Category: Health

Treatment of diffuse fibrocystic mastopathy

In premenopausal women, mastopathy occurs in 20 % of women. After the onset of menopause, new cysts and nodes usually do not appear, which proves the involvement of ovarian hormones in the occurrence of the disease.

Currently, it is known that malignant diseases of the mammary glands occur 3-5 times more often against the background of benign neoplasms of the mammary glands and in 30% of cases with nodular forms of mastopathy with proliferation phenomena. Therefore, in the fight against cancer, along with the early diagnosis of malignant tumors, timely detection and treatment of precancerous diseases is no less important.

There are non-proliferative and proliferative forms of mastopathy. At the same time, the risk of malignancy in the non-proliferative form is 0.86%, with moderate proliferation – 2.34%, with pronounced proliferation – 31.4%

The main role in the occurrence of fibrocystic mastopathy is assigned to dishormonal disorders in the body of a woman. It is known that the development of the mammary glands, regular cyclic changes in them in puberty, as well as changes in their function during pregnancy and lactation are influenced by a whole complex of hormones: gonadotropin-releasing hormone of the hypothalamus, gonadotropins (luteinizing and follicle-stimulating hormones), prolactin, chorionic gonadotropin, thyroid-stimulating hormone, androgens, corticosteroids, insulin, estrogens and progesterone.

Any disorders of the hormone balance are accompanied by dysplastic changes in the breast tissue. The etiology and pathogenesis of myopathy have not yet been definitively established, although more than a hundred years have passed since the description of this symptom complex. An important role in the pathogenesis is assigned to relative or absolute hyperestrogenism and progesterone deficiency. Estrogens cause the proliferation of the ductal alveolar epithelium and stroma, and progesterone counteracts these processes, ensures the differentiation of the epithelium and the cessation of mitotic activity. Progesterone has the ability to reduce the expression of estrogen receptors and reduce the local level of active estrogens, thereby limiting the stimulation of breast tissue proliferation.

Mastopathy – Hormonal imbalance

Hormonal imbalance in the breast tissues in the direction of progesterone deficiency is accompanied by edema and hypertrophy of the intra-lobular connective tissue, and the proliferation of the ductal epithelium leads to the formation of cysts.

In the development of mastopathy, an important role is played by the level of blood prolactin, which has a diverse effect on the breast tissue, stimulating metabolic processes in the epithelium of the mammary glands throughout a woman’s life. Hyperprolactinemia outside of pregnancy is accompanied by swelling, swelling, soreness and swelling in the mammary glands, more pronounced in the second phase of the menstrual cycle.

The most common cause of mastopathy is hypothalamic-pituitary diseases, thyroid disorders, obesity, hyperprolactinemia, diabetes mellitus, impaired lipid metabolism, etc.

The cause of dyshormonal disorders of the mammary glands can be gynecological diseases; sexual disorders, hereditary predisposition, pathological processes in the liver and bile ducts, pregnancy and childbirth, stressful situations. Often, mastopathy develops during menarche or menopause. In the adolescent period and in young women, the diffuse type of mastopathy with minor clinical manifestations, characterized by moderate soreness in the upper-outer quadrant of the breast, is most often detected.

mastopathy & clomid

At the age of 30-40, multiple small cysts with a predominance of the glandular component are most often detected; the pain syndrome is usually pronounced significantly. Single large cysts are most common in patients aged 35 years and older.

Fibrocystic mastopathy is also found in women with a regular two-phase menstrual cycle.

Conclusions:

