A fairly significant proportion of pregnancies are interrupted before the twelfth week, and one of the reasons for this is considered to be hyperandrogenism in women during pregnancy. This phenomenon indicates an increase in the amount of active male sex hormones in female body. However, not every woman knows that this is a very a big problem even at the planning stage, although this syndrome is noticeable even visually. In the article we will discuss the issue of pregnancy and hyperandrogenism syndrome in women.
What hormones are needed for what?
Hormones are highly active substances, they are required to maintain the normal functioning of the genital organs and, thanks to them, secondary sexual characteristics are formed. Every woman has normal conditions there is always a small amount of active androgens - male sex hormones. In addition, these hormones are necessary for the normal functioning of systems and organs. However, if there are too many of them, this becomes a problem.
Hyperandrogenism in women or an increase in male sex hormones is due to their production in the adrenal glands, ovaries. In adrenal gland problems, this is often a birth defect and is caused by a deficiency of several enzymes that help hormone synthesis.
And in ovarian hyperandrogenism in women, the causes of appearance are usually acquired under the influence of many factors during puberty.
If a pregnant woman is diagnosed with hyperandrogenism, they often worry about this, and it should be determined whether it is congenital or acquired. this problem. However, it is quite difficult to answer this question during pregnancy; laboratory tests are required. The main task becomes normal gestation child, especially if there is a threat of termination of pregnancy. In this case, a decrease in hormone levels is required. And when there is hyperandrogenism, and there is no threat of pregnancy, a doctor can prescribe treatment for preventive, prophylactic purposes. Contact our clinic, and our qualified specialists will determine the most optimal treatment option for you so that you normally endure a healthy baby.
Hyperandrogenism in women - symptoms
It is recommended to identify and treat this condition at the planning stage, especially if there is external manifestations increase in the level of male sex hormones - increased hair on the face, in the nipples, but the midline of the abdomen, on the thighs and legs. Generally, this is male signs. Skin covering with hyperandrogenism, it is usually oily, there are a lot of acne, the pores on the face are enlarged, hair may begin to fall out in the upper third of the head, and the menstrual cycle is sometimes disturbed.
During pregnancy, the syndrome of hyperandrogenism and the increase in hormones is dangerous, since the pregnancy can be interrupted for early dates, sometimes completely unnoticed by a woman. This is due to a violation of the ratio of male and female fractions of hormones, and an increase in androgens does not allow the fetal egg to stay in the uterus. The threat of pregnancy is expressed spotting, painful sensations the lower back and lower abdomen, the signs of pregnancy weaken - vomiting and nausea disappear, swelling of the breasts disappears.
Approximately 12-14 weeks involution occurs corpus luteum, which is a special place in the ovary that determines the development of pregnancy in the early stages. It produces progesterone, and after its attenuation, this function will gradually be taken over by the placenta. And as a result of the beginning of the functioning of the placenta, the level of female hormones increases - including progesterone and estrogen, gradually increasing towards childbirth. Since the formation of the placenta, the probability of termination of pregnancy due to androgens has already decreased quite sharply.
This problem reappears after 18-20 weeks - during the period when the "mother-placenta-child" system begins to work, which helps to provide mother and baby with estriol, which is a pregnancy hormone. Start their active work the adrenal glands of the fetus, and a special hormone is produced that has a weak androgenic effect. His level increases two or more times in comparison with non-pregnant women, however, it is quite small in the blood - it is actively consumed by tissues. Some of this substance in the tissues forms the male hormone testosterone. Again, there may be a problem with an increase in testosterone levels, again there is a threat of pregnancy. And it doesn’t matter at all whether you have hyperandrogenism during pregnancy as a boy or a girl.
Sometimes this causes a manifestation of isthmic-cervical insufficiency. This condition is characterized by the fact that the growing fetus ceases to be held by the cervix and it begins to open, it can even come out fertilized egg. Some danger may arise last dates pregnancy - an excess of male hormones often causes premature passage water and the onset of preterm labor.
How is the diagnosis carried out
This condition can be confirmed with the help of laboratory analysis - the detection of the number of active male sex hormones in the plasma. The study is carried out with the threat of interruption, as well as during the examination. But it is not easy to identify them - partially active metabolites can be detected in daily urine. This is a fairly simple and very revealing research technique, although tedious. In the urine, the level of a particular composition is determined. This testing has not lost its relevance since the beginning of its discovery.
Hyperandrogenism in women: treatment
Not every woman with signs of androgenism needs treatment, as many successfully give birth to several babies. The need for treatment appears when there are threats of termination of miscarriage or infertility, which appeared against the background of androgenism. However, it is quite difficult to choose a therapy during pregnancy to block - since the spectrum medicines not very big. Temporary synthesis or exposure to androgens is needed, for this hormones glucocorticoids are used, since no others can be used during pregnancy. According to the mechanism of action, they suppress the function of the pituitary gland, which is located in the brain of a special endocrine gland that controls the production of androgens. This reduces the stimulus to the adrenal gland for androgen synthesis and lowers its level in tissues and blood plasma. The dosage is selected by the doctor, based on the level of the problem according to the results of laboratory tests. Usually, treatment is started with the lowest possible dosage and control of well-being.
