Hypoplasia of the uterus is congenital, when at the stage of embryonic development of a girl there is a failure in the formation and formation of internal organs. The body of a pregnant woman is most sensitive to external influences (radiation, industrial hazards, infections, medications, severe stress), which also affect the child.
- In addition, size discrepancy also occurs in adolescence, when all organs are actively growing and developing.
- The causes of the disease can be divided into two groups.
- Exogenous factors are called external causes, that is, acting from the outside:
- trauma, surgery on the genital organs in childhood and adolescence;
- damage to the central nervous system as a result of injury or disease, leading to a failure in the regulation of the reproductive system;
- heavy physical activity (including professional sports);
- bad habits impair blood supply and nutrition to organs, including the genitourinary area;
- insufficient nutrition, prolonged fasting leads to vitamin deficiency and deficiency of important elements necessary during the formation of the body;
- Frequent and severe stress reduces the body's adaptive forces, causing growth retardation and the impossibility of full formation.
Endogenous causes
Much more often, uterine hypoplasia is caused by endogenous (internal) causes:
- endocrine diseases: hypothalamic-pituitary dysfunction, thyroid dysfunction;
- tumors of the pituitary gland and hypothalamus;
- somatic diseases: decompensated heart defects, severe renal or liver failure, epilepsy;
- hereditary predisposition.
Degrees of uterine hypoplasia
The pregnant uterus, under the influence of hormones and the growing fetus, increases significantly. After delivery, the uterus contracts for several months, but it remains slightly larger than before pregnancy. Thus, the more births a woman has had, the larger the size of the uterus.
The length of the uterine body along with the cervical canal is measured with a special probe. For nulliparous women, this size should be at least 7 cm, for those who have given birth, at least 8 cm. The normal length of the cervix is about a third of the uterine length. The severity of the disease is determined by the size of the uterus.
I degree of hypoplasia is the most severe pathology. The uterus is very small in size, the cavity is usually not formed, which makes it impossible to bear a child.
The length of the probed uterus is no more than 3 cm, and basically the entire size falls on the cervix. This degree of underdevelopment is also called the fetal, rudimentary or embryonic uterus.
However, the fetal uterus is very rare and is usually a congenital pathology.
The second degree of underdevelopment is called the infantile, or children's uterus. Unlike the fetal uterus, the children's uterus has a more regular anatomy and a pronounced cavity. However, the cervix occupies almost the entire length, and the proportional ratio of the length of the body to the cervix is 1:3. The length of the infantile uterus ranges from 3.5 to 5.5 cm.
III degree of uterine hypoplasia is synonymous with a teenage or hypoplastic uterus. The length of the uterine body predominates, and its proportion to the size of the cervix is 3:1. The length of the uterus measured with a probe is closer to the border of normal values and is equal to 5-7 cm.
- From the point of view of childbearing, a hypoplastic uterus has the most favorable prognosis and treatment effect.
- It is quite difficult to suspect such a disease on your own. Traditionally, the following symptoms force you to see a doctor:
- late onset of menarche (first menstruation) - later than 15-16 years;
- menstrual dysfunction. Menstruation is irregular and short-lived, usually very painful (algodysmenorrhea), the amount of menstrual blood is insignificant, but there may be heavy periods. With a fetal uterus, menstruation may be completely absent, or appear in the form of scanty spotting;
- Primary infertility, as a consequence of underdevelopment of the main reproductive organ, manifests itself in the form of habitual miscarriage - spontaneous miscarriages following each other. Pregnancies are more often terminated at short stages.
Often, uterine hypoplasia, especially grades I-II, is combined with delayed physical development. In appearance, girls are often short, thin, asthenic in build, with a uniform narrowing of the pelvis, and fragile shoulders. Secondary sexual characteristics are poorly developed - hypoplastic mammary glands, sparse hair on the genitals and armpits.
What is needed to confirm the diagnosis?
A gynecologist can assume the presence of uterine hypoplasia during examination when there are signs of general infantilism. During a vaginal examination, attention will be drawn to underdevelopment of the vulva, scant hair growth, a short and narrow vagina, and a disproportionate ratio of the uterus to the cervix. The leading criterion is a reduction in the size of the uterus.
Data from laboratory and instrumental studies help determine the diagnosis.
Ultrasound diagnostics provides the most information.
