Functional hyperandrode in women. Folk treatments

You probably paid attention to women having men's features in their appearance. This may be a low voice, the appearance of vegetation on the face and body, typical of men's body structure and the like.

To such a situation, the excessive secretion of androgens or their enhanced impact on the body of the woman is most often caused. In medicine, such pathology is defined as hyperandrode.

Symptoms, causes and ways to deal with it We will consider in this article.

What provokes the appearance of hyperandrogenation?

The disease described is the most common disruption of the functions of the endocrine system in women. As a result of research, it was established that 20% of the weak floor representatives have a diagnosis of hyperandrode.

In women, such a state is usually due not only to the excess number of men's genital hormones produced by ovaries or adrenal glands. The pathology provokes and enhancing the transformation of androgen-precursors into their even more active shape (for example, testosterone becomes dihydrotestosterone, active 2.5 times more). It aggravates the situation and an increase in the utilization of androgens, pushed by increased sensitivity of the organ (for example, the skin) to this hormone.

Some features of the development of hyperandrode

So, hyperandrode in women, the symptoms of which are manifested, in particular, acne (acne (acne), develops with increasing sensitivity to androgens at the sebaceous glands. Note that at the same time the level of men's genital hormones in the blood of the patient remains normal!

In addition, the development of hyperandrode is also affected by a decrease in the number of globulin, which binds sex hormones (normal it does not give to penetrate the free testosterone into the blood cell and enter into interaction with androgen receptors).

The synthesis of globulin occurs in the liver, so the violation of the function of this body can provoke the beginning of hyperandrode or to spur its development. The same effect has a decrease in the level of estrogen produced by the thyroid gland.

Signs of hyperandrode in women

Hyperandrogenation can manifest themselves with virization, that is, the occurrence of men's male signs. As a rule, this is expressed in the collaboration of the chest area, the middle line of the abdomen, the inner side of the hips and enhancing hair growth on the face. But in the hair on the head at this time they may appear poisons (t. Alopecia). In addition, pathology often accompanied and cosmetic defects: acne (acne rash), peeling and inflammation of the skin on the face (Seborrhea), as well as atrophy of the abdominal muscles and limbs.

For women with hyperandrogenics are characterized by violations menstrual cycle or amenorrhea (no monthly), obesity, hypertension, myocardial hypertrophy and infertility.

In addition to the listed, women suffering from described pathology usually have reinforced susceptibility to different types infections, a tendency to depressions, as well as increased fatigue.

By the way, remember that this pathology Does not have age. Gyperandrogenation in women can manifest itself in any period of life since birth.

How is hyperandrode diagnosed?

The described diagnosis cannot be delivered only on the basis of external signsAvailable in the patient. Even in the case when they seem very eloquent. It is necessary to conduct a number of analyzes and ultrasound of internal organs. And the key method of diagnosing this pathology is the study of blood on the number of steroids.

Please note that the patient's condition can manifest itself both sugar diabetes, Cushing syndrome (which is externally expressed by obesity, moon-shaped face and thinning limbs), ovarian polycystic, tumors of adrenal glands, etc.

As you can see, all this implies the most miscellaneous methodsWith the help of which will be diagnosed with hyperandrode in women.

How to distinguish between girsutism and hypertrichosis?

As mentioned above, one of the earliest and permanent symptoms The appearance of the described pathology in women is overweight hair and body hair (girsutism).

But such a sign should not be confused with a hyperitrihosis - a state in which the exhaustion passes on any part of the body, including where the hair growth does not depend on the action of androgen.

And syndrome hyperandrode in women provokes hair appearance in such places, that is, on the male type: on the face (beard and mustache), on the chest, the inner side of the hips, on the stomach and lower back, as well as between the buttocks.

The patient with hirsutism, as a rule, is proposed for treatment, which includes cosmetic measures (epilation), and hormonal correction.

The effect of androgens on hair growth in a woman

How is an interrelated hair growth with the development of androgens in the body of a woman? The fact is that it is precisely the amount of this hormone determines how and where the hair on the body of a woman will grow. So, during the start of sexual development, the girl is under the influence of androgens under the mouse and on the pubis appear in a small amount of hairs.

But if the level of hormones begins to exceed the norm, then the exhaustion will appear on the face, and on the chest, and on the stomach. A very high level Androgens causes, besides this, a decrease in hair growth on the head, which is why the lumbers are needed there.

Moreover, note that the growth of powder hair, as well as eyelashes and eyebrows, this hormone has no effect.

How does the ovarian hyperandrode develop?

In medicine, three forms of the described disease are distinguished: ovarian, adrenal and mixed.

The development of the first form of pathology leads a shortage of enzymes contained in the ovaries (it is usually about hereditary pathology). This interferes with the conversion of androgens into female sex hormones - estrogens and, accordingly, causes them to accumulate. As a result, the woman develops ovarian hyperandrode.

By the way, what exactly androgens (testosterone, dea-sulfate or Androstendion) will prevail in the blood of the patient, directly depends on which enzymes are not enough in its body.

How does the functioning of the ovaries violates?

The ovarian form of the disease is most often characterized by polycystic and hypertepecosis (bilateral increase) of the authority. By the way, in girls dealing with strength sports, high risk of acquiring this pathology.

This is due to the fact that the excess level of androgens suspends the growth of follicles, of which the ovaries consist of, as a result, leading to their infection (t. N. Follicular atresia). In addition, it stimulates the development of the pathological formation of fibrous connective tissue (fibrosis) and causes polycystic.

According to the principle of feedback, this syndrome of hyperandrode in women leads to a failure in the central regulation of the level of androgens (at the level of pituitary and hypothalamus), which, in turn, strongly changes the hormonal background.

Adrenal hyperandrode

Now let's talk about adrenal hyperandrode. You probably know that the adrenal glands are a pair of small endocrine glands, which are located above the kidneys. By the way, they produce 95% androgen called Dae-sulfate.

A feature of the pathology of this body is that adrenal hyperandrode in women most often is congenital. It arises as a result of androgenital syndrome.

Such syndrome causes the absence of enzymes that contribute to the production of glucocorticoid hormones, which normally produced adrenal bows. This leads to the fact that their predecessors accumulate in the blood (progesterone, pregnenolone, etc.), forcing them to use them for excessive production Androgen.

It is less likely to occur hyperandrode, caused by tumors of adrenal glands, isolated androgens (such pathology is called the name of Itsenko-Kushing).

Mixed hyperandrode

Periodically encounters mixed hyperandrode in women. The causes of its occurrence lies in the simultaneous impairment of the functions of the ovaries and adrenal glands.

Due to increasing the level of adrenal androgens, their formation in the ovaries increases, and the increased content of the latter stimulates the hypophies, forcing it to enhanced the production of luteinizing hormone, provoking the formation of hyperandogenic syndrome.

The mixed form also occurs as a result of injuries, pituitary tumors or brain intoxication in a woman.

What is dangerous hyperandrode during pregnancy?

