Treatment of anovulation

If this condition is the result of an incorrect eating behavior, in most cases it is enough to adjust (reduce or increase) the weight of the body to normalize the menstrual cycle. Sometimes even in cases of poly- (sclero-) cystosis, accompanied by obesity, literate diet programs can help restore reproductive function, which returns with normalization of weight.

Women with emotional type of temperament are susceptible to psychogenic anovulation, they need competent psychotherapeutic help.

In other cases, as a rule, preference is given to medical hormonal therapy. Such therapy is only under the supervision of a doctor and after a thorough examination. Scheme, drugs and dosing are selected individually, guided by the results of diagnosis, the nature of the symptom complex and the duration of anovulation.

Hormonal treatment of anovulatory cycles

Hormonal drugs are prescribed to normalize the balance of hormones, restore the ovulatory function, stop uterine bleeding (if any).

Of course, women are interested in: how to get pregnant with anovulation? The main conservative method at the desire of a woman with a violation of the ovulatory function to become a mother is the stimulation of the ovaries. This procedure should be performed under the strict supervision of a doctor and ultrasound. The most dangerous complication of this procedure is the ovarian hyperstimulation syndrome, when the number of developing follicles is approximately twice the norm, the estrogen level rises, the ovaries grow, the follicles become cysts and there is a high probability of their rupture. Symptoms of this syndrome - pain in the lower abdomen, flatulence, uterine bleeding. When signs of this state appear, stimulation is immediately stopped. For the whole life of a woman, you can perform the stimulation procedure no more than five to six times. Repeated courses of such therapy increase the risk of developing the hyperstimulation syndrome, and its consequence is previously ovarian exhaustion and premature menopause.

When stimulating different drugs are used. For example,  Clomiphen citrate, which in small doses is a stimulator of the maturation of the egg and its release from the ovary. However, with a thin layer of the endometrium (up to eight millimeters), other medicines are preferred, since this drug does not promote the growth and development of its cells.

Stimulates the proliferation of the endometrium of  Menogon, containing gonadotropic hormones. The drug induces ovulation and facilitates the implantation of a fertilized egg. Puregon - β-foliotropin, provides normal growth and maturation of follicles before reaching the state of preovulation.

Stimulation of the ovaries is contraindicated in neoplasms of the pelvic organs, pituitary and hypothalamus, mammary glands; vaginal bleeding; diseases of the thyroid gland, adrenal glands, pituitary gland, not related to the genital area.

Scheme, preparation and duration of stimulation are determined by the doctor. Upon reaching the state of preovulation (the dominant follicle is not less than 18 mm), the patient is injected with chorionic gonadotropin. After proven ovulation, usually occurring on the second day after the administration of the drug, progesterone therapy is prescribed (injections or tablets - Utrozhestan or Dufaston). Admission is continued until the confirmed onset of pregnancy or monthly.

In general,  Dufaston  is a very popular drug, prescribed almost indiscriminately, and patients with anovulation including. This is due to the prevalent among practitioners opinion about the general deficit of progesterone. Indeed, one can not underestimate the role of progesterone in the successful implantation of the fetal egg and its further development. The "hormone of pregnancy" synthesized by the yellow body ensures its safe flow, prevents the release of eggs from neighboring follicles in this cycle and stimulates the proliferation of cells of the mucosal layer of the uterus. In the event that ovulation exactly occurred, and the plasma concentration of progesterone is below normal, progesterone medication helps to keep the pregnancy. With a single-phase cycle in the case of a violation of the ovulatory function, progesterone monotherapy does not make sense.

Dyufaston during anovulation can be used to stop dysfunctional uterine bleeding, during premenopause, and also in the ovarian stimulation scheme. The absence of such a side effect as the suppression of ovulation, which the instruction, attached to Dufaston repeats, raises doubts among adequate gynecologists. Moreover, ovulatory dysfunction is not indicated in the same indications for use from the manufacturer.

