Ovulatory syndrome

This is a violation in which ovulation is accompanied by subjective symptoms in the form of pain or discomfort in the lower abdomen, uterine discharge, which should not normally be present.

Ovulatory syndrome is a pathology that any woman can meet in her life. In view of the spread of hormonal disorders in women of reproductive age today, this syndrome often occurs. As a rule, this syndrome does not cause any pathological abnormalities in the reproductive system, but sometimes the symptomatology can be expressed strongly, disrupting the normal life activity of a woman. It is necessary to know the main signs of this syndrome and the methods of its correction in order to know how to help yourself.

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

Epidemiology

Every third woman has a permanent ovulatory syndrome. Every second woman experienced at least once in her life the manifestations of this syndrome. In a percentage of more than 85% of women with menstrual irregularities have problems with a marked ovulatory syndrome. But strangely enough, more than 30% of women with symptoms of ovulatory syndrome, do not know what they are talking about and do not go to the doctor, considering this a normal phenomenon

[6], [7], [8], [9], [10]

Causes of the ovulatory syndrome

The main reason for the development of ovulatory syndrome is the ingress of blood into the peritoneal receptors. Given these pathogenetic mechanisms about the pathological process, one can not speak. Therefore, the treatment of this syndrome is not mandatory and completely depends on the degree of severity of the clinic. If we are talking about the development of complications that are associated with this syndrome, then it has another direction.

[11], [12], [13]

Risk factors

Speaking about the main causes of the development of this syndrome, it is necessary, first of all, to find out the risk factors, which can be assumed to be a high probability of pathology. Risk factors include all pathologies that are accompanied by a disruption of the normal structure and function of the ovaries and uterus:

1. Ovarian cysts - they arise when the proliferation of cells of the ovary or the yellow body. This is directly related to hormonal changes, so in the presence of this pathology, the risk of violations associated with the maturation of the egg and its release increases.
2. Chronic inflammatory diseases of the ovaries - they are the cause of the formation of adhesions on the ovary and this in turn disrupts the normal release of the oocyte from the follicle.
3. Violations ovario-menstrual cycle of a central or peripheral nature - it also disrupts the functioning of the endometrium and its regulation with the development of characteristic symptoms.
4. Algodismenorrhea in a woman - painful menstruation increases the risk of pain syndrome and during ovulation, as the nervous regulation of this process is disturbed above all.
5. Frequent abortions in anamnesis increase the risk of adhesions and disrupt normal ovulation.

All these risk factors through hormonal imbalance or due to local changes may interfere with normal ovulation. Therefore, speaking about the ovulatory syndrome, it is necessary to determine how it passes in the normal process of ovulation.

Ovulation is the process of the release of the oocyte from the follicle after its maturation. Normally, this process occurs at the peak of the change in the level of different hormones. This reduces the amount of follicle-stimulating hormone and estrogens, which causes a gradual increase in progesterone and luteinizing hormone - it is at the peak of its increased concentration that the follicle breaks. Ovulatory syndrome occurs when the rupture of the follicle occurs against a background of insufficient concentration of certain hormones. Therefore, the main cause of ovulatory syndrome is the rapid rupture of the follicle, which is accompanied by the ingress of blood outside the uterine space onto the peritoneum - this leads to irritation and the appearance of symptoms.

[14], [15], [16]

Pathogenesis

The pathogenesis of the development of this syndrome also lies in the presence of local adhesions of the tubes or ovaries, which leads to a wrong movement of the egg - not in the ampullar part of the tube, but into the cavity of the small pelvis, since there is an obstacle to its movement and even the pili do not correct this process.

The development of symptoms is also due to other changes. During ovulatory syndrome, there is also a violation of the hormonal background, which normally do not occur. But in this case, when the follicle is ruptured, the amount of estrogen that is synthesized by the oocyte decreases, and a sufficient amount of progesterone has not yet developed. Therefore, there are initial small changes at the level of the endometrium. It can in some places exfoliate at the level of the functional layer, which leads to the development of a corresponding clinical picture.