In addition to the reduced size, flattening of the uterine body and a pronounced anterior tilt - hyperanteflexia - will be characteristic. The fallopian tubes are usually long and twisted, which increases the likelihood of an ectopic pregnancy.
Often, with general infantilism, ultrasound can detect ovarian hypoplasia.
This is associated with a decrease in the formation of sex hormones, so determining the concentration of steroids plays a significant role in the diagnosis of uterine underdevelopment.
Another study that helps confirm uterine hypoplasia is hysterosalpingography (HSG). The uterine cavity and fallopian tubes are filled with a special contrast agent, after which a series of x-rays are taken. The resulting image allows you to see a small uterus with long fallopian tubes, which allows you to confirm the diagnosis.
To determine the hormonal status, the level of hormones in the blood is determined (androgens, estrogens, prolactin, follicle-stimulating and luteinizing hormones, T3, T4 - thyroid hormones).
In doubtful cases, the attending physician has the right to order an X-ray of the skull and an MRI of the brain.
Treatment approaches
Therapeutic tactics are determined by the severity of the disease and the reasons for the development of hypoplasia.
Hormonal drugs
The main treatment is to correct hormonal imbalances. Based on hormone levels, replacement therapy in a cyclic mode is indicated. The selection of drugs is carried out by an obstetrician-gynecologist. If there is a lack of sex hormones, artificial analogues of estrogens and gestagens are selected (Estrofem, Duphaston, Femoston, Microfollin, Ovestin). The choice of drugs is purely individual, as it depends on the concentration of steroids and the response to the drugs. If you have concomitant diabetes mellitus or thyroid pathologies, you will need to consult an endocrinologist.
Physiotherapy
Physiotherapy is used as an auxiliary method. Mud therapy and baths, UHF, laser therapy, magnet, ozokerite and paraffin applications are widely used.
The procedures help improve blood supply to the pelvic organs, endometrial growth, and stimulate the production of hormones by the ovaries.
A good effect is achieved by gynecological massage, which allows you to increase the elasticity of the ligamentous apparatus, eliminate hyperanteflexion, increase blood supply and contractility of the myometrium.
Vitamins and diet
A balanced diet helps maintain the body's defenses. The diet must contain animal proteins, as well as fresh vegetables, fruits and herbs.
It is worth abandoning “starvation” diets, vegetarianism, raw food diet, and overeating.
Taking vitamin complexes in courses has a general strengthening effect, improves tissue nutrition and increases the ability to regenerate.
ethnoscience
Traditional medicine is an auxiliary method and should be used only after consulting a specialist. The most commonly used are herbal infusions. Decoctions of hogweed, knotweed, and sage contain natural phytoestrogens and help normalize hormonal levels. Chamomile, St. John's wort, and calendula are used for anti-inflammatory purposes. Extracts of valerian, oregano, and lemon balm have a calming effect.
It is important to understand that any non-traditional treatment methods will not give a therapeutic effect, so using folk remedies is permissible only after consulting a specialist.
Prognosis for fertility
With uterine hypoplasia of the 1st degree, the prognosis is disappointing. Treatment usually does not produce significant results and focuses on maintaining menstrual function.
With severe hypoplasia, it is not possible to conceive and carry a pregnancy.
If folliculogenesis (the process of follicle growth and egg formation in the ovaries) is not impaired, you can resort to surrogacy through in vitro fertilization.
With grade II-III hypoplasia, after adequate therapy, the likelihood of pregnancy increases.
However, it is worth considering that despite the treatment, the risks of early miscarriage and premature birth remain high. Therefore, a pregnant woman needs to register her pregnancy as early as possible and attend an antenatal clinic in a timely manner.
Is it possible to warn?
Severe uterine hypoplasia is usually a congenital pathology, so it is difficult to prevent the development of the disease. However, thoughtful planning of pregnancy, maintaining a healthy lifestyle and eliminating the influence of harmful factors can reduce risks.
It is important to pay attention to the development of girls during puberty during the formation of the body. For the full formation of the reproductive system, you should avoid harmful factors, hypothermia, excessive stress, and bad habits. It is worth giving up diets in favor of a nutritious healthy diet.
Conclusion
Considering the congenital causes of underdevelopment of the uterus, it is impossible to completely prevent the occurrence of organ hypoplasia. However, we can reduce the risks of pathology.