Naturally, women are afraid to use hormones, especially in the first weeks of pregnancy, during the period when the main systems and organs of the baby are being formed, worrying about the birth of a child with abnormalities. However, it has now been unambiguously proven that these drugs do not affect the development of the child, and many children born after such therapy are now giving birth to children themselves. Therefore, reviews for the treatment of hyperandrogenism in women are usually only positive. But all the same, tablets are prescribed only for the presence of strict indications and with exact observance of doses. All drugs today have a warning for pregnant women, and doctors prescribe drugs based on clinical trials, as well as experience with the use of drugs. If there is the slightest doubt, the therapy will be canceled.
In our clinic, a detailed study of patients is carried out, according to the results of which the most sparing, but at the same time effective course of treatment is prescribed. That's why future mommy may not worry about his health or the condition of his crumbs.
Nushencia
Sep 12, 2008 11:55 PM
I am 10 weeks pregnant, at 6 weeks I was diagnosed with "Hyperandrogenism, the threat of interruption", they prescribed dexamethasone, duphaston. 2 years ago I had a missed pregnancy. Now I live in constant fear that everything will happen again. Who had a similar situation? How did the pregnancy end? There is absolutely no one to talk to about this.
Sep 13, 2008, 11:00 AM
I had a ZB, the second B was successful: now my goat is almost 3 years old. drank the same as you do everything that the doctor says and be less nervous everything will be fine
Nushencia
Sep 14, 2008 12:21 PM
Thank you very much, it has become much easier, though it’s not always possible to be less nervous
Sep 14, 2008 01:49 PM
Yes, it’s understandable myself, I calmed down only when they showed me my daughter, though there were already other fears there, but now the main thing for you is to think only about your good mood great importance It has
partisan
Sep 14, 2008 03:01 PM
Analogous bullshit .. my testosterone is almost 10 times higher than normal ... for the last 1.5 years I have been sitting on metipred ... they will probably tell you to cancel tomorrow ... it’s already 37 weeks so drink pills and don’t worry (I’ve had threats all my pregnancy - threats, threats... but we don't care! :))
Nushencia
Sep 15 2008, 07:50 PM
In - in general, with children - solid fears!
Nushencia
Sep 15, 2008 07:54 PM
Please tell me, do you have any external signs Do you have hyperandrogenism? It's just that there are acquaintances - bearded, mustachioed fat women - and nothing, they give birth without pills! And I seem to look normal, and testosterone is several times higher than normal ...
partisan
Sep 16, 2008 12:51 PM
Well, I have “increased warmth” arms and legs during pregnancy, thick hair began to appear on my stomach ........ I won’t say that it’s very thick ... but it corroded before B on the nerves up to 66 ... and there was also a hormonal failure .... there is no mustache as such .. but sometimes a thick hair may appear on the neck or on the back ... the husband carefully tracks them and pulls
Sep 16, 2008 06:47 PM
Hyperandrogenism does not interfere with pregnancy (and often even conception) unless there is CHD, which is defined outside of pregnancy.
It makes no sense to take tests during pregnancy, when hormones go off scale - pumping out money.
My kind superdoctor prescribed me metipred, which I did not drink for a day. Result in signature
related link
too
and here
During pregnancy, it makes sense to take only tests for thyroid hormones.
Sep 16, 2008 06:48 PM
Girls, tell me, my male hormones are not elevated, but 17-hydroxy progesterone is very low. Has anyone experienced this?
Sep 17, 2008, 11:39 AM
| QUOTE |
| Hyperandrogenism does not interfere with pregnancy (and often even conception) |
although outwardly almost nothing showed up ... slightly more hair on the arms and legs, but not much ...
but progesterone had to be increased on the contrary. and before and during pregnancy, he was controlled ... because. in the first pregnancy, due to its insufficiency, there was a STD ...
partisan
Sep 17, 2008 12:28 PM
alas ... she interfered with my conception ......
and coming from one of the Dulka data links
| QUOTE |
| Hyperandrogenism interferes with conception |
Sep 17, 2008 07:36 PM
I write the opposite point of view, because most women still do not need steroids during pregnancy. And of the pregnant women I knew, there was not one to whom they would not have been appointed.
In a group conflict (women with the first blood group), steroids are generally contraindicated.
Yes, and I forgot to add that I still passed the DEAS tests (so as not to irritate the doctor and myself at the same time, and also for the sake of the experiment), and so - the indicators returned to "normal" in the second trimester and without taking the drug.