[17], [18], [19],

Symptoms of the ovulatory syndrome

It is difficult to argue with the fact that the ovulatory syndrome is a pathology. It is not accompanied by any organic changes from the uterus or ovaries and does not interfere with the process of normal pregnancy, so it is not considered a disease. But as the symptoms increase, it can cause functional problems. After all, the normal process of ovulation is almost imperceptible, especially no painful sensations. Some women even do not even suspect when they ovulate. And some - can feel a slight increase in secretion in the form of increased serous discharge from the uterus. Stages of ovulation development are the gradual growth of the ovule from the primordial follicle to the tertiary, when full maturation and its exit from the membranes for fertilization take place.

The first signs of ovulatory syndrome can occur already in the period after twenty years, when menstruation becomes regular. Girls, as a rule, do not suffer from this pathology. This syndrome is characterized by lability - it can disappear, for example, after childbirth or appear for the first time after them. In the presence of risk factors, this symptom may appear in such compromising situations and also disappear suddenly.

Then the first clinical manifestations of this syndrome appear. The most pronounced symptom is pain in the lower abdomen, as a rule, it is one-sided. This pain arises from the irritation of the peritoneum by particles of blood that fall into the rupture of the follicle. In this pathognomonic symptom is the occurrence of pain on the 13-14 day of the menstrual cycle, if it lasts 28 days or whether the pain coincides with ovulation for another cycle time. Such pain can have a different degree of severity - from non-intensive to very pronounced. It depends on the degree of irritation and the amount of fluid that has entered the peritoneum. The process is one-sided, because ovulation occurs most often due to the rupture of one follicle.

Also the second most severe symptom is the discharge from the vagina of a bloody nature. They are not massive and usually insignificant - these are manifestations of relative hypoestrogenism on the background of insufficient stimulation of the ovaries and a partial detachment of the functional layer of the endometrium. Such discharge may also be serous.

The duration of ovulatory syndrome should not be more than two days, otherwise it can be another serious pathology.

Ovulatory syndrome with a temperature within the normative values can be manifested by a slight increase in it by no more than one degree. This is due to the fact that normally the process of ovulation occurs with an increase in basal temperature under the influence of luteinizing hormone, but it does not exceed 0.8 degrees. If it is an ovulatory syndrome, then such a rise in temperature can be systemic due to the reaction of the hormonal background and an increase in the level of catecholamines. But it is very important that such a rise in temperature should not last more than a day and should not exceed 38 degrees. If the fever is strong and prolonged, then you should immediately think about the development of an acute abdomen. This is very important for the timely diagnosis of pathology and for carrying out a clear differential diagnosis.

Psychosomatics in ovulatory syndrome is of great importance for assessing the severity of manifestations. Indeed, against the background of increased emotional inconsistency, there is an increase in the production of catecholamines - stress hormones. They, in turn, contribute to the development of increased blood circulation in the uterus and ovary region - this can cause an intensified reaction when the follicle is ruptured and a small bleeding of a local character, which will cause symptoms of ovulatory syndrome. Therefore, the increased emotionality of women also contributes to this syndrome, as well as constant stress. The increase in the severity of symptoms can worsen in the face of increased emotionality, so these are interrelated processes, which must be taken into account when correcting this condition and include in the complex drugs that are aimed at reducing nervous excitability.

Complications and consequences

Complications that can occur in cases of ovulation disorders are mainly due to incorrect and untimely differential diagnosis. If acute pain in the abdomen is misinterpreted, serious inflammatory complications can occur.

The consequences of ovulatory syndrome can be expressed mainly in violation of the daily activity of a woman, reducing libido and the development during this period of depressive thoughts. If ovulatory disorders are caused by adhesive processes, serious pathology can develop in the form of obstruction of the tubes and infertility. Then, interventions are needed to correct this condition. Therefore, it is necessary to exclude in time such a cause of ovulatory disorders.