It is important to remember that regular preventive examinations with a doctor will help to detect abnormalities in time and begin treatment as soon as possible.
Modern medicine has many treatment methods, so the diagnosis of uterine hypoplasia no longer sounds like a death sentence.
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Sonographic signs of uterine hypoplasia. Uterine hypoplasia: causes of baby uterus, how to get pregnant
Poor physical development of a girl can subsequently lead to reproductive health problems. The cause of menstrual disorders and infertility is underdevelopment of the uterus. Sometimes it is possible to correct a natural defect by eliminating hormonal imbalance.
It is possible to bring the size of the uterus to normal with minor deviations using physiotherapeutic procedures. However, it is not possible to cope with uterine hypoplasia if it is too small or if such pathology is combined with a violation of the structure of the ovaries.
An anomaly is often detected by external signs.
The varieties of this pathology are:
- Hypoplasia of the uterine body.
- Hypoplasia of the endometrium (mucous membrane inside the uterine cavity). If it is too thin, the fertilized egg cannot stay in it. Pregnancy either does not occur or fails in the early stages. Normally, the thickness of the endometrium is 7-12 mm.
- Hypoplasia of mixed type. Often this pathology is combined with underdevelopment of the ovaries, tubes and external genitalia.
Note:
When diagnosing diseases of the cervix, its underdevelopment is often discovered. However, the cervix is only an extension of the body of the uterus. Therefore, “cervical hypoplasia” is not considered as an independent anomaly. Its detection indicates a general underdevelopment of the organ.
Degrees of uterine underdevelopment
A normal uterus is pear-shaped. The cervix goes directly into the vagina.
The walls of the organ are so elastic that it is able to stretch and accommodate a growing fetus (and sometimes more than one). During childbirth, due to muscle contraction, the fetus is pushed out, after which the uterus gradually shrinks to normal size.
The length of the body of the uterus in a nulliparous woman is 7 cm, in a woman who has given birth - 8 cm. The normal length of the cervix is 2.5 cm. Underdevelopment is considered to be a deviation of the size from the norm downward by at least 1 cm. The ratio of the length of the body of the uterus and its cervix is also taken into account (in Normally it is 3:1).
There are 3 degrees of uterine hypoplasia.
1st degree.
The length of the body of the uterus is less than 3 cm. The main part of the organ is the cervix. Such a uterus is called “embryonic” or “rudimentary”. Developmental disorders begin during the formation of organs in the embryo.
2nd degree.
The organ has a length of 3-5.5 cm. In this case, they say that the woman has an “infantile” (children’s) uterus, since its growth stopped in childhood. The ratio of the length of the uterine body to the cervix is 1:3.
3rd degree.
The prognosis for recovery from infertility in this case is the most favorable. The size of the organ is 5.5-7 cm. The ratio of the length of its body and neck is normal. In this case, the uterus is called “teenage”. Her development stopped during puberty.
Underdevelopment of the uterus and pregnancy
In the presence of stage 1 pathology, a woman cannot become pregnant or give birth. The disorder cannot be corrected through treatment.
If the size of the organ with degree 2 hypoplasia is close to 5 cm, then after treatment in rare cases, conception becomes possible, but the woman has very little chance that the pregnancy will continue. She will have to spend almost the entire period of gestation in the hospital.
Addition:
If the ovaries function normally, then you can have the desired child in the presence of grade 1-2 hypoplasia using IVF, using the services of a surrogate mother.
With stage 3 pathology, after short treatment, a woman will be able to conceive, carry and give birth to a healthy baby. During pregnancy, especially careful monitoring by doctors of her condition and the development of the fetus is required.
Possible consequences of hypoplasia
Hypoplasia of the uterus can lead to infertility. The reason is not only the discrepancy between its dimensions and the norm, but also the curvature and shortening of the pipes. Violation of their patency often becomes the cause of ectopic pregnancy.
If conception does occur, the pregnancy usually proceeds with complications such as severe toxicosis and the constant threat of miscarriage. Deviations in the child's development may occur.
Labor often begins prematurely, and the fetus may be malpositioned, making it impossible to avoid a cesarean section. There is a risk of bleeding.