In recent years, as a result of the conducted research, the need for active therapy, in which the leading place belongs to hormones, has become obvious. With the accumulation of clinical experience with the use of norplant, there were reports of its positive effect on diffuse hyperplastic processes in the mammary glands, since under the influence of the gestagenic component in the hyperplastic epithelium, not only the inhibition of proliferative activity, but also the development of decidual-like transformation of the epithelium, as well as atrophic changes in the epithelium of the glands and stroma, consistently occurs. In this regard, the use of progestogens is effective in 70 % of women with hyperplastic processes in the mammary glands. The study of the effect of norplant on the condition of the mammary glands in 37 women with diffuse mastopathy showed a decrease or cessation of pain and tension in the mammary glands. In a control study after 1 year on ultrasound or mammography, there was a decrease in the density of glandular and fibrous components due to a decrease in the areas of hyperplastic tissue, which was interpreted as a regression of hyperplastic processes in the mammary glands. In 12 women, the condition of the mammary glands remained the same. Despite the disappearance of their mastodinia, the structural tissue of the mammary glands did not undergo any changes. The most common side effect of norplant, as well as depo-provera, is a violation of the menstrual cycle in the form of amenorrhea and intermenstrual spotting. The use of oral progestogens for intermenstrual spotting and combined contraceptives for amenorrhea (for 1-2 cycles) leads to the restoration of the menstrual cycle in the vast majority of patients.

Currently, oral (tableted) progestogens are also used for the treatment of mastopathy.

There is no treatment algorithm for mastopathy. Conservative treatment is indicated for all patients with diffuse mastopathy.

Empirical therapy of vulvovaginitis in women

Empirical therapy of vulvovaginitis in women: At the turn of the millennium, a real revolution took place in our understanding of vaginal infections. The Koch postulate “one disease-one pathogen”, which was once accepted as an axiom, was replaced by the understanding that in the vast majority of cases these conditions have a mixed etiology, and nosological forms caused by a single pathogen are rare. When treating a patient with bacterial vaginosis or vaginitis, the obstetrician-gynecologist should be guided by new data on the causes and pathogenesis of these diseases. We won’t talk about clomid today.

“Lonely” microbes are rare, usually there is a “cocktail” of bacteria, fungi, viruses and protozoa. A wide variety of” permanent inhabitants “of the biotope ensures its normal functional state, and also prevents colonization by” external ” obligate and facultative pathogens of diseases. In one patient, mutually exclusive states of the vaginal microbiome can be observed simultaneously. For example, candidiasis or aerobic vaginitis, the” instigators ” of which need oxygen, and bacterial vaginosis caused by anaerobic microorganisms.

J. Sobel distinguishes two types of mixed infections: mixed infection and co-infection. In mixed infections, all pathogens jointly damage the mucous membrane of the genital tract, entering into complex relationships aimed at increasing virulence and drug resistance. Coinfections are detected against the background of an active inflammatory process caused by a dominant pathogen. The rest remain invisible and manifest themselves only after the elimination of the predecessor.

Antibiotic resistance is an interdisciplinary and inter-state problem, for the effective solution of which, both at the hospital and outpatient level, it is necessary to consolidate doctors of different specialties. The growing resistance of microorganisms to antibiotics poses a difficult task for the obstetrician-gynecologist. The scientific justification for the combination of most vaginal infections and vaginal dysbiosis makes doctors more scrupulous in their diagnosis and treatment. A drug for the local therapy of vulvovaginitis should “cover” the entire spectrum of possible pathogens due to its constituent substances of multidirectional action. In order to avoid reducing compliance, instead of several drugs, it is advisable to prescribe a combined drug with the widest possible spectrum of action, covering most of the potential pathogens of vaginal infection – bacteria, fungi and protozoa.

Empirical therapy of vulvovaginitis: Materials and methods

Exclusion criteria:

  • hypersensitivity to one or more components of the drug Gainomax;
  • taking antiseptics, antibiotics, and antibiotics at the time of inclusion in the study;
  • the need for systemic use of glucocorticosteroids, cytostatics and systemic antibiotics;
  • documented HIV infection, syphilis and other sexually transmitted infections (chlamydia infection, gonorrhea, trichomoniasis) detected during the screening stage;
  • acute somatic diseases;
  • the period of pregnancy or breastfeeding.

Patient follow-up included consecutive visits.

At the first visit (screening, inclusion in the study), the written informed consent of the patients was obtained, the inclusion criteria were checked, and the exclusion criteria were evaluated. After examination and taking the material for analysis (bacterioscopy and pH-metry of vaginal secretions, real-time polymerase chain reaction (PCR) analysis (Femoflor-16)), based on complaints and clinical symptoms, the patients were immediately prescribed empirical therapy with the complex antimicrobial drug Gainomax. All patients were divided into two representative groups. 36 (50%) patients of the first group took Gainomax one suppository once a day for seven days, according to the approved instructions; 36 (50%) patients of the second group – Gainomax one suppository twice a day for three days, according to the approved instructions.