[20], [21], [22], [23], [24], [25], [26]

Diagnostics of the ovulatory syndrome

Diagnosis of the ovulatory syndrome may be limited only to history data, but when the severity of symptoms is intense, then more serious methods of research may be needed. First of all, it is necessary to find out from the woman whether these manifestations are for the first time or they already bothered before and their degree of expression then and now. An important role is played by the response to antispasmodics or pain medication. If a woman says that after these funds becomes easier, then for sure it is a question of functional violations. It is also necessary to find out the data concerning the duration of the menstrual cycle and the severity of the pain syndrome in this case. It is necessary to pay attention to which day of the cycle the painful syndrome occurs and if it is during the period of supposed ovulation, then we can say that it is an ovulatory syndrome. And in most cases further diagnostics is not necessary, at this stage it is possible to determine and with treatment. But there are cases when it is impossible to relate the symptoms to ovulation with an irregular cycle. Then it is necessary to conduct more precise methods of investigation.

Analyzes that are aimed at diagnosing the syndrome of ovulatory pain are laboratory methods of confirming ovulation. The most reliable method is to determine the level of luteinizing hormone. The peak concentration of this hormone leads to the process of ovulation, so its determination within certain numbers may indicate an ovulatory syndrome. In this case, you can use simple rapid tests based on the qualitative definition of this hormone, which you can buy at the pharmacy. You can also use quantitative tests, but this analysis is more specific. If there is a massive discharge during the ovulatory syndrome, then there is the need to determine the level of estrogens and progesterone during the period of ovulation. In this case, a reduced amount of estrogen can cause such symptoms and it is necessary to take this into account when preparing a treatment program.

Instrumental diagnosis of the syndrome of ovulatory pains must be carried out with the goal of differentiation with other manifestations in complex manifestations of pathology. The main method that allows you to exclude a serious pathology of the pelvic organs and the abdominal cavity is ultrasound examination of the small pelvis. In this case, you can determine the presence of a cyst, apoplexy, free fluid in the circumbus.

[27], [28], [29], [30], [31], [32]

Differential diagnosis

Differential diagnosis of this syndrome in a severe pain attack should be carried out with the diseases that give the clinic an acute abdomen and require immediate surgical intervention.

When the pain is localized in the lower abdomen, differential diagnostics with acute appendicitis should be performed. The distinctive feature of appendicitis is that the pain begins first in the epigastric region, and then migrates to the right iliac. Also, appendicitis is accompanied by an intoxication syndrome with an increase in temperature and a change in the blood test (shift of the leukocyte formula to the left). Ovulatory pains from the very beginning are localized in the right ileal region and are not accompanied by symptoms of inflammation, in addition, the symptom of irritation of the peritoneum is not characteristic at the same time.

Apoplexy of the ovary is a specific syndrome that occurs when bleeding into the ovary. Typical for this condition is, as a rule, the sharp nature of the pain that occurs during exercise or during sexual intercourse. Moreover, according to the results of ultrasound, it is possible to determine free fluid in the small pelvis and fuzzy echogenicity of the ovary.

A rupture of the ovarian cyst can be accompanied by a sharp pain in the abdomen. At the same time, during the examination of the woman on the armchair, soreness on the part of the cyst is determined and in the anamnesis there are data on this disease. The rupture of such a cyst is in no way connected with ovulation and can be in any period of the cycle, which distinguishes ovulatory pains.

It is very important to differentiate the ovulatory syndrome with an ectopic pregnancy, which can also be accompanied by spotting from the vagina. But at the same time, the main sign can be considered a delay in menstruation in case of suspected pregnancy and a normal menstrual cycle with ovulatory pains and associated discharge.

These are the main pathologies with which it is necessary to differentiate ovulatory pains in order to establish a diagnosis in time and, if necessary, not postpone surgical treatment. Not always the data of the anamnesis is enough, therefore diagnostics should be complex.

[33]

Treatment of the ovulatory syndrome

Treatment of ovulatory syndrome is exceptionally symptomatic if it is only a functional disorder. The use of hormonal drugs is possible only with confirmed deficiency of certain hormones, which can be the cause of excretions in ovulatory syndrome. There are also alternative methods of treating this pathology, which can be successfully used to reduce symptoms.

Of course, it is important during ovulation in the presence of a woman such a syndrome to limit physical activity, give priority to peace and normalize your diet by eating fruits and vegetables rich in vitamins and minerals.

