Ovarian wasting syndrome is commonly called the premature cessation of ovarian function in women of childbearing age. This condition can develop in women under forty years of age who previously had a normal menstrual cycle and the ability to conceive. Ovarian wasting syndrome is also called premature menopause.
If you are affected by this problem, you may notice that your sexual desire has decreased, hot flashes occur as during menopause, and your mood has become unstable. All this happens in the background absence of menstruation due to the fact that your body begins to produce fewer female sex hormones.
Ovarian wasting syndrome is characterized by the fact that the number of follicles decreases, which means it stops happening.
Mechanism and causes of development of ovarian wasting syndrome
It is worth noting that the exact reasons for the development of ovarian depletion syndrome in women have not yet been identified, but medical scientists suggest that this may be facilitated by:
- some congenital chromosomal abnormalities;
- autoimmune processes;
- CNS lesions.
In addition to these physiological factors, there are a number of other influences that can trigger the development of primary and secondary ovarian failure syndrome. You may be at increased risk of developing primary ovarian failure syndrome if your mother:
- was exposed to radioactive radiation;
- suffered from rubella, influenza, mumps;
- took medications or had contact with chemicals that could harm the fetus.
The development of the secondary form of ovarian wasting syndrome can be influenced by the following factors:
- exposure of your body to radiation or harmful chemicals;
- exhausting diets, starvation;
- previous chemotherapy;
- a history of ectopic pregnancy;
- multiple independent .
It is important to say that one of the main factors influencing the development of ovarian wasting syndrome is heredity. The conducted studies helped to establish that such a pathological condition occurs much more often in those women whose close relatives had similar symptoms of ovarian depletion.
Signs of ovarian exhaustion
The main symptom of this pathological condition is. In some cases, the complete cessation of menstruation may be preceded by a period of oligomenorrhea, during which menstruation becomes scanty and irregular. However, if your period stops suddenly, this may also indicate ovarian wasting syndrome. In this case, you will most likely have clinical manifestations characteristic of menopause:
- hot flashes combined with increased sweating, as well as redness of the skin in the chest and neck area;
- dryness in the area of the external genitalia, discomfort and even pain may occur during sexual intercourse;
- decreased libido;
- irritability, frequent mood swings, depression;
- memory impairment, general decrease in performance.
All of the above symptoms significantly contribute to a decrease in a woman’s quality of life. However, based on the clinical picture alone, the diagnosis of ovarian failure is not made. If you notice the signs described above, contact us - experienced doctors will conduct all the necessary diagnostic tests and help you cope with unpleasant symptoms.
Diagnostics in our clinic
If you suspect ovarian wasting syndrome, our doctors will suggest you undergo a comprehensive examination, which will include:
- collecting a detailed medical history - you need to tell the doctor in detail about what worries you (lack of menstruation, hot flashes, etc.), as well as about previous diseases;
- research - our specialist, using this analysis, will be able to reveal that the level of gonadotropic hormones has increased 3 times from the basal norm, anti-Mullerian hormone is critically low;
- study of metabolism, blood biochemistry, bioimpedance analysis;
- Ultrasound of the pelvic organs - a transvaginal ultrasound method will allow the doctor to assess the condition and size of the uterus, ovaries, and also notice the absence of primordial follicles;
During these studies, our specialists will be able to identify signs indicating ovarian wasting syndrome. Such signs certainly include: a decrease in the size of the uterus and ovaries, the absence of follicles in the ovaries and symptoms characteristic of menopause.
Possible complications
If you have been diagnosed with ovarian wasting syndrome, be sure to contact them so that they can prescribe you competent replacement therapy. If this is not done and the disease is allowed to take its course, this may be fraught with the following consequences:
- premature aging of the whole organism;
- increased risk of developing severe diseases of the cardiovascular system;
- osteoporosis, in which calcium levels decrease and increased bone fragility occurs;
- serious psychological problems up to severe depression;
- a decrease in the overall quality of life, including intimate life.
Treatment methods
To date, the only treatment for ovarian wasting syndrome is well-chosen hormone replacement therapy. Your doctor may prescribe natural estrogens and progestins, and high-dose oral contraceptives may also be used. Along with hormonal treatment, you may be prescribed physiotherapeutic procedures, vitamin therapy, metabolic therapy, and physical therapy.
