Causes, symptoms and treatment of exhausted ovarian syndrome. Possible causes and treatments for ovarian wasting syndrome

Ovarian wasting syndrome is characterized by the appearance of signs of menopause at an early age. Typically, menopause occurs in women aged 45-50 years, and with premature ovarian failure syndrome, menopause occurs before the age of 40 years. The incidence of this pathological condition reaches 1.6%. The important thing is that these women previously had a normal menstrual cycle, and reproductive function was not impaired. Rational treatment of this syndrome helps prevent early aging of a woman and promotes the onset of a desired pregnancy. In some cases, IVF using donor eggs is required to achieve pregnancy.

Causes of ovarian wasting syndrome

• chromosomal abnormalities, hereditary predisposition that are transmitted from mother to daughter. In 50% of cases, women with a similar pathology have a burdened family history - late menstruation, oligomenorrhea, early menopause in the mother and sisters;
• autoimmune diseases in which antibodies to ovarian tissue are detected, autoimmune hypothyroidism;
• damage to hypothalamic regulatory centers in the brain;
• consequences of rubella, mumps, streptococcal infection;
• fasting or malnutrition, vitamin deficiencies, stress overexertion;
• galactosemia, in which there is a damaging effect of galactose on the ovaries;
• intrauterine damage to the follicular apparatus as a result of negative influences (bad habits of the mother, chemicals, ionizing radiation, taking medications). At the same time, the number of germ cells - the precursors of eggs - decreases. Within 15 years, the number of cells is exhausted, and early menopause sets in;
• gestosis and extragenital pathology of the mother, which may contribute to the development of this syndrome;
• subtotal resection of the ovaries for an endometrioid cyst, myomectomy or ectopic pregnancy. Surgery leads to a decrease in ovarian reserve and their depletion.

Ovarian wasting syndrome. Symptoms

This pathology has characteristic symptoms: secondary amenorrhea, infertility, vegetative-vascular disorders.

This disease manifests itself at the age of 36-38 years, but maybe earlier. The onset of the disease is considered to be sudden or gradually developing amenorrhea. It is possible that oligomenorrhea may appear first, followed by persistent amenorrhea. Premature menopause in some patients may be cyclical, so there is a possibility of pregnancy.

With this syndrome, the symptom of persistent amenorrhea is accompanied by vegetative-vascular manifestations characteristic of menopause: hot flashes, sweating, weakness, irritability, sleep disturbances, headaches and pain in the heart.

A decrease in estrogen levels is also manifested by symptoms: atrophic changes in the mammary glands, atrophic colpitis, decreased bone density, urogenital disorders (frequent urination, urinary incontinence). Depression and decreased ability to work are observed. Obesity is not typical for this pathology. When examining women, a decrease in the size of the uterus and thinning of the mucous membrane are noted, the ovaries are reduced in size and compacted.

Early ovarian failure and its diagnosis

If there is any alarming change in your health status, you should immediately seek medical help. So, if the above symptoms appear and ovarian depletion is suspected, it is worth conducting a thorough examination.

It includes:

1. Metrosalpingography.
2. Ultrasound diagnostics.
3. Study of hormonal status.
4. Laparoscopy.
5. Provocative tests, tests with hormones.
6. Ovarian biopsy.

Metrosalpingography is one of the most informative diagnostic methods in this case. With its help, you can detect a decrease in the size of the uterus, as well as thinning of its mucosa.

A laparoscopic examination reveals significantly wrinkled ovaries without follicles; the corpus luteum will not be detected. Follicles will not be identified during histological examination.

Particular attention is paid to hormonal tests during diagnosis. The most frequently used and informative tests are with gestagens, progesterone and estrogens. Normally, in response to the administration of progesterone, a menstrual-like reaction is observed; in patients with ovarian depletion it will not occur.

To determine the degree of sensitivity of the ovaries, tests are performed with gestagens and estrogens, during which a menstrual-like reaction and a significant improvement in overall well-being are observed. The administration of human chorionic gonadotropin also does not cause any reaction.