Empirical therapy of vulvovaginitis

At the second visit, 10-12 days after the completion of seven – or three-day therapy with Gainomax, a control examination was performed, which included a repeated gynecological examination, an assessment of the dynamics of clinical symptoms, the pH index and the microbial landscape of the vaginal discharge. Satisfaction and compliance of therapy, adverse events associated with the use of Gainomax were evaluated, the proportion of patients with a complete cure was determined, and cases of ineffectiveness of therapy were recorded. All medical procedures performed in the study were routine, used in everyday clinical practice, which determined the non-interventional (observational) nature of the study.

Conclusion

The analysis of the effectiveness of empirical therapy of acute vulvovaginitis using the drug Gainomax showed no complaints of abnormal vaginal discharge at the second visit in 94.4% of patients of the first and 97.2% of patients of the second group. A significant decrease in the volume of vaginal discharge was noted by 83.3% and 80.6% of patients of the first and second groups, respectively. The complete disappearance of unpleasant odors, itching and burning sensations in the vagina was indicated by 91.7% of the patients of the first group and 94.4% of the patients of the second group. When objectively evaluated, normalization of the color of the vaginal walls, moderate volume and “slimy” nature of secretions were recorded in all participants of the study. In most of them, bacterioscopy of vaginal smears after empirical therapy revealed a significant decrease in the number of white blood cells in the visual field. After therapy, yeast-like fungi of the genus Candida were not detected in any patient.

Modern view on the problem of tubal-peritoneal infertility

Tubal-peritoneal factor is currently the leading cause of female infertility, accounting, according to various authors, from 20 to 72%. Despite the achievements of modern medicine, tubal-peritoneal infertility is still one of the most serious pathological conditions, taking into account the difficulty of its diagnosis and treatment, as well as the possibility of restoring reproductive function.

The main causes of tubal-peritoneal infertility are:

  • previously transmitted inflammatory diseases of the pelvic organs of a specific and non-specific nature, of which the most important are chlamydia, gonorrhea, mycoplasma and trichomonas infections;
  • various intrauterine manipulations (artificial termination of pregnancy, separate diagnostic scraping of the endometrium and endocervix, hysteroscopy with removal of endometrial polyps or submucous myomatous nodes, etc.);
  • postpartum and postabortem complications of traumatic and inflammatory genesis;
  • previous surgical interventions on the pelvic organs (ovarian resection, conservative myomectomy, tubectomy, tubal ligation) and the abdominal cavity, especially those performed according to emergency indications from traditional laparotomy access and complicated by the development of peritonitis (for example, appendectomy).

Damage to the abdominal cavity during surgery and the subsequent development of aseptic inflammation lead to the deposition of fibrin in the area of the surgical wound with local activation of fibrinolysis and proteolysis, which ultimately contributes to the resorption of primary fibrinous deposits without the formation of adhesions. With the development of postoperative infection, the inflammatory-dystrophic process is delayed, which does not allow fibrinous formations to dissolve and contributes to excessive local collagen production with the formation of powerful connective tissue junctions – adhesions.

tubal-peritoneal infertility

The severity of the adhesive process in the pelvis directly depends on the extent of the spread of adhesions in the abdominal cavity, which is mainly determined by the volume and type of surgical intervention. In this regard, in order to prevent the development of the adhesive process in the abdominal cavity, one should strive to minimize the surgical intervention, giving preference to the laparoscopic method (especially when performing planned surgical interventions on the pelvic organs in women of reproductive age).

Treatment of tubal-peritoneal infertility

Treatment of tubal-peritoneal infertility includes conservative and surgical methods used sequentially or in combination with each other. Conservative treatment of tubal-peritoneal infertility involves anti-inflammatory antibacterial, immunomodulatory, antifibrosing therapy and physiotherapy.