Video: Signs of uterine hypoplasia
Signs of hypoplasia
The presence of a pathology such as uterine hypoplasia can be suspected in a girl already at the age of 13-15 years, when menstruation begins and other changes occur in the body associated with an increase in the level of female sex hormones. Signs that may indicate organ underdevelopment in adolescents are:
- Lack of menstruation (amenorrhea) at the age of 15-16 years and older.
- Irregularity of the cycle. Menstruation may arrive with a delay of 3-6 months. The cycle should be established no later than 2 years after the appearance of the first menstruation.
- Pain in menstruation due to reduced plasticity of the uterine muscles and imbalance in the proportions in its structure. Swelling of the organ before menstruation and during bleeding leads to pain. The discharge of blood may be short-lived and very scanty (spotting) or, conversely, too long and profuse.
- Weak physical development: short stature, low weight, narrow pelvis.
- Underdevelopment of the mammary glands, lack of pubic and armpit hair.
After the onset of sexual activity, uterine hypoplasia is manifested by impaired reproductive function, difficulties in conceiving and bearing a child. A woman may lack interest in intimate relationships and be unable to experience orgasm. Underdevelopment of the uterus provokes the frequent occurrence of inflammatory processes in the cervix and endometrium.
Causes of uterine underdevelopment
Hypoplasia of the uterus can be congenital. In this case, disruption of the formation of the uterus occurs in the embryo.
It may be associated with pathologies and complications that arise in the expectant mother during pregnancy due to infectious diseases, surgical interventions, stress, severe toxicosis, and poor ecology.
Sometimes underdevelopment of the uterus is explained by hereditary characteristics of the formation of the genital organs.
The causes of anomalies in childhood and adolescence are usually some infectious diseases (rubella, mumps, measles), as well as heart disease, epilepsy, severe kidney or liver disease, diabetes mellitus, and damage to the central nervous system. The development of the uterus may stop if the child or adolescent has suffered trauma to the genitals or brain.
The cause is also a malfunction of the thyroid gland, the formation of a tumor of the brain, ovaries. Excessive physical activity at a young age (for example, intense sports training, ballet classes) contributes to the occurrence of pathology.
Poor and monotonous nutrition, an unfavorable emotional environment at school, and conflicts with loved ones have an extremely negative impact on the sexual development of girls. The most harmful factors that can lead to uterine hypoplasia in girls are smoking, drinking alcohol, and drugs.
Diagnosis of genital hypoplasia
Assumptions about the presence of hypoplasia appear from the doctor after the initial gynecological examination of the patient. With this pathology, there are usually deviations in the development of the external genitalia: small size of the vagina, irregular shape of the labia and clitoris. The neck has a conical shape, the formation of a bend is possible. The following diagnostic methods are used:
- Ultrasound. Allows you to determine the size of the body and cervix, detect tortuosity of the tubes, underdevelopment of the endometrium and ovaries. The degree of uterine hypoplasia is determined.
- Blood test for hormones. The content of hormones of the pituitary gland (FSH, LH, prolactin), ovaries (estrogens, progesterone, testosterone), as well as the thyroid gland is examined.
- X-ray of hands. The so-called “bone age” is determined, that is, the degree of ossification of certain areas of the hands. By the characteristic change in bone structure, one can judge the achievement of puberty.
- X-ray and MRI of the brain. They are carried out to detect any pathologies in the condition of the pituitary gland, which regulates the production of sex hormones.
The size of the patient's pelvis is measured. A narrow pelvis may be a sign of underdevelopment of the genital organs.
Treatment
For grade 2 and 3 uterine hypoplasia, the basis of treatment is hormonal therapy, physiotherapy and vitamin therapy.
Hormone therapy
The duration of drug use varies from person to person. It depends on the degree of deviations in the development of the uterus and other reproductive organs, and the presence of concomitant diseases.
If it is determined that the cause of delayed sexual development is a lack of female hormones in the body, then most often the patient is prescribed Diane 35 (an oral contraceptive containing estrogens and progesterone). If necessary, the functioning of the thyroid gland and pituitary gland is adjusted.
Physiotherapy
This includes mud therapy, magnetic therapy, diathermy, UHF, ozokerite therapy, laser therapy, paraffin therapy. Physiotherapy helps improve blood circulation in the uterus and pelvic organs, activate endometrial growth, and stimulate the production of ovarian hormones.
