What to do and how to treat multifollicular ovaries?

Treatment of multifollicular ovaries consists of:

1. Elimination of metabolic disorders and pathologies of the endocrine system. Patients are prescribed medications, most often oral contraceptives and other hormonal drugs. OK reduce the level of androgens and make cells less sensitive to them. With MFN, adolescents use homeopathic remedies for treatment. The duration of such therapy is at least 3 months.
2. The doctor gives recommendations on nutrition and exercise to reduce weight and restore normal body functioning. For women with overweight, the diet is 1500-1800 kcal per day, and for patients with a deficit of weight, the daily calorie is increased. Particular attention is paid to BIO.
3. Vitaminotherapy - regardless of the cause of MFN, patients are prescribed multivitamin complexes with high content of tocopherol and B vitamins.
4. If after the restoration of the hormonal background and the menstrual cycle there is no ovulation, then the ovulation cycle is stimulated. This makes it possible to become pregnant.
5. Psychotherapy. One of the reasons for multifallikulyarnosti - it's stress and emotional experiences. To eliminate this factor and minimize its effect in the future, conversations are held with the psychologist. In especially severe cases, sedatives, antidepressants or tranquilizers may be prescribed.

The syndrome of multifollicular ovaries is treated by a gynecologist-endocrinologist and a number of related specialists. The doctor's task is to eliminate the hormonal imbalance and prevent its disruption in the future, as well as to restore the patient's reproductive abilities.

Medications

The choice of drugs for the treatment of multifollicular ovary syndrome depends on the cause of this condition. Consider the medications prescribed for MPF:

1. Utrozhestan

A medicinal preparation with an active component - progesterone (a hormone of a yellow body of an ovary). Normalizes secretory transformations in the uterine mucosa. Promotes the transition of the endometrium to the secretory phase. Potentiates endometrial changes during fertilization for implantation and embryo development. It has antiandrogenic properties, normalizes the formation of dihydrotestosterone.

• Indications for use: correction of endogenous progesterone deficiency, anovulatory menstrual cycle, premenstrual syndrome, infertility, ovulation disorder, mastopathy. Replacement hormonal therapy with climacteric syndrome. The drug supports the luteal phase of the menstrual cycle in preparation for reproductive technologies.
• Usage: orally in a dosage of 200-300 mg, divided into 2 divided doses. With MFN and insufficiency of the yellow body of the ovary, Utrozhestan is taken from the 16th to the 25th day of the menstrual cycle. Intravaginal application is prescribed in non-functioning ovaries or in the case of egg donation.
• Side effects: intermenstrual bleeding, spotting, headaches and dizziness, hypersensitivity reactions. Overdose has similar symptoms. Treatment is symptomatic with reduced dosage.

Contraindications: allergic reactions to the components of the drug, bleeding from the genital tract of unknown origin, propensity to thrombosis, incomplete abortion, malignant lesions of the mammary glands and reproductive organs, porphyria, severe violations of the liver. Use during pregnancy is possible only for medical purposes.

Utrozhestan is available in capsules of 100 and 200 mg for 30 and 14 pcs. In the blister pack.

2. Acetonepredenol

A drug with high progestogenic activity. The active component refers to female sex hormones produced by the adrenal glands and the yellow body of the ovary. Causes changes in the endometrium and inner layer of the uterus, provides a normal course of pregnancy.

• Indications for use: risk of miscarriage in the first trimester of pregnancy, menstrual irregularities, prevention of unwanted pregnancies.
• Usage: orally 0.5-1 mg 2-3 times a day for 5 days with a repeated course in one cycle. The total dose for one course is up to 15 mg. For preventive purposes, appoint 0.5-1.0 mg 2-3 times a day for 6 days. With dysfunctional uterine bleeding, 0.5-2.5 mg per day from 15 to 24 days of the cycle. Treatment lasts 3-6 cycles.
• Side effects: headaches and dizziness, swelling of the mammary glands, insomnia, allergic reactions.
• Contraindications: increased blood clotting, violations of the liver, tumor neoplasms.

Form release: tablets for oral administration of 0.5 mg of 30 pcs. Packaged.

3. Dimestro

Synthetic drug with an estrogen-like effect. It is used when ovarian function is inadequate. The drug is administered intramuscularly in a 0.6% oily solution. The dosage is individual for each patient. As a rule, injections are carried out once a week for 12 mg / 2 ml of the solution. The course of treatment consists of 2-3 injections. The effect of the first injection appears on the 3-6th day of therapy.

With prolonged use of the drug, there is a risk of uterine bleeding. Dimestrol is contraindicated in neoplasm of genital organs, mammary glands and other organs. It is not used for mastopathy, endometritis, propensity to uterine bleeding, as well as in the hyper-oestrogenic phase of menopause. Ampoules are produced in 2 ml of 0.6% oily solution in a package of 10 pieces

4. Norcoolut

Medication with an active component from the group of progestins - norethisterone. Has the properties of estrogens and androgens. Promotes the transition of endometrial proliferation into the stage of secretion. Maintains endometrium in optimal condition for embryo development. Oppresses the production of gonadotropic hormones of the pituitary gland, which disrupt the maturation of follicles and the process of ovulation.

• Indications for use: violations of the menstrual cycle of various etiologies, PMS, mastodinia, endometriosis, dysfunctional uterine bleeding in menopause, adenomyoma of the uterus. Cystic-glandular changes in the endometrium, cessation of breastfeeding or prevention of lactation.
• Method of application: 5-10 mg from 16 to 25 day of the cycle. The drug is allowed to be used simultaneously with estrogens. The number of treatment courses is determined by the attending physician, individually for each patient.
• Side effects: dyspeptic disorders, headaches, changes in body weight, asthenia, engorgement of the mammary glands.
• Contraindications: malignant neoplasms in the reproductive organs. With special care is prescribed for epilepsy, severe pathology of the liver, heart, kidneys, bronchial asthma, propensity to thrombosis, violations of blood clotting.