Essential medicines are as follows:

1. Baralgin is a three-component agent that works well for algodismorrhoea and menstrual pain. The composition of the drug includes non-narcotic analgesic (Metamizol sodium) and spasmolytic (Pitofenon + Fentiverinia bromide), which have a complex effect, and relieves symptoms. Therefore, this drug is a symptomatic treatment. The drug is used in severe pain syndrome and is dosed on one tablet. If the effect was not achieved, then after half an hour you can take another pill. Precautions - it is impossible to take during the feeding of the child and take a long time, since it is possible to depress the effect on the hematopoiesis. Side effects are possible in the form of lowering blood pressure and allergic phenomena.
2. Tamipul is a complex remedy for symptomatic treatment of pain of any genesis, including ovulatory syndrome. It includes two non-narcotic analgesics (paracetamol and ibuprofen) and codeine. It has central analgesic effects. The method of administration is oral. Dosage of one capsule with pain syndrome, it is better only at its beginning, then the effect is more pronounced. Adverse events are possible side gastrointestinal tract in the form of glossitis, lesions of the esophagus, stomach, intestines with dyspepsia, violation of the evacuation function of the intestine. Also possible allergic manifestations of varying severity. When the drug acts on the hematopoietic system, anemia, a decrease in the number of platelets and granulocyte neutrophils may occur. When acting on the heart and the vascular system, there may be an increased heart rate, pain in the heart, heart rhythm disturbance, lability of blood pressure. Precautions - with severe pain syndrome, which is accompanied by a severe intoxication syndrome, this medication can conceal the clinic of an acute abdomen, therefore it is impossible to apply the drug if you suspect another etiology of pain syndrome.
3. Mirena is a contraceptive that can be used in the complex treatment of ovulatory pains, which are intense and persistent. This drug, containing levonorgestrel, is the method of choice for women who have children, and the symptoms of ovulation are accompanied by uterine secretions. In this case, the insufficiency of estrogens is regulated and the contraceptive effect is achieved in parallel. The method of application of the drug is the setting of the intrauterine device, which is performed only by a specialized obstetrician-gynecologist. Such a spiral is set for five years with further replacement of the facility. Precautions - Before using the intrauterine device, little preparation is necessary. The mechanism of action of this remedy is based on the effect of the gradual release of estrogen hormones and the normalization of excreta during ovulation.
4. Perfectil is used for the complex treatment of ovulatory syndrome, because it has an effect not only on vitamin deficiency, but also on the regulation of nervous excitation in the expressed psychosomatic component of the ovulatory syndrome. The composition of the drug includes vitamins - A, B1, B2, B5, B6, B9 B12, C, D, E, H, as well as trace elements - magnesium, calcium, copper, manganese, zinc, iron, molybdenum. The drug is issued in the form of pharmacological capsules. It is taken in a dose of one capsule once a day, (preferably after a meal, so it improves digestion). Side effects with respect to the dose are not detected, there may be changes in the color of urine due to the composition of the drug. Contraindications to taking the drug are serious violations of kidney and liver function. Precautions - do not combine with other vitamins.

Physiotherapeutic treatment has a positive effect in the acute period, especially in the formation of adhesions on the ovaries. In an acute period, heat can be used to lower the abdomen, as well as radiotherapy. If there is a suspicion of an acute inflammatory process, then the thermal procedures are strictly contraindicated.

Operative treatment of the ovulatory symptom is not used, only some surgical manipulations are possible in the formation of tube adhesions and their obstruction.

Alternative treatment of ovulatory syndrome

Alternative therapies are also aimed at eliminating pain syndrome and normalizing the emotional state. Use methods that eliminate spasm and have analgesic effect.

1. A hot-water bottle of salt extends spasmodic vessels well and relaxes muscles, which reduces the intensity of ovulatory pain. For such a heater, you need to heat the salt in a frying pan to a warm state, pour it into the towel, add it in several layers, so that it is not hot, and then put it on the bottom of the stomach. If there is any temperature increase, then no warmers can be used.
2. It is necessary to make a sitting bath from the infusion of chamomile and cinnamon. To do this, brew in a liter of water two bags of chamomile grass and insist until the solution becomes warm. Then you need to add a teaspoon of cinnamon and take such a bath, after sitting there for at least ten minutes.
3. It is necessary before the supposed ovulation to use a tampon from the herb of calendula. It has an antimicrobial and analgesic effect. To do this, you need to brew the flowers of marigold and moisten the gauze tampon, enter into the vagina for two hours.