In the absence of ovulation due to disturbances of the hypothalamic-pituitary function against a background of increased prolactin level, therapy with dopamine stimulants, which restore the control of the hypothalamus behind the production of prolactin, follicle-stimulating and luteinizing hormones, and also allow reducing the adenoma of the pituitary gland, has a good therapeutic effect. For example, Bromocriptine - the dopaminergic effect of the drug is based on the ability to stimulate the dopamine receptors of the hypothalamus while simultaneously inhibiting the secretion of the hormones of the anterior lobe of the pituitary gland, in particular prolactin. The process of its synthesis does not break the drug. When taking bromocriptine, blood pressure and development of catecholamines decrease. It is contraindicated in patients who have undergone a recent myocardial infarction, with propensity to spasm of peripheral vessels, arrhythmias, pathologies of digestive organs, mental illnesses. Calms and reduces concentration of attention, is not compatible with oral contraception, drinking, taking antidepressants from a number of MAO inhibitors and drugs that depress the work of the central nervous system. Begin reception from three tablets and gradually reduce to a maintenance dose - one tablet a day. Duration of admission is determined by the doctor (the course can last more than six months). If the patient has a reduced function of the thyroid gland, the drug is prescribed simultaneously with substitution therapy with thyroid hormones, for example, Levothyroxine. Dosed individually.

In normogonadotropic anovulation, estrogen-progestational medications are used, with a contraceptive mechanism of action that stabilize the menstrual cycle to activate the function of the hypothalamic-pituitary system after their abolition - the rebound effect (Cleohest, Divina) and anti-estrogens, for example, Clomiphene citrate, which blocks the synthesis of estrogens and suppresses proliferation of the endometrium.

With hypogonadotropic anovulation, drugs are prescribed in the following order: Pergonal, containing in equal proportions follitropin and luteotropin, stimulates the development of ovarian follicles and proliferation of endometrial cells, increases the content of estrogens; human chorionic gonadotropin (gonakor, prophase, choragon), regulating the synthesis of progesterone, development and preservation of the yellow body. An alternative is pulse-therapy with gonadotropin-releasing hormone.

Excessive production of male sex hormones is suppressed by  Dexamethasone, a synthetic analogue of a steroid produced by the adrenal cortex of prolonged action. Designed for systemic use. The action is carried out through the receptors of two systems in the cell cytoplasm: gluco- and mineralocorticoid. Through the first there is a regulation of glucose homeostasis and inhibition of the activity of proinflammatory mediators. The second - normalize the water and mineral balance. Therapy of androgenital syndrome involves taking the drug in a daily dose of 2.5 to 5 mg, divided into two or three doses.
Polycystic ovary syndrome requires consistent treatment, including a course of taking estrogen-progestins, restoring regularity and normal duration of the menstrual cycle, as well as triggering a rebound effect. Then, clomiphen citrate therapy is performed, which replaces the use of follicle-stimulating hormone. The drug Metrodine, the active ingredient of which urofoliotropin performs the function of an endogenous substance, activating the development of ovarian follicles, the synthesis of estrogens, an increase in the layer of the endometrium. Luteinizing effect does not render, therefore, if necessary, small dosages of Pergonal or human chorionic gonadotropin are used to support this function.

If the patient has a concomitant androgenital syndrome and is prescribed an additional course of Dexamethasone, dopamine stimulants are used when the level of prolactin is excessive. When an inflammation of the appendages, sexual infections, etc. Is detected. In the scheme include appropriate means, almost always in prescriptions there are vitamins or vitamin-mineral complexes.

When anovulation is of unknown origin, the doctor can prescribe stimulation of the ovaries with vitamins. It is known that the lack of vitamin E inhibits the development of the follicle, prevents the maturation and the release at the right time of the egg, ready for fertilization. Therefore, the appointment of this vitamin in combination with vitamin B9 (folic acid) is the base in the anovulatory cycles. Folic acid contributes to the development of a full ovum and its release from the follicle, promotes the realization of the luteal phase after ovulation - prevents progesterone insufficiency and promotes the growth of the endometrial layer.