In addition to the problems listed above, the described pathology is dangerous for women who want to conceive and endure a child. For example, hyparandrogenation during pregnancy is the cause of 20 to 40% of miscarriage or fetal fetal, which occur in early terms.

And notice that such a state of affairs is sad because the pregnancy interrupts themselves aggravate hormonal disorders. And in this case, against the background of existing hormonal changes, it also leads to the fact that the pregnancy in the future becomes impossible.

Pregnancy pregnancy prognosis under hyperandrode

If a woman addresses a specialist with specific complaints, which were listed above, then it will necessarily be appointed a survey to the exclusion of described pathology.

For proper diagnosis And adequate treatment of hyperandrode during pregnancy prevents the patient to successfully endure and give birth to a child. This helps drugs that reduce the level of androgens in the blood. Their patient must be taken regularly throughout the entire period of pregnancy.

How to treat hyperandrode?

Before starting treatment with hyperandrode in women, it is required to undergo a detailed examination to identify the type of disease and the reasons that provoked its development.

If a woman does not plan the birth of a child, then the doctor picks up a patient oral contraceptives that have an antandogen effect. In the opposite case, preparations are prescribed, stimulating the yield of the egg, and sometimes a wedge-shaped excision of the ovary is applied to help an egg to get out of it.

In the event of a high level of androgens, which the body cannot dispose, patients, as a rule, are prescribed dexamethasone drugs and "methipret", which increase the number of female hormone in the body.

If the disease is provoked by the presence of a tumor, then the patient shows surgical intervention. The same forces specialists and ovarian polycytosis. As a rule, its most is removed.

In the adrenal impact of the disease applied hormonal therapycomprising glucocorticoid hormones (for example, dexamethasone means). By the way, it is prescribed in the maintenance dose and during pregnancy.

Drugs used for the treatment of hyperandrode

To improve the condition of the skin with the described disease, the drug "Diana-35" is used, which suppresses the production of androgens with adrenal glands and ovaries, as well as the release of a luteinizing hormone woman's blood. In this case, the ciproteronacetate, which is part of the drug, blocks the skin receptors sensitive to androgen, without giving contact them.

As a rule, to increase the efficiency, the named drug is prescribed in conjunction with the Androkur means. These drugs help women having a pronounced acne. But they can be appreciated only after 3 months after the start of treatment.

It is very effective and therapy with antidrogenic drugs "Janin" and "Zhanin". Treatment of hyperandrode in women with the help of these funds lasts at least six months. It does not cause an increase in body weight and contributes to the normalization of the menstrual cycle.

Are there folk remedies that help with hyperandrode?

Known Pretty Wide Circle medicinal herbalwhich are included in the exchange processes of the female organism and have a positive effect on the controls of the equilibrium of hormones.

Of course, with such a disease, like hyperandrode, treatment folk remedies - not at all, not a panacea, but, for example, such a means as cymifuga (or, in other, clopogan) can help in cases of violation of hormonal balance. No less effective and the Pruznok Sacred, on the basis of which the drug "Cyclodinone" is produced.

However, you can list a whole list of representatives of the Flora, which along with the designated specialist medicinal preparations It will help to adjust the hormonal equilibrium: the root of licorice, mint, Dyagil, Peony is evading, etc. The finished charges of such plants are sold in the pharmacy network and are always ready to relieve the state of the woman.

A few words finally

Do not try to treat your pathology yourself! If you are diagnosed with hyperandrode, feedback from friends or relatives about any "magic" means will not help solve the problem.

Incorrect treatment may have very serious consequences for women. Therefore, when suspected of the disease, first of all, it is necessary to contact the gynecologist and an endocrinologist. Their joint efforts and your patience and perseverance will help to stop the development of pathology and prevent irreversible consequences.

The most notable symptom hyperandrogenation is garisutism, but it must be remembered that it is not always due to hyperanegenemia (for example, it may be constitutional). Conversely, an excess of androgens is not necessarily accompanied by pronounced garisutism - as, for example, in Asian with polycystic ovaries syndrome.

Androgen synthesis in women

Androgens are C19-steroids that are secreted from cholesterol in the mesh zone of adrenal cortex, as well as in Tekocytes and stromes of ovaries. In addition, in these organs and in peripheral tissues, androgens can be converted into more active derivatives (for example, testosterone - in dihydrotestosterone), in estrogen (under the action of aromatase) or inactivate by conjugation with glucuronic acid or sulfatization and in the future are derived from the body.

Androgens act both systemically (classical endocrine regulation) and locally (Paraconne or autocrine regulation, for example, in skin hair follicles). They bind to intracellular androgen receptors located in the cytoplasm. Then the hormone-receptor complex moves to the kernel, where in the course of complex interaction with other transcription factors and with proteins - coactivators regulates the transcription of target genes. In addition, androgens can act and indirectly, through metabolites (for example, through electrogenes).

In the plasma androgens circulate in the complex with a number of proteins, first of all - with GSPG. In comparison with the latest Albumin possesses a much greater binding capacity due to more high concentration and greater total. However, the affinity of androgens to albumin is much lower, therefore, the main part of the plasma testosterone is circulating in the complex with the GSPG. In such an androgens complex is biologically less available for target cells than in a complex with albumin. GSPG is produced by the liver. Estrogens, including those taken inward, stimulate the production of this protein, and androgens, and, especially important, insulin - inhibit. Therefore, women with hyperagratenia and men are the levels of the GSPG below. Androgens are metabolized in the liver and in other peripheral tissues, and their metabolism strongly depends on the level of free hormones in the plasma.

The development of androgen depends on the age and the presence of obesity. With age, the level of adrenal androgens, especially dehydroepiyndrosterone, its metabolite (dehydroepiyndrosterone sulfate) and Androtandion, gradually decreases; Such a decrease begins before the onset of menopause. At the level of testosterone, age is influenced to a lesser extent; The ovaries continue to produce this hormone in fairly large quantities and in postmenopausal.

Symptoms and signs of hyperandrode

Clinical manifestations of hyperandrode diverse; They are due to the effects of androgen on hair follicles and sebaceous glands (Girsutism, ordinary acne, androgenetic alopecia) and on the hypothalamic-pituitary-ovarian system (disorders of ovulation and the menstrual cycle). With severe hyperandrode, other signs of virilization are developing.