If you want to have children, but you have been diagnosed with ovarian wasting syndrome, assisted reproductive technologies can be a solution to the problem. In our clinic, it is possible for this pathology using donor oocytes.
Preventive measures
If you are at risk of developing ovarian wasting syndrome, it is very important to adjust your lifestyle now before the first signs of pathology appear. The following tips will help you with this.
Exhausted ovarian syndrome is a pathological phenomenon represented by a complex of symptoms that characterize the onset of menopause. The disease is considered quite rare in gynecological practice. It occurs in women under 40 years of age who have had normal menstrual and reproductive function in the past.
With exhausted ovarian syndrome, their hypoplasticity is observed. They become small in size - 1.5x2.0 and 1.0x1.5 cm and light in weight - no more than 1-2 grams each. Such ovaries are correctly formed, but the number of primordial follicles in them is significantly reduced, so they will last for a too short reproductive period - 5-15 years. By the time reproductive function is completed, a sterile cortex with atrophying interstitial tissue develops in the ovaries.
During a gynecological examination, the doctor notes rapid hypoplasia of the uterus and a decrease in the estrogenic response of the mucous membranes. In depleted ovaries, eggs do not mature, therefore, the girl does not ovulate, and the corpus luteum, responsible for the production of estrogen and progesterone, does not form. Conception in such conditions is impossible.
Gynecologists distinguish two forms of exhausted ovarian syndrome:
- Primary. The total number of eggs is laid in a female fetus during the period of embryonic development. Thus, the newborn already has a supply of follicles, which begin to be used up from the onset of the first menstruation. Eggs should last up to 45-55 years, and in some women up to 60 years. When the supply is exhausted before this time, we can talk about exhausted ovarian syndrome.
- Secondary. Appears when the relationship between the pituitary gland and reproductive function is disrupted. The patient's lifestyle is important.
Causes of ovarian failure
The occurrence of ovarian wasting syndrome can be influenced by various factors, both external and hereditary. Almost 80% of patients were exposed to unfavorable factors during embryonic development, as well as during adolescence.
Anamnesis of hereditary data showed that in 45-50% of cases, women in the first and second degrees of kinship experienced menstrual dysfunction and relatively early menopause. Along with this, it is worth paying attention to some exogenous effects:
- severe intoxication of the body;
- pelvic organ infections;
- frequent stressful situations;
- bad habits;
- obesity;
- metabolic disorders;
- frequent instrumental abortions;
- autoimmune diseases;
- use of low quality intrauterine devices.
One of the causes of atresia of the follicular apparatus may be gene mutations.
During embryonic development, the likelihood of exhausted ovarian syndrome in a female fetus increases if the mother has suffered the following diseases and dangerous conditions:
- severe form of influenza;
- rubella;
- measles;
- intoxication with toxic vapors of chemical reagents;
- high doses of radioactive exposure;
- long-term use of medications harmful to the embryo.
Lifestyle has a great influence on the stable functioning of the organs of a woman’s reproductive system. Girls should avoid:
- exposure to strong toxic substances on the body;
- fasting;
- overeating;
- bad habits;
- frequent stimulation of ovulation using hormonal drugs.
At risk are women who make frequent attempts at in vitro fertilization. By artificially causing ovulation by taking hormonal drugs, they place an unbearable burden on the reproductive organs.
Symptoms of exhausted ovarian syndrome
The disease manifests itself as amenorrhea, lasting from six months to three years. A couple of months after the cessation of menstruation, the following symptoms are observed:
- "flushes" of heat to the head;
- variability of thermoregulation;
- low-grade fever;
- general weakness;
- redness of the skin of the face, neck and chest;
- dyspnea;
- increased drowsiness;
- frequent headaches;
- sudden heartbeats;
- decreased performance;
- loss of sexual desire.
Lack of estrogen causes dryness of the mucous membrane of the external genital organs and thinning of the vaginal walls, which provokes severe discomfort.