A popular method of physiotherapy is gynecological massage. It allows you to increase the plasticity of the uterine ligaments, strengthen muscle contractility, correct the position of the uterus, eliminate congestive processes, and improve blood supply to the uterus and ovaries.
Vitamin therapy and herbal medicine
Taking vitamins helps improve nutrition and accelerate the growth of cells in various tissues of the reproductive organs.
Folk remedies for uterine hypoplasia use decoctions and infusions of herbs containing phytoestrogens. These include sage, red brush, knotweed and others. They are taken to normalize hormonal levels and build up the endometrium.
Herbal anti-inflammatory agents are also used (infusions of birch buds, chamomile flowers, strawberry leaves, as well as immortelle or St. John's wort herbs).
It is advisable to use any traditional treatment methods only after consultation with your doctor.
Video: Borovaya uterus in the treatment of female ailments
- Date: 05/30/2019
Source: https://papeleta.ru/feeling/ehograficheskie-priznaki-gipoplazii-matki-gipoplaziya-matki/
Hypoplasia of the uterus
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Hypoplasia of the uterine body can often be detected by the results of an ultrasound examination performed to analyze the abdominal cavity or pelvic organs. The disease is divided into 3 stages of development: it depends on the age of the girl at the time the organ stopped developing. The sooner development stops, the worse the consequences. According to the established norm, the length of the cavity should be approximately 7 cm, and the length of the cervix - 2.5 cm. Deviations from the norm, of course, are allowed, but they should not exceed 1 cm. You can also find an anomaly when hypoplasia and endometrium of the uterus are combined (underdevelopment of the organ and thickening of its walls).
The presence of this pathology plus tortuous and long fallopian tubes as a result threatens with absolute incurable infertility.
If this anomaly is present, a woman can become pregnant, but the development of the fetus will occur outside the uterus. Such a pregnancy ends with surgery to remove the embryo or a miscarriage.
Often, hypoplasia of the uterus and ovaries is diagnosed together, which leads to big problems.
Symptoms of uterine hypoplasia
- the onset of menstruation occurs at 16 years of age (which is considered a late indicator);
- the discharge itself is irregular, scanty and accompanied by painful sensations;
- lag in general physical development.
Women with acquired uterine hypoplasia have their own symptoms:
- libido decreases and orgasm is absent;
- spontaneous abortions that happened more than 2 times;
- ectopic pregnancies;
- problems associated with childbirth (bleeding, weak labor, the uterine os does not open enough during childbirth);
- cervicitis, endometritis.
Adolescents aged 11-15 years are at greater risk of developing the disease than others, when the uterus begins to actively develop.
Degrees
Underdevelopment of the uterus can occur even at the stage of intrauterine fetal formation or during puberty. This is what determines the degree of organ anomaly:
- Hypoplasia of the uterus of the 1st degree - called the embryonic (fetal) uterus, occurs in very rare cases. With this pathology, the organ cavity is almost undeveloped, and its size is no more than 3 cm, where most of it is the neck itself. There is no bloody discharge during menstruation.
- Uterine hypoplasia of the 2nd degree (other names - childish, infantile) is diagnosed when the size of the organ is more than 3 cm. The uterine cavity, taking into account the length of its cervix, can reach up to 5.5 cm. This degree is characterized by painful, scanty and irregular menstruation, elongation of the tubes, high location of the ovaries.
- Uterine hypoplasia of the 3rd degree does not differ greatly from standard development. It differs in the ratio of the body itself to the neck with a difference of 3:1. The length of the organ cavity can reach 7 cm. The disease of this degree tends to disappear after the onset of sexual activity or pregnancy.
Forms
There are two main forms of this pathology: congenital and acquired. The first form includes congenital hypoplasia, which cannot be cured and threatens complete infertility. Hypoplasia of 2 and 3 degrees can be considered acquired.
Causes
Uterine hypoplasia of degrees 1 and 2 has its own causes of development:
- the woman had an alcohol or drug addiction during pregnancy;
- smoking;
- During pregnancy, certain medications were used to treat diseases;
- viruses, infection with which could harm the fetus (for example, rubella).
Cervical hypoplasia of the 2nd and 3rd degrees could begin to form after hormonal disorders resulting from physical activity, stress, fasting or poor nutrition.