Clinical manifestations of hyperandrode

Hair follicles and sebaceous glands

• Girsutism
• Ordinary Ugra A.
• netrogenetic alopecia

Hypothalamic-pituitary-ovarian system

• Disorders ovulation
• Oligomenorrhea
• Dysfunctional uterine bleeding
• Infertility caused by anointing

Fat fabric

• Obesity for male type

Virilization

• Pronounced garisutism
• Androgenetic alopecia
• Low voice
• Hypertrophy clitoris
• Obesity for male type
• Increase muscular mass
• Reducing the mammary glands

Exposure to hair follicles and sebaceous glands

In androgen-dependent zones instead of thin, colorless powder hair begin to grow rude, thick, pigmented terminal hair. The effects of androgens on the peripheral tissues depends mainly on the activity of 17p-hydroxyster-iddhydrogenase (turns the Androtandion to testosterone) and 5α-reductase and on the amount of androgen receptors. Before the start of puberty, the body grows mainly thin, short, colorless guns (vers). In the pubertal period, an increase in the level of androgens leads to the fact that some of these hair is replaced by coarse, long, pigmented terminal hair. It should be noted that the terminal hair of eyebrows, eyelashes, the occipital and temporal parts of the head from androgen depends a little.

Ordinary acne

Androgens stimulate the production of skin saline and the energization of the walls of the follicle, which contributes to the development of seborrhea, folliculitis and acne during puberty and at hyperandrode. In patients with ordinary echs, the levels of androgens in the plasma and the activity of the 5a-reductase converting testosterone in dihydrotestosterone are elevated. Therefore, when appointing antandrogens, Kok or glucocorticoids often occurs.

Androgenetic alopecia

Excess androgens, stimulating hair growth on the face and body, on the hair follicles of the scalp, on the contrary, acts opposite: the hair follicles are reduced in size, instead of terminal hair, hair begins to grow, similar to flush. Androgenetic alopecia is found in both men and women. Women leak it can bic. With severe hyperandrode and symptoms of virilization, hair loss on the dark part of the head is observed, the change in the front edge of the hair growth with the formation of the gears. But more often, the baldness is reduced to hair waste, mainly in the dark area. Approximately 40% of women with androgenic alopecia are hyperandrode, but if we take into account cases of insulated alopecia without hirsutism, this indicator will decrease to 20%.

Influence on the ovarian function

Hirerandrogenation is often accompanied by disorders of ovulation or due to the violation of the secretion of gonadotropic hormones, or as a result of the immediate action of androgens into ovaries. On the hypothalammopofizar system and the secretion of gonadotropic hormones in women androgens are indirectly influenced (after transformation into estrogens) or directly. In the experiment, Digidotestosterone violated the ability of progesterone to control the frequency of gonadoliberine pulses, which led to an increase in LG secretion. In addition, an excess of androgens can suppress the ripening of the ovarian follicles, as a result of which multiple small cysts appear in the cortical substance (so-called polycystic ovaries). The clinical expression of the disorders of the ovarian function in hyperandrode is becoming disorders of the menstrual cycle, which can be considered as a symptom of an excess androgens, even in the absence of anrognese-dependent leather lesions.

Impact on adrenal glands

In 25-50% of women with hyperandrogenia, the level of adrenal androgens (for example, dehydroepiypiderosterone and its sulfate) is elevated. However, the amplification of steroidogenesis in the adrenal glands and the growth of the level of adrenal androgens may be due to at least partially, at all-adhesive (for example, ovarian) androgen. Elevated level The dehydroepiyprosterone sulfate in women with polycystic ovarian syndrome decreases by 20-25% after the appointment of a long-acting gonadoliberin analogues, although the normalization of the level of adrenal androgens against the background of such treatment is rarely observed. The secretion of adrenal androgens, especially the dehydroepyondrosterone sulfate, can be intensified with an excess of non-suite androgens, which further exacerbates hyperandrode.

Obesity

Obesity and hyperandrode are closely interrelated, especially with polycystic ovarian syndrome. It is not known which of these states is developing in the first place. In case of polycystic ovarian syndrome, the number of androgens, which can turn into estrogens in peripheral tissues, increases, resulting in increasing estradiol levels. During a prospective study of ten young people with a normal weight transferring the operation to change the floor with female on male, MRI was carried out: before appointing testosterone, after a year of reception of the drug and after three years of reception. In the course of treatment, the weight changed slightly, but the distribution of subcutaneous fatty fiber changed significantly. After a year of treatment, its thickness in the abdomen, the pelvis and the hips significantly decreased compared with the initial indicators, but after three years of treatment, these differences were no longer statistically significant. The mass of fatty fiber of internal organs, on the contrary, in the first year of treatment practically did not change, although he rose from those who added in weight during this period. However, after three years of testosterone reception, this figure grew by 47% compared to the initial, and, as before, the strongest of those who added in weight.

All of these data confirm that excess of androgens or estrogen formed from them contributes to the development of obesity on male type, which leads to increased insulin resistance and further growth of androgens in patients with hyperagratenia. The indirect effect of androgens on an increase in weight through the CNS is not excluded. The role of androgens in the development of obesity is not quite clear, but in favor of their influence the fact that among men the prevalence is overweight higher than among women.

Anabolic effect of androgens and virilization

With severe and long-term hyperandrode, virilization can be observed - the appearance of baldness in the dark part of the head and it is necessary for the forehead, the clitoris hypertrophy and severe girsutism. In the future, especially if hyperandrode has developed before the start of puberty, the physique (atrophy of the mammary glands, the growth of muscle mass) can change and drop the voice of the voice. In women of childbearing age, Virilization is almost always accompanied by amenorrhea. Most often, virilization indicates an androgensecreet tumor. Moderate virilization is also found in girls with severe insulin resistance (for example, with HAIR-AN syndrome).

Rare causes of hyperandrode

The clinical picture of hyperandrode is also observed with ACTG-secreting tumors - the adenome of pituitary gland (Cushing's disease) or ectopic tumor. However, Cushing syndrome is extremely rare (1: 1 000 000), and methods for its detection do not have one hundred percent sensitivity and specificity, so there is no need to examine on Cushing syndrome with hyperandrogen. Occasionally hyperandrode may also be a consequence of the administration of androgen inside. During pregnancy, heavy girsutism or even virilization can have a benary ovarian cause, such as tecalkyunic cysts, pregnancy luteomes, or an extremely rare aromatase deficiency, in which the placenta is not capable of synthesize estrogens from androgen, which leads to hyperandrode.

Examination at hyperandrode

In order to establish the cause of hyperandrode, history and physical research are important primarily, the laboratory studies are necessary mainly in order to confirm or disprove various diagnoses arising during the survey.

Survey in suspect of hyperandrode

Anamnesis

• Reception medicines or other androgen-containing drugs
• Impact on the skin of irritants
• Information about menstrual cycle, pregnancies and childbirth
• The appearance and progression of hirsutism, acne and alopecia
• An increase in the size of the limbs or head, changing the contours of the face, weight gain
• Information regarding lifestyle (smoking, drinking alcoholic beverages)

Physical research

• Assessment of hirsutism, for example, according to the modified scale of Ferriman-Golluea
• Androgenetic alopecia
• Black acanthosis and soft fibromes
• Signs of Cushing Syndrome
• Obesity and its type
• Hypertrophy clitoris
• Other signs of virilization

Laboratory research

• TTG (measured by highly sensitive method)
• 17-hydroxyprogesterone in the follicular phase of the menstrual cycle
• Prolactin
• Common and free testosterone, dehydroepyondrosterone sulfate (usually in cases where symptoms of hyperandrogenation are insignificant or cause doubts)
• Insulin level on an empty stomach and after meals

Anamnesis

Collect detailed history: Reception of medicines and other preparations containing androgens: Impact on the skin of irritating substances; data on menstrual cycle, pregnancies and childbirth; The time of appearance and progression of girsutism; an increase in the size of the limbs or head, a change in the face form, weight gain; the presence of baldness, hair loss and acne; It is also found out if there are similar diseases from the nearest relatives. Diabetes for the nearest relatives is an important prognostic factor of β-cell dysfunction in the patient. Anamnesis should also include information regarding lifestyle (smoking, alcoholic drinks).