Ovarian wasting syndrome. Treatment

Treatment of the pathology is aimed at correcting vascular and urogenital disorders. Since the disease is characterized by a decrease in hormone production, treatment consists of hormone replacement therapy (HRT). Good results are achieved if HRT is prescribed as a contraceptive regimen. The choice of hormonal drugs depends on the woman’s age.

Young patients are prescribed Marvelon, Mercilon, Regulon, Novinet, Logest Silest, and older patients are prescribed Femoston, Klimonorm, Organametril. Hormonal preparations contain female sex hormones and help restore the menstrual cycle, the appearance of ovulation and pregnancy. Hormone replacement therapy prevents the development of osteoporosis, various genitourinary diseases, and cardiovascular pathology. Hormonal therapy is carried out until the age of natural menopause. For the treatment of various genitourinary disorders, estrogen preparations in the form of suppositories and ointments are widely used.

For ovarian wasting syndrome, treatment also involves the administration of vitamins, herbal sedatives and phytoestrogens. Along with this, hydrotherapy (circular shower, carbon dioxide, iodine-bromine, pine and radon baths), neck massage, acupuncture and psychotherapy are carried out.

These physiotherapeutic and balneological procedures have a restorative and stimulating effect. In general, metabolism in the body improves, as well as blood circulation in the pelvic organs. Of no small importance for premature ovarian failure syndrome are physical exercises, which increase muscle tone, relieve pain in the joints, and give vigor.

Some information about the syndrome can be found on the forum. However, it should be borne in mind that the information is provided on the forum not by specialists, but by patients suffering from this disease. Moreover, you cannot carry out treatment on your own on the advice of forum visitors, since this is a serious disease and treatment must be prescribed by a doctor after the necessary examination.

Possible complications and prevention

Complications of premature ovarian failure syndrome:

• premature (early) withering of the body;
• infertility;
• osteoporosis (decreased calcium content in bones, as well as their increased fragility);
• increased likelihood of heart disease (coronary heart disease, myocardial infarction);
• decreased quality of life, performance and intimate relationships;
• psychological problems (depression, feelings of inferiority, thoughts of suicide).

Prevention of pathology:

1. Rational nutritious nutrition, complete refusal of diets (except when the diet is prescribed by a doctor).
2. Prevention and timely treatment of viral infections (rubella, influenza, mumps).
3. Complete exclusion of the effects of toxic chemicals and radioactive radiation.
4. Taking medications only under the supervision of a doctor.
5. Elimination of psycho-emotional and intense physical activity.
6. It is necessary to exclude unreasonable or inadequate stimulation of ovulation (administration of drugs that cause the maturation and release of oocytes from the ovary).
7. Careful adherence to the rules of administration and regimen of hormonal medications.
8. Regular visits to a gynecologist (twice a year).

With premature ovarian failure syndrome, pregnancy is very problematic. In some situations, hormone replacement treatment (the patient taking female sex hormones - gestagens and estrogens) can temporarily restore ovarian function and cause egg maturation and ovulation. If it is not possible to induce ovulation, then pregnancy is only possible through in vitro fertilization with egg donation.

Premature ovarian failure syndrome (POF) is a pathology caused by the cessation of normal ovarian function in women even before menopause, when they could still have children. With this syndrome, the follicles in the ovaries stop maturing (either completely or mature in small quantities), and disruptions occur in the menstrual cycle. In general, the symptoms of SPIA are similar to those experienced during menopause. Today we will talk about what premature ovarian failure is, the causes, symptoms and treatment of this pathology will be discussed in detail.

Causes of ovarian failure prematurely

The exact reasons for the development of this syndrome have not been thoroughly studied, but doctors have come to the conclusion that the following conditions can provoke it.