Dangerous complications when ovarian function declines
Estrogens are called “beauty hormones.” A decrease in these hormones in the blood immediately affects a woman’s appearance. This manifests itself in premature aging of the body. Unfortunately, such processes are generally considered irreversible. The first signs of aging appear in the following:
- loss of elasticity and firmness of the skin;
- the appearance of wrinkles on the body;
- noticeable hair loss on the scalp;
- the hair becomes dull and brittle;
- delamination of nail plates;
- the appearance of white spots and uncharacteristic relief on the nail plates;
- decreased joint mobility.
Of course, such metamorphoses have an extremely negative impact on the mental state of a woman, who is forced to accept that the aging process is beginning. Mood swings due to negative changes in appearance can manifest themselves in increased anxiety and irritability, as well as complete indifference to oneself and the entire world around us. Women during this period experience causeless outbursts of aggression, after which they may fall into prolonged depression. However, apathy can suddenly give way to impulses for vigorous activity.
Working women with ovarian failure syndrome may complain of:
- impaired concentration;
- forgetfulness;
- decreased performance;
- panic attacks;
- deterioration of interpersonal relationships in the team.
Often, when the production of one hormone decreases, the amount of other hormones may increase chaotically. Therefore, a sudden decrease in the concentration of progesterone and estrogen in the blood is fraught with consequences. The thyroid gland is one of the first to respond to the problem. Variability in the functions of the thyroid gland can cause undesirable symptoms:
- frequent heartbeats;
- tremor;
- jumps in basal temperature;
- blood pressure disorders;
- increased sweating;
- drowsiness.
Also, exhausted ovarian syndrome can trigger the development of autoimmune diseases:
- systemic lupus erythematosus;
- allergic reactions;
- malignant tumors;
- bronchial asthma.
Some complications may occur as a “hidden” type. This:
- type 2 diabetes mellitus;
- metabolic disorder;
- malignant tumor processes;
- heart failure.
A deficiency of female hormones can lead to an increase in the level of male hormones, for example, testosterone. Thus, a woman begins to notice how her body takes on a masculine shape, the hair on her head thins, and the hair growth on her skin increases in a “male” pattern.
Methods for diagnosing exhausted ovarian syndrome
To make the correct diagnosis, instrumental examinations and laboratory tests are prescribed after a gynecological examination.
Ultrasonography. Ultrasound collects detailed information about the condition of the pelvic organs. In this way, the size of the uterus, the thickness of the endometrial walls, the structure of the ovaries and the number of follicles in them are examined. The device will show signs of egg maturation.
Blood test for the concentration of sex hormones. With depleted ovaries, the results will differ significantly from the norm.
Laparoscopic examination. A flexible probe with a sensor is inserted into the abdominal cavity through a small incision in the abdominal wall, showing the condition of the internal organs.
Karyotyping. Quite a “young” diagnosis. Allows you to collect detailed information about the chromosomal structure.
When making a diagnosis, it is extremely important not to confuse the developing syndrome of exhausted ovaries with diseases that occur with similar symptoms. The signs of ovarian exhaustion look very vague, so attempts to make a diagnosis on your own will not bring a positive result.
Treatment and prevention of exhausted ovarian syndrome
Treatment of exhausted ovarian syndrome is reduced to sex hormone replacement therapy. If amenorrhea lasts too long, then a course of estrogenization is prescribed. Usually after this the first menstruation occurs. It can be very scarce and short-term, however, on its basis we can talk about the beginning of the regeneration process.
Following hormonal therapy, they begin to eliminate vegetative symptoms, manifested in “hot flashes” and increased sweating. Treatment is carried out in small doses until a positive result is obtained.
Hormone therapy is carried out until the age of natural menopause. In the spring months, courses of taking vitamin and mineral complexes are recommended.
As preventive measures for the decline of ovarian function, it is necessary to prevent the influence of unfavorable factors. This:
- toxicosis of pregnancy;
- unwanted pregnancy;
- infectious diseases at any age.
Every woman must observe safety measures during sexual intercourse, carry out timely diagnosis of various pathologies, and lead a healthy lifestyle.
The diet should not contain alcohol, tonics and sweet carbonated drinks, too fatty and salty foods. Products rich in plant fiber and microelements will have a beneficial effect on the functioning of all internal organs.