Sep 17, 2008 08:38 PM
Anya, I have high testosterone, but the pregnancy went well. There was no toxicity. Analysis has always been excellent. True, at the very beginning, when there was a delay, my stomach periodically hurt badly. I ran to the doctor and she determined my pregnancy on an ultrasound scan and prescribed, like you, dexamethasone and duphaston. Duphaston seems to drink up to 12 weeks, and dexamethasone up to 30 weeks. Get ready for weakness labor activity. I was stimulated. The contractions were tolerable, the opening was good. In general, she gave birth to a karapuzik weighing 4 kg. The most important thing is to calm down and not worry, everything will be fine.
Regarding the signs of increased testosterone, I read somewhere that the hair on the arms and legs does not necessarily occur with elevated T. This may be individual feature, as well as among southerners. A sign of increased T. - hair growth on the face, chest and back. I have all this, hair grows everywhere, on my back only in the lumbar region. Arms and legs are also insulated with hair.
Nushencia
Sep 17, 2008 10:10 PM
It also seems to me that it is better to play it safe and drink dexamethasone. The first time I had a ZB, I didn’t drink dexamethasone, and all the tests were perfect - except for testosterone and DHEA (they were elevated), so there were simply no other reasons for fading. Let it be better then the weakness of labor activity - if only to inform!
Sep 18, 2008, 08:52 AM
Where is the information from?
Sep 18, 2008, 09:24 AM
I completely agree... personally, I could not survive a few more STs or miscarriages... I also played it safe and did everything.
even though testosterone evened out during pregnancy (the doctor was sure "you are wearing a girl" - it turned out so) and now I had duphaston until 20 weeks, then it’s true ginepral ... the only thing was that I had to induce childbirth ... but the sweetness of labor was not it was: the bubble was pierced and away we go))
but I do not regret it: who knows, maybe it would have done without special therapy ... and if not? I was not ready for this for sure ... but everyone chooses for himself
good luck Nushencia everything will be fine
Sep 18, 2008, 10:18 am
Was at the doctor yesterday. I found out everything.
The gynecologist explained to me. that the main thing is that the hormones have not been elevated, then it can hurt. But reduced and normal - no need to worry.
Sep 18, 2008, 10:25 AM
So I also want to know what kind of group conflict is this? Some stupidity
Sep 19 2008, 07:21 AM
Group conflict is practically the same as Rhesus conflict.
You probably know that women with the first blood group or Rh negative take an analysis for the child's blood type already in the hospital.
If the mother (from 1 gr.) And the child different groups blood, then already in the first hours after birth, hemolytic disease of the newborn may develop.
Sometimes this is a contraindication to HB (because anemia develops in a child).
It makes sense to take tests for hormones only if the woman is not pregnant. And here they are prescribed to everyone, and all of a sudden they turn out to be sick.
Only the Lord God can tell us the true causes of STD or miscarriage.
If we take masculine-type hair growth in women as a symptom, then Jewish and Azerbaijani women, for example, would not be able to endure pregnancy at all, and practice shows that this is not at all the case.
And to drink such serious drugs for insurance ... In the world, they are generally prohibited for use during pregnancy.
Sep 19, 2008 12:50 PM
Hmm ... therefore, probably only in our country women are helped to bear a child ... and in most countries natural selection is carried out ..... this can also be argued ...
partisan
Sep 19, 2008 01:31 PM
Hmm ... I have the first blood group .. for the first time I hear about a "group conflict", ... in general, as far as I know = 1 group is a universal donor ....
Of course, I don’t pretend to have super knowledge .. but IMHO - it’s better to overdo it ....
Nushencia
Sep 19, 2008 05:53 PM
Sep 19, 2008 06:02 PM
This is more like the truth.
Today I specifically asked the doctor, because. I have 1 blood type, what kind of group conflict is this. She looked at me with those eyes.
Girls, before you say, clarify, otherwise you will scare everyone here, and we are already suspicious.
Dulka, you are clearly confusing the concepts of blood type and Rh factor
Sep 19 2008, 07:25 PM
http://www.med2000.ru/article/article83.htm Here is an article about blood conflicts on Rhesus and blood type. I have the first blood group and during pregnancy the doctors did not control the level of antibodies. The child had jaundice for a month and a half after birth. I don’t know for sure, but maybe this was the result of a conflict in the group. And pediatricians were also not interested in my blood type, and even Rh.
Sep 20, 2008 08:47 AM
Hare to pump. Needless to say, women with type 1 blood have problems. It can be with any blood type.
The main thing - what follows from this article is the COMPATIBILITY of the blood of the father and mother.
Olyusha, what is your husband's blood type and Rh?
Sep 20 2008, 05:06 PM
The group and Rh of my husband's blood is a mystery to everyone. But the child has a second.
Sep 20 2008, 06:48 PM
Thank you so much and I hope everything goes great!!