When sexually transmitted infections are detected and / or a morphologically verified diagnosis of chronic endometritis, therapy should be comprehensive, etiopathogenetic and aimed at the complete elimination of the identified pathogens. Immunomodulatory therapy is an indispensable part of the treatment of tubal-peritoneal infertility, since chronic inflammatory processes of the pelvic organs are always accompanied by immunological disorders, which requires mandatory correction.

One of the options for antifibrosing therapy is the general and local use of various drugs with a resorbing effect – biostimulants, enzymes and glucocorticosteroids (hydrocortisone) in the form of tampons, as well as hydrotubation. Unfortunately, the clinical experience of using hydrotubation as a method of local treatment of tubal-peritoneal infertility has demonstrated insufficient effectiveness and a high frequency of various complications. Among them, most often there is an exacerbation of chronic inflammatory diseases of the pelvic organs with a violation of the functional ability of endosalpinx cells and the development of hydrosalpinx, which significantly reduces the peristaltic activity of the fallopian tubes and disrupts the transport of gametes through them.

Thus, tubal-peritoneal infertility requires early diagnosis and gradual long-term rehabilitation after undergoing surgical treatment. Also remember that ovulation stimulation is possible with the help of the drug clomid. One of the most effective ways to preserve the reproductive function is the prevention of tubal-peritoneal infertility, which consists in the prevention and timely treatment of inflammatory diseases of the pelvic organs, the rational management of childbirth and the postpartum period, and the implementation of rehabilitation measures in the near future after gynecological operations.

Clomid for men

Clomid for men: Clomiphene Citrate (Clomid, Clostilbegit) is often prescribed to men with low testosterone levels as a replacement therapy. Low testosterone (hypogonadism) cannot be considered a normal healthy condition for a man in his 30s, 50s, or 75s.

Symptoms of this hormonal disorder usually include:

  • lack of energy;
  • depressed mood;
  • loss of vitality;
  • muscle atrophy (sarcopenia);
  • muscle pain;
  • low libido;
  • erectile dysfunction;
  • weight gain,
  • bone loss (osteopenia) and osteoporosis;
  • moderate anemia;
  • increased risk of Alzheimer’s disease, prostate cancer, and an increased risk of death.

Low testosterone levels in men can be caused by problems in the testes (or gonads). This condition is called primary hypogonadism, it is associated with mumps, testicular trauma, testicular cancer and is treated only with testosterone replacement therapy.

The most common causes of low testosterone (hypogonadism) are problems with the pituitary gland and/or hypothalamus in the male brain. The reduced T caused by such “brain” problems is collectively referred to as secondary hypogonadism, or hypogonadotropic hypogonadism. It can be the result of depression, anxiety, traumatic brain injury, excessive exercise, an overdose of anabolic steroids, diabetes, lack of sleep, or taking certain medications.

Clomiphene for men: What is assigned for?

Traditionally, if low testosterone is diagnosed, a man is prescribed testostin replacement therapy in the form of a cream, gel, tablet, patch or injection. And while these types of therapies are effective, each of them has side effects. For example, testicular shrinkage, gynecomastia (breast enlargement), low sperm count, and polycythemia (an overabundance of red blood cells) are common side effects of T replacement therapy (for most patients, these side effects are treatable and do not exceed the potential benefit of hormone treatment).

However, in particular, due to the decrease in the number of sperm, this method of increasing testosterone is not the best option for men who want to have children. Young men with hypogonadism are usually prescribed clomiphene citrate (CC tablets, or Clomid) and / or human chorionic gonadotropin (hCG). These drugs have been used by specialists for many decades to increase the natural production of testosterone, sperm, and increase the likelihood of conception in patients. This method of treatment causes the testes to produce T and thereby increases the natural level of testosterone.

When a healthy man’s pituitary gland releases luteinizing hormone (LH) into the bloodstream, the testes receive a signal to produce testosterone. After that, some of the testosterone is converted to estrogen (the female hormone), and the pituitary stops producing LH.

