrogenic properties, clover, alfalfa, viburnum, sage, ginger, and Abraham tree are used. 0.5 tsp dry raw materials are brewed in 250 ml of water and infused for 15-20 minutes. Take 2-3 times a day for two to three weeks.

Traditional medicine is used only after agreement with the attending physician. Any plant is a potential allergen and, if the body is sensitive, can produce the opposite effect.

Timely identification of the true cause of early depletion of the follicular reserve, an integrated approach to treatment prevent the loss of fertility and unpleasant symptoms of early menopause.