A gynecologist can recommend the intake of other vitamins - A, C and D, minerals. Usually in such cases prescribe the reception of vitamin-mineral complexes. In combination with a full and varied diet, a healthy lifestyle, such therapy can lead to the normalization of reproductive function and natural conception.

In addition to medicinal and vitamin therapy, physiotherapy procedures are used. It can be a gynecological vibro-massage, effective is considered mud treatment from anovulation. The stimulating ovulation method is endonasal electrophoresis on the hypothalamic-pituitary site, electrostimulation of the cervix, acupuncture, helium-neon laser therapy. Sometimes the physiotherapeutic effect is effective even without the use of medications, but this is possible only with minor disorders of the ovulatory cycle.

The inefficiency of conservative therapy serves as an indication for laparoscopic ovarian biopsy and correction of the treatment regimen taking into account the revealed changes. Modern methods of treatment quite successfully cope with the problems of recovering fertility during anovulation. With the help of conservative therapy, the ovulatory cycle is restored in more than half of patients with this problem.

In the case when all the therapy was powerless and pregnancy did not come, you can resort to assisted reproductive technologies. The most simple is intrauterine insemination with anovulation, consisting in the fact that a woman who has undergone hormonal treatment is given specially prepared sperm to the uterine cavity.

To obtain the happiness of motherhood for women, even with severe forms of ovulation, extracorporeal fertilization can help. IVF during anovulation will become a real way out of the implementation of its main dream. This is a more complicated procedure, which is carried out in several stages. A woman in the womb is already fertilized and "podrochennuyu" in vitro pre-extracted from her egg, which remains only to gain a foothold in the mucous membrane.

Alternative treatment

As with all disease states of the body, there are no-drug methods for their correction, which came to us from the depths of the centuries, and since they are still used, it is not worth excluding their positive action.

Healing completely without the use of any means inward offers an alternative Indian treatment - yoga-therapy. The best way out is by training under the guidance of an experienced trainer or yoga therapist. However, it is possible to study some poses on their own. Starting to engage in regular activities, basically, all women notice positive changes in their state of health. The course of the yoga system can very well normalize the hormonal balance of the body, which manifests itself in the stabilization of the menstrual cycle and the absence of other unpleasant symptoms. And it is quite compatible with the reception of medicinal, herbal, homeopathic preparations, with the time of necessity the reception of which will disappear by itself. It has long been proven that the impact on certain muscle groups affects the condition of internal organs.

Pose, which contributes to the restoration of the function of the ovaries and the normalization of the hormonal background of Buddha Konasana (posture of the Connected Corner). Ideally, in order to adopt this position, you need to sit flat on the rug spread out on the floor, fold your feet together with one another and pull them to the crotch, trying to put your hips on the floor. The back should be even, shoulders are freely lowered, the spine is straight, we look straight ahead, the parietal part is stretched upwards. The pose should not cause discomfort. How clearly it is possible to fulfill it depends on the mobility of the hip joints. Many even not trained women sit down in this pose without difficulty at once, others - putting hips on the floor does not work even after long training. There are options for doing this position - leaning back on the wall, sitting on a folded blanket, podstavochke in the form of a brick. Under the hips in this case, you can also put the rollers to provide comfort and comfort. Fix and hold the pose several breaths (inhale-exhale for four seconds).

Then you can master the pose of the triangle (trikonasana) and the pose of the hero (virasan). Doing your own, the technique of execution can be found on the Internet. Gradually mastering several poses and practicing for 15 minutes a day, within a month you will notice an improvement in your condition. Classes should be persistent and regular, they should be accompanied by a healthy full-fledged diet, a positive attitude and a rejection of bad habits.

Treating herbs with ovulatory disorders can also be very effective. Many plants contain phytohormones, reminiscent of the effect of sex hormones and restoring reproductive health. Herbal preparations are devoid of most of the side effects of medications, however, before starting a course of phytotherapy, it is advisable to consult a specialist in the field, since medicinal herbs also have contraindications.