Clomid for men

Clomid for men works by blocking estrogen in the pituitary gland and hypothalamus. Thus, estrogen does not signal the brain to stop producing LH. Luteinizing hormone continues to be produced, and as a result, the production of testostin in the testicles increases.

When using traditional methods of testosterone replacement therapy, the brain (hypothalamus and pituitary gland) receives the message that there is a lot of T in the testes and it no longer needs to be produced. Subsequently, the pituitary gland ceases to produce LH, and the natural production of testostin (and sperm) in the testes ceases, so the traditional results of testosterone replacement therapy — TST) are a decrease in the testicles and a low sperm count.

Clomiphene for men together with hCG (or without it) does not turn off the production of test-na. Depending on the condition, its reception can be continuous or course, for 3-6 months.

Clomiphene and hCG were previously thought to work only on young men, but in the last decade, these drugs have also been successfully used by older patients.

Compared to testosterone replacement therapy, clomid for men with hypogonadism can be considered a better alternative due to the fact that:

  1. Clomiphene stimulates the body’s own production of test-na.
  2. Clomid is available in tablets and is easy to take.
  3. This drug is quite cheap and affordable.
  4. Clomid has a relatively low risk of side effects.

The main active ingredient clomifene is available under several trademarks: “Clostylbegit”, “Clomid” (Clomid), “Serpafar”. The main drug that can be found and purchased is “Clostylbegit” or generic clomid.

Clomid for men: Conclusion

Clomid for men can serve as a good alternative to dough therapy in both the short and long term. Despite this, you can only take clomiphene as prescribed and under the supervision of a doctor.

Three medicines that still remain a dream

Against the background of incredible discoveries that promise to completely transform the medicine of the future, making it preventive, there are a number of tools that have been waiting for a very long time.

Malaria vaccine

Bill Gates spends tens of millions of dollars on the search for a miracle cure. Thousands of scientists around the world are working on this problem. The first tangible success is the recent work of American researchers from the National Center for the Study of Allergies and Infections. They were able to remove mosquitoes that develop malaria parasites inside, and then make these parasites unable to infect with radiation exposure.

Super Cold Remedy

Scientists from the Massachusetts Institute of Technology are developing a drug that can mean victory over the banal cold — the most annoying disease on the planet. They claim to have created a virus that attacks an infected cell and programs it to self-destruct, but does not affect healthy cells in the neighborhood. There are years of clinical trials ahead.

A cure for infertility

Artificial insemination is becoming an increasingly popular method of conception, and many technologies have already been tested and brought to mind. Also, do not forget about the stimulation of ovulation with clomid. Nevertheless, the search for new solutions continues. Canadian scientists from the University of Vancouver are working on drugs that stimulate ovulation in women who want to get pregnant. They are able to stimulate the appearance of several eggs per month instead of one, which increases the chances of artificial insemination. But the method developed by Canadian scientists still has many side effects, including a dangerous syndrome that is associated with kidney failure and heart failure.

Coronavirus vaccine

In modern realities, humanity also dreams of one more medicine – a 100% effective coronavirus vaccine, because neither the Russian Sputnik-V, nor Pfizer, nor even the Chinese vaccine, have yet produced any results.

Women suffer from menstrual cycle disorders and infertility

The menstrual cycle is one of the most mysterious phenomena in human biology. Why did our species develop a rhythmic ovulation that is independent of coitus? What is the biological meaning of menstrual bleeding, which is absent in other mammals? There are also more practical questions: it is known that physical and psychological stress, as well as body weight, significantly affect the menstrual cycle – but how and why does this happen? In search of answers, we turn to high-level processes – the analytical system of the hypothalamus.

The extension of the genus requires an optimal external and internal environment. A woman should be safe, have a favorable social environment, and have unrestricted access to nutrients. Otherwise, the pregnancy may be terminated or the fetus will suffer from developmental defects.

How can the body assess the many external and internal factors and make a choice: to take the risk of conception now-or to sacrifice part of the fertile time, waiting for more suitable conditions? Taking into account the complexity of the task, we can say that the choice of physiological states suitable for conception cannot be carried out by the pelvic organs. This function should be performed by an organ that “knows” the whole physiological context.