Treatment with herbs can be used for several days, applying herbs for two days before the expected ovulation and two days after it. It also normalizes the nervous system and blood circulation.

1. Celery is a plant that is not only used for food, but also used to reduce the pain syndrome. The root of this plant is poured cold water, add the juice of half a lemon and drink half a cup of this drink three times a day. He also normalizes the amount of missing hormones.
2. One tablespoon of horsetail should be mixed with a few twigs of lemon balm and pour hot water. This infusion should be drunk three tablespoons in a warm form.
3. The combination of a hog queen with a strawberry regulates bloody discharge with ovulatory syndrome. To do this, take the leaves of the hog uterus and add a tablespoon of fruit or the leaves of strawberries. This infusion can be drunk as tea three times a day in a glass.
4. Water pepper and nettle leaves can be used if the ovulatory syndrome is combined with abundant secretions, which indicates a severe shortage of gestagens. For this, use the infusion of these herbs and consume them half a glass twice a day.

Homeopathic remedies have the same principle of action as other drugs, that is, symptomatic treatment is used. Also, treatment can be preventive in correcting the formation of adhesions on the ovary.

1. Lachessis-plus is a combined homeopathic remedy that affects all disturbances in the regulation processes in the body, as well as due to its rich plant composition, has an anesthetic and antispasmodic effect. The drug is produced in the pharmacological form of homeopathic granules and is dosed on eight granules five times a day half an hour before meals or an hour after. It is necessary to dissolve the granules until completely dissolved and not washed down with water. Side effects are not common. Perhaps a slight increase in pain in the abdomen, then you need to increase the dose to five drops. Treatment should be carried out at least two months, and in order to prevent the dose reduction and take five pellets three times a day.
2. Ignacy-homaccord is a complex plant and animal homeopathic remedy, which is especially effective in case of psychosomatic disorders accompanying ovulatory pain. The drug is released in the pharmacological form of homeopathic drops and dosed ten drops once a day. In this case, the drops should be diluted in a tablespoon of water and taken irrespective of the intake of food. Adverse events were not identified.
3. Pulsatilla compositum is a homeopathic remedy of natural origin. The drug is released in the pharmacological form of the homeopathic solution in ampoules and is dispensed on the third part of the ampoule once a week with possible oral use. Side effects are not common, but there may be stool disorders, dyspepsia and allergic reactions. Precautions - it is impossible to use the drug for an acute process in the uterus.
4. Belladonna is a one-component preparation that has a very pronounced antispasmodic effect due to the blocking of cholinergic receptors in muscle fibers. Method of application of the drug - one tablet once a day. Side effects are possible with an overdose of the drug, so you need to follow the doctor's prescriptions.

These are the main alternative means, the advantage of which is the possibility of their preventive use.

[34], [35], [36], [37], [38], [39]

Prevention

Prevention of any ovulation disorders is nonspecific methods. It is necessary to observe the rules of personal hygiene, hygiene of an intimate life with regular sexual relations, which contributes to the normalization of the hormonal background. It is also necessary to prevent inflammatory diseases of the ovaries and timely treat various pathologies.

[40], [41], [42], [43], [44]

Forecast

The prognosis of ovulatory syndrome is favorable in any case, since this is a functional disorder that is well adjusted.

Ovulatory syndrome is one of the frequent complaints of women of reproductive age who disrupt daily activity and are accompanied by repeated painful sensations that are caused by ovulation. It is not a pathological condition, but with any changes in the pain syndrome or the appearance of other symptoms it is necessary to consult a doctor for differential diagnosis. Treatment of this pathology is symptomatic and does not require special medical prescriptions, so you can take painkillers, but only if you are sure of the cause.

[45], [46], [47], [48], [49]