And as for the group conflict - as far as I know, it occurs if the mother has Rh -, and the baby has Rh +, but only if: a) the woman was already pregnant with Rh + fetus b) she was previously transfused with Rh + blood. In these cases, antibodies to Rh + blood cells are formed in her body, and they destroy them, and as a result, hemolysis (destruction of red blood cells) can occur in the child. But, as far as I know, gynecologists are quite successfully fighting this problem.
And it’s not at all a fact .... antibodies are formed only during a complicated pregnancy ....... or something like when the blood flows of the mother and child can mix .....
I am 1 minus .... my husband was 4+ ..... 2 healthy girls were born ... both times without problems .... then an abortion, ..... then unsuccessful B ...... all times injected for 72 hours with immunoglobulin against antibodies ...... now checked in this pregnancy .. everything is clean ......
so .... Rh is not so terrible, it can be as they paint .....
Sep 20 2008, 06:50 PM
Sep 21, 2008, 09:02 AM
Stasie I don't confuse group conflicts occur much less frequently than Rhesus, which is probably why few people know about it.
A conflict can arise (it does not occur with every pregnancy, of course) if the child does not have the first group (in the case of Rhesus - positive Rhesus with a negative mother).
Physiological jaundice begins on the 3-4th day, if I'm not mistaken, jaundice due to conflict - almost immediately after birth (I had this in my first pregnancy, although they say that it practically never happens in the first). Then they were tortured to treat the child for anemia.
I'm wildly sorry that my randomly thrown phrase served as the beginning of an offtopic
And if on the topic, for some reason it is believed that they really help us endure pregnancy (although what is destined to happen will happen. No matter how I drank no-shpu in my 3rd pregnancy, the result is still disappointing). No-shpa and candles from the tone did not help me in any way, only more nervous.
I talked with the female sex from other countries - there is nothing there, as they say, that they don’t save up to 12 weeks (the fact that a woman came and complained about the tone of the uterus, and she was told not to do anything about it, is logical, because nowhere, except in our country, there is no concept of "uterine tone", and if there is, it is considered normal, already in the first trimester 100%). They keep them lying down and at rest, and do not stuff them with medicines.
Again, I am not writing about the fact that specifically someone does not need steroids, but about the fact that tests are taken that are not informative during pregnancy, and the treatment of these same tests begins. The Russian medical server, links to which I gave at the very beginning, was created just "thanks" to problems in our medicine.
The pathological state of the hormonal balance in the female body, in which there is an excessive production of male sex hormones - androgens, is called hyperandrogenism. The disease is associated with dysfunction endocrine system. Hyperandrogenism syndrome is noted in about 5-7% of women, about 20% of them cannot become pregnant or bear a child.
Normally, androgens are produced by the genital organs in an amount that ensures growth. hairline on the pubis and in the armpits, the formation of the clitoris, timely puberty and sexual attraction. Androgens are responsible for normal work liver and kidneys.
Active production of androgens occurs in adolescence during the formation of secondary sexual characteristics. In adulthood, androgens are necessary to strengthen bone tissue. However, excessive production of these hormones leads to pathological changes which significantly impair the quality of a woman's life. The most deplorable results include and. In these cases, treatment is needed that will contribute to the normalization hormonal background.
Varieties and causes of the syndrome
The process of maturation of androgens occurs in the ovaries and adrenal glands. Normal quantity produced hormone and its correct ratio with estrogens provides the hormonal balance necessary for the full functioning of the body.
Depending on the origin of the pathology, several of its forms are distinguished:
- Hyperandrogenism of ovarian origin - occurs with polycystic ovary syndrome. The reason is a malfunction of the hypothalamus-pituitary gland system. The disorder is hereditary.
- Hyperandrogenism of adrenal origin is caused by a malfunction of the adrenal cortex. The disease is congenital in nature, and can also be caused by tumors (Itsenko-Cushing's disease). In this case, the first menstruation begins late, with scant discharge, and over time it may stop altogether. Other characteristics- an abundance of acne in the back and chest, underdevelopment of the mammary glands, the formation of a figure according to the male type, an increase in the clitoris.
A number of patients are diagnosed with hyperandrogenism of mixed origin. In this case, the functioning of the ovaries and adrenal glands is simultaneously disrupted in the body. This pathology caused by hypothalamic and neuroendocrine disorders. Disruptions in hormonal balance are exacerbated by vegetative-neurotic disorders. In some cases, mild hyperandrogenism is diagnosed, in which androgen levels are normal, and does not reveal the presence of tumors in the internal organs.
The mixed form prevents the onset of pregnancy and makes it impossible to successfully bear a child.