Form release: tablets for oral administration of 5 mg of 20 capsules per package.

5. Regevidon

Combined oral contraceptive. Refers to monophasic preparations, contains in equal amounts the estrogenic and gestagenic component. The active substance is levonorgestrel, a synthetic derivative of 19-nortestosterone. Has progesterone activity, but it exceeds the strength of the action. Another active ingredient is ethinyl estradiol, a synthetic analogue of endogenous estradiol.

• Indications for use: contraception in women of childbearing age, correction of functional disorders of the menstrual cycle, dysmenorrhea, functional uterine bleeding. PMS, pain syndrome in the middle of the cycle.
• Method of administration: Orally 1 tablet of white color once a day for 21 days. Further therapy is continued with tablets of red-brown color for 1 pc. Per day for a week. The next course of treatment can be started only 4 weeks after the beginning of the previous one.
• Side effects: dyspeptic disorders, nausea, vomiting, headaches and dizziness, emotional instability. Increased irritability and fatigue, cramps calf muscles, decreased / increased libido. Breast engorgement, skin allergic reactions, intermenstrual bleeding.
• Contraindications: hypersensitivity to the components of the drug, severe violations of the liver, stones in the gallbladder, cholecystitis, hepatitis, chronic colitis. Diseases of the cardiovascular system, lipid disorders, endocrine pathologies, anemia, vaginal bleeding of unknown genesis, and clotting disorders. It is not used during pregnancy and lactation.
• Overdose: nausea, vomiting, epigastal pain, vaginal bleeding. There is no specific antidote, symptomatic treatment with gastric lavage and intake of enterosorbents.

Form release: tablets with enteric coating. The package contains two blisters for 21 and 7 tablets.

6. Remens

Normalizes the functioning of the hypothalamus-pituitary-ovary system. Promotes the restoration of the hormonal background. Contains plant components that have an anti-inflammatory effect in diseases of the pelvic organs, reduce blood pressure and reduce the symptoms of menopause.

• Indications for use: amenorrhea, oligomenorrhoea, dysmenorrhea, algodismenorea, PMS, menopause. Complex treatment of adnexitis and endometritis.
• Method of application: in 1-2 days 10 drops / 1 tablet 8 times a day, starting from 3 days 10 drops / 1 tablet 3 times a day. Duration of treatment is 3-6 months.
• Side effects: allergic reactions, hypersalivation.
• Contraindications: individual intolerance to the components of the drug. Application during pregnancy is possible in the event that the potential benefit to the mother, higher risks for the fetus.

Form release: tablets in blisters for 12, 24, 36 and 48 pcs., Drops for oral use in bottles of 20 ml, 50 ml and 100 ml.

Use the above drugs can only be for medical use with the observance of dosage and duration of therapy.

Stimulation in multifollicular ovaries

If the syndrome of MFW caused female infertility, then the method of stimulation of ovulation is used for treatment. Its main goal is to help the body to form an egg that is capable of fertilization and its release from the follicle. This technique is an effect on the ovaries with the help of hormonal medications that enhance the release of hormones necessary for ovulation.

Stimulation with multifollicular ovaries is carried out in such cases:

• Anovulatory cycle.
• High / low body mass index.
• Hormonal dysfunction, incurable in other ways.
• Infertility of unknown etiology.
• Preparation for IVF and other methods of artificial insemination.

Before the procedure, a woman is prescribed a set of studies to exclude contraindications to ovulation stimulation: obstruction of the fallopian tubes, inflammatory processes in the pelvic organs, and hormonal imbalance.

Particular attention is paid to the estimation of the ovarian reserve. This study determines the intensity of ovulation and the likelihood of its onset with stimulation. For analysis, blood is taken after taking hormonal drugs. The results allow to choose the optimal therapy scheme with the most effective medicines.

To stimulate ovulation, there are several groups of drugs:

• Medications based on human menopausal gonadotropin.
• Medicines based on follicle-stimulating hormone.
• Drugs that depress estrogen and increase FSH.
• Hormones that stimulate the rupture of the follicle and release the egg.

Stimulation is performed no more than 6 times, as it can cause exhaustion and rupture of the ovaries, cystic neoplasms. There is also a risk of violations from the central nervous system, digestive tract, a set of excess weight, hormonal disorders. If after the passed therapy the pregnancy has not come, then the patient is prescribed other methods of treatment.

Treatment of multifollicular ovaries by hormonal means

To date, the pharmaceutical market has many medicines for the treatment of multifolliculosis and its complications. Therapy is carried out with the help of hormonal preparations, as a rule these are the following means:

• Follicle-stimulating and luteinizing hormones - stimulate ovulation and growth of follicles in the ovaries, increase the chances of successful conception.
• Preparations of human chorionic gonadotropin - support the dominant follicle, help to bring the egg to the sperm for fertilization.
• Progesterone - prepares the inner layer of the uterus to fix the embryo. It helps to endure the fetus safely.

Consider the popular hormonal drugs for the treatment of multifollicular ovaries and the features of their use:

1. Lindinet

Combined oral contraceptive. Contains three active components: lindineth, ethinyl estradiol and gestodene. Reduces the secretion of gonadotropic hormones in the pituitary gland. Regulates the menstrual cycle, changes the nature of cervical mucus. Reduces the risk of developing dysmenorrhea, functional ovarian cysts and ectopic pregnancy. It prevents stagnant and inflammatory processes in the organs of the small pelvis, improves the general condition of the skin with acne eruptions.