Physical research

Pay attention to the signs of Cushing syndrome, the presence of black acanthose, bald, acne, on the nature and distribution of hair on the body. The scale is widely used to assess the degree of hirsutism, which is the modification of the scale proposed in 1961 by Ferriman and Gollueem. Looking for signs of virilization and masculinization (as a rule, they are well noticeable). The hypertrophy of the clitoris is usually indicated if the product of the longitudinal and transverse diameters of the clitoris head exceeds 35 mm 2 (normally both diameters are approximately 5 mm). Pay attention to signs of insulin resistance: obesity, especially on the male type, the presence of black acanthose and soft fibrom. Women in obesity on male type are noted dlypoprotehemia, increased compared to obesity in the female type of insulin resistance, higher risk cardiovascular diseases And higher overall mortality. The type of obesity is easiest to evaluate the waist circle measured in the most narrow part of the abdomen, usually slightly above the navel. The waist circle in women more than 80 cm testifies to the presence of an excess of visceral fat and is considered to be a deviation from the norm, although the incidence and mortality increases significantly with an indicator of 88 cm and more.

Laboratory research

The goal is to eliminate certain diseases with similar manifestations and, if necessary, confirmation of hyperandrode. In addition, the presence of metabolic disorders. Diseases that should be excluded in suspected hyperandrode - pathology thyroid gland, hyperprolactinemia, HAIR-AN syndrome and androgen-set tumors. The pathology of the thyroid gland is excluded by determining the level of TSH with the help of a highly sensitive method.

As already mentioned, even if the patient with Girsutism argues that she has a regular menstrual cycle, it is necessary to make sure that there is no disorders of ovulation; usually make up schedule basal temperature. With disorders of ovulation, polycystic ovary syndrome is possible. It is also necessary to determine the level of prolactin to exclude hyperprolactinemia, and the level of insulin and glucose on an empty stomach to exclude HAIR-AN syndrome.

Detection of metabolic disorders

Metabolic disorders are often found in the syndrome of polycystic ovaries, and with HAIR-AN syndrome - always. In the HAIR-AN syndrome, the presence of insulin resistance is obvious, but in the syndrome of polycystic ovary, this is not always the case. Unfortunately, accurate, inexpensive and reproducible analysis methods for evaluating sensitivity to insulin in ordinary practice does not exist. In research institutions, stimulation and suppressive samples are usually used, such as an eugalchemic sample, and an intravenous test for glucose tolerance with frequent selection of blood samples, but in everyday conditions during examination of patients with hyperagratenia, they are rarely applied.

Rady diagnosis

Ultrasound of a small pelvis in hyperandrode allows you to clarify the presence of anoint disorders and polycystic ovarian changes. It should be remembered that polycystic ovary can be found in many diseases causing hyperandrode, and not only with polycystic ovaries syndrome. The value of ultrasound using a vaginal sensor increases in obesity, since to identify pathological formations in the ovaries in such women in case of inspection.

If the androgensection tumor is suspected to eliminate adrenal tumors of more than 5 mm in size and to identify two-sided hyperplasia of adrenal cortex in the case of an ACT-secreted tumor, CT or MRI of adrenal glands is shown. However, since 2% of the population has asymptomatic adrenal adenomes (revealed randomly), the detection of the tumor does not always mean precisely androgeneous tumor and can provoke invasive and at the same time unnecessary procedures. Therefore, CT and MRI of the adrenal glands spend only when the symptoms clearly indicate the adrenal cause. In rare cases in order to establish the localization of the androgensection tumor, the selective catheterization of the adrenal veins or scintigraphy C, 3β-cholesterol is carried out.

Treatment of hyperandrode

Treatment of hyperandrogenation is mainly symptomatic.

It pursues four main objectives:

1. normalization of the menstrual cycle;
2. elimination skin manifestations;
3. elimination and prevention of accompanying metabolic disorders;
4. treatment of infertility caused by anointing.

Treatment methods are aimed at suppressing the synthesis of androgen, the blockade of their peripheral action, the correction of insulin resistance and dlypoprotehemia (if any), eliminate the skin manifestations of the disease with local, mechanical or cosmetics. In most cases, several methods are used. Methods of normalization of the menstrual cycle and eliminate skin manifestations, primarily gursutism, are discussed below.

Basic goals for the treatment of hyperandrode

Regulation of menstrual cycles

• Glucocorticoids
• Changes in lifestyle

Elimination of skin manifestations (hirsutism, acne, alopecia)

• Reducing the level of androgenov
• Analogs of Gonadoliberin Long Action
• Blockers androgen receptors
• Spironolakton
• Flutamide
• Ciproteron
• 5α-reductase inhibitors
• Finasterid
• Hair growth suppression by local means
• Orpibers Ornithinesearboxylase
• Mechanical and cosmetic hair removal methods
• Electroepilation
• Hair removal with laser
• Cosmetic procedures (shave, chemical epilation, discoloration)

Elimination and prevention of concomitant metabolic disorders

• Preparations that increase insulin sensitivity
• Changes in lifestyle

Reception of infertility caused by anointing

• Klomifen.
• Preparations of gonadotropic hormones
• Gonadoliberin analogues in pulse mode
• Surgical intervention (coagulation of ovaries)
• Changes in lifestyle

Normalization of menstrual cycles

The normalization of the menstrual cycle reduces the risk of dysfunctional uterine bleeding and caused by these violations of anemia. As a rule, Kok, progestogen in cyclic or constant mode are prescribed.

Combined oral contraceptives

Kok reduce the level of gonadotropic hormones and, consequently, the production of ovarian androgens. Estrogens contained in COC synthesis synthesis of GSPGs and, as a result, reduce the level of free testosterone. Progestogens consisting of COC can inhibit 5α-reducts and block the binding of androgen with receptors. Finally, Kok can suppress the synthesis of adrenal androgens, although the mechanism of this action is not yet clear. COC normalizes the menstrual cycle and reduce the risk of endometrial hyperplasia and uterine body cancer in hyperandrode of any origin. Best (although it is not necessary) to choose COC, containing a progestogen with antandogenic effect: Ciproteron, Chlorine Madinone (Belarus), Dienengest, Chrospirenone. When using Kok women with polycystic ovarian syndrome, the activation of the renin angiotensin-aldosterone system can negatively affect the metabolism, and in this connection, certain advantages have preparations, such as Midian and Dimia, which include a neighborhood, which has antinerogenic, antimineralocorticoid activity. Endogenic progesterone, whose deficit under annotulatory states is inevitable, inherent in small antandrogenic and antimineralo-corticidal effects.