The cause of the disease can also be frequent infection with viral diseases, tonsillitis that is not completely cured, as well as intoxication with nicotine or drugs.
For these reasons, the uterus begins to slow down its development, although at birth the indications for formation were normal.
Diagnostics
- It becomes possible to determine the pathology during a gynecological examination based on the following signs: underdevelopment of the genital organs, protruding clitoral head beyond the vulva, minimal hair growth of the skin. The vagina has a short, narrow shape, and its arches are weakly expressed. The uterine body is reduced and flattened with a conical shape.
- Using echo signs of uterine hypoplasia, the degree of anomaly is determined. An ultrasound can also be prescribed to accurately determine the volume and size of the organ, to what extent the ovaries are developed, as well as to clarify data on the tortuosity of the tubes.
- Since hypoplasia often begins to form due to hormonal disorders, tests are carried out to determine the amount of sex hormones. The importance of this study lies in the prognosis of a possible pregnancy for a woman. It is advisable to take tests to determine the level of hormones in the thyroid gland.
Additionally, X-ray examinations, probing in the uterus, MRI of the brain and determination of the girl’s bone age are prescribed.
Treatment of uterine hypoplasia
You can undergo successful treatment of uterine hypoplasia in Moscow at the Klinika K+31 medical center. Using equipment created using the latest technologies, specialists will conduct a full diagnosis and determine to what degree the pathology present in the woman belongs.
Taking into account the individuality of the patient’s body and the cause of the development of the anomaly, the most optimal method of treating the disease is prescribed.
In addition to standard methods of treating hypoplasia (hormonal therapy, gynecological massages and physiotherapeutic procedures), the center's leading doctors also offer other effective methods.
Complications and consequences
Many women are interested in: if stage 1 uterine hypoplasia is diagnosed, is it possible to get pregnant? As mentioned above, stage 1 pathology implies underdevelopment of the genital organs. And infertility is the main complication with this anomaly.
Secondary infertility can also be a consequence of hypoplasia. The diagnosis is made to patients who have had premature birth or spontaneous miscarriages. The pathology is characterized by elongation and tortuosity of the fallopian tubes, and this makes it difficult for the egg to pass to the cavity, resulting in tubal pregnancy.
Pathology contributes to the development of tumors in the genital organs of a malignant nature, therefore, when diagnosed with uterine hypoplasia, a woman should be registered with a gynecologist. Due to the pathology, low resistance to infections occurs, so women are exposed to infectious lesions: colpitis, cervicitis, adnexitis and endometritis.
Prevention of uterine hypoplasia
Prevention of this disease does not apply to specific actions. It is enough to minimize the negative factors that affect the girl’s body, starting from her birth.
A complete diet in a child’s diet, no diets, timely treatment of diseases - all this is an effective prevention of hypoplasia. If possible, somatic and infectious diseases should be avoided.
The girl’s mental state also plays an important role, so it is better to avoid stressful situations.
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Symptoms and treatment of female uterine hypoplasia and pregnancy prognosis
Violation of the development of the uterus and, as a consequence, arrest of its growth, is encountered in gynecological practice under the diagnosis of “uterine hypoplasia.” At the same time, during ultrasound diagnosis, signs of hyperanteflexia are observed - a pathological bend of the uterus anteriorly.
Often accompanied by infertility due to obstruction of the fallopian tubes. With this disease they are also pathologically changed.
The pathology is often accompanied by underdevelopment of other organs of the reproductive system and polycystic ovary syndrome.
The structure of the female genital organs
Causes and degrees
Various causes and factors can contribute to the development of the disease. Pathology of a congenital nature manifests itself as a result of a negative impact on the embryo during intrauterine development; this also includes a hereditary factor.
More often, the main cause is a violation in the “hypothalamus-pituitary-uterus” stepwise regulation system. Similar disruptions occur in girls of early age or during puberty. At the same time, a delay in the normal development of the uterus occurs.
Doctors identify the following factors involved in the development of uterine hypoplasia:
- damage to the central nervous system, toxic or infectious;
- constant exposure to stressful situations, prolonged depression;
- benign adenoma of the pituitary gland or hypothalamus;
- disruption of the endocrine system, pathology of the thyroid gland;
- surgical intervention on the pelvic organs at an early age;
- increased physical activity: in particular, this applies to girls involved in professional sports.