Given the degree of excess of the permissible level of androgens, the absolute and relative forms of adrenogenital syndrome are distinguished. In the first case, the concentration of male hormones exceeds the permissible limits. Relative hyperandrogenism is diagnosed with acceptable levels of male hormones. At the same time, they note hypersensitivity organs and glands of a woman to their effects.
Summing up, the following main causes of this syndrome can be distinguished:
- improper production of a special enzyme that synthesizes androgens, resulting in their excessive accumulation in the body;
- the presence of tumors of the adrenal glands;
- diseases and malfunctions of the ovaries, provoking excessive production of androgens;
- thyroid pathology (hypothyroidism), pituitary tumors;
- long-term use of steroids during professional strength sports;
- obesity in childhood;
- genetic predisposition.
With violations of the ovaries, an increase in the adrenal cortex, hypersensitivity of skin cells to the effects of testosterone, tumors of the genital and thyroid glands possible development of pathology in childhood.
Congenital hyperandrogenism sometimes does not allow to accurately determine the sex of the born child. A girl may have large labia, a clitoris enlarged to the size of a penis. The appearance of the internal genital organs is normal.
One of the varieties of adrenogenital syndrome is the salt-losing form. The disease is hereditary and usually detected in the first months of a child's life. As a result of the unsatisfactory work of the adrenal glands, girls develop vomiting, diarrhea, and convulsions.
At an older age, hyperandrogenism causes excessive hair growth throughout the body, a delay in the formation of the mammary glands and the appearance of the first menstruation.
Clinical manifestations
Symptoms can range from mild (excessive growth of body hair) to severe (development of secondary male sexual characteristics).
Clinical manifestations of hyperandrogenism in women in the form of acne and male pattern hair
The main manifestations of pathological disorders are:
- acne - occurs when high fat content skin, which leads to blockage and inflammation of the sebaceous glands;
- seborrhea of the scalp;
- hirsutism - the appearance of strong hair growth in places atypical for women (face, chest, abdomen, buttocks);
- thinning and hair loss on the head, the appearance of bald patches;
- increased muscle growth, the formation of muscles according to the male type;
- coarsening of the timbre of the voice;
- , scarcity of discharge, sometimes complete cessation of menstruation;
- increased sex drive.
Occurring failures in the hormonal balance cause the development diabetes, appearance excess weight, lipid metabolism disorders. Women become very susceptible to various infectious diseases. They often develop depression chronic fatigue, increased irritability and general weakness.
One of the most severe consequences hyperandrogenism is virilization or virilization syndrome. This is what developmental pathology is called. female body, in which he acquires pronounced male characteristics. Virilization is a rare abnormality, it is diagnosed in only one patient out of 100 who have excessive growth of body hair.
A woman develops male figure with increased muscle growth, menstruation completely stops, the size of the clitoris increases significantly. Very often, these signs develop in women who take steroids uncontrollably to increase endurance and physical strength when playing sports.
Establishing diagnosis
Diagnosis of a pathological condition includes an external and gynecological examination of the patient, an analysis of her complaints about general well-being. Pay attention to duration menstrual cycle, localization of excessive hair growth, body mass index, appearance genitals.
What tests should be taken to determine the level of androgens?
Doctors (gynecologist, endocrinologist, geneticist) prescribe the following studies:
- determination of the level of testosterone, follicular hormone, prolactin, estradiol in the blood and cortisol in the urine;
- tests with dexamethasone to determine the cause of the syndrome;
- Ultrasound of the ovaries and adrenal glands;
- CT scan of the pituitary gland;
- studies of glucose, insulin, cholesterol levels.
Ultrasound of the pelvic organs will determine the possible presence. Testing is necessary to establish the type of disease.
Materials for research are taken in the morning, before meals. Since the hormonal background is unstable, three samples are taken at intervals of at least half an hour for accurate diagnosis. It is advisable to take tests in the second half of the menstrual cycle, closer to the expected start of menstruation.
Principles of therapy
Treatment of hyperandrogenism should be comprehensive and, first of all, aimed at eliminating problems and diseases that act as provoking factors. The list of such diseases includes pathologies of the thyroid gland, polycystic ovary syndrome, adrenogenital syndrome.
The choice of treatment methods depends on the form of the pathology and the goal pursued by the therapy (combating hirsutism, restoring reproductive function, maintaining pregnancy in the event of a miscarriage).
The main treatment measures include:
- drug therapy;
- surgical intervention;
- the use of traditional medicine;
- normalization of nutrition and physical activity.
Conservative therapy
It is used to reduce the amount of male hormones produced and to block processes that contribute to their excessive activity. The presence of tumors in the genital organs, causing ovarian hyperandrogenism, is eliminated with the help of surgical intervention.
If a woman is not planning a pregnancy in the near future, but suffers from acne and excessive body hair, to get rid of these symptoms, they are prescribed with an antiandrogenic effect (for example, Diana 35).