Menstrual cycle: Stress and procreation

In modern biology, the concept of “stress” means an overload of the adaptive abilities of the body. As a universal response to long-term adverse conditions, the hypothalamus increases plasma cortisol (and CSF) through the pituitary-adrenal system. In response, cortisol, among other things, suppresses the secretion of GnRH. This occurs in a variety of chronic conditions, different in nature and origin, but uniformly interpreted by the hypothalamus as stress: depression and anxiety disorders, diabetes, alcoholism, violation of the “sleep – wake” mode (working night shifts). Excess cortisol is also seen in many professional athletes.

menstrual cycle

So, the species Homo sapiens is adapted to long-distance running, in which endogenous cannabinoids enter the blood. At the dawn of human history, they made it easier to run for hours during times of migration and hunting, providing an analgesic and euphoric effect. Of course, they also inhibit the release of GnRH, since such severe trials are not combined with the prolongation of the genus. This probably explains some of the cases of amenorrhea among the runners these days.

Social and psychological stress

Human society has undergone significant changes over the last millennium. However, social distress, lifestyle changes, and information overload involve the same stressful mechanisms as the threat to physical survival.

In many mammals, females fight among themselves for resources and those partners that could provide tactical and genetic advantages to future offspring. In primates, a subordinate social position causes an increase in cortisol plasma. At the same time, the peak luteinizing hormone emissions required for ovulation are reduced. As resources decrease and aggressiveness increases within the community, conception is most promising in the dominant female. Aggression, including between close relatives, seems to play an important role in the suppression of ovulation among subordinate individuals.

Menstrual cycle and microecology of nutrition

In addition to the three main nutritional classes: proteins, fats and carbohydrates – with each meal, the human body receives microscopic doses of regulatory substances that have not nutritional, but informational value. The availability of vitamins of plant and animal origin historically included Homo sapiens in specific food chains, and the microelement composition of the environment determined favorable zones for habitation. Thus, vitamins and trace elements, whose importance is often underestimated, combine the biogeocenosis with individual physiology. The female body, constantly looking for optimal conditions for the prolongation of the genus, can not ignore such data.

Today, humanity has spread across the globe everywhere, often spending most of their lives moving. Thus, medical science is faced with the task of compensating for the change of ecological subsystems, which in market conditions is available only through the development of universal adaptive complexes. The degree of their influence is individual, because each organism is unique. However, such substitution drugs occupy their own therapeutic niche along with higher-level treatment methods.

Conclusion

It is possible that both in cases of metabolic stress and in cases of chronic psychological threats, the hypothalamus acts uniformly: it seeks to protect the body by reducing energy consumption and preventing risky pregnancy. This should be taken into account in patients with functional amenorrhea. In such cases, replacement therapy alone may not be sufficient, as it does not affect adrenal hyperfunction, body weight, and psychological problems. Even with artificially induced ovulation, subsequent pregnancy is threatened by ongoing psychological and / or metabolic stress. In other words, the full restoration of sexual function requires the correction of a fundamental problem-lifestyle.

Stress during pregnancy

Researchers have identified a link between common mental illnesses and complications during pregnancy, such as pre-eclampsia and infections that lead to stress. The results of the study were published in the journal Proceedings of the National Academy of Sciences (stress during pregnancy).

Scientists from Massachusetts General Hospital and Harvard Medical School conducted a study that lasted 40 years. The researchers wanted to find out whether prenatal stress affected a person’s response to stressful situations in adulthood.

Experts followed 40 men and 40 women from the moment of birth to their fortieth birthday. Half of the participants had a history of severe depression or psychosis that was in remission.

The researchers say that the mothers of some of the study participants had complications during pregnancy, such as fever due to an infectious disease or pre-eclampsia. One in three mothers who participated in the study had an infectious disease, and one in six had preeclampsia, which increases the level of cytokines. It turns out that the experts analyzed the data of those people who in the womb were exposed to pro-inflammatory cytokines.

stress during pregnancy

It is noted that tumor necrosis factor-alpha and interleukin-6 regulators of the immune system initiate inflammation in response to infection or injury. They can also be activated in response to stress.

