Ovarian dysfunction

Introduction Ovarian dysfunction is characterized by premature ovarian failure. Definition of premature ovarian failure: The phenomenon of ovarian dysfunction in women before the age of 40, known as premature ovarian failure. The incidence of POF accounts for 1-3% of adult women. Premature ovarian failure means that women have had a natural menstrual cycle, and ovarian atrophy continues to amenorrhea before the age of 35. At the same time, the clinical manifestations of secondary sexual retraction, facial fever, upset, irritability and other menopausal symptoms; usually easy to catch cold, elevated levels of blood follicle stimulating hormone, up to 40 units, equivalent to postmenopausal women's level; and blood Estradiol levels were significantly lower. Gynecological examination showed significant atrophy of the genitals, and the vaginal mucosa was thin and congested. Ovarian biopsy was performed on the laparotomy. The ovarian atrophy was observed. Under the microscope, the ovarian cortex was found to be fibrous tissue, and no follicles such as primordial follicles were visible.

Cause

1. Immune factors: about 20%, ovarian antibodies can be detected in the blood, such patients often combined with other autoimmune diseases such as lupus erythematosus, rheumatoid arthritis, lack of an enzyme in the congenital body.

2. Cytogenetic factors: fewer congenital germ cells, accelerated follicle atresia, abnormal X chromosome, 10% of patients have a family history.

3. Physical factors: such as surgery, chemotherapy, infection, etc. lead to defects in gonadotropin secretion or gonadotropin receptor or receptor defects.

4. Idiopathic ovarian premature aging: patients with no clear cause, normal chromosomes, blood levels of FSH (follicle stimulating hormone), LH (luteinizing hormone) increased, E2 (estrogen) is low, PRL (prolactin) is normal. Patients not only lack estrogen, but also have insufficient ovarian androgen secretion, or mild defects in the ability of the adrenal gland to produce steroids. Laparoscopy often sees small ovaries or atrophic ovaries.

an examination

Related inspection

Luteinizing hormone laparoscopic gynecological routine examination ovarian function test ovarian examination

Laboratory examination: E2<5g/L, FSH>13/L, LH>301u/L, normal PRL, T<5ng/dl can be identified by pituitary stimulation test, and antibodies can be determined by ELIS method. Can identify the existence of autoimmune problems.

Other examinations: laparoscopy, cervical mucus examination.

Differential diagnosis

Laboratory examination of electro-immunoluminescence assay for E213/L, LH>301u/L, normal PRL, and premature ovarian failure.

1. Non-developed gonads, primary amenorrhea, gonadal dysplasia, delayed menarche or irregular menstruation.

2. Gonadal development is secondary to infertility. After a few years, menstruation is gradually rare until amenorrhea.

3. Ovulation, typical POF has hot flashes, hypogonadal performance, such as night sweats, constipation, hair loss, vaginal dryness, sexual pain, decreased sexual desire, hypothyroidism, urinary tract infection.

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.