Such drugs not only eliminate unpleasant external signs, but also contribute to the normalization of the menstrual cycle. For a cosmetic effect, anti-inflammatory ointments are prescribed, which reduce the production of sebum.
In the presence of contraindications to the use of contraceptives, Spironolactone is used for treatment. It is prescribed for severe premenstrual syndrome and with polycystic ovaries. The drug successfully treats acne and excess hair growth.
The analogue drug is Veroshpiron. Its main active ingredient is also spironolactone. Reception of Veroshpiron is highly undesirable without agreement with the doctor on the duration of use and the required dosage.
If hyperandrogenism is caused by the absence of an enzyme that converts androgens into glucocorticoids, agents are shown that normalize this process. The drug Metipred is very effective. Forms of its release - tablets and powders for injection. The remedy is contraindicated in the presence of infectious and viral diseases, tuberculosis, heart failure. The duration of the course of treatment and dosage is determined by the doctor.
Drugs used to treat hyperandrogenism
One of the successful methods of conservative treatment is a low-calorie diet. It is necessary to get rid of excess weight, which often complicates the course of the disease and brings a woman additional psychological discomfort.
The total number of calories consumed daily should not exceed 2000. In this case, with sufficient physical activity, the number of calories consumed will be lower than those consumed, which will lead to a gradual weight loss.
The diet indicated for hyperandrogenism provides for the exclusion from the diet of fatty, salty and spicy foods, as well as alcohol, sauces and fatty gravy.
Compliance with the principles proper nutrition supported by regular exercise. Useful running, aerobics, swimming, active games outdoors.
The fight against hirsutism is carried out using various cosmetic procedures: wax removal, depilation, elimination unwanted hair laser.
The use of traditional medicine
Treatment with folk remedies is quite applicable in the complex drug therapy, but is not a full replacement for traditional methods.
Popular recipes:
- Herbs of sweet clover, sage, meadowsweet and knotweed are mixed in equal proportions, poured into 200 ml of water, kept in a water bath for 20 minutes and filtered. To the resulting broth, add 1.5 ml of tincture of Rhodiola rosea. Take a decoction of a third cup several times a day before meals.
- 2 tablespoons of chopped string, 1 tablespoon of yarrow and motherwort are poured with boiling water, insisted for about an hour, filtered. Take half a glass on an empty stomach in the morning and at bedtime.
- A few tablespoons of dry nettle leaves are poured into a glass of water, insisted in a closed vessel, filtered. Take several times a day for a tablespoon.
- Rose hips, blackcurrants are poured with boiling water, insisted for about an hour. Then some honey is added. The resulting cocktail is drunk several times a day after meals.
Among the most common folk remedies in the fight against diseases of the gynecological sphere - upland uterus. It is used in conjunction with others therapeutic agents in the form of a decoction or tincture.
- Pour 100 g of boron uterus with 500 ml of vodka and infuse for 2 weeks. Tincture take 0.5 teaspoon three times a day.
- Pour 2 tablespoons of boron uterus with a glass of boiling water, leave for about an hour. Drink in small portions throughout the day.
- Mix 100 g of green peeled nuts and boron uterus with 800 g of sugar, add the same amount of vodka. Put the bottle with the mixture in a dark place for 14 days. After straining, take a teaspoon half an hour before meals.
Mint is used to reduce the amount of androgens produced. Based on it, tinctures and teas are prepared. For greater effectiveness, milk thistle can be added to mint. Regular intake of green tea normalizes female hormonal balance.
How to treat the problem with medicinal herbs and combine this method with other types of treatment, the attending physician will always prompt. Self-medication is unacceptable!
Hyperandrogenism and infertility
An excess of produced androgens often becomes an obstacle to a desired pregnancy.
How to get pregnant with drug therapy and how realistic is it?
Infertility treatment in this case is aimed at the use of drugs that stimulate the release of an egg from the ovaries. An example of such a drug would be Clomiphene.
One of the most effective drugs used to stimulate ovulation and normalize the menstrual cycle is Duphaston. After the onset of pregnancy, the drug is continued to prevent miscarriage and normalize the development of pregnancy.
If stimulation is ineffective, doctors advise resorting to surgical treatment. Modern medicine widely uses the method. During this procedure, the ovaries are excised to help the “exit” of a mature egg. The probability of getting pregnant after laparoscopy is the higher, the less time passes from the day of the operation. The maximum ability to conceive is noted in the first three months.
But even after successful conception the presence of hyperandrogenism can prevent the successful bearing of a child. An excess of male hormones often leads to the fact that the fetal egg cannot stay in the uterus. The chance of miscarriage remains high.
Dangerous weeks of pregnancy with hyperandrogenism are the period before the 12th week and after the 19th. In the first case, hormones are produced by the placenta, and after the 19th week they can be produced by the fetus itself.
To maintain pregnancy, the patient is prescribed Dexamethasone (metipred). It helps to lower androgen levels. The dosage of the drug is selected exclusively by the doctor!