• Indication for use: prevention of unwanted pregnancy, functional disorders of the menstrual cycle.
• Method of administration: oral from the first day of the menstrual cycle, 1 capsule per day for 21 days. After a week's break, the chicken continues treatment.
• Side effects: engorgement of the mammary glands, bleeding bleeding, increased blood pressure. Nausea, vomiting, diarrhea, worsening of outflow of bile. Changes in libido, fungal infections of the vagina, headaches and dizziness, lower abdominal pain, allergic reactions.
• Contraindications: individual intolerance of the components of the drug, severe violations of the liver, thrombosis, pathology of the cardiovascular system, metabolic disorders. Tumor neoplasms, a tendency to uterine bleeding of unexplained etiology, epilepsy, pregnancy and lactation, age over 35 years.
• Overdose: nausea, vomiting, vaginal bleeding. There is no specific antidote, treatment is symptomatic.

Product: coated tablets 21 pcs. In the blister on 1, 3 blisters in the package.

2. Pureghon

The drug with recombinant follicle-stimulating hormone is foliotropin beta. Stimulates the growth and maturation of follicles, the normal synthesis of steroid hormones in the reproductive system in women with ovarian failure.

• Indications for use: anovulatory cycles, infertility, polycystic ovary syndrome. The drug is prescribed for the control of ovarian hyperstimulation during the induction of the development of multiple follicles with assisted reproduction. The distillation can be used to treat men with insufficiency of spermatogenesis due to hypogonadotropic hypogonadism.
• Method of application: parenterally (subcutaneously, intramuscularly), dosage and duration of treatment is determined by the attending physician, individually for each patient.
• Side effects: local reactions in the field of drug administration, edema, soreness, skin rashes, allergic reactions. Headaches and dizziness, engorgement of the mammary glands, pain in the nipples, vaginal bleeding.
• Contraindications: individual intolerance of drug components, hormone-dependent tumors and any other neoplasms, vaginal bleeding of unexplained etiology, violations of the anatomy of the genitals, uterine fibroids, endocrine diseases. It is not used during pregnancy and lactation.
• Overdose: the development of ovarian hyperstimulation. Treatment is symptomatic.

Product: bottles of 50 or 100 IU.

3. Diferelin

Synthetic analogue of natural gonadotropin-releasing hormone. The active ingredient is tryptorelin. Stimulates the gonadotropic function of the pituitary gland and inhibits it. Suppresses the functions of the ovaries and testes.

• Indications for use: anovulatory cycles, stimulation of fertilization in IVF programs. Higher doses of the drug are effective in prostate cancer, breast cancer, uterine myoma, endometrioid cysts. The way of application and dosage is individual for each patient.
• Side effects: demineralization of bones, allergic reactions, decreased libido, obstruction of the ureters, headaches and excessive sweating. Vaginal dryness, ovarian hyperstimulation syndrome, hypogonadotropic amenorrhea. Nausea and vomiting, hot flashes, emotional lability. Peripheral edema, weight gain. Overdose has similar symptoms, treatment is symptomatic.
• Contraindications: hypersensitivity to the components of the drug, osteoporosis, pregnancy and lactation, hormone-resistant prostate cancer.

Form release: lyophilizate in vials of 0.1 mg, 3.75 mg and 11.25 mg.

4. Gonal

The drug with the active substance is follitropin alfa. Recombinant human follicle-stimulating hormone. Affects the growth and development of follicles. Has gonadotropic properties, stimulates the process of ovulation.

• Indications for use: anovulation, ovarian hyperstimulation, stimulation of spermatogenesis, ovarian stimulation in severe deficiency of FSH, LH. The drug is released in syringes-pens for p / c injection. Dosage and treatment is chosen by the doctor, individually for each patient.
• Side effects: skin hyperemia, headaches, nausea and vomiting, acne, itching, formation of ovarian cysts, diarrhea, thromboembolism, multiple pregnancies. Syndrome of hyperstimulation, weight gain, pain in the epigastric region.
• Contraindications: hypothalamic-pituitary tumors, ovarian and breast cancer, premature menopause, hypersensitivity to the drug components, ovarian failure, uterine fibroids, pregnancy and lactation.
• Overdose: Ovarian hyperstimulation syndrome. Treatment is symptomatic.

Form release: injection solution, lyophilizate 0.5 ml, 0.75 ml and 1.5 ml.

5. Folliculin

A natural follicular hormone, has an estrogenic effect. It is used for diseases that occur with insufficient functions of the ovaries, acne, viral hypertrichosis. The drug is effective in amenorrhea, dysmenorrhea, hormonal disorders.

Dosage and duration of therapy is determined by the attending physician. Folliculin Contraindicated in neoplasm of genital organs and mammary glands, mastopathy, propensity to uterine bleeding of an unknown genesis. Long-term use can cause uterine bleeding. The preparation is issued in the form of an oily solution in ampoules of 1 ml of 6 pcs. Packaged.

6. Horses

The composition of the drug includes gonadotropin chorionic of natural origin. The active ingredient is isolated from the urine of pregnant women, purified and sterilized. Upon ingestion, it has an effect similar to that of the luteinizing hormone of the pituitary gland. Thanks to this, the maturation of the yellow body occurs, the synthesis of progesterone and estrogens is intensified, ovulation occurs.