Currently, it is customary to distinguish three degrees of pathological changes in the uterus.
First degree
The most severe case of hypoplasia, in gynecological practice, is called the fetal or rudimentary stage. The size of the organ remains at the embryonic stage of development and does not exceed 3 cm, the body of the uterus is not formed. Conservative methods in the treatment of first degree hypoplasia are not effective. The fetal stage is accompanied by amenorrhea and, as a consequence, infertility.
Second degree
Diagnosed most often, in medical terminology it is called infantile uterine hypoplasia. The size of the organ does not exceed 5 cm. For this diagnosis, treatment is practiced, but the therapy is complex and lengthy. The chance of recovery and conception is relatively small.
Third degree
With this diagnosis, the prognosis is most favorable. The size of the uterus is characterized as teenage and is 5-6 (7) cm.
These are completely acceptable sizes that allow, after adequate therapy, to conceive and bear a child. In some cases, third degree hypoplasia goes away on its own.
The phenomenon is associated with an initially erroneous diagnosis, when the doctor mistakes minimal deviations from the norm in the size of the uterus for a disorder.
Clinical signs
The main clinical picture of the disease is a deviation from the norm in the size of the uterus. This is quite clearly visualized during ultrasound examination.
A characteristic feature of hypoplasia is the late onset of menstruation - 16-18 years. Menstruation is quite painful; they are characterized by irregularity and alternating periods of heavy and scanty discharge.
With hypoplasia, a violation of the physiological development of a girl is often observed - a narrowing of the hip area, a lack of expression of the mammary glands and secondary sexual characteristics.
At a later age, the disease is accompanied by a violation of libido, its decrease and anorgasmia - the absence of orgasm during sexual intercourse. In addition, disorders of the reproductive system are often observed:
- ectopic pregnancy;
- early miscarriages;
- weak labor activity.
Quite often, the pathology occurs in conjunction with inflammatory processes, more often it is endometritis or cervicitis, which can provoke the development of erosions.
Methods for diagnosing the disease
To make an accurate diagnosis, several stages of diagnostic examination are used.
Gynecological examination:
- Visually, you can notice clear signs of the disease, characterized by a lack of hair in the pubic area, a protruding clitoris, and abnormal changes in the labia.
- During a vaginal examination, the doctor diagnoses narrowing of the vagina, a conical shape of the cervix and an anatomically incorrect location of the uterus.
Ultrasonography:
- Ultrasound allows you to confirm hypoplasia; during the study, echo signs of pathology are clearly visualized, which include abnormal size of the uterus, bends of the fallopian tubes, and changes in the ovaries.
- At the end of the diagnosis, the specialist determines the extent of the disease.
Hormonal panel:
- A laboratory blood test is required to determine the concentration of hormones: follitropin, progesterone, prolactin, luteotropin, estrogen, testosterone.
- Additionally, a study of thyroid hormones is carried out: thyrotropin, T3, T4.
If necessary, other instrumental research methods may be prescribed:
- Colposcopy. Diagnostics provides high-quality visualization of the vaginal cavity. It has no particular disadvantages, the procedure is quick, painless and informative.
- Computed tomography (CT). Typically used when ultrasound or x-rays do not provide the desired information. CT scans can be done with or without a contrast agent.
- Hysteroscopy. It is an endoscopic method for examining the uterine cavity. The main advantage of the method is high diagnostic quality and minimal invasiveness.
- Magnetic resonance imaging (MRI) of the brain. It is prescribed as a replacement for X-ray or CT; the study does not use radiation, which makes the procedure as safe as possible. Magnetic resonance imaging can examine almost all tissues and organs, which makes it indispensable in making an accurate diagnosis.
Upon completion of the examination, based on the results, the diagnosis and the degree of the pathological process are confirmed, and therapeutic tactics are outlined, if any makes sense.
Diagnostic methods, pregnancy prognosis
Treatment
Treatment tactics are selected individually and depend on the degree of the disease. The main therapy consists of taking specialized hormonal drugs. If hormonal treatment is adequate, it is possible to achieve uterine enlargement and normalization of the menstrual cycle.
In combination, it is recommended to carry out physiotherapeutic procedures, such as ultra-high-frequency therapy, magnetic therapy, and laser exposure. These manipulations improve blood circulation in the pelvic organs, eliminate the inflammatory process, and eliminate pain.