Many expectant mothers are very afraid side effects drug and fear that it could harm the unborn baby. Many years of experience in the use of this drug proves its safety, both for the development of the unborn child, and for the course of the birth itself.
In most cases, to avoid the risk of miscarriage, doctors advise to first undergo full course treatment, and only then plan a pregnancy. If a woman fails to conceive a child, it is possible to carry out.
Prevention
There are no specific measures to prevent hyperandrogenism, since this syndrome develops at the hormonal level.
To general preventive measures include:
- rational nutrition, including foods rich in fiber in the menu, weight control;
- quitting smoking and alcohol abuse;
- regular visits to the gynecologist;
- taking medications and contraceptives only after the recommendation of a doctor;
- timely treatment of pathologies of the thyroid gland, diseases of the liver and adrenal glands.
Hyperandrogenism is not only problems with the skin, hair and menstrual cycle. This is a common disease of the body, which does not allow a woman to lead a quality lifestyle and often deprives her of the joys of motherhood. Modern methods diagnostics and treatment allow to identify the pathology in time and successfully eliminate its manifestations.
Increased blood levels in women of male sex hormones - androgens is called hyperandrogenism. The disease is quite "popular" and is one of the common causes of infertility and miscarriage. Most often, the tragic ending is the result of ignorance. With early diagnosis and proper treatment disease, the pregnancy will proceed smoothly, and the child will be born healthy.
WHAT'S HAPPENING
Normally, in the body of every girl there are not only female, but also male sex hormones. They are produced in the ovaries and adrenal glands and are necessary for the "production" of female sex hormones - estrogens. But within reason. With an increase in at least one male hormone, they speak of hyperandrogenism. Well-known outward signs advanced level androgens - excessive growth of body hair, weight gain, acne. But the dominance of androgens delivers not only cosmetic inconvenience. Pathological processes occur inside the reproductive system. An excess of androgens provokes serious changes in the ovaries: inhibition of egg maturation, the appearance of small cysts inside the ovary (polycystosis) and the formation of a dense capsular membrane around it, which prevents the release of the egg if it does mature. All this leads to a violation of the menstrual cycle, the absence, and therefore the inability to become pregnant. If pregnancy does occur, then the risk of it is very high. spontaneous interruption or fading for short periods.
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The reasons are the increased content of male sex hormones and the low level of female ones - cortisol and progesterone, the “pregnancy hormone”.
TYPES OF HYPERANDROGENIA
Hyperandrogenism can be of adrenal, ovarian or mixed origin.
OVARIAN HYPERANDROGENIA is determined by an increased content of male sex hormones produced by the ovaries. The most famous among them is testosterone. The causes of the appearance of the ovarian form of hyperandrogenism are different. Most often, it accompanies other ovarian diseases: polycystic, tumors; also among the reasons may be adverse factors during puberty, excessive passion for power sports during this period. Hyperandrogenism of ovarian genesis can not bring any harm to pregnancy, and treatment during pregnancy is not required. It only affects ovulation, so when planning a pregnancy, it must be treated. If at the same time pregnancy occurs, then the treatment can be safely canceled.
ADRENAL HYPERANDROGENIA is most often congenital and is caused by a lack of a number of enzymes involved in the formation of the main adrenal hormone - cortisol. The disease is called congenital adrenal dysfunction (CHD), and it can be both the cause of non-occurrence of pregnancy and the cause of miscarriage, miscarriage. And if before pregnancy the lack of adrenal hormones does not affect in any way, then during the period of expectation of the child, the need for them increases significantly. Treatment - replacement therapy, that is, taking medications, synthetic hormones that make up for the natural lack of the desired hormone. And this treatment should be started as early as possible, since it is in the early stages that pregnancy requires an increased amount of cortisol and, if there is a shortage, it can be interrupted. The mandatory period of therapy is up to 12 weeks. It is important to remember that adrenal hyperandrogenism is a congenital disease and cannot be completely cured. This means that when planning next pregnancy must be taken into account again unfavorable background and take action early.
MIXED FORM OF HYPERANDROGENIA means that the amount of male sex hormones is increased both in the ovaries and in the adrenal glands. This form should also be treated during pregnancy.
FACT! Among the numerous types of VDKN, there are especially many so-called “erased” forms, which are the most difficult to identify and which proceed unnoticed, manifesting themselves only at certain, most often stressful moments for the body: pregnancy is one of such “stimulants”.