• Indications for use: gonadal gland hypofunction with dysfunction of the hypothalamic-pituitary system, dysmenorrhea, anovulatory cycle, yellow body deficiency, ovarian superstimulation in reproductive technologies, threat of spontaneous miscarriages. Adiposogenital syndrome, hypogenitalism, oligoasthenospermia.
• Method of application: lyophilizate solution is administered intramuscularly. Dosage and duration of treatment is determined by the attending physician.
• Side effects: hypersensitivity reactions, pain at the injection site, headaches and asthenic conditions, increased anxiety, suppression of the synthetic functions of the pituitary gland and others.
• Contraindications: hypersensitivity to the components of the drug, ovarian cancer, hyperprolactinemia, androgen-dependent tumors, pregnancy and lactation, hypothyroidism, tubal obstruction, early menopause, thromboembolic disorders, ectopic pregnancy in anamnesis. Cystic ovarian formations (not associated with polycystosis), adrenal insufficiency, gynecological bleeding of unclear etiology.
• Overdose: Ovarian hyperstimulation syndrome. Treatment is symptomatic.

Form release: powder lyophilizate for parenteral administration of 1500 and 5000 IU, 3 ampoules per package.

All of the above medicines are only used as directed by your doctor.

Duphaston in multifollicular ovaries

The drug on the basis of female sex hormones is Dufaston. The drug contains dydrogesterone 10 mg in 1 capsule. The active component is an analog of natural progesterone. Does not have an androgenic, corticoid or estrogenic effect.

Does not affect the metabolic processes, but selectively affects the progestin receptors of the uterine mucosa. Causes secretory transformations in the endometrium with sufficient estrogenic saturation. Does not affect follicular ovulation, does not possess virilizing properties.

• Indications: endogenous progesterone deficiency, endometriosis, PMS, menstrual irregularities, amenorrhea. Habitual loss of fetus, threatening abortion, dysmenorrhea. Hormone replacement therapy.
• The method of application and the dosage regimen is selected by the attending physician, individually for each patient. To obtain the maximum therapeutic effect, the clinical signs of the disease and the phase of the menstrual cycle are taken into account.
• Side effects: bleeding, individual reactions of drug intolerance. Overdose has a similar symptomatology. Symptomatic therapy is indicated for treatment.
• Contraindications: hypersensitivity to the components of the drug, Rotor syndrome, Dabin-Johnson syndrome. The drug can be used during pregnancy, but lactation should be discarded, since the active ingredient penetrates into breast milk.

Duphaston has a tablet form for oral administration.

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Clostilbite

The antagonist of female sex hormones with an active component is clomiphene. The active substance belongs to the group of antiestrogens, which stimulate the process of ovulation. Stimulation is carried out by increasing the synthesis of sex hormones through the effect on estrogen hormones in the ovaries and the hypothalamus.

• Indications for use: Chiari-Frommel syndrome, Stein-Levental syndrome, galactorrhea, amenorrhea and other conditions with no ovulation.
• Method of application: if the menstrual cycle is maintained, then the treatment is started on the 5th day of the cycle. The patient is prescribed 50 mg per day up to the 10th day of the cycle. Ovulation occurs on the 11-15 day of the cycle. If ovulation does not occur, then in the next period the dosage is increased to 100 mg. The total dose for a course of therapy should not exceed 750 mg.
• Side effects: headaches, nausea, dizziness, increased anxiety, asthenic state, depression, epigastric pain, vomiting, weight gain. In rare cases, note the increase in the ovaries to 5-8 cm, skin allergic reactions, urination disorders and chest pain. When treating this drug should be noted that it significantly increases the risk of multiple pregnancies.
• Contraindications: intolerance of drug components, pregnancy, liver disease, history of uterine bleeding, oncological processes in the body, decreased function of the pituitary gland, ovarian cyst.
• Overdose: nausea, vomiting, epigastric pain, impaired vision, enlarged ovaries. Treatment of symptomatic, there is no antidote.

Klostilbegit has a tablet form of release of 50 mg in each tablet, 10 capsules per package.

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AMG in multifolllicular ovaries

Antimulylerov hormone (AMG) - is produced by granulosa cells of the ovaries. Actively affects the growth and formation of tissues. Participates in sexual function, affects the reproductive system. Violation of the production of this substance or a change in its level negatively affects the ability to become pregnant. The analysis on AMG is appointed in such cases:

• Infertility of unknown genesis.
• High values of follicle-stimulating hormone.
• Multifollicularity.
• Polycystic ovary syndrome.
• Suspicions for granulosa cell lesions of the ovaries.
• Unsuccessful attempts at artificial insemination.
• Monitoring the effectiveness of anti-androgen treatment.

The level of antimulylerova hormone is assessed by the functional capacity of the ovaries, the number of ovules. The level of AMG depends on the age of the woman. Before puberty, that is, the first menstruation, the hormone is not determined at all. Its values are zero during the menopause. The maximum values are fixed in 20-30 years, that is, at the peak of female fertility.

When studying the results, the ovarian period is taken into account, that is, the number of remaining eggs that can ovulate and be fertilized.

• With multifolllicular ovaries, AMH is elevated and such women have a greater chance of successful in vitro fertilization. High characters for polycystic, ovarian tumor, delayed sexual development, anovulatory infertility.
• At low values of a hormone there are difficulties with natural conception. This condition is observed during menopause, with improper operation of the ovaries, obesity, early puberty.

The analysis on AMG is carried out on the third day of the cycle. To obtain reliable results, a few days before the analysis, you should minimize physical stress and stress overexertion, and quit smoking. In this case, acute respiratory viral infection and influenza are a contraindication for taking the test. For the study, the venous blood sampling takes place, the result is ready in 2-3 days. The analysis of the analysis is handled by a gynecologist.

Metformin in multifollicular ovaries

Very often, with MPJ, insulin resistance is observed, that is, the disturbed biological response of the body to the action of insulin. It does not matter where the hormone comes from the pancreas or injections. To treat this condition, use drugs, one of which - Metformin.

The drug refers to oral anti-diabetic drugs from the biguanide class. Its mechanism of action is based on the inhibition by the active component of gluconeogenesis in the body. Due to this, the transport of electrons in the respiratory chain of the mitochondria is slowed, which entails a decrease in ATP and stimulation of glycolysis.