Although it was not studied specifically, it was noticed that Kok, containing 30-35 μg of ethinyl estradiol, usually less often lead to breakthrough bleeding. This statement does not apply to adolescents who have sensitivity to sex steroids higher than adult women. Microhodosis of ethinyl estradiol is better transferred, but the passing of the tablet of such KOC is more likely to lead to ineffective contraception.

Cyclic or permanent reception of progestogen

Normalize the menstrual cycle in hyperandrode, especially in the case of amenorrhea, can also be possible by appointing progestogen in cyclic mode. Since sometimes progestogens can stimulate ovulation and since not all sick ovulation is completely broken, women leading sex lifeIt is better to appoint inside the micronized progesterone (100-200 μg twice a day) or Didrogesterone (10 mg twice a day), and not synthetic progestogens, derivatives of Northestosterone.

Preparations that increase the sensitivity of peripheral tissues to insulin

Designed originally for the treatment of type 2 diabetes mellitus, these drugs are also used in polycystic ovaries syndrome. This includes metformin and derivatives of thiazolidindion. Encouraging results were also obtained in respect of a number of other drugs (for example, acarbosa).

Metformin

Metformin, belonging to the Biguanids, suppresses gluconeogenesis in the liver. Side effects Diarrhea, nausea and vomiting, bloating, meteorism, loss of appetite - they are observed in 30% of cases. In rare cases, lactacidosis is possible; In predisposed people, it can provoke it to / in the introduction of iodine-containing radiopatrum, although it basically happens with decomposed diabetes or impaired kidney function. In the polycystic ovary syndrome, Metformin normalizes the menstrual cycle, leading to regular menstruation, according to various sources, in 40 or even 100% of cases. There are several explanations positive influence Meetformmina on steroidogenesis: Reducing the activity of CYP17, suppression of Androtandion products due to the direct effect on tekocytes, a decrease in the stimulated FSH of the activity of zβ-hydroxysteroiddehydrogenase, the level of Star protein, the activity of CYP11A1 in granolascent cells. Molecular mechanisms of the actions of metformin per ovary are not fully clear, but in recent studies it was shown that metformin increases the expression of AMF-activated protein kinase in granular cells. The use of metformin leads to a decrease in the level of androgens and, with the duration of therapy at least 6 months, hormone antimyuller. Interestingly, a reliable reduction in the level of antimulller hormone is observed in women who have a regular menstrual cycle on the background of Metformin therapy, while the inefficiency of metformin was conjugate increased concentration Antimuller hormone. In the polycystic ovary syndrome, Metformin is taken at a dose of 1500-2000 mg / day, although in 15-30% of cases, complications on the part of the gastrointestinal tract can develop. The initial purpose of metformin at a lower dose and then its gradual increase to full within 2-4 weeks, as well as the use of long-acting drugs can reduce the frequency of side effects.

Tiazolidindion derivatives

Tiazolidinedione derivatives are PPAR-γ receptor agonists (nuclear receptors in peroxisis activators).

Thiazolidindions (Pioglitazone) and metformin were compared in randomized controlled studies. The effect of these drugs on the level of glucose in an empty stomach plasma, the testosterone level, the evaluation on the ferrime-Golluea scale was significantly significant, but the reception of metformin, in contrast to the pioglitazone, was accompanied by a weight loss.

Weight loss

According to preliminary data, the type of diet (for example, the content of carbohydrates is 15-25% instead of 45%) is less important as compared with the total content of calories. However, a diet with a low (25%) content of carbohydrates is better normalized by the level of insulin in an empty stomach, the ratio of glucose and insulin and the content of triglycerides: apparently, with insulin resistance, such a diet is preferable. Clear recommendations for dietary preferences in the syndrome of polycystic ovaries can be developed only after prospective studies.

Surgical intervention

The ovulatory function can normalize after a wedge-shaped resection or laparoscopic coagulation of the ovaries and persist for 10-20 years. But if the woman does not seek the birth of a child, with polycystic ovarian syndrome, laparoscopic coagulation does not have special advantages before taking COC Will, the present time as a method of normalizing the menstrual cycle. not used.

Gyperandrogenation in women is a collective term, which includes a number of syndromes and diseases, accompanied by an absolute or relative increase in the concentration of men's sex hormones in the blood of a woman. Today, this pathology is widespread enough: according to statistics, it suffers 5-7% of adolescent girls and 10-20% of women of childbearing age. And since hyperandrogenation entails not only different appearance defects, but is one of the reasons for infertility, women are important to have an idea of \u200b\u200bthis state, to notice similar symptoms, immediately seek help from a specialist.

It is about the reasons for hyperandrode in women, about the clinical manifestations, as well as how the diagnosis is made, and the tactics of the treatment of this pathology you will learn from our article. But first let's talk about what is androgens and why are they needed in women's body.

Androgens: Fundamentals of Physiology

Androgens are men's genital hormones. The leader, the most famous representative is Testosterone. In the body of a woman, they are formed in the cells of the ovaries and the bark of the adrenal glands, as well as in the subcutaneous fatty tissue (PJK). Regulate their production of adrenocorticotropic (ACTH) and luteinizing (LH) hormones synthesized by the pituitary gland.

Androgen functions are multifaceted. These hormones:

• are predecessors of corticosteroids and estrogen (female sex hormones);
• form a sexual attraction of a woman;
• during puberty, the growth of tubular bones causes, and therefore the growth of the child;
• participate in the formation of secondary sexual signs, namely, exhaustion on the female type.

All these functions of androgens are performed under the condition of normal, physiological concentrations of them in the female organism. The excess of these hormones becomes the cause of cosmetic defects and metabolic disorders, and fertility of a woman.

Species, reasons, mechanism for the development of hyperandrode

Depending on the origin, 3 forms of this pathology are distinguished:

• ovarian (ovarian);
• adrenal;
• mixed.

If the root of the problem is located in these organs (ovaries or adrenal cortex), they are called primary hyperandrode. In the case of pathology of the pituitary, determining the violation of the regulation of the synthesis of androgen, is regarded as secondary. In addition, this state can be inherited or developed during the life of a woman (that is, being acquired).

Depending on the level of male sex hormones in the blood, it is highlighted by hyperandrode:

• absolute (the concentration exceeds normal values);
• relative (the level of androgen is within the limits of the norm, but they are metaly metabolized in more active forms Either the sensitivity to them, target organs is significantly increased).

In most cases, the cause of hyperandrode is. It also takes place when:

• adrenogenital syndrome;
• neoplasms or ovaries;
• and some other pathological conditions.