Perhaps the most famous plant that is used to treat female infertility is the medicinal sage. It contains phytoestergens that fill the deficiency of these female hormones and stimulate the development of their own. When giperestrogenii, neoplasms of the breast, endometriosis, hypothyroidism and low arterial pressure, this plant is not used. Therefore, just so, without examination, to drink an infusion of sage is not recommended. Sage has a haemostatic effect, so you need to take it according to a certain pattern. Begin reception on the third or fourth day of menstruation and take before the onset of preovulation. Then the infusion should be discontinued, since the grass helps to lower the level of progesterone, stimulates the smooth muscles of the uterus and after ovulation does not promote successful implantation of the fetal egg. Sage in anovulation can be taken only under the supervision of ultrasound or baseline temperature measurements. If the patient has anovulatory cycles are clear, you can take infusion, calculating the moment of ovulation. For example, with a short cycle of 21-22 days, sage is taken from the fourth to the ninth to the eleventh day, with a 32-day day, from the fourth to the 16th-17th day. The course of treatment with sage is three months, in the year of such courses you can hold no more than three. To make a teaspoon of chopped dry grass, boil 200ml of boiling water, after 30 minutes, filter and drink a third of the glass before three meals. The lime flower, licorice root, yellow clover, mistletoe also have an estrogen-like effect.

With increased content of sex hormones, herbs with antihormonal activity may be useful. It is a grass of a lively, pearl grass, a bruise-honey plant.

When hyperprolactinemia is used Abraham tree, raspberry, goose goatee, which affect the pituitary gland, stimulating the production of luteotropin and, consequently, progesterone.

On the extract of the fruits of the Abrahamic tree, the preparation Cyclodinone was created, which can be purchased in the pharmacy network and without a prescription. It is designed to treat hormonal disorders of the reproductive system and is used for anovulation with hyperprolactinemia. This drug can become a valuable substitute for dopamine receptor antagonists.

I would like to remind once again that all herbal preparations that affect the hormonal background of a woman are not harmless herbs. They should be used only after a thorough examination and consultation of a specialist in phytotherapy.

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

Homeopathy

Homeopathic restoration of the ovulatory function can also be very successful. For the treatment of anovulation, constitutional drugs are used more often, so the choice of a homeopath can fall on any remedy from the arsenal of homeopathic medicine. Symptomatic drugs for restoring the ovulatory function are Juniperus Cossack (Sabina juniperus), Eupatorium purpureum, Crocus sativus, Aletris farinosa, Caulophyllum thalicroides and many others. The appointment should be done by a specialist, then there is hope for a successful cure and a lasting effect.

The medicinal treatment regimens can include integrated homeopathic remedies by Heel. They can make a worthy alternative to synthetic hormones.

Muleimen droplets   stimulate the activation of natural immunity, due to which the restoration of disturbed neurohormonal functions of the female body takes place. Its pharmacological properties are determined by the action of the ingredients.

Abraham tree (Agnus castus) - has a favorable effect and normalizes the pituitary-ovarian axis, besides it eliminates spasms of smooth muscles, migraine-like pains and improves mood;

Cimicifuga (Cimicifuga) - complements the antispasmodic and antidepressant effect of the previous component;

Jasmine evergreen (Gelsemium) - corrects defects of sexual development of adolescence;

St. John's Wort (Hypericum) - removes inflammation, regulates the central and autonomic nervous system, corrects endocrine disorders;

Stinging nettle (Urtica) - has a hemostatic effect in dysfunctional uterine hemorrhages, itchy and swollen in the genital area and mammary glands;

Contents of a bag of black cuttlefish (Sepia) - eliminates systemic symptoms of physical and nervous exhaustion;

Substance from the intestine of the sperm whale (Ambra grisea) - it stops signs of insufficiency of female sex hormones;

Calcium carbonicum Hahnemanni and Potassium Carbonate (Kalium carbonicum) - eliminates anxiety, apathy and improves mood;

Contraindications and undesirable effects of the drug are not identified, compatible with any medication.