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We, endocrinologists, often disagree about hyperandrogenism with obstetrician-gynecologists. I believe that for the diagnosis of "hyperandrogenism" one blood test for hormones (by which gynecologists judge) is not enough. If an increased level of some of the male sex hormones of the adrenal glands is detected, it is necessary to do more genetic analysis cuts to either confirm or rule out a mutation in a gene that blocks the necessary enzymes. If genetic analysis does not confirm congenital dysfunction of the adrenal cortex, then treatment is not required, since an increase in hormonal levels may simply be an individual reaction to pregnancy. Especially often this happens after IVF. Thus, a single blood test can lead to a false diagnosis and unnecessary treatment. Therefore, when planning a pregnancy, it is necessary to visit not only a gynecologist, but also an endocrinologist.
The onset of pregnancy is accompanied hormonal changes in the body future mother. In some cases, this process may go wrong, provoke complications, or interrupt it. One of the options for pathology is hyperandrogenism. What it is? What causes this hormonal imbalance? How to endure and give birth healthy child with hyperandrogenism? The answers to these and other questions are below in the article.
Symptoms
Sex differences between men and women are due to different hormonal composition.
The female hormonal set always contains a small amount of male components - androgens. This is necessary for the normal functioning of the reproductive system.
Under the influence of external and internal factors, their number may increase. Consequently, the girl develops hyperandrogenism.
Pathology has 2 forms:
- congenital - occurs as a result of the action of a hereditary factor;
- acquired - occurs as a result of exposure to environmental factors.
Pregnancy with hyperandrogenism proceeds with complications and there is a possibility of its premature termination. Therefore, it is important to be able to recognize alarming symptoms in time.
Symptoms:
- hair growth in places atypical for a girl - face, stomach, chest, hips;
- oily skin;
- acne;
- there are many enlarged pores on the skin;
- disruptions in the menstrual cycle;
- male pattern hair loss - crown region of the head.
If the jump in hormones occurred during pregnancy, then in the early stages it may be asymptomatic.
An increase in the amount of hormones provokes a miscarriage, so the following symptoms should alert a pregnant woman:
- pulling pain in the lower abdomen;
- symptom reduction;
- bloody issues;
- lower back pain.
If you find one or more of these symptoms in yourself, you should consult a doctor for advice and get tested for hormones.
Diagnostics. What diseases occurs
To diagnose pathology, a blood test for hormonal composition is performed. During the study, active male hormones in the blood plasma are detected.
To compile a complete clinical picture the hormonal background of a pregnant woman is recommended to undergo additional studies. These include:
- pelvic organs;
- ultrasound examination of the adrenal glands.
Based on the data obtained, the doctor makes a conclusion and, if necessary, makes a diagnosis.
Pathology can occur against the background of the following diseases:
- polycystic ovaries - primary and secondary form;
- adrenal dysplasia;
- neoplasms in the ovaries;
- tumor process of the adrenal cortex.
The presence of these diseases will determine the risk group according to the likelihood of developing hyperandrogenism in women.
Features of treatment in pregnant women
Hyperandrogenism does not always require treatment. If pregnancy against the background of this disease proceeds without complications, therapy begins to be carried out after the birth of the child.
If there are difficulties with conception or the pregnancy has repeatedly ended in miscarriages, the disease requires treatment.
Suggests the following treatment:
- blocking the synthesis of male hormones in a woman's body;
- decrease in androgen activity.
For achievement this effect The woman is on hormonal therapy.
This leads to a decrease in the activity of the adrenal glands and a decrease in the production of hormones.
Treatment during pregnancy does not always go smoothly.
If during treatment a woman has a deterioration in well-being, then it is necessary to immediately tell the doctor who is treating.
In this case, the dosage of the drug is changed or it is completely canceled.
It is best to treat hyperandrogenism at the stage of pregnancy planning, when there is no threat negative impact medicines to the fruit.
The reasons
An increase in the content of male hormones in a woman's body occurs as a result of the following reasons:
- presence of diseases associated with wrong work adrenal glands;
- improper functioning of globulin synthesis;
- type 2 diabetes;
- taking anabolics and testosterone preparations;
- doping drugs;
- taking antigonadotropes;
- taking certain sedatives;
- tuberculosis therapy;
- epilepsy treatment;
- drugs derivatives of interferon;
- improper use of oral contraceptives.
Changes in hormonal levels can occur against the background of a state of chronic stress.
An unstable psycho-emotional state negatively affects the functioning of all organ systems. First, the endocrine system begins to malfunction.
As a result, the woman develops hyperandrogenism.
Classification
Medical science distinguishes the following types of hyperandrogenism:
- ovarian - occurs due to pathological processes that are localized in the ovaries;
- adrenal - causes hormonal imbalance- diseases of the adrenal cortex;
- mixed - the ovaries and adrenal glands do not work correctly at the same time;
- central - occurs due to pathologies of the hypothalamus and pituitary gland;
- peripheral - hereditary form.
Hyperandrogenism - dangerous pathology which can lead to abortion.
In the first weeks of the perinatal period, it is quite difficult to identify it due to the absence of characteristic symptoms.
Interesting video: Hyperandrogenism and pregnancy