Often at the appointment with a gynecologist, a woman learns that the reason for her lack of pregnancy is anovulation. It is a pathological condition characterized by menstrual irregularities and a lack of ovulation. In this article, we will analyze the causes of the disease and possible treatment.
Pathology Description
Anovulation is a disorder of the menstrual cycle in which the ovaries do not perform their functions. In this case, the dominant follicle does not develop or its membrane does not rupture. Anovulation plays a huge role in the development of infertility, being one of the main causes of pathology. Frequent lack of ovulation provokes severe malfunctions of the menstrual cycle, and sometimes its complete absence. It is worth noting that in healthy women 1-2 cycles per year do not end with the release of the egg. This is not a pathological condition and does not pose a threat to women's health. 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 consider them in more detail.
Physiological. In this case, the absence of ovulation is considered to be a normal option.
- It can occur in the teenage period when the menstrual cycle is just beginning to take shape.
- With menopause.
- During pregnancy and lactation, the occurrence of anovulation is influenced by the increased content of prolactin in the blood of a woman.
- It happens that the absence of ovulation, the body reacts to stressful situations, overwork.
- When changing climate. After a while, the condition stabilizes.
Pathological (chronic) type. In this case, a large number of factors can provoke anovulation - 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 broken.
Causes
There are many causes of anovulation. Their definition is very important when drawing up a treatment program.
Disorders can be caused by the following factors:
- Hormonal disbalance. This is the main reason for the development of the disease, because hormones affect the work of the entire reproductive system of women. Violations can cause even slight fluctuations.
- Pregnancy and lactation. In this case, anovulation causes 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 disorders of female genital mutilation.
- Infectious diseases.
- Chronic inflammation of the pelvic organs.
- Polycystic ovaries. In this pathological condition, the follicle membrane is too dense. The egg is unable to break through it 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 occur. In this case, the woman learns about the pathology after an ultrasound scan and a series of tests. The reason for visiting a doctor in most cases is the inability to become pregnant.
The most common signs of pathology include:
- Irregular menstruation. In this case, menstruation may not occur for several months or they occur several times per cycle. Menstruation during anovulation can be very scarce or resemble bleeding.
- Change the nature of the discharge. Normally, in a woman, the discharge varies depending on the phase of the cycle. With anovulation, this does not happen.
- If the cause of the pathology is increased prolactin, you can notice changes in the mammary glands - mastopathy. Breast tenderness may also be a concern.
- Acne.
- Excessive hair growth on the body. This happens due to hormonal disorders, when male hormones begin to prevail over female ones.
- In the middle of the cycle, there is no increase in basal temperature.
- Inability to get pregnant.
Diagnostics
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 reasons for its occurrence.
Common diagnostic methods to date are the following:
- The first step is to consult 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 in order to check for infections, inflammatory processes and dysbiosis.
- General urine analysis.
- General and biochemical analysis of blood.
- Blood donation for hormones is an important diagnostic method, since it is hormonal disorders that are the main reason for the development of anovulation.
- Basal temperature measurement. This is not an accurate method, since the readings can be influenced by third parties and factors - stress, lack of sleep, intake of alcoholic products, medicines.
- Rapid tests to determine ovulation. The principle of action for them is the same as for tests to determine pregnancy. Their peculiarity is that the test strip should be much brighter control. Executed one day before the expected ovulation. But doctors recommend using this method for several days.
- The most informative diagnostic method is an ultrasound examination of the pelvic organs. Using this procedure, you can find out about pathological processes, determine the size of the uterus, ovaries, endometrial thickness. 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 is determined. Folliculometry is recommended in the middle of the cycle every 2-3 days. If the dominant follicle bursts, the doctor will see a small amount of free fluid in the abdominal cavity and the presence of the 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.
- Ultrasound of the thyroid gland.
- Laparoscopic examination.
Menstruation with anovulation
Despite the fact that pathology causes cycle disorders, there are cases in which anovulation occurs with regular menstruation. Both natural and pathological causes can contribute to this.