The ovaries are a paired organ of the female reproductive system in which the maturation of eggs and the synthesis of sex hormones occur. A woman’s well-being, appearance and health largely depend on their work. The production of small amounts of hormones occurs in the ovaries throughout life, and their peak activity occurs during childbearing age, which lasts on average 35-37 years.
Afterwards comes menopause - the natural decline of female reproductive function. Such changes do not happen to a woman by chance. With age, not only the body ages, but also the genetic material transmitted with the egg to the offspring. Age-related changes in germ cells lead to numerous errors in DNA, which often results in serious illnesses for the child. Thus, the frequency of birth of a baby with Down syndrome increases exponentially after 40 years.
Ovarian wasting syndrome is a pathological condition in which a woman’s menopause occurs much earlier than the aging process. It usually occurs before the age of 40 against the background of normal reproductive function. The syndrome is rare - according to statistics, its prevalence in the population does not exceed 3%. Hereditary transmission of ovarian wasting syndrome is observed: in most cases, there are indications of similar problems in the mother or immediate blood relatives.
Causes of pathology
To date, there is no consensus on the cause of premature ovarian failure syndrome. The only known consequence is a sharp cessation of follicle maturation and, accordingly, the synthesis of sex hormones. During the prenatal development of a girl, a strictly defined number of primordial follicles are formed in her gonads and on average it is 400 thousand. After birth and until puberty, they are in an inactive state, since their maturation requires a signal from the outside - hormones of the hypothalamus and pituitary gland.
The listed structures are located in the brain and are responsible for the functioning of the endocrine glands of the body like a conductor. At the time of puberty, the amount of GnRH increases, which, in turn, stimulates the synthesis and release into the blood of follicle-stimulating (FSH) and luteinizing hormones (LH). Under their influence, the growth of primordial follicles begins inside one of the ovaries. From 5 to 15 vesicles develop at the same time, but only one of them will reach final maturity and release an egg during ovulation. As it develops, structures are formed that synthesize female sex hormones - estrogens.
During ovulation, the follicle bursts, the egg is released into the fallopian tube, and the membrane remaining from the vesicle is transformed into the corpus luteum. The latter synthesizes progesterone, the pregnancy hormone. Under its influence, the female body prepares to conceive and bear a child. The described processes are also controlled by hormones of the pituitary gland and hypothalamus according to the type of negative feedback. This means that with a high level of estrogen or progesterone in the blood, the production of FSL and LH is suppressed, the ovaries reduce the activity of the synthesis of their own hormones and the endocrine balance in the body is restored.
As already mentioned, the supply of primordial follicles is established during intrauterine development and is not replenished throughout life. Therefore, after each menstrual cycle it decreases and as soon as it reaches a certain minimum, the woman experiences menopause. On average, the ovarian reserve lasts up to 45-55 years of life. Early ovarian failure syndrome has the same morphological basis - the number of follicles is insufficient to further maintain reproductive function, however, it occurs much earlier than the specified age.
Among the provoking factors of the syndrome are:
- genetic defects - in women whose mothers suffer from this pathology, it develops much more often than average;
- negative factors affecting the prenatal development of a girl - maternal illness, severe psycho-emotional stress during pregnancy, poisoning, trauma disrupt the process of formation of primordial follicles in a female fetus, and therefore their number can be sharply reduced compared to the norm;
- resection of the ovary during surgery to remove a tumor or gonadal cyst - a sharp decrease in the amount of ovarian tissue sometimes leads to premature depletion of the ovaries and menopause;
- the influence of unfavorable environmental factors (poisons, toxins, viral infections, medications) - affecting ovarian tissue, they lead to an inflammatory process, as a result of which functional cells are replaced by connective tissue.
Manifestations
The symptoms of ovarian wasting syndrome are identical to those of menopause. First of all, a woman pays attention to the irregularity of the menstrual cycle. Menstruation does not occur every month, becomes scanty and gradually disappears altogether. Against this background appear:
- Hot flashes and sweating - they occur suddenly, usually at night, after stress, heavy food, or a change in ambient temperature. The woman suddenly gets hot, she sweats profusely, the skin of her face and upper chest turns red. There may be a feeling of palpitations, pain in the chest, darkening of the eyes and a short-term loss of consciousness.