• Indications for use: diabetes mellitus type 1, type 2. Supplement to the main insulin therapy or in combination with other antidiabetic drugs. Obesity, the need to monitor blood glucose levels.
• Directions for use: by mouth after eating, with plenty of liquid. The initial dosage is 1000 mg per day, divided into 2-3 doses. After 10-15 days, the dosage is increased. The maintenance dose is 1.5-2 g per day, the maximum allowable dosage is 3 g per day. A persistent therapeutic effect is observed after 10-14 days of drug administration.
• Side effects: disorders of the stool, nausea, vomiting, pain in the epigastric region, anorexia, metallic taste in the mouth, skin allergic reactions.
• Contraindications: hypersensitivity to the components of the drug, age less than 15 years, diabetic precoma or ketoacidosis, gangrene, dehydration of the body. Renal / hepatic dysfunction or insufficiency, diabetic foot syndrome. Lactatecidosis, chronic alcoholism, severe infectious diseases, nutrition with a daily caloric content of less than 1000 kcal. Pregnancy and lactation, extensive injuries and surgical interventions, intra-arterial or intravenous administration of drugs with iodine.
• Overdose: vomiting, diarrhea, nausea, muscle weakness and pain, fever, headaches and dizziness. Treatment is symptomatic, hemodialysis is effective.

Metformin is available in the form of tablets with a film coating of 500 and 850 mg of 30, 120 tablets in a blister pack.

Yarin with multifollicular ovaries

Combined estrogen-progestogen-containing hormonal with contraceptive properties. Contains two active components: 3 mg of drospirenone and 0.03 mg of ethinylestradiol. The contraceptive effect is due to inhibition of ovulation and a change in the viscosity of the cervical mucus. Because of this, the endometrium remains unprepared for implantation of the ovum, and the viscosity of the cervical mucus makes it difficult to penetrate the spermatozoa into the uterine cavity.

Yarina has anti-androgenic activity, reduces the formation of acne and reduces the production of sebaceous glands. Does not affect the level of globulin, which binds sex hormones. In combination with ethinyl estradiol, it improves the lipid profile, increasing the concentration of HDL. Has a positive non-contraceptive effect on the body: reduces the risk of anemia, reduces symptoms of PMS, makes menstrual bleeding easier and shorter.

• Indications for use: prevention of unwanted pregnancy, hormone-dependent edema, seborrhea, acne.
• Usage: 1 capsule every day at the same time for 21 days. Each next package is started after a one-week break, during which menstrual bleeding is possible. It is recommended to start therapy on the 2nd-5th day of the cycle with the additional use of barrier contraception.
• Side effects: soreness of the mammary glands, discharge from the chest, headaches and dizziness, decreased libido, mood changes. Nausea, vomiting, changes in vaginal secretion, fluid retention in the body, changes in body weight, sensitivity reactions.
• Contraindications: hypersensitivity to the components of the drug, the presence of thromboses or conditions preceding thrombosis, diabetes mellitus with vascular complications. Liver diseases, renal / hepatic insufficiency, liver tumors. Vaginal bleeding of unknown origin, pregnancy and lactation.
• Overdose: nausea, vomiting, small vaginal bleeding. There is no specific antidote, treatment is symptomatic.

Yarina is available in packs of 21 capsules for oral use.

Cyclovitis with multifollicular ovaries

Biologically active additive, affecting the genitourinary system and normalizing the cyclic processes in the body. The drug is designed for women of fertile age to eliminate pathological conditions in the menstrual cycle and gynecological diseases.

Cyclovite contains a complex of vitamins and minerals: A, Group B, C, D3, E, PP, copper, selenium, zinc, iodine, manganese, rutin, lutein. Each tablet is intended for a certain period of the menstrual cycle.

• Indications for use: normalization of the menstrual cycle with deficiency of vitamins and minerals, regulation of the abundance of secretions, elimination of complications of hormonal changes and blood loss.
• Method of application: treatment starts from the first day of the month and until the 14th, taking 1 tablet of red color. From the 15th day, a blister with blue tablets starts taking 2 capsules a day. If the cycle is less than 28 days, then the drug is stopped taking on the first day of menstruation. If the cycle is more than 28 days, then you should take a break in treatment before the start of the 1 day of menstruation.
• Contraindications: hypersensitivity to the components of the drug, age younger than 14 years, male patients, pregnancy and lactation. There have been no cases of overdose.

Form of release Ciclovitis: tablets of red 14 pcs. And blue 28 pcs. Colors in the package.

Inofert for multifolllicular ovaries

Biologically active food additive, contains two active components:

• Inositol is a vitamin factor of the B group. It is found in citrus fruits, whole grains, peanuts, wheat germs, legumes, yeast. In the body is present in phospholipids, stimulates endogenous synthesis of lecithin. It controls the metabolism of fats and sugars, the cellular functions of the nervous system. Regulates the parameters of follicle-stimulating hormone. It restores the regularity of the menstrual cycle and the process of ovulation. Eliminates metabolic and reproductive disorders.
• Folic acid - water-soluble vitamin B9, takes part in the metabolism of amino acids. It synthesizes proteins, nucleic acids and takes part in the repair of chromosomes. Contained in green vegetables, liver, eggs, legumes, meat and milk.

The drug is used as an additional source of folic acid and inositol. Used in the protocols of controlled ovarian hyperstimulation, with polycystic and multifollicularity due to insulin resistance, pre-diabetes and type 2 diabetes,

Dosing and Administration: 1 packet per meal. The contents of the sachet are dissolved in a glass of water. Duration of treatment is 30 days. Inofert is contraindicated in case of hypersensitivity to its active components.

