Although the skin is far from the ovaries, it has estrogen receptors and is one of the important estrogen target organs. Estrogen plays a very important role in influencing the changes in a woman’s skin throughout her life. Estrogen can bring a beautiful face. What if the ovaries are low in function?
1. Low ovarian reserve function refers to.
Decreased ability of ovaries to produce eggs and decreased quality of follicles, resulting in decreased female fertility and decreased sex hormones and lack of sex hormones, which can further develop into premature ovarian failure (POF).
2. Clinical manifestations.
The symptoms of perimenopause include menorrhagia, prolonged menstruation and even amenorrhea, as well as perimenopausal manifestations such as lumbar and knee weakness, insomnia and dreaminess, hot flashes and sweating, heartburn and fatigue.
3. Assessment and influencing factors.
(1) Age: As women age the number of primordial follicles decreases and the quality of eggs and embryos decreases.
(2) Shortened menstrual cycle, decreased menstrual flow and disorders.
(3) Hormone levels: FSH, LH, E2, inhibin B, AMH.
(4) Ovarian imaging, ovarian stimulation test, etc.
(5) Smoking: Cigarettes are complex in composition and many substances have been shown to be carcinogenic, teratogenic and mutagenic. Smoking leads to chronic hypoxia and reduced estrogen secretion, which can cause women to age prematurely. Women who smoke a lot have early menopause and an increased risk of ovarian cysts.
(6) Pelvic surgery: hysterectomy, ovarian tumor debulking, removal of one ovary, tubal ligation or removal, endometriosis surgery, and other pelvic surgeries. If the blood supply around the ovary is damaged, or if the ovarian tissue is directly damaged, this can lead to ovarian failure. Some studies have shown that changes in ovarian function after surgery stem from damage to the ovarian cortex from the surgery, which reduces the number of follicles retained in the ovary that respond to gonadotropins, resulting in a decrease in ovarian reserve function.
(7) Radiotherapy and chemotherapy: The damage of chemotherapy on ovarian function is mainly related to the patient’s age, drug dose and dosage form. The side effects of adjuvant chemotherapy in premenopausal women are cytotoxic damage to ovarian function, which is caused by the destruction of proliferating granulosa cells and mesenchymal cells, the initial components of developing follicles, manifested as a decrease in the number of secondary follicles and follicular fibrosis without follicles. The most common damaging effect on germ cells is caused by huanicides, which may work by altering cellular DNA. Cytotoxic drugs can cause irregular menstruation, hypomenorrhea, amenorrhea and premature ovarian failure, but it is difficult to predict if and when POF will occur in every individual receiving chemotherapy.
Radiotherapy can be used to achieve tumor growth control, and radiotherapy to the pelvic and abdominal radiotherapy will also kill ovarian cells at the same time. When the dose of abdominal and pelvic radiotherapy is <1.5gy, it has no effect on ovarian function mostly; 2.5-8gy can reduce ovarian reserve capacity, increase the probability of miscarriage and premature ovarian failure, or occur temporary premature ovarian failure; if 8gy or more can cause premature ovarian failure, 20-30gy will occur permanent POF.
(8) Autoimmune factors: there is a lot of evidence that part of POF is caused by the immune system’s inability to recognize its own ovarian tissue.
(9) Body mass index (BMI): In recent years, the effect of BMI on ovarian function in women has received increasing attention. A foreign analysis has compared 223 IVF cycles with long protocols of ovulation, 164 patients with no significant differences in basal hormones, and found that those with higher BMI had fewer eggs than those with lower BMI, and the number of Gn branches applied increased.
(10) A large number of worm-killing drugs, long-term use of anti-rheumatic drugs (Reglan) may cause POF. mumps in childhood, severe purulent or tuberculous and gonorrheal pelvic inflammatory disease, can cause POF.
4, the current treatment of POF is still based on hormone replacement therapy, so the prevention of low ovarian function and POF is particularly important. Prevention programs are as follows.
(1) to regulate the mood: it is recommended to maintain a relaxed mood, to get rid of adverse psychological changes, followed by avoiding mental stimulation, changing the living environment, looking for ways to vent and so on to change their own psychological and mental state.
(2) regulate diet: such as fresh vegetables, fruits, fish, lean pork, eggs, etc.. Daily diet should be light, avoid eating fatty, sweet, thick, spicy and stimulating food, while careful alcohol and avoid smoking.
(3) physical exercise: Sun Simiao said “the body often make a small labor, it is a hundred and smooth, blood and long nourishment, meridian movement, external evil is difficult to attack.” Moderate exercise is not only to enhance physical functions, but also to enrich life.
(4) Actively treat primary diseases that inhibit ovarian function, such as hyperthyroidism, diabetes, endometriosis, and certain ovarian malignancies that inhibit ovarian function.
(5) Eliminating and reducing the damage to ovarian function caused by drugs and surgery is also an important means to prevent and control the decline of ovarian function.
(6) Chemotherapeutic drugs combined with GnRH-a or OC strategies, embryo freezing strategies, and oocyte freezing strategies are used to prevent premature ovarian failure.
(7) Young women can also artificially alter their “biological clock” by freezing and preserving one ovary of a young woman so that she can rely on the other ovary to maintain normalcy. When she reaches middle age, the cryopreserved ovary can be frozen and thawed and transplanted back to delay menopause or amenorrhea.