1. Autoimmune diseases (when the body perceives ovarian tissue as foreign and produces antibodies to it).
2. Congenital malformations, heredity.
3. Some dangerous diseases and abnormalities of the mother during pregnancy (preeclampsia, etc.).
4. Bad habits of the mother during pregnancy.
5. Intoxication of the mother’s body during pregnancy, chemical poisoning or radiation exposure.
6. Disorders of the hypothalamus.
7. Infectious diseases suffered by a woman - rubella, mumps, etc.
8. Surgeries on the female organs can lead to early ovarian depletion.
9. Abuse of diets, general exhaustion of the body, vitamin deficiencies.

Symptoms of ovarian failure

If you suspect ovarian depletion, the symptoms you need to pay attention to are:

The first sign of SPIA may be the sudden cessation of menstruation. However, this does not always happen abruptly. At first, the cycle may be disrupted and its duration may increase, which is called oligomenorrhea. In this condition, the interval between periods can increase to 40 days, and sometimes more.

Often, SPIA is accompanied by the same symptoms as the onset of menopause - frequent mood changes, a woman feels hot and then cold, often suffers from migraines, and sleep disturbances are observed. In addition, libido decreases, and dry mucous membranes are felt in the genitals, which interferes with normal sexual intercourse. In women, performance decreases, and memory deterioration is often observed. Due to the similarity of the symptoms of this pathology with menopause, premature ovarian failure syndrome is often called early menopause.

Methods for diagnosing SPIA

To diagnose a woman with premature ovarian failure, it is necessary to first conduct some research. First, the doctor collects information about the patient - her medical history. The doctor is interested in the woman’s complaints, as well as the diseases she currently has and those she suffered previously. Next, laboratory and other tests are carried out. What is checked if you suspect SPIA?

Hormonal status – anti-Müllerian hormone levels must be assessed. If it has low values, and gonadotropic hormones, on the contrary, are increased three times the norm, one can judge the presence of premature depletion syndrome of female ovaries. But that’s not all - they also examine the biochemistry of the blood and evaluate the patient’s metabolism. Ultrasound of the female organs is very revealing. With its help, the doctor will determine the size of the uterus and ovaries (they are reduced in SPIA), and will also see whether the follicles in them are maturing. If they are absent, then a conclusion can be drawn regarding the pathology - premature ovarian failure.

Treatment of ovarian exhaustion

Taking hormones is the only effective way to treat SPIA today. The doctor will prescribe the patient to take female sex hormones - estrogens and gestagens, which are lacking in her body. In addition to hormone replacement therapy, women with this pathology are recommended general strengthening procedures - therapeutic exercises, massage, health baths with the addition of pine needles, and sedatives are prescribed. Hormone replacement therapy helps restore women's health, thanks to which the patient's reproductive function returns and is maintained until the onset of menopause.

Prevention measures

To prevent a woman from experiencing ovarian depletion and nerve-wracking treatment, it is best to take preventive measures in advance. How to avoid developing premature ovarian failure syndrome? There are general recommendations that a young woman should follow, especially if there is a risk of developing this pathology due to a hereditary factor.

1. Give up exhausting diets, eat nutritiously, take vitamin complexes twice a year.
2. Monitor the level of anti-Mullerian hormone.
3. Treat any viral infections on time.
4. Do not stimulate ovulation without doctor's instructions.
5. Regularly visit a gynecologist and have an ultrasound of the pelvic organs.

Of course, such measures will help to some extent reduce the risk of premature depletion of female ovaries, but they cannot provide a 100% guarantee of protection if the cause of such pathology lies in a disruption of the central nervous system or there are congenital defects.

If you experience irregularities in your menstrual cycle or are experiencing signs of menopause, although this should not be the case at your age, seek help from a gynecologist. Perhaps the cause is premature ovarian failure. Timely treatment will help cope with the problem, and you may still be able to get pregnant.

Prematurely exhausted ovarian syndrome occurs in 2% of women among the world's population. The gonads cease to perform their function long before physiological aging. This affects not only the ability to have children, but also the woman’s entire body as a whole. The disease is difficult to treat. Women in most cases remain infertile; IVF (in vitro fertilization) is required to give birth to a child.