Jesse with multifollicular ovaries

The hormonal contraceptive contains two active components: ethinylestradiol (in the form of betadex clathrate) 0.02 mg, drospirenone 3.00 mg. It restores the regularity of the menstrual cycle, prevents an unwanted pregnancy. Reduces the risk of ovarian and endometrial cancer.

Has an antimineralocorticoid effect, reduces the risk of edema due to the action of estrogens and fluid retention. It alleviates the painful symptoms of the premenstrual period. Reduces the symptoms of acne, the fatness of the skin and hair. The mechanism of action of the drug is similar to the activity of natural progesterone, produced by the body.

• Indications for use: contraception, severe premenstrual syndrome, mild form of acne.
• How to use: tablets are taken in the order indicated on the packaging at the same time. Treatment should be continuous for 28 days.
• Contraindications: thrombosis and prethrombotic conditions, diseases of the coronary arteries and cerebral vessels, arterial hypertension, prolonged immobilization due to surgical intervention. Pancreatitis, liver tumors, renal / hepatic insufficiency. Hormone-dependent malignant processes in the body, pregnancy and lactation. Hypersensitivity to the components of the drug, vaginal bleeding of unknown etiology.
• Side effects: nausea, vomiting, pain in the abdomen and mammary glands, irregular uterine bleeding, bleeding of an unknown genesis. Arterial and venous thromboembolism, mood swings, decreased libido, allergic reactions.
• Overdose: nausea, vomiting, spotting spotting from the vagina. Treatment is symptomatic, there is no specific antidote.

Jess is available in blisters for 28 tablets for oral administration.

Vitamins

The weakened immune system is one of the causes of many diseases. In combination with hormonal imbalance, it causes problems with the menstrual cycle, reduces the level of libido. There are headaches, increased anxiety, urinary tract infections and a number of other disorders, the progression of which can cause MFN.

Consider the most useful vitamins for patients with MFN:

• B6 - supports the hormonal balance, promotes the normalization of the level of progesterone, estrogen, androgens and glucocorticoids. Takes part in the formation of glucose and the exchange of amino acids. Pyridoxine is found in foods such as bananas, chicken, turkey, beef, cod, tuna, salmon, perch, halibut.
• B8 - increases the sensitivity to the hormone insulin, promotes the transfer of glucose to the cells of the body. Inositol reduces testosterone and restores the ovulatory function.
• B9 - beneficially affects the functioning of the entire reproductive system. Folic acid protects against neural tube defects of the fetus, which can occur in the early stages of pregnancy. Vitamin is prescribed both at the stage of pregnancy planning, and during gestation.
• B12 - is necessary for patients who take oral contraceptives. Cyanocobalamin normalizes the level of estrogens in the blood and maintains mental health. Contained in salmon, beef, lamb, shrimp, scallops.
• C - prevents damage to healthy cells by free radicals. Reduces the level of cortisol and reduces stress stress, which is exacerbated by hormonal imbalance. Ascorbic acid regulates the production of thyroid hormones, reduces the level of histamine, stimulates the immune system. Products with high antioxidant content: red pepper, broccoli, strawberries, cauliflower, kiwi, melon, oranges.
• D - deficiency of this vitamin is one of the factors of metabolic disturbances in MFN. According to the research, about 30% of women with multifollicularity and PCOS lack this substance. In combination with calcium reduces the risk of developing diabetes, improves sensitivity to insulin.
• E - improves the production of progesterone and normalizes the quantity of estrogen. Tocopherol reduces the level of prolactin in the blood. Its antioxidant properties regulate the vitamin A content, improve the skin condition and reduce wrinkles. Vitamin alleviates menstrual pain. Contained in such products: sunflower seeds, blueberries, olives, spinach, almonds.

Vitamins for multifolu-lukular ovaries are prescribed at all stages of correction of this condition. The doctor selects useful substances individually for each patient. This is due to the fact that some vitamins induce ovulation, others reduce the level of cortisol and testosterone in the blood, lower prolactin or increase progesterone.

Physiotherapeutic treatment

To accelerate the recovery processes in gynecology, physiotherapy techniques are often used. With MFY, physiotherapy is aimed at normalizing the hormonal background, reducing pathological processes in the ovaries and strengthening the body.

The use of physiotherapy causes such reactions:

• Normalization of metabolic processes.
• Reduction of inflammatory processes.
• Thinning of a dense shell of appendages.
• Reduction of pain.
• Stimulation of ovulation.
• Improvement of microcirculation and lymph flow in the sex glands.

The main techniques used in the syndrome of multifollicular ovaries:

1. Galvanophoresis - the procedure is carried out using various active drugs, most often with vitamin B1 or Lydase. Under the influence of low-voltage galvanic current, the drug passes the epidermis and gets to the sex glands. Lidase improves blood flow, triggers enzymatic activity in organs. B1 affects the metabolic processes in the body.
2. Magnetotherapy - a low-frequency magnetic field is used for treatment. The effect is directed to the collar zone, which regulates the pituitary and hypothalamus.
3. Mud treatment - medical mud is applied to the abdomen in the appendages. Thanks to this, metabolic processes are improved and ovary capsules softens.
4. Hydrotherapy - anesthetizes, has an anti-inflammatory, soothing and improving blood supply in the reproductive organs action. For treatment, use sodium chloride, sea or conifer baths, Charcot's douche or circular.

Contraindications to physiotherapy:

• Exacerbation of chronic diseases.
• Pathologies in an acute form.
• The general or common serious condition.
• Uterine bleeding.
• Infectious processes in the body.
• Oncological pathologies of any localization.
• Early postoperative period.
• Psychoneurological disorders.
• Diseases of the genital organs: condyloma of the vagina, dysplasia, polyps in the uterus.

