TREATMENT OF GYNECOLOGICAL DISEASES Hypermenorrhea Points used for the treatment of hypermenorrhea: qi-hai (Zs), guan-yuan (Zs), zhong-tszi (Zs), gui-lai (G2), chi-tsze (P1), jiao-sin ( H4), san-yin-jiao (H4), da-du (H5), da-dun (H3), di-chi (H3), tai-chun (H3), yin-gu (H5), wei-chung (H6) .Treatment is carried out during

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Endocrine gynecology studies various kinds of hormonal changes in a woman's body. Under the influence of stress, unfavorable ecology and an unhealthy lifestyle, the hormonal system malfunctions, and a hormonal imbalance occurs in the body. Hormones play a significant role in a woman's body.

They regulate reproductive function, are the basis of lipid, carbohydrate and mineral metabolism. Hormonal disruptions lead to serious enough consequences for a woman, therefore the main task of the gynecologist-endocrinologist- diagnose these disorders in time, determine how serious they are, remove the symptoms of failures and restore the balance of hormones in the woman's body.

Reproductive function is regulated at 5 levels:

- hypothalamus;
- the pituitary gland;
- cortex;
- ovaries;
- tissues and organs (uterus, genitals, mammary glands, adipose tissue, bones and skin).

Failures at any of the levels cause a violation of reproductive function, which can only be adjusted and restored by a gynecologist-endocrinologist.

When should you seek help from endocrine gynecology?

For the help of a gynecologist-endocrinologist, a woman may need to contact at any age. It is important to know the symptoms for which a doctor's consultation is simply necessary:

- early signs of maturation in childhood: enlargement of the mammary glands, early (at about 10 years old) hair growth in the pubis and axillary area, spotting;
- the absence of menstruation in adolescence or its irregularity;
- with a long interval between cycles in adolescence;
- if your period is very painful or profuse;
- skin rashes, acne on the face, excess weight, hair loss;
- soreness in the area of ​​the mammary glands, uncharacteristic discharge from the nipples.

You should also consult a doctor before using hormonal contraceptives.

What problems does endocrine gynecology solve?

The following pathologies are within the competence of a gynecologist-endocrinologist:

- menstrual irregularities;
- hormonal infertility;
- endometriosis;
- excess weight, hair and skin problems;
- diseases of the breast caused by hormonal disruption in the body;
- fibroids of the uterus;
- problems arising in women during menopause.

Be more attentive to your health. Every woman needs to know that with problem skin it is necessary first of all to contact a gynecologist-endocrinologist, and only then to a cosmetologist.

Before developing a treatment regimen, the doctor will conduct a comprehensive diagnosis, which includes:

- a blood test for hormones, reflecting their level in the blood;
- analysis of the level of insulin and blood glucose;
- examination of the thyroid gland and adrenal glands;
- colposcopy;
- measurement of basal temperature;
- Ultrasound of the mammary glands and pelvic organs;
- endometrial biopsy and a comprehensive study of the uterine cavity.

If a hormonal disruption in the body is detected, the doctor will prescribe the appropriate treatment, with the help of which the normal functioning of the female body will be restored.

Endocrine gynecology is a special section of gynecology, whose specialists are engaged in the diagnosis and treatment of hormone-related reproductive disorders in women. Therefore, the area of ​​interest of the gynecologist-endocrinologist is the neuroendocrine link in the regulation of the reproductive system.

What are hormones and where are they formed?

Hormones are biologically active substances produced by the endocrine glands. They regulate the metabolism and the functioning of all organs. And even the work of the endocrine glands themselves is also controlled by pituitary hormones. This provides the body with balance and integrity, allows it to quickly and effectively respond to the slightest changes of endogenous and exogenous nature. And any hormonal disorders affect the work of internal organs - including the state of reproductive health.

The endocrine system includes the pituitary gland, thyroid gland, parathyroid glands, adrenal glands, islets of Langerhans pancreas, thymus, pineal gland (called pineal gland), testes or testes (in men), and ovaries (in women). There are also additional hormonally active cells or even small ganglia. They are found in the walls of the respiratory and digestive systems, in the structure of the juxtaglomerular apparatus of the kidneys and sometimes in the bifurcation of large aortic vessels.

Hormones and Reproductive Health: What's the Connection Between Them?

The functioning of the female reproductive system is more than 80% due to endocrine regulation. The most important are the so-called ovarian sex hormones: estrogen and progesterone. It is their fluctuations that are the basis for the formation of the ovulatory-menstrual cycle in women of reproductive age. Moreover, not only the level of individual hormones is important, but also their ratio with each other at certain intervals.

But not only the ovaries affect the reproductive system of women. In adolescence, the correct functioning of the hypothalamic-pituitary system is very important. After all, it is the gonadotropic hormones secreted here that trigger the secondary development of the gonads with the activation of their endocrine function. In case of violations at this level, the girl, after entering reproductive age, will have genital infantilism with secondary endocrine infertility.

The pituitary gland also synthesizes follicle-stimulating hormone, which is responsible for the onset of follicular development and egg maturation in each ovarian cycle. Its deficiency is also the cause of chronic anovulation and endocrine infertility.