Even hyperandrode can develop as a result of receiving a woman anabolic steroids, drugs of men's sex hormones and cyclosporin.

Clinical manifestations

Such women are concerned about the enhanced hair loss on the head and their appearance in other places (on the face or chest).

Depending on the causal factor, symptoms of hyperandrode varies from a minor, light hirsutism (increased collaboration) to a pronounced virile syndrome (the appearance of a female genital genital sexual signs in a sick female).

Consider in more detail the main manifestations of this pathology.

Acne and Seborrhea

- The disease of the hair follicles and the sebaceous glands arising if their ducts are cleaned. One of the reasons (more correctly to say - the pathogenesis links) acne is precisely hyperandrode. It is a physiological for a puberty period, which is why rashes on the face are found more than half of adolescents.

If the acne persists in a young woman, it makes sense to be examined in hyperandrode, the cause of which in more than a third of cases will be the polycystic ovaries syndrome.

Acne may proceed independently or accompanied (increased products of the secrets of the sebaceous glands in separate areas of the body). It can also occur under the influence of androgen.

Girsutism

This term designates an excessive growth of hair in female people in the areas of the body dependent on androgens (speaking otherwise, the woman's hair grows in places typical of men - on the face, chest, between the blades, and so on). In addition, the hair change its structure - from soft and light powder become hard, dark (they are called terminal).

Alopecia

This term is indicated by baldness. Under alopecia associated with an excess androgens, implies the change in the structure of the hair on the head from terminal (rich in pigment, hard) to thin, light, short flush and their subsequent loss. The baldness is found in the frontal, dark and temporal areas of the head. As a rule, this symptom indicates prolonged high hyperandrode and is observed in most cases with neoplasms producing men's sex hormones.

Virilization (virile syndrome)

This term denote the loss of signs of women, the formation of male signs. Fortunately, this is quite a rare state - it is detected only in 1 of the 100 patients suffering from girsutism. Leading etiological factors are adrenoblastoma and ovarian teomatosis. The cause of this state becomes the androgen-producing adrenal tumors.

Virilization is characterized by such symptoms:

• girsutism;
• acne;
• androgen alopecia;
• reducing voice timbre (barithonia; the voice becomes rude, similar to male);
• reduction in the sizes of the germ;
• an increase in the size of the clitoris;
• muscle growth;
• redistribution of subcutaneous fatty fiber on male type;
• disorders of the menstrual cycle up to;
• increase sexual entry.

Principles of diagnosis

An increase in the level of androgen in the patient confirms the diagnosis.

In the diagnosis of hyperandrode, it is important both complaints, history and data of the patient's objective status and laboratory and tool methods Research. That is, after estimating the symptoms and data data, it is necessary not only to reveal the fact of increasing the level of testosterone and other male sex hormones in the blood, but also to detect their source - neoplasm, polycystic ovary syndrome or other pathology.

Sex hormones are examined by 5-7 days of the menstrual cycle. Determine the blood level in general testosterone, GSPG, DHEA, follicle-suite, luteinizing hormones, as well as 17-hydroxyprogesterone.

To detect the source of the problem, the ultrasound of the small pelvis organs is carried out (if the ovarian pathology is suspected - using a transvaginal sensor) or, if there is an opportunity, magnetic resonance imaging of this area.

In order to diagnose adrenal tumors, the patient is prescribed computer, or scintigraphy with radioactive iodine. It is worth noting that small-sized tumors (less than 1 cm in diameter) in many cases cannot be diagnosed.

If the results of the above studies are negative, the patient may be appointed vehicle catheterization, carrying blood from adrenal glands and ovaries in order to determine the level of androgens in the blood flowing directly from these organs.

Principles of treatment

Tactics of treatment of hyperandrode in women depends on whether the pathology has arisen.

In most cases, combined oral contraceptives are prescribed patients, which in addition to contraceptive have antagandogenic effects.

Adrenogenital syndrome requires the purpose of glucocorticoids.

If the level of androgens in the blood of a woman is raised due to the hypothyroidism or elevated level of prolactin, it turns out on the fore medical correction These states, after which the concentration of men's sex hormones decreases by itself.

In obesity and hyperinsulism, the woman shows the normalization of body weight (by complying with dietary recommendations and regular physical Loads) and metformin reception.

The neoplasms of adrenal glands or ovaries producing androgens are removed surgically, even despite their benign nature.

To which doctor to turn

With symptoms of hirsutism, it is necessary to refer to the gynecologist-endocrinologist. Additional assistance will be made by specialists - dermatologist, trichologist, nutritionist.

Conclusion

Gyperandrogenation in women is a complex of symptoms arising due to increased concentration in the blood of men's genital hormones accompanying a series endocrine diseases. Most frequent reasons Its are polycystic ovary syndrome and adrenogenital syndrome.

Gyperandrogenation is a pathological condition that occurs in girls and women, and is characterized by an elevated level of androgens in the body. Androgen is considered a male hormone - in the female body, it is also present, but in minor quantities, therefore, when its level increases, a woman has characteristic symptoms, among which the cessation of menstruation and infertility, the male type and some others. The change in the hormonal background requires urgent correction, as this may cause the development of many pathologies in the body of a woman.

Androgens are produced by ovaries, adipocytes and adrenal glands. And they affect not only some external manifestations, but also to the work of the internal organs, including the kidneys, liver, the reproductive system, the musculoskeletal system.

Varieties and causes of occurrence

Depending on which organ begins to produce a large number of Androgen, allocate several forms of this pathological condition. The most common form is ovarian hyperandrodeIn which excess hormones is produced by ovaries. This is usually due to pathologies such as ovarian polycystosis or organ tumors capable of producing androgens.

Most often, such a form of pathology is hereditary in nature - if the increase in the development of androgens was observed in the mother, then the likelihood is highly like that the diseases appear and its offspring. Accumulating, androgens and cause the development of such a pathological condition as hyperandrode. Also, the reasons for the development of this form of hyperandrode can be held in violations of the hypothalamus and pituitary glands responsible for the normal hormonal background of the female organism.

Second form - adrenal hyperandrodewhich can meet girls already in early age. The reasons for the development of this form are the insufficiency of enzymes that ensure the products of adrenal hormones.

The central form of pathology develops in cases where the pituitary gland or hypothalamus is affected by a tumor. But there is also a peripheral form that occurs as a consequence of diabetes and with violations of fat metabolism.

Most common is mixed hyperandrodewhich is due to several violations at once. It can be adrenal hyperandrode and disruption of ovarian genesis or ovarian and central genesis, etc.

Hyperandrogenation and pregnancy

As mentioned above, hyperandrode can cause girls and. But there are such exceptional cases when a woman with such pathology can still become pregnant, and then it should be prepared for the fact that hyperandrode during pregnancy is mainly ends with involuntary miscarriage. In those cases, if the miscarriage did not occur, the likelihood of fetal fetal is high in the womb with the need to mechanically clean the uterine cavity for its evacuation.