- Changes in psycho-emotional status - a woman becomes irritable, tearful, and prone to depressive thoughts. Any existing mental abnormalities are aggravated, be it manic-depressive psychosis, psychopathy, or depression. Night sleep is disturbed, anxiety appears, and libido decreases.
- Disorders in the urogenital tract - a lack of estrogen with depleted ovaries leads to atrophy of the mucous membrane of the vagina and vulva, a feeling of dryness, itching in the genitals and urethra, chronic inflammatory processes (colpitis, vulvitis, urethritis). Sex life becomes unpleasant due to dryness and burning during intercourse.
- Skin aging – in the presence of ovarian depletion syndrome, it loses its elasticity, becomes thinner, and numerous wrinkles appear on the face and hands. Hair becomes dull, brittle, dry, and its density decreases due to excessive hair loss. Nails change: the nail plate peels off, grooves, irregularities, and white spots appear on it.
- Metabolic disorders - the concentration of other hormones in the blood changes. There may be insufficiency of the thyroid gland or its excessive activity, leading to thyrotoxicosis. The latter is manifested by hand tremors, anxiety, outbursts of anger, palpitations, increased blood pressure and body temperature. In some cases, type 2 diabetes mellitus, metabolic syndrome, and hyperadrogenism develop—a partial change in a woman’s body into a male pattern due to the predominance of testosterone.
Without appropriate treatment, the symptoms of ovarian wasting syndrome progress, complicating a woman’s life and disrupting her activity.
Necessary research
Diagnosis of the syndrome is within the competence of a gynecologist, gynecologist-endocrinologist. The doctor collects anamnesis, paying special attention to heredity and harmful factors. He studies the complaints, the time of their appearance and examines the patient. Externally, the woman looks older than her age; age-related changes in her skin and hair are visible. When examined in a chair, the doctor reveals a decrease in the size of the uterus and its appendages, and dryness of the vaginal mucosa.
To clarify the diagnosis, hormonal blood tests are performed, which reveal:
- increased levels of FSH and LH;
- insufficient concentration of estrogen and progesterone;
- low levels of prostaglandin E2.
Since only ovarian function suffers, the hypothalamic-pituitary system adequately responds to a decrease in sex hormones by increasing its activity. A trial administration of estrogen-gestagen drugs reduces the level of FSH and LH down to normal, causing the appearance of a menstrual-like reaction.
Among the imaging methods, ultrasound of the uterus and its appendages is used, during which the following is revealed:
- reduction in the size of the uterus;
- thinning of the endometrium to 0.5 cm or less;
- a decrease in the size of the ovaries, the absence of large maturing follicles in them.
One of the reliable ways to diagnose early ovarian failure syndrome is. The surgeon observes small, wrinkled ovaries in the pelvic cavity, without signs of ovulation. During the examination, the doctor takes a small piece of gonadal tissue for cytological examination - biopsy. The resulting material is studied in the laboratory, the replacement of ovarian connective tissue and the absence of maturing follicles are revealed.
Therapy
The only possible treatment for ovarian wasting syndrome today is hormone replacement therapy. Its essence is to maintain normal hormonal levels by introducing female sex steroids from the outside. In rare cases, such measures lead to spontaneous restoration of reproductive function.
The gynecologist’s task is to select the optimal drug that will reliably reproduce the cyclical fluctuations in hormone concentrations in a woman’s body. For this purpose, oral contraceptives containing estrogen and progesterone are used, for example Femoden, Marvelon, Regulon, Novinet. They should be taken under the supervision of a gynecologist with laboratory monitoring of a biochemical blood test. They are prescribed for the period until the onset of physiological menopause, that is, up to 45-50 years.
Possibility of pregnancy
The main question that worries childless women: is pregnancy possible with ovarian wasting syndrome? It is impossible to get pregnant naturally, since there are no mature eggs necessary for conception and the corpus luteum does not form in the ovary. The only way to become a mother with ovarian wasting syndrome is. The procedure uses a donor egg and sperm from a partner. A woman is prepared for pregnancy with increased doses of progesterone: under its influence, the endometrium reaches sufficient thickness for implantation of the embryo.
Throughout pregnancy, the patient takes hormonal medications that simulate normal ovarian function. If it is impossible to prepare her body for pregnancy, they resort to surrogacy.