Often at a gynecologist's appointment, a woman finds out that anovulation is the reason for her lack of pregnancy. This pathological condition is characterized by a violation of the menstrual cycle and the absence of ovulation. In this article, we will analyze the causes of the disease and possible treatment.
Description of pathology
Anovulation is a disorder of the menstrual cycle in which the ovaries do not perform their functions. At the same time, the dominant follicle does not develop or its membrane does not break. In the development of infertility, anovulation plays a huge role, being one of the main causes of pathology. The frequent absence of ovulation provokes severe disruptions of the menstrual cycle, and sometimes its complete absence. It is worth noting that in he althy women, 1-2 cycles per year do not end with the release of an egg. This is not a pathological condition and does not pose a threat to women's he alth. The diagnosis of chronic anovulation is made if ovulation does not occur for several consecutive cycles.
Classification
Specialists distinguish two types of disease. Let's take a closer look at them.
Physiological. In this case, the absence of ovulation is considered a variant of the norm.
- May occur during adolescence when the menstrual cycle is just beginning to form.
- With menopause.
- During pregnancy and lactation, the occurrence of anovulation is affected by an increased content of prolactin in the blood of a woman.
- It happens that by the lack of ovulation, the body reacts to stressful situations, overwork.
- When the climate changes. After a while, the condition will stabilize.
Pathological (chronic) type. Anovulation in this case can be provoked by a large number of factors - for example, ovarian damage, hormonal disruptions, and others. It happens that a woman finds out about the diagnosis by accident, since the menstrual cycle is not disturbed.
Reasons
There are many reasons for anovulation. Their definition is very important when drawing up a treatment program.
Disorders can be caused by:
- Hormonal failure. This is the main reason for the development of the disease, because hormones affect the work of the entire reproductive system of a woman. Violations can cause even slight fluctuations.
- Pregnancy and lactation. In this case, anovulation is caused by an increased level of prolactin in the body of a woman, which inhibits the production of FSH, which is responsible for the process of egg maturation in the follicle.
- Congenital pathologies of femalegenitals.
- Infectious diseases.
- Chronic inflammatory processes of the pelvic organs.
- Polycystic ovaries. With this pathological condition, the follicle shell is too dense. The egg fails to break through and ovulation does not occur.
- Obesity. Excess adipose tissue provokes the growth of estrogens, which inhibit ovulation.
- Endometriosis.
- Intoxication.
- Stress.
- Genetic factor.
- Late puberty.
- Excessive exercise.
- Anorexia.
- Eating disorders.
- Incorrect use of oral contraceptives.
Symptoms
An interesting fact is that the symptoms of anovulation may not appear. In this case, the woman learns about the pathology after an ultrasound examination and passing a series of tests. The reason for visiting the doctor in most cases is the inability to conceive.
The most common signs of pathology include:
- Irregularity of the menstrual cycle. In this case, menstruation may not be for several months, or they occur several times per cycle. Periods during anovulation can be very scanty or resemble bleeding.
- Changing the nature of the selection. Normally, a woman's discharge varies depending on the phase of the cycle. This does not happen with anovulation.
- If the cause of the pathology is increased prolactin, you can notice changes in the mammary glands - mastopathy. May also be of concernbreast tenderness.
- Acne.
- Excessive body hair growth. This happens due to hormonal disorders, when male hormones begin to prevail over female ones.
- There is no increase in basal temperature in the middle of the cycle.
- Failure to conceive.
Diagnosis
Since completely different factors can provoke the development of anovulation, diagnostic measures are very important. The doctor will not be able to prescribe effective therapy without an accurate diagnosis and the causes of its occurrence.
Common diagnostic methods today are the following activities:
- First of all, you need to get advice from a specialist. The doctor will collect an anamnesis of the disease, clarify the presence of chronic diseases, the duration and nature of menstruation.
- Taking a smear to check for infections, inflammation and dysbacteriosis.
- Complete urinalysis.
- General and biochemical blood tests.
- Donating blood for hormones is an important diagnostic method, since it is hormonal imbalances that are the main cause of anovulation.
- Basal temperature measurement. This is not an accurate method, since third-party factors can also influence the readings - stress, lack of sleep, taking alcoholic drugs, medicines.
- Express tests to determine ovulation. Their principle of operation is the same as that of pregnancy tests. Their peculiarity is that the testthe strip should be much brighter than the control. It is performed the day before the expected ovulation. But doctors recommend using this method for a few days.
- The most informative diagnostic method is an ultrasound examination of the pelvic organs. With the help of this procedure, you can learn about pathological processes, determine the size of the uterus, ovaries, and the thickness of the endometrium. Folliculometry is also performed. This is an ultrasound examination of the ovaries. Using this method, the number of follicles is determined, the presence of a dominant one is determined. Folliculometry is recommended to be carried out in the middle of the cycle every 2-3 days. If the dominant follicle has ruptured, the doctor will see a small amount of free fluid in the abdomen and the presence of a corpus luteum. If these signs are not monitored, and the dominant follicle is not determined at all, then there was no maturation and release of the egg.