Causes

The disease does not have a specific cause. Cessation of ovarian function occurs due to a combination of predisposing factors:

• genetic disorders - the syndrome is often inherited;
• autoimmune diseases;
• disorders during intrauterine development;
• viral infections suffered in childhood - measles, rubella;
• strict diet, vitamin deficiency;
• ovarian injuries during surgical interventions;
• constant stress;
• ovarian cysts.

Under the influence of these factors, the follicular apparatus is prematurely replaced by connective tissue and their production of sex hormones ceases. In the presence of congenital pathologies, the wasting syndrome is called primary. The secondary form is spoken of if there was exposure to external factors.

Symptoms

Manifestations of early ovarian failure syndrome begin in women aged 35-40 years, less often in younger women.

Before signs of the disease appear, menstrual and reproductive functions are completely preserved. The girl undergoes menarche in a timely manner, her cycle is then regular, and full-fledged pregnancies are possible.

Suddenly, a disturbance of the monthly cycle occurs, such as oligomenorrhea, and then a complete absence of menstruation. This is accompanied by symptoms of menopause:

• the appearance of hot flashes - a sudden feeling of heat in the face and upper half of the body;
• vegetative-vascular disorders - sweating, difficulty breathing, heart pain;
• increased irritability, insomnia.

As hormone levels decrease, the following changes develop:

• dry skin and mucous membranes;
• formation of atrophic colpitis;
• development of mastopathy;
• osteoporosis.

A woman's libido decreases, sexual intercourse becomes painful. The process of urination is disrupted, and urinary incontinence is possible. The reproductive function completely disappears - the woman cannot become pregnant. This occurs because the eggs in the ovary stop maturing. In their place, connective tissue is formed. The woman's appearance changes. The skin becomes dry, covered with wrinkles and age spots. The condition of the nails is disturbed - they break, white stripes appear on them. Hair is falling out more and more.

During a gynecological examination, pronounced dryness of the mucous membrane, a decrease in the size of the uterus, and the absence of cervical mucus are noted. Basal temperature stops changing, it remains constantly at the same level. Ultrasound reveals small ovaries with no follicles.

Wasting syndrome leads to a general imbalance of hormonal balance in the female body. The risk of developing thyrotoxicosis, diabetes mellitus, and metabolic syndrome increases. A woman's weight increases, signs of hyperandrogenism appear - a low voice, increased growth of body hair, oily skin on the face.

Treatment

Changes in the ovaries are irreversible; it is currently not possible to restore their normal structure. Therefore, treatment is aimed at correcting symptoms and improving the woman’s quality of life. The main method is the use of hormone replacement therapy. Drugs containing different combinations of hormones are prescribed:

• ethinyl estradiol is recommended for young girls in combination with desogestrel or gestodene;
• Older women are prescribed estradiol with levonorgestrel or dydrogesterone.

It is necessary to take hormonal drugs constantly, until the age corresponding to the physiological menopause. For severe vaginal dryness and urination disorders, suppositories and gels containing hormones are prescribed. As a complement to hormone replacement therapy, treatment with folk remedies is carried out. It involves the use of products and plants containing phytoestrogens. The diet should include the following:

• walnuts, peanuts - they contain vitamin E, which is involved in the formation of sex hormones;
• cauliflower and caviar include lecithin;
• Flaxseed oil is a source of phytoestrogens.

To eliminate irritability and insomnia, women are prescribed decoctions of lemon balm, valerian, and hop cones. Use a decoction and infusion of red brush or boron uterus. Phytoestrogens are also contained in various homeopathic remedies - Klimadinon, Remens. Homeopathy treatment is not always effective, so replacing real hormones with such drugs is not recommended. Medicines are taken under regular medical supervision.

Physiotherapy has a good effect. They promote blood flow to the pelvic organs, slow the progression of the disease, and eliminate symptoms. Women are prescribed the following procedures:

• Charcot's shower;
• electrophoresis of drugs;
• UHF (ultra high frequency therapy);
• paraffin and ozokerite applications.

