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Here you can find information about a central disorder in the areas of the brain that are responsible for the hormonal control of the ovaries. The hormone GnRH is usually secreted rhythmically every 90 minutes from cells of the hypothalamus. If this rhythm is disturbed or abolished, it leads to a wide range of disorders of the ovarian function. The ovaries are completely intact in their function, but are not sufficiently stimulated.
The cause of hypothalamic ovarian failure is usually due to mental stress, which influences the hormonal metabolism in the hypothalamus, resulting in a reduced secretion of GnRH. Common triggers are underweight due to anorexia nervosa (anorexia) or competitive sports. For the proper work of the hypothalamus and secrete a sufficient level of GnRH, the body requires a minimum fat mass of 22%, or a body mass index of more than 19%. Other causes include stress, tumors that interfere with the secretion of hormones (eg prolactinomas), hypothyroidism or medication.
A rare, genetically inherited cause is the Kallmann syndrome. It is defined as a concomitant occurrence of a disorder of olfaction and lack of control of GnRH production. Mostly the male sex is affected (here it is expressed in a missing testicular system), but it can also occur in women. In case if the external genitalia are developed normally, the diagnosis is often made only in puberty or early adulthood.
The causes of the hypothalamic-pituitary problem can be physical or mental stress, infections (meningitis, encephalitis), nose and throat diseases (tonsillitis, sinusitis), trauma, sleep deprivation, starvation. All these factors cause the problems of hormone secretion.
Such a dysfunction is characterized with the following symptoms:
- luteal phase insufficiency,
- anovulation (lack of ovulation)
- intensive production of ovarian androgens (testosterone)
Increased secretion of estrogen and high levels of prolactin and gonadotropin in the blood disturbs the normal ovarian function. Lack of estrogen and FSH leads to insufficient follicle growth, anovulation and that can be a reason of infertility. Pregnancy occurs only in 2% of patients with hypothalamic dysfunction. High levels of androgens results in suppression of ovulation and can cause hirsutism (increased hair growth), acne (acne), anovulation, the absence of menstruation.
Hypothalamic-pituitary insufficiency and amenorrhea: Is pregnancy possible?
This syndrome is characterized with a decrease in the level of hormones of the hypothalamus, leading to hypomenstrual syndrome. Because of hypоthalamic problem, ovaries don’t work properly. Lack of ovulation makes pregnancy impossible.
In women with hypothalamic-pituitary insufficiency syndrome there can be observed uterus or cervix malformations, elongated tube, thin, convoluted, narrow vagina. Such a pathological condition is classified as physiological infertility. Management of hypothalamic insufficiency is conducted depending on the nature and localization of the pathological process. The gynaecologists regularly monitor the amount of sex hormones (estrogen) in blood and urine and adjust the therapy in an individual and holistic way.
Patient-oriented treatment of endocrine infertility
It is important to know: Endocrine dysfunction therapy in 98% of all therapy cases in Germany ends up in healthy pregnancy during the next 6 months.
The German fertility centers exercise interdisciplinary approach in medical managing of hypothalamic disorder syndrome and amenorrhea. It is important not only to eliminate symptoms, but also to highlight the root cause of hormone disorders. In women with hypothalamic-pituitary dysfunction and amenorrhea the type of therapy depends on the level of estrogen in the blood test. In case of high levels of prolactin in the blood, prolactin level stabilization should be performed before the hormonal therapy.
In case of ovulation problems or disrupted estrogen and gonadotropin secretion, treatment should begin as soon as possible. In chronic anovulation, resistant primary or secondary amenorrhea, treatment may require not only elimination of the disorder of the endocrine glands, but also surgical or conservative correction of the fallopian tubes, endometrial and cervical mucus properties. These disorders develop due to long-term hormonal imbalance.
Gonadotropin substances proved to be indispensable in the treatment of infertility. Due to gonadotropin injections specialists are able to achieve the growth of several follicles in one menstrual cycle and thereby dramatically increase the chance of pregnancy without any risk.
German Medical Group: Your medical partner for solving endocrine fertility problems!
The appointment with a specialist at German reproductive center is going to be very detailed. If you decide for diagnosis or therapy at one of the German fertility centers, we will help you to get prepared for this important step. Initial consultation of international patients concerning costs and methods of treatment in Germany can occur via Skype or per telephone. We would be glad to find the best German, Swiss or Austrian fertility center for you, so that you could solve your health problem without risk or side effects as soon as possible.