The team evaluated the correlation between the participants neurological responses and their prenatal exposure to pro-inflammatory cytokines. The researchers did this by showing participants images designed to stimulate a stress response during an MRI scan of the brain.

It was found that prenatal exposure to pro-inflammatory cytokines caused by stress in mothers affected men and women after 40 years. Among all participants, lower prenatal levels of necrosis factor-alpha caused increased hypothalamus activity in adulthood. This area of the brain is responsible for regulating the level of cortisol, the so-called stress hormone.

However, only in men did lower levels of necrosis factor-alpha cause a more active connection between the hypothalamus and the anterior cingulate gyrus, which is responsible for controlling impulses and emotions. In female participants, higher levels of IL-6 in the prenatal period correlated with increased activity in the hippocampus, a region of the brain that helps control memory and arousal associated with stressful stimuli.

Absence of pregnancy

Absence of pregnancy – one of the causes of female infertility is premature ovarian failure. In 74% of cases, the only chance to get pregnant is to perform in vitro fertilization using donor oocytes. In this regard, it is relevant to search for new approaches to solving this problem.

The incidence of premature ovarian failure in the female population is 1.5%, and in the structure of secondary amenorrhea-up to 10%. There are several theories that explain the causes of ovarian insufficiency: pre-and post-pubertal destruction of oocytes, chromosomal abnormalities, autoimmune disorders, etc. A typical portrait of a patient: a young girl with the presence of menopausal symptoms, who does not become pregnant against the background of secondary amenorrhea. The diagnostic criteria for insufficiency include oligomenorrhea, amenorrhea for 4-6 months, the level of follicle-stimulating hormone (FSH) in the blood above 25 IU/l in two studies with an interval of at least four weeks, a decrease in the level of estradiol (E2) and anti-muller hormone (AMH) in the blood.

Hormone replacement therapy is recognized as a pathogenetic approach to treatment. However, at the moment, there are no effective treatment regimens that can improve the prognosis for fertility recovery. An alternative method of treatment is placental therapy with the drug Melsmon.

Clinical case absence of pregnancy

A 22-year-old patient came to the medical center with complaints about the absence of menstruation (amenorrhea) for a year and the absence of pregnancy for four years, a feeling of hot flashes up to ten times a day, hyperhidrosis, decreased libido, lethargy, increased fatigue, shortness of breath, insomnia. The patient has been married for four years, the first marriage, with a regular sexual life in the absence of any methods of contraception, pregnancy in this marriage did not occur. The patient’s husband underwent a study of the state of reproductive health. The male factor of infertility is excluded. Menstruation in a patient from 11 years old, established immediately, duration-five days, after 30 days.

absence of pregnancy

From the anamnesis, it is known about the violation of the menstrual cycle in the form of scanty bloody discharge (oligomenorrhea) and their gradual disappearance. When examined in the mirrors, a fibrous polyp of the cervical canal was found. A hysteroscopy was performed with separate diagnostic curettage and removal of the cervical canal polyp. Histological conclusion: glandular endometrial hyperplasia with elements of polyposis on the background of chronic endometritis. Fibrotic polyp of the cervix. The somatic history is not burdened. No previous tests have been performed for sexually transmitted infections. He has no professional harms or bad habits. For four months, in order to regulate the menstrual cycle, she took Regulon (she did not take the drug clomid), then stopped taking it due to a sharp increase in the body mass index (after the withdrawal of the drug Regulon, the weight returned to its previous values).

When collecting a family history, it turned out that the mother’s menstrual function stopped at the age of 34. Due to the lack of pregnancy, the family is under stress.

Difficulties with conception and clomid

Approximately 20% of married couples who have difficulties with conception, this is because, a woman’s ovaries do not produce and release an egg in each menstrual cycle (anovulation). Clomid acts by causing a gland in the brain (the anterior pituitary gland) to release hormones that stimulate ovulation.

It must be remembered that there are many causes of anovulation, so Clomid may not be effective in all cases.