The pituitary gland secretes another hormone that directly affects the functioning of the female reproductive system. This is prolactin. Its main target is the mammary glands during pregnancy and lactation. But an increase in the level of prolactin in the blood (hyperprolactinemia), according to the feedback principle, suppresses the synthesis of follicle-stimulating hormone. This leads to violations of the ovarian cycle, and they are not always diagnosed in a timely manner. Hyperprolactinemia is one of the main causes of endocrine infertility.

What about other endocrine glands?

The usefulness of the reproductive system is also affected by other hormones, which at first glance seem to have nothing to do with the genitals. For example, insufficient thyroid function (hypothyroidism) leads to a change in the luteal phase of the ovarian-menstrual cycle. This can be manifested by a tendency to amenorrhea, endocrine infertility or miscarriage of the onset of pregnancy.

Oddly enough, in the body of women there is also testosterone, which is mistakenly considered a truly "male" hormone. It is synthesized in the ovaries and adrenal glands, taking part in the regulation of the maturation of the follicle at the first stage of the ovarian cycle. An increase in testosterone levels leads to problems with conception and can lead to miscarriage in early pregnancy.

Even the so-called stress hormones (cortisol, adrenaline and others) produced by the adrenal glands can negatively affect the functioning of the female genital organs.

Obvious and indirect signs of hormonal problems

What disorders can indicate the presence of endocrine disorders? These include:

• later menarche and a long period before the establishment of a regular menstrual cycle in adolescent girls;
• inconsistency of the severity of secondary sexual characteristics with the average age norm (taking into account national characteristics);
• a tendency to various irregularities in the menstrual cycle with irregularity, delay or acceleration of the onset of menstruation, with too scanty, profuse or prolonged bloody discharge;
• excessive hair growth (hirsutism) or male-pattern hair growth;
• the appearance of stretch marks on the skin in the absence of obvious weight fluctuations;
• persistent dermatological problems (acne, oily or excessively dry skin on the face);
• obesity;
• diagnosed pathology of the mammary glands (fibrocystic mastopathy);
• the appearance of whitish-yellow discharge from the nipples in non-lactating women, which may be a consequence of increased prolactin;
• endometriosis;
• thickening of the neck, bulging eyes, unmotivated weight loss, or a tendency to dense swelling of the face and body;
• infertility;
• habitual miscarriage.

Do not forget that hormonal disorders and associated reproductive disorders do not always appear at a young age. Endocrine infertility and hyperprolactinemia can be diagnosed in women who have previously given birth.

When may you need the help of a gynecologist-endocrinologist?

Endocrine gynecology is becoming an increasingly popular specialty. After all, many problems in women are caused by hormonal imbalance, and the "ordinary" endocrinologist and gynecologist in most cases fails to correctly correct the existing violations.

The most common reason for contacting a specialist in endocrine gynecology is previously diagnosed infertility. Unfortunately, most often women who have been treated unsuccessfully by a gynecologist for several years come to such a doctor. At the same time, they have rather obvious signs of various endocrine disorders, which are left without due attention. But it was possible to avoid these several years of inadequate treatment by timely contacting a specialist at ICLINIC and eliminating endocrine infertility. It is hormonal imbalance in many cases that is the cause of chronic anovulation and other problems with conception.

A consultation with a gynecologist-endocrinologist is sometimes necessary not only at the stage of diagnosing the cause of infertility. It is often required when a couple is included in the IVF protocol and when using other assisted reproductive technologies (ART).

At ICLINIC, this specialist is involved in the management of a pregnancy with complications if endocrine disorders were diagnosed during gestation or were noted in a woman before.

Also, a gynecologist-endocrinologist is engaged in the diagnosis and treatment of various disorders of the menstrual cycle (including in adolescents), genital and sexual infantilism. His help is required in identifying fibroids, endometriosis, fibrocystic mastopathy, postovariectomy syndrome, early or complicated menopause.

Sometimes treatment by a gynecologist-endocrinologist is required with increased prolactin, even if the patient is not planning a pregnancy. Hyperprolactinemia may be due to the use of certain non-hormonal drugs, or it persists after lactation is complete.

Another important area of ​​endocrine gynecology is the individual selection of hormonal contraception. Therefore, the help of a gynecologist-endocrinologist at the ICLINIC Clinic for Reproductive Medicine may be required for women who are not yet planning a pregnancy. Competently selected contraception allows you to avoid many reproductive problems in the future.

Examination in endocrine gynecology

A basic endocrine gynecological examination includes:

• collection of anamnesis;
• examination of the patient to determine the external signs of endocrine pathology, the severity of secondary sexual characteristics;
• biochemical screening of diabetes mellitus (blood glucose level, if necessary - carrying out a sugar load and other tests);
• determination of the nature of the functioning of the thyroid gland - tests for hormones (TSH, T3 and free T4), assessment of the level of antibodies to TPO, ultrasound of the thyroid gland;
• tests for hormones that directly affect the functioning of the ovaries (FSH, LH, testosterone, DHEA-s, estradiol, progesterone, prolactin), such tests are carried out strictly on certain days of the cycle;
• gynecological ultrasound.