- Thyroid ultrasound.
- Laparoscopic examination.
Menstruation during anovulation
Despite the fact that the pathology causes cycle disorders, there are cases in which anovulation occurs during regular periods. Both natural and pathological causes can contribute to this.
Natural include:
- Anovulatory cycles in young girls. This condition occurs during the first menstruation, when the hormonal background has not yet fully returned to normal. After a while, the condition will stabilize.
- Using hormonal contraceptives that block ovulation.
To pathologicalfactors include:
The presence of infectious processes, such as mycoplasmosis, chlamydia and others
Treatment
Definition of therapy is impossible without diagnostic measures. Having specified the causes and symptoms of anovulation, the treatment is selected by the gynecologist individually in each case. Therapy includes drug treatment, the use of traditional medicine and diet. In more severe cases, surgery may be indicated.
The main treatment will be aimed at stabilizing the hormonal background, because it is endocrine disorders that are the most common reason for the lack of ovulation.
- In case of obesity or diseases associated with pathological thinness, it is recommended to adjust the diet and follow a certain diet.
- If the culprit of anovulation was an increased level of prolactin in the blood, then drugs are prescribed to normalize it. But it is worth remembering that increased values \u200b\u200bmay appear once due to third-party factors - stressful situations, taking certain medications. It is necessary to retake the analysis. When a pathological increase in the hormone is confirmed, hormonal therapy is prescribed. Drugs such as Bromkriptin, Parlodel may be prescribed.
- If the problem is caused by thyroid disorders, thyroid hormone treatment is used.
- If all possible causes have been eliminated, but ovulation does not occur, it may be necessary to stimulate it with hormonaldrugs.
Medications
The following medicines are used in most cases:
- "Klostilbegit" is an antiestrogen drug that takes part in the formation of the dominant follicle and the maturation of the egg.
- Since taking "Klostilbegit" can significantly reduce the level of estrogen in the blood, which can affect the thickening of cervical mucus, drugs are prescribed to compensate for the lack of estrogen and prevent early ovarian exhaustion. These include Proginova.
- HCG is prescribed to break the follicle shell and release the egg. A few days later, ultrasound control is needed to confirm that ovulation has occurred.
- Approximately from the 16th day of the cycle, progesterone preparations are prescribed to support the corpus luteum. "Utrozhestan" and "Dufaston" during anovulation increase the chances of becoming pregnant and bearing a child, since a lack of progesterone can suppress ovulation, and in case of fertilization, prevent the egg from attaching to the uterus.
It is important to remember that stimulation drugs are prescribed by the attending physician individually in each case. The procedure must take place under strict ultrasound guidance.
Folk remedies
The treatment of anovulation with folk remedies has proven itself well. The use of herbs can normalize the menstrual cycle, restore ovulation and promote conception.
There are certain rules in the treatment of folk remedies.
- It is forbidden to drink herbaldecoctions during menstruation.
- Before taking, it is necessary to clarify the cause of anovulation and take a hormone test.
- Therapy should last at least three months, after which a break is taken.
- If pregnancy occurs, traditional medicine is discontinued.
- Hormonal drugs should not be taken during herbal treatment.
- All treatment should be under the supervision of the attending physician and ultrasound. Periodically, you need to check the hormonal background.
Herbs in the treatment of pathology
Herbs used in the treatment of pathology include:
- Sage. Plant analogue of estrogen. Promotes the growth of the follicle, the maturation of the egg and its release. It has a beneficial effect on the entire reproductive function of a woman. Contraindications include: kidney disease, bleeding and thyroid disease.
- Plantain. The seeds of the plant are used in the treatment of female diseases.
- Upland uterus. This herb is used to treat many gynecological diseases. But misuse can cause bleeding.
- Aloe. Moreover, the plant must be 5 years old, and before preparing the medicine, aloe should not be watered for a week.
The use of folk recipes in the treatment of anovulation can bring very effective results. But you need to remember that before using herbs, you need to consult with your doctor, as improper use can aggravate the situation, causing serious complications.
Additional treatments
Besidesdrug therapy and the use of traditional medicine, there are situations in which a surgical method of treatment may be indicated.
In most cases, laparoscopy is used to treat anovulation. This method is used for diagnostic purposes or for polycystic disease.
Physiotherapy, mud therapy, therapeutic baths may also be recommended.
Cons of ovarian stimulation
Despite the fact that stimulation is an effective way to get pregnant, not all women can use this type of treatment. For example, when producing defective eggs or in the presence of genital infections, stimulation is not recommended.
It is also important to remember that no more than five such procedures can be performed in a lifetime, as this method depletes the ovaries, which can lead to early menopause.
Conclusion
Anovulation is a serious pathological condition, which, as a rule, is more a symptom of other diseases. When determining the method of treatment, it is necessary to undergo the necessary tests, as a result of which therapy is prescribed. When determining the most effective therapy, the likelihood of recovery is very high.