Drip 15-20 droplets under the tongue from three to five times a day for 30 minutes before meals or 60 minutes later. Swallowed, holding in the mouth. You can dissolve a single dose in a small amount of water (one or two tablespoons) or a day in the glass, drinking evenly throughout the day.

Ginicheel drops  can  also be prescribed for various forms of infertility, including those caused by the absence of ovulation. Their multicomponent composition has a beneficial effect on the sexual sphere of a woman and contributes to the normalization of reproductive processes.

Metallic palladium (Palladium metallicum) - diseases of the uterus and ovary (especially right), accompanied by pain and discharge;

The poison of the honey bee (Apis mellifica) is the absence or too abundant menstruation, dysfunctional uterine bleeding, accompanied by pain, swelling and severe weakness;

Ammonium bromate (Ammonium bromatum) - effective for inflammation of the appendages and its complications;

Aurum iodateum (Aurum jodatum) - beneficial effect on endocrine organs;

The poison of the Indian cobra (Naja tripudians) - diseases of mainly the left ovary, dysmenorrhea, pain, consequences of gynecological operations;

Hornet (Vespa crabro) - ulcers and erosions of the cervix, lesions of the left ovary;

Metallic platinum (Platinum metallicum) - infertility, cysts and tumors, bleeding, vaginismus;

Yellow chamelirium (Chamaelirium luteum) - disorders of the menstrual cycle, the normalization of the production of female sex hormones, prevents spontaneous abortion;

Lilium lancifolium (lilium lancifolium) - pain in the ovaries, sensation of prolapse of genitals, depression, increased excitability, haste;

Kalina vulgaris (Viburnum opulus) - disorders of the menstrual cycle, infertility, pain in the uterus;

Donicant officinalis (Melilotus officinalis) - discharge from the genitals with pains and sore sensations in the lower back.

The drug is prescribed to patients over 18 years of age, with caution used in patients with liver and thyroid pathologies, after traumatic brain injuries. Take 10 drops, dissolved in half a glass of water three times a day, holding in your mouth.

In the treatment of inflammatory gynecological diseases, to increase the effectiveness, the combination with Traumeel C drops is combined, in menstrual cycle disorders - with the homeopathic spasmolytics Spaspucrel.

Alternate injections of Ovarium and Placenta compositum preparations   can be prescribed in the treatment of anovulation.

The first drug includes two dozen components of different origin - organ, vegetable, mineral, and also - catalyzing their action, aimed at regulating hormonal status in disorders of the hypothalamic-pituitary-ovarian axis. The drug improves nutrition and drainage of female genital tissues; normalizes metabolic processes in diseases of the pelvic organs. Has a mild soothing and anti-inflammatory effect.

The second one has a detoxifying, spasmolytic and tonic effect, it has a beneficial effect on the functioning of the pituitary system, improves blood circulation and respiration of tissues.

Drugs are prescribed by one ampoule alternately twice a week. You can use the contents as a drinking solution, diluting it in a tablespoon of water. Swallow, holding in your mouth for a while.

Surgery

At present, laparoscopy is quite widely used in anovulation - a minimally invasive surgical intervention involving the puncture or partial removal of the ovarian medulla under the control of ultrasound equipment.

This operation allows you to release the follicles to exit from them a mature egg and returns the possibility of conception. During the operation, the cysts that produce excess estrogens are removed. This procedure normalizes the activity of the ovaries.

Before the operation, diagnostic scraping of the uterine cavity is carried out to exclude mag- nization. The disadvantage of the method is the lack of a sustainable result. Without further treatment, the effect persists for approximately six months after the operation. Laparoscopic treatment allows for more accurate diagnosis, exclude or confirm the causes of anovulation. Sometimes it allows, by changing the medical technique, to achieve pregnancy.