The sudden cessation of menstruation cannot but alert any woman of reproductive age. If there is no reason to think about the cessation of menstruation as a result of pregnancy, then secondary amenorrhea is provoked by some pathology. Resistant ovarian syndrome is one such pathology that causes secondary ovarian amenorrhea. The resulting menstrual dysfunction leads to the fact that a woman cannot become pregnant, and this is especially important, given the fact that young women under 35 years of age are susceptible to resistant ovary syndrome.
Resistant ovary syndrome: symptoms and treatment
Resistant ovary syndrome includes secondary amenorrhea, infertility, normal development of secondary sexual characteristics and unchanged ovaries, with significantly elevated levels of gonadotropins: luteinizing and follicle-stimulating hormones. Resistant ovary syndrome accounts for about 10% of all forms of amenorrhea. The reasons for the development of this condition have not been precisely clarified to date, scientists are inclined to the autoimmune theory of the origin of the syndrome. Some sources also talk about iatrogenic factors such as ovarian surgery, exposure to radiation, cytotoxic drugs, immunosuppressants.
Resistant ovary syndrome:
- clinical picture of resistant ovary syndrome;
- diagnostic criteria for resistant ovary syndrome;
- methods of treatment of resistant ovarian syndrome.
Clinical presentation of resistant ovary syndrome
In the clinical picture of resistant ovary syndrome, menstrual dysfunction comes to the fore. Patients report the timely onset of menarche and the occurrence of amenorrhea 5-10 years after the first menstruation. At the same time, the majority of patients during this time had episodic rare menstruation. Hot flashes to the head are also a frequent complaint. Usually patients with resistant ovarian syndrome are of normal build and with well-developed secondary sexual characteristics. But during a gynecological examination, signs of ovarian hypofunction are found: hyperemia and thinning of the mucous membranes of the vagina and vulva, a weak symptom of the "pupil", CPI up to 25%.
Diagnostic criteria for resistant ovary syndrome
Diagnosis of resistant ovarian syndrome is based on the competent collection and analysis of anamnestic data, the results of laboratory and instrumental research methods. The main criteria for diagnosing resistant ovarian syndrome are as follows:
- sudden cessation of menses (secondary amenorrhea);
- "hot flashes" and occasional bleeding;
- high plasma levels of gonadotropins;
- low plasma estrogen levels;
- positive test with estrogen-gestagens in cyclic mode;
- reduced size of the uterus and ovaries on ultrasound and laparoscopy;
- Ovarian biopsy specimens show primordial and preantral follicles.
Methods of treatment of resistant ovary syndrome
Treatment of resistant ovarian syndrome today is an extremely difficult process, since reliable etiological factors in the development of the disease have not yet been elucidated. Patients are prescribed hormone replacement therapy aimed at correcting estrogen levels and reducing the secretion of gonadotropic hormones. Estrogen treatment is based on the blockade of endogenous gonadotropins and the achievement of the so-called rebound effect. Unfortunately, complete recovery and restoration of reproductive function in patients with resistant ovarian syndrome cannot be achieved. The dream of motherhood for such women is realized through in vitro fertilization with a donor egg.
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