All this adversely affects the health of the woman and further aggravates the problem of hormonal imbalance, so that this does not happen, the diagnosis of hyperandrode should be carried out before conception, in order to follow, after treatment, the woman had a chance to become a mothers of a beautiful baby.

Of course, not in all cases of hyperandrogenation and normal pregnancy are incompatible concepts - if hormonal violations developed on late time, there is a risk of premature birth, but the baby will be healthy. Therefore, it is very important to start in a female consultation in a timely manner - the doctor can not only determine the pathology in the early terms, but also to successfully treat it, giving a woman the opportunity to endure a child.

Symptoms

As mentioned above, the syndrome of hyperandrode in girls can be determined in a small age. These are such symptoms of violation of the hormonal background, as:

• clitoris hypertrophy;
• partial battle of large germ lips;
• increased sketching on male type (median band of belly, chin and cheeks, chest.).

In girls who suffer from this disease in adolescence, menstruation does not begin, and if the disease occurs in women, the menstrual cycle occurs. Other symptoms of such pathology as hyperandrode is:

• hair loss on the head;
• appearance skin rashes on the face and body (by type acne);
• pronounced dryness of the skin, peeling.

Also in girls and women are celebrated metabolic disordersexhibited most often different Stages, as well as muscle atrophy. In some cases, a female voice can freeze and become similar to male - most often such a symptom manifests itself in adult women. If women's hyperandrode develops in young age, The likelihood is high that their muscle corset will increase, which is why the body will acquire a courageous relief and a large muscular array.

Of course, there are general symptoms pathological condition in women. These include:

• irritability;
• fatigue;
• susceptibility to infections due to the decrease in immunity, etc.

Diagnosis and treatment

To diagnose, based only on the external manifestations of pathology, it is impossible. Therefore, the doctor appoints to patients laboratory studyallowing to appreciate the hormonal background, including the level of androgens. It is also shown to conduct an ultrasound study that will give a specialist the opportunity to identify the causes of the disease, without which effective treatment It is impossible.

Treatment depends on the form of pathology discovered by a woman. In particular, if it has hyperandrode of the ovarian genesis, shows the reception of antandrogenic oral contraceptives. And to dispose of excess hormones, the use of such drugs such as methiprette and dexamethasone is shown. These funds increase the level of female hormones, and those, in turn, utilize the surplus of men.

When the cause of the development of pathology becomes a tumor, its operational removal is required with the subsequent treatment, which will be selected for the patient individually in each case.

If the girls or women are diagnosed with adrenal hyperandrode, then its treatment will be to apply glucocorticoid hormones - the one of the above decxamethasone. Note that the easiest to treat the disease of the ovarian genesis, since the modern pharmaceutical industry offers a large amount of means that can stabilize the hormonal background of women. The adrenal hyperandrode and a mixed form of pathology is more difficult to treat, and representatives of beautiful sex are required for a long time (and even life) to use drugs prescribed by the doctor.

It is possible to treat the disease by folk methods, but their effectiveness is very low. Nevertheless, there are some herbs with a hormone-stabilizing effect, so if they are drunk in the form of infusions and decoctions, they can improve the state of the woman slightly. True, it is possible to treat pathology in this way only after consulting with a specialist.

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Answer only if you have confirmed medical knowledge

Diseases with similar symptoms:

Avitaminosis is the painful state of the person who comes as a result of an acute shortage of vitamins in the human body. Distinguish the spring and winter avitaminosis. Restrictions as for the floor and age group, in this case there is no.

Itsenko-Cushing syndrome is a pathological process, on the formation of which the high levels of levels of glucocorticoid hormones are influenced. The main one is cortisol. Therapy of the disease should be complex and aimed at relieving the causes that promotes the development of alend.

Hyperandrode syndrome in women is a frequent disorder that affects endocrine system. The disease is accompanied by an increase in the number of male genital hormones. This negatively affects both the organism as a whole and to the work of the reproductive system. This state is found in 5% of women, which is a rather high indicator. The opposite situation is called hypoandrogenation - this is when men have a lack of genital men's hormones.

Hyperagonogenic syndrome is a condition that is accompanied by an enhanced production of androgens organism (male genital hormones). Sometimes their normal concentration is observed, which still may have a negative impact on the body. Excess androgens in the female part of the population is manifested by the appearance of male traits. Also, the patient has problems with reproductive function. This syndrome is also found in men. It is manifested with them (increasing the mammary glands like women). Also, such men often suffer impotence and other problems.

Androgens are a group produced by the human body. They are produced by testicles in men or ovaries in women. Also, these hormones are produced by adrenal cortex. The list includes:

• other.

The synthesis of androgen is controlled by substances that are produced by the pituitary. This includes adenocorticotropic hormone. The formation of androgen begins with the transformation of cholesterol in the pregnenolone. This process It is observed in all tissues that belong to steroid production. Subsequently, the synthesis continues in completely different organs. Most often they have nothing to do with steroidogenesis.

At the exit, different hormones are formed depending on the organ, which is included in the process. Testosterone, Estron, is produced by ovaries. The adrenal glands produce. Also, this body produces testosterone. In the process of producing androgens, not only organs, a and tissue of peripherals are taken involved, for example, subcutaneous fatty fiber.

Symptoms of hyperandrode in women

Signs of hyperandrode in women are considered:

• . It is characterized by increased sophistication on male type. In this case, an uncharacteristic hair cover is observed. It can be localized on the stomach, back, face, chest. In the presence of increased sophistication, it should be distinguished by a diagnosis of hyperandrode from. The last state has the same signs, but does not appear due to elevated androgen. Increased sophistication can develop due to the characteristics of the woman's body, which is the norm. A vivid example is representatives from the Central Asian countries;

• acne. It is characterized by the formation of acne on the skin (most often on the face). Accompanied by the lesion of hair follicles and sebaceous glands, blocking outputting ducts. This problem is often concerned about adolescents, which does not indicate the presence of this syndrome. After 20 years, the greater half of women who revealed eating rashes is diagnosed with an excess of male sex hormones;
• seborrhea. It is characterized by increased secretion of the sebaceous glands. Such a process is observed on the head, face, neck and other parts of the body. Seborrhea is often caused by the development of acne or other skin problems in women;
• alopecia. Hair follicles are very sensitive to raising the level of androgen in the blood. Bole is only such a phenomenon in the frontal, temporal and dark area. Under the influence of male hormones in these sections, the hair is modified, they become much thinner, and over time they fall at all. As a result, they are formed. Androgen alopecia is often observed in women who have significantly increased the level of men's hormones;

• virilization. It is characterized by the appearance of severe male features in women. This symptom is present in patients with serious pathologies that androgens are produced in a huge amount;
• violation of the menstrual cycle. Women put different diagnoses depending on the nature of the violation. Oposoligomoriya is often found (the presence of a too large or short period between monthly), amenorrhea (complete absence of menstruation over a long period);
• . May be observed in the presence of pathologies of adrenal glands or ovaries;
• amyotrophy;

• reducing immunity as a result;
• violation of glucose tolerance;
• the presence of intermediate genital organs. Such a woman can observe the battle of the germ lip, the clitoris hypertrophy and other defects. These problems are congenital character and appear due to hyperplasia of adrenal cortex. Such a person can call Androgin, which means the connection of a man and a woman in one body;
• chronic depressive condition, drowsiness, decay and other signs of hyperandrode.

