Ovulation syndrome

Ovulation syndrome is a painful sensation in the area of the ovulating ovary, sometimes accompanied by bloody discharge.

[ 1 ], [ 2 ], [ 3 ], [ 4 ], [ 5 ], [ 6 ], [ 7 ]

Causes ovulation syndrome

Pain syndrome most often occurs against the background of an excess of prostaglandins, which regulate the pressure inside the dominant follicle and participate in the process of rupture of its wall with the release of a mature egg.

Symptoms ovulation syndrome

Rupture of the follicle is accompanied by the outpouring of a small amount of blood into the abdominal cavity, which irritates the peritoneum and leads to the development of peritoneal symptoms. The intensity of the latter is determined by the volume of blood loss, increasing as the rupture passes from the follicle to the intact tissues of the ovary. The accumulation of blood in the Douglas space is accompanied by the appearance of a feeling of heaviness in the lower abdomen, perineum, pain radiating to the lower limbs, sacrum, coccyx. The volume of blood loss in some cases can be significant, causing anemia of the patient and threatening her life. Rupture of the ovary during ovulation, accompanied by noticeable blood loss and a typical clinical picture, is called ovarian apoplexy.

[ 8 ], [ 9 ]

Diagnostics ovulation syndrome

Diagnosis is based on the identification of typical complaints and clinical symptoms during the expected ovulation period, pelvic ultrasound data, puncture of the posterior vaginal fornix to confirm the presence of blood in the abdominal cavity, diagnostic laparoscopy and laparotomy.

[ 10 ], [ 11 ], [ 12 ], [ 13 ]

Treatment ovulation syndrome

Treatment is determined by the specific cause that caused its appearance, the nature of changes in the sexual function regulation system and the degree of menstrual cycle disorders. It can be both symptomatic and pathogenetic.

Pathogenetic treatment includes the use of prostaglandin synthesis inhibitors (indomethacin, ibuprofen 1-2 days before the expected ovulation), gestagens (duphaston, uterozhestan, norcolut) or combined estrogen-gestagen drugs. Symptomatic therapy involves the additional use of analgesics and antispasmodics during ovulation.

In surgical treatment of ovarian apoplexy, the scope of surgical intervention is determined by the degree of damage to the corresponding ovary and the condition of the surrounding tissues (often inflammatory). If there is an interest in preserving reproductive function, the principle of maximum, if possible, preservation of ovarian tissue and the corresponding fallopian tube is observed. Conservative management of ovarian apoplexy includes the use of hemostatic and blood-replenishing agents, anti-inflammatory and, if necessary, antibacterial therapy, and prevention of adhesions.