It is recommended to carry them out annually, in courses of 10-15 procedures. Treatment has only a symptomatic effect, but cannot restore the full functioning of the ovaries. Therefore, pregnancy does not occur naturally. To realize a woman’s reproductive function, she has to resort to the procedure of artificial insemination - IVF. Its essence lies in the fact that already fertilized eggs are transplanted into the uterus. They are taken from a healthy female donor. Pregnancy is possible at the very beginning of the disease, when there are still preserved eggs. However, it is not always possible to make a diagnosis at an early stage.

Early menopause or, as it is also called, ovarian wasting syndrome is an endocrine pathology that is manifested by secondary amenorrhea, infertility and vegetative-vascular disorders. It is worth noting that this disease affects women under 38 years of age who in the past had normal menstrual and reproductive function. Good afternoon, dear readers. You have come to the author’s blog of endocrinologist Dilyara Lebedeva “Hormones are normal!”

Women care more about their youth and beauty than men, and every woman strives to maintain her attractiveness for 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 appearance, 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 is known, 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. When the concentration of estrogen in the body decreases, degenerative processes begin to occur, aimed at aging the body. But ovarian wasting syndrome can be eliminated by prescribing medications, but more on that later, at the end of the article.

What causes early menopause?

According to experts, the main causes of ovarian wasting syndrome are chromosomal mutations and autoimmune disorders. Manifestations of these disorders are considered to be underdeveloped ovaries with follicle deficiency, primary damage to 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 medications, fasting, influenza virus, etc. Quite often, the influence of unfavorable factors was detected in intrauterine development (maternal concomitant diseases, gestosis and toxicosis). The occurrence of this disease is facilitated by severe stressful situations and infectious diseases.

How do you know that early menopause has begun?

Characterized by menstrual irregularities up to amenorrhea (absence of menstruation). Persistent amenorrhea in this disease is characterized by vegetative-vascular manifestations.

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 this disease have the correct physique. Obesity is not typical for ovarian wasting syndrome.

Diagnosis of the disease

The basis for diagnosing early menopause is the history and clinical signs. The timeliness of the onset of menstruation and the absence of disorders of menstrual and reproductive function for 10-20 years are noted.

Decreased ovarian function contributes to severe, persistent hypoestrogenism. Evidence of this is a negative pupil symptom, monophasic basal temperature, and a 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 reduced sizes of the uterus and ovaries. An ultrasound examination reveals a thinned uterine mucosa. Ovarian wasting syndrome is also indicated by the absence of follicles in the ovary.

To study the condition of the ovaries in depth, hormonal tests are used. Tests with estrogens and combined regimens are carried out. In this case, it is possible to clarify the nature of amenorrhea.

Treatment of ovarian wasting syndrome

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

Infertility is considered an indication for the use of assisted reproductive technologies. We are talking, first of all, about in vitro fertilization (IVF). It should be noted that it makes no sense to stimulate the exhausted follicular apparatus of the ovaries.

Provides for hormone replacement therapy. For this purpose, estrogen preparations, for example, progynova, are used. The regimen and regimen of administration is decided individually with each woman, with subsequent monitoring of 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 just a few decades ago, it was simply impossible for them to maintain women’s health, since hormonal drugs appeared not so long ago.

– premature cessation of ovarian function in women under 40 years of age who previously had normal menstrual and reproductive function. Ovarian depletion syndrome is manifested by secondary amenorrhea, infertility, and vegetative-vascular disorders. Diagnosis of ovarian wasting syndrome is based on data from functional and drug tests, studies of hormone levels, ultrasound, and laparoscopic ovarian biopsy. The treatment uses HRT, physiotherapy, and vitamin therapy. To achieve pregnancy, patients with ovarian wasting syndrome require IVF using donor oocytes.

Treatment of ovarian wasting syndrome

Therapy for ovarian wasting syndrome is aimed at correcting vegetative-vascular and estrogen deficiency conditions - general health, urogenital disorders, osteoporosis, cardiovascular pathology. The best results are achieved when HRT is prescribed in the regimen