Physiotherapy is started on the 5th-7th day of the menstrual cycle. Treatment during menstruation is not carried out, since there is a risk of severe bleeding. Before the procedure, you should empty the bladder and do not go to the toilet for 30 minutes after. The therapeutic effect persists for 6-12 months.

Alternative treatment

To restore the hormonal background, many women resort to using non-traditional methods. Consider the most popular recipes for alternative treatment of MFIA:

1. Take in equal proportions grass nettle and yarrow. Pour vegetable raw materials 250 ml of boiling water and let it brew for 10-12 hours. Strain and take in small portions throughout the day. The course of treatment is 30 days with a weekly break and repeated intake of the present. To normalize the work of the ovaries therapy should last at least 6 months.
2. Take 100-80 g of herb red brush and pour 500 ml of alcohol or vodka. The resulting solution is poured into a container with a tight lid and put in a dark place for 7 days. After a week, strain and take ½ teaspoon 3 times daily before meals.
3. Take in equal proportions such ingredients: buckthorn bark, birch leaves, peppermint, herbs millennia and the root of valerian. Mix all ingredients and chop. A tablespoon of the collection pour 300 ml of boiling water. After 6 hours strain and take during the day in small sips. Infusion normalizes the work of the hypothalamic-pituitary system.
4. 1 kg of mature viburnum fruits mix with a liter of liquid honey and the same amount of 70% medical alcohol. Thoroughly mix everything and put in a closed container to insist for a week in a dark place. After a week, mix everything again and take 1 tablespoon in the morning and evening.
5. Spread a tablespoon of soda with vinegar, add 100 ml of alcohol and 20 ml of water. Thoroughly mix everything and soak in the resulting liquid gauze bandage. Adapt the compress at night on the groin area. The procedure is recommended to be performed daily for 14 days. After a month's break, the treatment should be continued.

Application of the above recipes is possible only after the permission of the attending physician.

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

Herbal Treatment

Medicinal plants are popular in the treatment of many diseases, including multifollicular ovaries. Vegetable broths and infusions gently affect the female body, normalize the hormonal background and restore ovulation.

Herbal treatment can be carried out using such recipes:

1. 50 g of ground peony roots, pour 500 ml of vodka or 70% alcohol. The infusion is placed in a container with a lid and placed for 10 days in a dark cool place, shaking daily. After that, the medicine is filtered and taken on 30 drops 3 times a day for 30 minutes before meals. The course of treatment is 2 months.
2. A tablespoon of chopped herb Kirkazon pour 250 ml of boiling water and cook for 5 minutes over low heat. Remove from the plate, wrap and let it brew for 2-3 hours. Strain and take 1 tablespoon 4-5 times a day.
3. Mix in equal proportions horsetail grass, nettle, dog rose, dandelion and mint root. Thoroughly grind everything and brew in a glass of boiling water a spoonful of the mixture. Strain and take ½ cup 2 times a day. The duration of treatment with this prescription should be less than 6 months.
4. Take in equal proportions grass kirkazona, sporisha and heather ordinary. A tablespoon of the collection pour 250 ml of boiling water and cook on low heat for 10-15 minutes. Strain and use for syringing from the 3rd to the 15th day of the menstrual cycle for 2-3 cycles.
5. Take 100 g of crushed leuzea root safflower and pour 500 ml of vodka. The drug should be infused for 30 days in a closed container at room temperature. Ready infusion filter and take 20 drops 3 times a day for 30 minutes before meals. The course of treatment is 2 months.

Before using the above recipes, you need to consult your doctor. It should be noted that the treatment with herbs is contraindicated in allergic reactions to plant components, severe violations of kidney and liver function.

Boron uterus

Ortilia lopsided refers to the family of heather. In people, the plant is called grass from forty diseases or a borax uterus. Its medicinal properties are confirmed by official medicine, medicinal preparations are manufactured from it.

The plant includes phytohormones, phytoestrogens and phytoprogesters, as well as glycosides, coumarins, arbutin, acids, saponins, tannins, vitamins and microelements, necessary for the female body. A rich composition has such an effect on the body:

• Strengthens the cardiovascular system.
• Normalizes blood pressure.
• Prevents the growth of malignant cells.
• Prevents ischemic heart disease.
• Antimicrobial and anti-inflammatory action.
• Immunostimulating.
• Anesthetic.
• Diuretic.

The bovine uterus has a wide range of applications:

• Infertility.
• Violations of the hormonal background.
• Violations of the menstrual cycle.
• Inflammatory processes.
• Endometriosis.
• Mastopathy.
• Fibroma.
• Polycystic ovary.
• Spikes in the organs of the small pelvis.

The herb is prescribed for diseases of the digestive tract, locomotor apparatus, endocrine pathologies. The boron uterus with MFN normalizes the hormonal background and helps restore the menstrual cycle and ovulation. Also, the plant reduces the painful symptoms during the menopause.

For women with a decreased level of estrogen, one-sided orthility should be taken in the second phase of the menstrual cycle. For the treatment of anovulatory cycles and infertility caused by MPL, such recipes are used:

• 10 grams of dry herbs, pour 250 ml of boiling water and let it brew for an hour. Strain and take 1 tablespoon 3 times a day after meals.
• 20 g of the plant, pour 400 ml of chilled water and put on a water bath for 5-10 minutes. After cooling, strain through gauze and take 1 spoon 3-4 times a day.
• Take 50 g of grass and 500 ml of vodka. Mix the ingredients in a glass container with a tight lid. The drug is infused for 30 days, then it is filtered. Alcohol tincture is taken on 15 drops 3 times daily before meals.
• 50 g of fresh herbs, pour 200 ml of vegetable oil and let it brew for 1-1.5 months. The ready-mixed mixture is used for compresses or oral administration.

Use boron is possible only for medical purposes. The plant contains potent substances, which, if incorrectly dosed, negatively affect the state of the body.