If necessary, the gynecologist-endocrinologist prescribes ultrasound monitoring of follicular maturation (if chronic anovulation is suspected) and other targeted examinations.

What to do next?

After receiving the results of a comprehensive diagnosis, the gynecologist-endocrinologist draws up a scheme for correcting the identified violations. This takes into account the main objectives of the treatment. This can be the restoration of fertility, preparation for IVF, elimination of dysmenorrhea or complex therapy of chronic gynecological diseases. Competently selected treatment in many cases can improve a woman's condition, correct the causes of endocrine infertility and significantly increase the chance of pregnancy in the natural cycle or with the use of ART.

Endocrine gynecology is a branch of medicine that requires the highest professionalism, clinical thinking skills, flexible and inquisitive mind, delicacy from the doctor. The specialists of the ICLINIC Clinic for Reproductive Medicine are considered to be among the best in their field. This is confirmed by the consistently high rates of successful infertility treatment in our patients.

The most favorite thing in my work, my hobby, food for my soul and mind, this is undoubtedly endocrine gynecology.
Until I found a more interesting area for myself, from which I would be so delighted!

In the modern world, in conditions of constant stressful situations, the lack of the possibility of maintaining a healthy lifestyle, an imbalance in the hormonal sphere of women often arises.

The role of hormones in the body is colossal - it is the regulation of a woman's reproductive function, basic and mineral metabolism, lipid and carbohydrate metabolism, and, in fact, it is hormones that make a woman a woman.

Naturally, one cannot discount the hereditary factor. There is such a tendency as "rejuvenation of the realization of genes", speaking not in medical words: a disease that manifests itself in a mother in adulthood, in a daughter can manifest itself in a young, or even in a young age.

Our body is a well-coordinated self-regulating system, and a "breakdown" at one level leads to a "failure" in the work of other components of the body.

The task of the gynecologist-endocrinologist is to timely identify hormonal disorders in the work of the female body, determine the level of damage, remove the manifestations of violations and restore the necessary hormonal balance in the woman's body.

The reproductive system of a woman is regulated at 5 levels: the cerebral cortex, hypothalamus, pituitary gland, ovaries (in which not only follicles are found and mature, but also steroid hormones are synthesized), target tissues and organs - genitals, uterus, mammary glands, hair follicles, skin, bones, adipose tissue.

In addition, the condition and function of the adrenal glands and the thyroid gland is of immense importance.

For a variety of reasons, "breakdowns" are possible at each of the levels.

The hormonal sphere is a whole complex world, where each link is interconnected with the previous one and directly or indirectly affects the rest.

It is the gynecologist-endocrinologist who will be able to understand this complex system of endocrine regulation of the body and put everything in its place.

The help of a gynecologist - endocrinologist may be needed by a woman at any age and at different stages of development:

• In childhood, if early signs of puberty appeared (at the age of 10 years, the girl's mammary glands increased, there was abundant hair growth in the pubis and armpits, bloody discharge from the genital tract appeared)
• In adolescence, if the menstrual cycle has not become regular one year after the onset of menstruation
• In reproductive age, if the interval between periods is less than 20 days or more than 40 days, periods are profuse or painful
• If you need to prescribe hormonal contraceptives, or you are already taking hormonal contraceptives, but something confuses you or does not suit you.
• Excessive hair growth on the face and body, skin rashes, especially before menstruation, hair loss on the head
• Overweight, which is combined with menstrual irregularities.
• Breast engorgement and tenderness, nipple discharge
• In the period of perimenopause, with the appearance of symptoms of shortening or lengthening of the menstrual cycle, "hot flashes", fluctuations in blood pressure, dry skin and vaginal mucosa.

A woman should be attentive to herself. Sometimes a problem with skin and hair is solved by a gynecologist - an endocrinologist faster and easier than a cosmetologist.

Even if we are talking about the treatment of inflammatory processes, a violation of the microflora of the vagina - they are often the result of hormonal disorders and themselves often cause hormonal imbalance.

Problems that help to solvegynecologist-endocrinologist

• All forms of menstrual irregularities
• Endometriosis
• Infertility caused precisely by hormonal disorders (violation of the maturation of the follicle and corpus luteum)
• Hyperandrogenic conditions, which are manifested by excess weight, skin problems, hair loss
• Fibroids of the uterus
• Dyshormonal diseases of the breast.
• Problems associated with menopause

Endocrine gynecological examination

Often, women are very afraid that the doctor will prescribe hormonal drugs, and as a result of the intake of which they will begin various changes in the body.

It is necessary to understand that not all disorders require the administration of hormones, and are corrected by a whole range of non-hormonal drugs. If the doctor has prescribed a hormonal drug for you, do not be alarmed, it means that there is an urgent need to restore the hormonal background of the female body.

Each specific situation should be approached individually.

Dear women, do not look for answers to your questions on women's forums, it is better to seek advice from a qualified specialist who can dispel your doubts and can help you.

So you will save yourself from fears, frustrations, incorrect information, and other annoying surprises.