The natural ones include:
- Anovulatory cycles in young girls. This condition occurs during the first menstruation, when the hormonal background has not yet fully normalized. After a while, the condition stabilizes.
- Taking hormonal contraceptives that block ovulation.
Pathological factors include:
- The presence of infectious processes, for example, mycoplasmosis, chlamydia and others.
Treatment
The 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 medication, the use of traditional medicine and a 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 cause of lack of ovulation.
- In case of obesity or diseases associated with pathological thinness, dietary adjustment and adherence to a certain diet are recommended.
- If the cause of anovulation is an increased level of prolactin in the blood, then drugs are prescribed to normalize it. But it is worth remembering that increased values can appear once because of third-party factors - stressful situations, taking certain medications. It is necessary to retake the analysis. With confirmation of a pathological increase in the hormone, hormone therapy is prescribed. Such drugs as Bromkriptin, Parlodel can be prescribed.
- If a problem in the thyroid gland provoked a problem, 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 hormonal drugs.
Medicines
In most cases, the following drugs are used:
- "Clomid" - anti-estrogenic drug, which is involved in the formation of the dominant follicle and egg maturation.
- Since taking Klostilbegit can significantly reduce blood estrogen levels, which can affect the thickening of cervical mucus, drugs are prescribed that make up for the lack of estrogen and prevent early ovarian exhaustion. These include Proginova.
- To rupture the follicle membrane and release the egg, an hCG drug is prescribed. After a few days, ultrasound monitoring is necessary to confirm the ovulation that has occurred.
- About 16 days cycle to support the corpus luteum is appointed by progesterone drugs. When anovulation, Utrozhestan and Dufaston increase the chances of getting pregnant and having a baby, since a lack of progesterone can inhibit ovulation, and in case of fertilization, prevent the egg from attaching to the uterus.
It is important to remember that the medication for stimulation is prescribed by the attending physician individually in each case. The procedure should take place under strict US control.
Folk remedies
Treatment of anovulation with folk remedies has worked well. The use of herbs can normalize the menstrual cycle, restore ovulation and contribute to conception.
There are certain rules in the treatment of folk remedies.
- It is forbidden to drink herbal decoctions during menstruation.
- Before taking, it is necessary to clarify the cause of the anovulation and pass an analysis for hormones.
- Therapy should last at least three months, after which a break is made.
- If pregnancy has occurred, the reception of traditional medicine is stopped.
- In the treatment of herbs should not take hormones.
- All treatment should be supervised by the attending physician and ultrasound. Periodically, you need to check the hormones.
Herbs in the treatment of pathology
The herbs used in the treatment of pathology include:
- Sage. Herbal analogue of estrogen. Promotes the growth of the follicle, the maturation of the egg and its exit. Beneficial effect on the entire reproductive function of women. Contraindications include: kidney disease, bleeding, and thyroid disease.
- Plantain. In the treatment of female diseases, plant seeds are used.
- Pine uterus. This herb is used to treat many gynecological diseases. But improper intake can cause bleeding.
- Scarlet. Moreover, the plant must be 5 years old, and before preparing the drug aloe should not be watered for a week.
Application folk recipes in treating anovulation can produce very effective results. But you need to remember that before using herbs, you should consult your doctor, as improper administration can aggravate the situation, causing serious complications.
Additional treatments
In addition to drug therapy and the use of traditional medicine, there are situations in which a surgical method of treatment can be indicated.
In most cases, laparoscopy is used to treat anovulation. This method is used for diagnostic purposes or for polycystic.
Physiotherapy, mud therapy, and therapeutic baths may also be recommended.
Cons Ovarian Stimulation
Despite the fact that the stimulation is an effective method for pregnancy, not all women can apply this kind of treatment. For example, when developing 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, since this method depletes the ovaries, which can lead to an early menopause.
Conclusion
Anovulation - 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, following which therapy is prescribed. When determining the most effective therapy, the probability of recovery is very high.