Causes of development of the problem

The development of hyperandrode syndrome is observed due to such reasons:

• hereditary factors. Android women can be transmitted from mother to her daughter. If the family has been revealed this problem, there is a high probability that it is inherited;
• violation normal work Brain, in particular, or. These departments are trained in the process of formation of sex hormones;

• dysfunction of adrenal cortex. It is congenital pathology, which is characterized by an increase in the production of one hormones and oppression of others. In 95% of cases there is a decrease in the concentration of aldosterone, which leads to the incorrect formation of the external genital organs of a woman;
• the formation of ovarian tumors or adrenal glands, which violate the normal process of the production of hormones. They are also called androgensecting. When localizing on the ovaries, testosterone production increases, on adrenal glands -;
• polycystic ovarian syndrome. This disease, which is characterized by the absence of tumors, but affecting the increase in the development of men's hormones in women. In the ovaries are formed multiple cysts, which causes. The elevated level of androgens, which is observed in the PCOS, leads to infertility, obesity, increased exhaust. During the diagnosis of a sick woman, a chronic absence of ovulation is detected;

• adrenogenital syndrome. It is characterized by excessive formation of male genital hormones adrenal glands;
• . Accompanied by an increase in hormones produced by the bark of the adrenal glands - glucocorticoids. The sick woman is observed where fat is predominantly postponed on the face, neck, torso. Other symptoms The disease is a disruption of the menstrual cycle, infertility, muscle atrophy (mainly on the limbs), osteoporosis, the absence of glucose tolerance, osteoporosis, chronic depressive state. Men has an increase in the mammary glands, impotence;
• prolactinoma. The tumor, which is localized in the pituitary. This education affects the production that is responsible for breast growth, milk formation;

• hypepecosis of ovary and stromal hyperplasia. There is an unnatural growth of their tissues. Most often found in adulthood after 60 years. In the study of patients, an increase in the level of estradiol and estron is determined. Violation is accompanied by obesity, development arterial hypertension, violation of tolerance to glucose, uterine cancer;
• high activity of 5-alpha reductase, which takes part in the production of steroid hormones;
• long and non-controlled reception of different types (including oral contraceptives);
• disruption of the thyroid gland;
• chronic liver diseases.

Increase the development of androgens in pregnant women

Excess androgens in women who carry the fruit is hazardous condition. 20-40% of all cases, pregnancy ends with spontaneous abortion on early time. This happens due to the undeveloping fetus or an embrypion (lack of an embryo in fruit eggs).

Such a problem can be chronic. Each subsequent pregnancy ends with miscarriage, which leads to such a state as the usual unbearable. Secondary infertility develops, and hormonal disorders become more pronounced.

SAME critical momentsWoman is experiencing, periods are considered when the fruit begins to additionally produce men's sex hormones. This occurs naturally and is observed:

• from 12 to 13 week of pregnancy;
• from 23 to 24;
• from 27 to 28.

If the pregnancy was identified a high level of androgens in women, treatment occurs at all stages - both before and during the tooling of the fetus. The doctor defines the risk for a woman and child and prescribes the reception of the appropriate drugs to normalize the hormonal background.

Diagnosis of the disease

Symptoms and treatment of this problem depends on the causes of its occurrence. To determine them, an analysis of the patient's condition is carried out. The attending physician takes into account when characteristic symptoms of hyperandrode - in children's, adolescent or mature age. Such an analysis will allow to determine the direction of further diagnostics. It should be aimed at an increased study of certain organs - ovaries, adrenal glands, etc.

Diagnosis of hyperandrode includes:

• blood and urine test. A study is carried out to determine the level of androgen and their metabolism products;
• Ultrasound of a small pelvis. It is often assigned both ordinary and transvaginal;
• Ultrasound of adrenal glands;
• tomography.

Treatment

If there was a high level of androgens in women, the treatment of such a state occurs with the use of different techniques. It all depends on the reason that should be in obligatory Defined. Mainly assigned:

• receiving glucocorticosteroids;
• reception of antiandrogen. They suppress the generation of male sex hormones;
• reception estrogen-gestagne drugs. They contain a female sex hormone as part;
• the use of gonadotropin-rilizing hormone agonists. Preparations of this type affect the pituitary gland, which allows to normalize the hormonal background;
• surgical treatment in identifying tumors;
• weight Normalization, Compliance with Principles healthy nutrition, physical activity.

Prevention

Enhanced growth of androgens in women is treated with compliance certain ruleswhich make it possible to prevent further development of the disease. These include:

• balanced diet. It is important to use healthy food, abandon fat, salty, smoked, fried, limit the use of sweet;
• normalization of weight. Excess weight directly affects the increase in the development of male sex hormones;
• moderate physical activity. You can sign up in the pool or gym. Physical activity must be daily, but excessive load should be avoided;
• prevention of stress. Increased psycho-emotional load also affects negatively on hormonal background women;
• refusal from harmful habits - smoking, alcohol abuse;
• regular visit to the gynecologist;
• it is necessary to treasurely treat the diseases of the thyroid gland, adrenal glands, liver and other organs.

Complications

If the treatment of hyperandrode in women was absent or did not give positive resultThe following complications are developed:

• diabetes;
• habitual non-penny of pregnancy;
• infertility;

Also sick women complain about cosmetic defects - fatty and problem skin, increased sophistication and others.

List of references

1. Emergency care for extragnenital pathology in pregnant women. 2008, publishing 2nd, corrected and supplemented, Moscow, Triada.
2. Savicheva A.M., Bashmakova M.A. Urogenital chlamydia in women and its consequences. Ed. E.K. Aylasyman - N.Novgorod.: Publisher NGMA, 1998. -182 p.
3. Zaporizhen V.M., Tsegely M.R. Obstetrics and gynecology. - K.: Healthy, 1996.-240 p.
4. New honey. Technology (methodically recommendations) "Maintaining premature pregnancy complicated by premature gap food shells"; Makarov O.V, Kozlov P.V. (Edited by Volodina N.N.) - Moscow; CCMS GOU VPO RGMU- 2006.
5. Cervical diseases, vagina and vulva / ed. V.N. Prile

He graduated from Kirov state medical Academy In 2006, in 2007 he worked in Tikhvin Central district Hospital on the base therapeutic office. From 2007 to 2008 - a mining company hospital officer in the Republic of Guinea ( West Africa). Since 2009, and to present works in the field of information marketing medical services. We work with many popular portals, such as Sterilno.net, Med.Ru, site