Ovarian failure

Ovarian failure is a condition that can be primary or secondary. This disease means that the ovaries do not work properly, and their hormonal and reproductive function is impaired. Ovarian failure can cause infertility. Depending on the causes of the failure, properly selected treatment can restore the function of the ovaries. Conditions such as premature ovarian failure, gonadal dysgenesis or Sheehan's syndrome may be responsible for ovarian failure.

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1. Primary ovarian failure

Primary ovarian failure is associated with low blood estrogen levels and high levels of pituitary gonadotrophins, especially follicle stimulating hormone (FSH). This condition may be due to premature ovarian failure or gonadal dysgenesis. Gonadal dysgenesis is a disorder characterized by a disorder of sex determination and differentiation. This means that the gametes typical of the testes or ovaries are not produced in the dysgenetic gonad. Such an organ consists mainly of fibrous connective tissue.

Gonadal dysgenesis can take several forms, including congenital, primary ovarian insufficiency. It is caused by disorders of the sex chromosomes. This type of disease is pure gonadal dysgenesis with the 46, XO karyotype. A person with this form of gonadal dysgenesis is normal in body and female genitalia, intellectually developing normally, but sexually delayed or not developing at all. Dysgenesis affects both gonads. Pure gonadal dysgenesis with 46, XO karyotype is associated with decreased estrogen levels, increased levels of gonadotropins, and sometimes also higher levels of androgens. Treatment of this condition requires the administration of ovarian hormones.

Another form of gonadal dysgenesis is Swyer's syndrome, which is pure gonadal dysgenesis with a 46, XY karyotype. This disease is characterized by a female phenotype with a male karyotype (XY). This translates into the presence of female genitalia, including the vagina, uterus, and fallopian tubes. However, there are no secondary sexual characteristics. The person suffering from this condition is of normal or tall stature. Primary amenorrhea occurs. Treatments for Swyer's syndrome include removal of the gonads and administration of ovarian hormones.

2. Secondary ovarian failure

The cause of secondary ovarian failure is diseases of the hypothalamic-pituitary system. Their consequence is secondary amenorrhea. These conditions are characterized by low levels of gonadotrophins and ovarian hormones in the blood. If there is hypogonadotrophic hypogonadism (congenital gonadoliberin deficiency), the patient has primary amenorrhea and incomplete or complete development of puberty.

Kallmann's syndrome may be the cause of secondary ovarian failure. It is a genetic disease characterized by hypogonadotrophic hypogonadism accompanied by an impaired sense of smell. Sometimes the ovaries do not function properly due to starvation. This condition is noted in women suffering from anorexia. They do not have periods and their premenstrual period is shortened. In this case, treatment is associated with measures aimed at restoring normal body weight. Giving hormones is also helpful.

Secondary amenorrhea can also occur in women who play sports intensively. Vigorous physical activity can lead to a prolongation of the postmenstrual phase and corpus luteum failure. Significant fat loss is also important here. If body fat is less than 17%, cyclical function of the hypothalamic-pituitary system may cease. Stress is also unfavorable and may contribute to a change in the frequency of luteinizing hormone (LH) secretion.

Another possible cause of secondary ovarian failure is Sheehan's syndrome, or postpartum pituitary necrosis. This condition is caused by perinatal hemorrhagic shock, the consequence of which is pituitary ischemia. Symptoms of Sheehan's syndrome are lack of lactation due to lowered blood prolactin levels and amenorrhea after childbirth. Due to this condition, hypothyroidism and adrenal cortex appear.

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