Also, the plant has a number of contraindications for use: patients under 14 years of age, pregnancy and lactation, individual intolerance to grass components, menstruation, hormonal therapy, peptic ulcer, hepatic insufficiency, genital tumors, tendency to bleeding.

[10], [11]

Sage

Popular in alternative medicine plant in the inflorescences and leaves which contain essential oils, linalool, aromatic resins, acids (formic, acetic) and tannins are sage. In its seeds is 30% fatty oil and 20% protein, the roots contain coumarin.

The healing properties of sage:

• Anti-inflammatory.
• Antimicrobial.
• Haemostatic.
• Restorative.
• Increases the secretory activity of the digestive tract.
• Increases the secretion of bile juice.
• Reduces perspiration.

Special popularity of sage was in the treatment of gynecological diseases. The plant contains hormones that stimulate the process of ovulation, that is, the maturation of the follicles and the formation of the egg.

Effects of plants on the reproductive system:

• Normalizes the hormonal background.
• Increases the level of estrogen in the blood.
• Warns and treats endometriosis.
• Regulates and restores the menstrual cycle.
• It alleviates the symptoms of PMS and menopause.

With multifollicular ovaries and their complications from sage prepare infusion. Finely chopped tablespoon of herbs pour 200 ml of boiling water. The product should be infused in a tightly closed container for 15 minutes. Then it is filtered and taken 1/3 cup 3-4 times a day before meals.

For conception, infusion is taken from the 4 days of the menstrual cycle and to the expected ovulation. With the anovulatory cycles, the infusion begins to be taken on any day of the cycle, counting it as day 5 from the onset of menstruation. When pregnancy begins, the sage should be discontinued. Infusions and decoctions from the plant are contraindicated in hypersensitivity to its components, as well as during lactation.

Homeopathy

An alternative method, which is used in the treatment of many diseases - is homeopathy. Homeopathic remedies are selected based on the constitutional type of patient. That is, not only the causes and symptoms of pathology are taken into account, but also the functional signs of the organism caused by different factors.

Homeopathic preparations:

• Apis - normalizes the work of the ovaries, heals and prevents the development of endocrine disorders in the early stages of pregnancy.
• Aurum Iodine - multifolliculosis, cysts of appendages, myoma of uterus.
• Barberis - stitching and burning pains in the lower abdomen.
• Aurum Metallicum - hormonal disorders, atherosclerosis, hypertension.
• Iodium - ovarian hypofunction, mastopathy, painful sensations in the lower abdomen.

To apply homeopathic preparations it is possible only after consultation with the attending physician. All medications and the scheme of their use are selected by a homeopath, individually for each patient.

Surgery

If conservative methods of treatment did not give the expected result, then surgical intervention can be shown. The main indications for the operation are hyperplastic changes in the tissues of the ovary and endometrium.

Surgical treatment is performed using a minimally invasive method - laparoscopy. This is due to the fact that the traditional operation of laparotomy leaves behind many complications, one of which is adhesive processes in the pelvic organs and the abdominal cavity.

Another effective surgical method is cauterization. The operation is aimed at removing the underdeveloped capsules and superfluous dominant follicles. Timely treatment allows you to fully restore the functionality of the ovaries and ovulation, to avoid the problem of infertility.

Laparoscopy of multifollicular ovaries

A popular minimally invasive surgical method of treatment is laparoscopy. It is used both for medical and diagnostic purposes. The main indications for its conduct with multifollicular ovaries are:

• Unsuccessful conservative therapy.
• Infertility due to lack of ovulation.
• Tumor neoplasms.
• Pronounced intermenstrual pain.
• Removal of undeveloped follicles.
• Polycystic ovary changes.

Before the operation, the patient is prescribed a set of preparatory measures: general clinical tests, blood for syphilis, HIV and hepatitis, ultrasound of the pelvic organs, chest X-ray, a swab of the genital flora.

12 hours before the planned procedure, the patient must give up eating and minimize the use of fluids. This is necessary in order to avoid vomiting during the postoperative period. Also, a day before the operation, bowel cleansing is performed with enemas or laxatives.

If, after laparoscopy, both ovaries are preserved, the chances of successful conception increase significantly. It is recommended to plan pregnancy in the next cycle or after complete recovery. The rehabilitation period lasts for a month. Ovulation occurs on the 10-14 day. In rare cases, there are minor delays in menstruation. Also, many patients note the occurrence of intermenstrual smearing discharge within 7-14 days, which pass as they recover.

Diet and nutrition in multifolllicular ovaries

For a full-fledged operation of the ovaries, a balanced diet is necessary. That is, the diet with MPJ is an obligatory component of complex treatment. A healthy diet increases the production of the necessary hormones, promotes normalization of body weight and accelerates the healing process.

Rules of dietotherapy:

• The basis of the diet should be products with a low glycemic index. The minimum amount of carbohydrates facilitates the pancreas and normalizes the production of insulin.
• Balance of proteins, fats and carbohydrates. It is necessary to limit the use of animal fats, which are rich in cholesterol.
• Fractional meals - 5-6 meals a day in small portions. The daily diet should be within 1500-1800 kcal.

Healthy foods:

• Liver and lean meat.
• Egg yolks.
• Products of beekeeping.
• Dark bread and bran.
• Carrots, sea buckthorn, red sweet peppers, pumpkin.
• Vegetable oils.
• Beans, cereals, nuts.
• Citrus.
• Seafood.
• Dairy products.

During the diet, you should stop using harmful products for the female reproductive system: fast food, baked goods, potatoes, sweets, fast food and with various chemical additives (flavors, dyes, flavors). Under the ban enters alcohol, which launches destructive processes in the ovaries and disrupts their work.

[12], [13], [14]