ovarian insufficiency syndrome
Introduction
Introduction to ovarian deficit syndrome Ovarian functional abscess syndrome (ovarian functional abscesses syndrome) also known as female castration syndrome originated from loss of ovarian function, estrogen deficiency, mainly manifested as autonomic dysfunction, resulting in a systemic and local symptoms of a group of syndromes. The mechanism of estrogen deficiency in the body of autonomic dysfunction is still unclear. Most scholars believe that the intrinsic is related to estrogen deficiency, and some scholars believe that it is related to high levels of gonadotropins. basic knowledge Sickness ratio: 0.0001% Susceptible people: women Mode of infection: non-infectious Complications: Osteoporosis Aged vaginitis
Cause
Causes of ovarian function deficiency syndrome
Causes:
The cause of ovarian deficit syndrome is relatively simple, belonging to iatrogenic gynecological diseases, due to surgery, radiotherapy, disease destruction or removal of the ovaries, loss of ovarian function, estrogen levels.
Pathogenesis:
It is still unclear how the estrogen deficiency in the body has its autonomic dysfunction. Most scholars believe that the intrinsic is related to estrogen deficiency. Some scholars believe that it is related to high levels of gonadotropin. The animal's feedback to the hypothalamus and pituitary gland disappeared by stopping the secretion of estrogen. The number and capacity of the pituitary increased, the DNA and RNA content increased, and the gonadotropin, especially the follicle stimulating hormone secretion, LH-RH stimulation test The pituitary reactivity is significantly enhanced.
The ovary is an important endocrine organ of women. In the hypothalamic-pituitary-ovarian axis, it plays a reproductive cycle, ovulation and pregnancy and other reproductive functions, while maintaining mutual regulation with other endocrine glands. Some reasons, such as surgical removal of the ovaries, excessive exposure to radiation, severe genital tract infections, malnutrition, systemic wasting diseases, or surgery that has impaired the blood supply to the ovaries, etc., when the ovarian function is suddenly lost, it is bound to cause endocrine The balance of function is imbalanced. At this time, the hypothalamus and pituitary gland function to improve the imbalance. As the target organ, the ovary has no function, while the endocrine glands such as the adrenal gland and thyroid gland are sensitive and secretive, resulting in a balance disorder between endocrine and endocrine. Finally, the balance of the hypothalamus and pituitary is lost.
In the absence of ovarian function, the lack of feedback estrogen is the main reason for the interference of sexual function, which can be proved by the fact that the intrinsic patients have achieved satisfactory results with the early use of estrogen therapy, of course, ovarian removal Post-endocrine disorders are not caused solely by estrogen deficiency. Campbell believes that low levels of estrogen do not necessarily produce symptoms. Older women have low levels of estrogen without symptoms, which can be proved by In terms of treatment, estrogen can relieve the symptoms, but non-estrogen drugs, such as progesterone, clonidine, etc., can also successfully relieve the symptoms, which is more illustrative. Therefore, Campbell believes that the level of estrogen seems to be high or low. Not a deciding factor.
It is also believed that estrogen acts on the hypothalamic-adenohypophysic axis and the limbic system of the brain. These limbic systems are the sites that control the stability of blood vessels, and are also the sites of emotional regulation. Due to the lack of estrogen, the effects on these parts are insufficient, and the symptoms There is a certain relationship. When Lanritzen studies the relationship between symptoms and estrogen levels, patients with bilateral ovaries are injected with estradiol benzoate, which usually lasts for 3 to 5 days. After that, estrogen levels decrease. When the levels of estrone and estradiol were measured regularly, it was found that when estrone dropped to 148 pmol/L (40 pg/ml) and estradiol decreased to about 73.4 pmol/L (20 pg/ml), the patient developed hot flashes. Symptoms of fatigue and agitation; another group of patients with bilateral ovariectomy, oral estradiol valerate, the same results as the former group, it seems that estrogen fluctuations at the above levels, is the cause of instability of the limbic system, Therefore, it is not difficult to understand the constant low level of estrogen in old age, but it is asymptomatic. Some scholars have observed the symptoms of menopausal syndrome and ovarian dysfunction syndrome. The former is gradually decreased estrogen levels, so a slow onset of symptoms, which is a sudden drop in estrogen levels, so fast symptoms significantly, it is considered that, consistent with the symptoms of estrogen secretion rate and extent of reduction.
In summary, after the ovary is removed, the estrogen deficiency state occurs quickly, causing changes in the diencephalon and hypersecretion of the pituitary gonadotropin, thereby stimulating the cerebral vasomotor center and the autonomic nerve center, causing variation.
Prevention
Prevention of ovarian function deficiency syndrome
1. In terms of spirit. Invigorate the spirit, try to keep your mood comfortable, don't give too much pressure to yourself, women should treat the menopause and old age with a positive attitude, eliminate unnecessary worries and fears, and in the event of some incompatibility Take active and effective treatment, and be good at getting sympathy, comfort and encouragement from family members.
2. Physical exercise. Insist on exercise and enhance physical fitness, which is the most important way for middle-aged women to maintain vigorous vitality. A strong body can maintain the functional health and coordination of various organ systems throughout the body, thereby disrupting the function of the nervous and endocrine systems, naturally delaying the decline of ovarian function.
Complication
Ovarian deficit syndrome syndrome Complications osteoporosis senile vaginitis
Concurrent osteoporosis and prone to changes similar to senile vaginitis, and cause sexual difficulties and pain.
Symptom
Symptoms of ovarian function deficiency syndrome Common symptoms Dizziness, menopause, premature age, fatigue, dysuria, urinary frequency, depression, urgency, urinary blood, menopausal anxiety
The clinical manifestations of intrinsic are closely related to the age of the disease.
1. Before puberty, the ovaries are resected or destroyed, generally do not have symptoms of ovarian function deficiency syndrome, but genital and secondary sexual development disorders, there is no menarche, if the loss of ovarian function will have serious symptoms, These signs and symptoms are similar to those of menopausal syndrome.
(1) systemic symptoms: first manifested as menopause, followed by autonomic dysfunction symptoms, manifested as paroxysmal hot flashes and chills, skin ants and temperament changes, such as impatience, anxiety, depression, Excitable, memory loss, lack of concentration, suspicious, and manifested as coronary heart disease symptoms, such as elevated blood pressure, heart palpitations, headache, dizziness, dizziness, general malaise.
(2) local symptoms: may have genitourinary changes, such as vaginal atrophy, shortened, vaginal external narrowing, frequent urination, urgency, dysuria, hematuria and dysuria, vaginal epithelial thinning, glycogen reduction, vaginal secretions cut back.
2. Menopausal loss of the ovary Because the patient has adapted to low estrogen levels, there is no symptom of ovarian deficit syndrome.
Examine
Examination of ovarian deficit syndrome
Hormone level check, secretion check.
Colposcopy, laparoscopy, histopathology.
Diagnosis
Diagnosis and diagnosis of ovarian deficit syndrome
diagnosis
According to the medical history and clinical manifestations, laboratory tests and necessary auxiliary examinations, the diagnosis is not difficult.
Differential diagnosis
The disease should be differentiated from premature ovarian failure, and also need to have menstrual disorders, amenorrhea, anovulation, hairy, obesity, infertility and bilateral ovarian enlargement cystic changes, known as polycystic ovary syndrome. Patients may have the above typical symptoms, but also some symptoms, but infertility due to ovulation disorders is the main clinical manifestations of polycystic ovary syndrome. Polycystic ovaries can be identified by pituitary stimulation tests.