When accepting Clomid, it should be 28-32 days from the beginning of one period to the next. Your ovaries should release the egg 6-12 days after a course of Clomid. You should have sexual intercourse at this time to increase your chances of conception.

If menstruation does not arrive after the 35th day there are two likely possibilities: the dose of Clomid was not enough to get ovulation, or you are pregnant.

If your menstrual period is overdue, contact your doctor who wrote you a prescription for clomid and he will advise you what steps to take.

difficulties with conception

Before taking Clomid, your doctor should perform a gynecological examination before you start taking the drug. This is necessary in order to ensure that there are no physical conditions that could prevent you from becoming pregnant or that could indicate that Clomid is not the right remedy for you.

Do not take Clomid if you are allergic to any of the ingredients of the drug. Also, do not take Clomid if you are pregnant.

To avoid accidental ingestion in the early stages of pregnancy, you should perform tests during each treatment cycle to determine if ovulation is occurring. You should have a pregnancy test before starting your next course of Clomid therapy.

Tell your doctor immediately if you notice the following side effects:

  • nausea or vomiting;
  • breast discomfort;
  • headache
  • insomnia, nervousness, depression, fatigue, dizziness, or delirium
  • rash or skin irritation;
  • increased frequency of urination;
  • hair loss;
  • fever;
  • vaginal discharge;
  • seizures;
  • vision problems;
  • increased heart rate;
  • heartbeat;

In general, the drug is absolutely safe. We wish you good health and a successful conception of the child, even if you are currently experiencing difficulties with conception!

How to stimulate ovulation?

So, how to stimulate ovulation? Problems of the reproductive system of the female body, as you know, can sometimes be solved without surgical intervention. It is enough just to go to the pharmacy for the “magic” pills prescribed by the doctor the day before. And, while your eyes are scattered when choosing medicines, we will help you understand the principle of the most popular of them, and what is the effect of each.

How to stimulate ovulation: Clomid.

Clomid was originally developed as a pilot version of a universal drug for breast cancer, but, failing to meet high expectations, began to be used as a drug to stimulate ovulation among women who want to become pregnant. So, clomid can be recommended by doctors in three cases:

  1. If the absence of ovulation is caused by a previously diagnosed polycystic ovary syndrome.
  2. If infertility does not have a certain genesis, that is, with ideal medical indicators, a woman still does not get pregnant after more than a year of intensive attempts. In this case, clomid is usually used in conjunction with another drug – metformin, which, in turn, increases the level of insulin and promotes ovulation.
  3. If in vitro fertilization (IVF, ICSI, etc. ) requires additional guarantees of the success of the procedure. Although from a medical point of view, this use of clomid is not sufficiently justified, many patients personally ask their doctor to include clomid in their treatment course, since this drug is considered effective when it comes to increasing the chances of becoming pregnant.

Studies and many years of experience show that about 80% of women who have problems with ovulation, observe the release of an egg from the ovaries after the first application of clomid. However, only 30% of patients manage to get pregnant immediately after the first cycle. However, a six-month course of clomid use is considered quite optimal, so even if you did not manage to get pregnant after your first use, you still have a good chance of seeing the long-awaited two stripes over the next few months, provided that you follow the medication course.

how to stimulate ovulation

The chronology of the process of using clomid is very simple. After your doctor has conducted a full medical examination and written out a prescription for the purchase of the drug, you can safely go to the pharmacy. Before use, it is necessary to consult a doctor about the interval of use, but, as a rule, clomid tablets are taken on the third to seventh day of the menstrual cycle. After a week from the beginning of the menstrual cycle, lead an active sexual life, preferably with a break interval of one day, so that your partner has time to accumulate sperm ready for fertilization. If by the tenth day of your menstrual cycle, your cervical mucus has the consistency of egg white, it means that you are on the right track, and that ovulation will occur soon. After another week or two, you can start using pregnancy tests and hope for the best.

The side effects of clomid are insignificant, and do not pose a direct threat to the female body. In the most frequent cases, abdominal pain, insomnia and weight gain are observed. The worst possible development is the appearance of ovarian cysts or the diagnosis of ovarian cancer. However, the chance of such consequences appearing is very, very small.