Cavity galvanization, based on the use of galvanic current, has proven itself quite well. The manipulation stimulates the production of sex hormones and has a positive effect on the pituitary gland. In addition, the procedure has an anti-inflammatory and regenerating effect. It is especially recommended when hypoplasia is accompanied by the formation of erosions on the uterine mucosa.
The course of treatment includes taking vitamins, therapeutic exercises, and gynecological massage. Like any pathology, hypoplasia requires an integrated approach. This is the only way to improve the situation and increase the chances of a successful pregnancy.
Folk remedies in the treatment of disease
Alternative medicine offers many options for treating hypoplasia using folk remedies. Using such therapy as an independent therapy will not give any therapeutic effect, and in some cases, will aggravate existing disorders.
Folk remedies are approved for use only after consultation with the attending physician, and only as an additional treatment to the main therapy.
The use of medicinal herbs is aimed at normalizing hormonal levels and stabilizing the general condition of the patient, the most famous of which are the following:
- Tinctures or decoctions based on sage, red brush, boron uterus.
- Calming herbs: chamomile, lemon balm, valerian, adonis.
Most patients negatively perceive the need for treatment with hormonal drugs, believing that hypoplasia can be eliminated with the help of traditional medicine or that it can go away on its own. Both opinions are wrong. Treatment should be prescribed by a qualified specialist on an individual basis, which will achieve the most favorable prognosis.
Forecast
After diagnosis, one of the most pressing questions concerns possible pregnancy and subsequent childbirth. It is difficult to predict this situation unambiguously; certain factors must be taken into account:
- In case of pathology of 2-3 degrees, after adequate treatment and normalization of the patient’s condition, conception is possible. However, it should be borne in mind that pregnancy and labor itself are fraught with complications.
- With grade 1 hypoplasia, conception is completely excluded, and medication is usually ineffective. In this case, they resort to assisted reproductive technologies. If the ovaries are functioning normally, the doctor recommends IVF.
In terms of reproductive capabilities, hypoplasia is not the most comforting diagnosis. However, with correct treatment and compliance with all doctor’s recommendations (provided there is no grade 1), the prognosis is quite favorable.
Prevention
It is impossible to completely prevent the development of hypoplasia, especially given its congenital factor, however, it is possible to reduce the risks. As a preventive measure, girls resort to nutritious nutrition, the absence of heavy diets, minimizing stressful situations, and timely treatment of inflammatory and infectious processes.
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Source: https://medik-24.ru/gipoplaziya-matki/
Treatment of endometrial hypoplasia
Today, more and more women suffer from infertility. There are many reasons for this, one of them is endometrial hypoplasia. The pathology is characterized by underdevelopment of the internal mucous membrane of the uterus, which covers the surface of the organ. The endometrium consists of connective tissue, integumentary and glandular epithelium, and blood vessels.
To successfully become pregnant, this complex system must function correctly; any malfunctions do not allow the egg to attach to the uterus and the embryo to develop inside it. A healthy mucosa has normal thickness, maturity and structure.
When the endometrium is too thin, it is unable to hold a fertilized egg. In addition, there is poor development of glandular tissue and blood vessels. This whole process is called hypoplasia of the functional layer.
The concept of hypoplasia
Endometrial hypoplasia is a disease in which there is underdevelopment of the uterine mucosa lining its surface. This layer creates the right environment for the egg to move into the uterine cavity. If the endometrium is too thin or a hyperplastic process is observed, the egg cannot attach normally, and as a result there is no pregnancy.
- Thin endometrium: causes and treatment
For successful fertilization, the thickness of the functional layer should be 7-13 mm, it depends on the menstrual cycle. At the very beginning, the old endometrium is excreted along with the blood, and after 3 days a new one develops.
On days 25-28 of the cycle, the normal thickness of the layer is at least 1 cm. Cases have been recorded when, with hypoplasia, the egg was still attached to the uterus, but weakly, which caused miscarriage in the early stages.
Most often, the pathology appears in women of reproductive age, sometimes diagnosed together with ovarian dysfunction. Often the disease develops as a result of a decrease in the level of female hormones estrogen.
The cause of hormonal imbalance may be menopause or improper functioning of the ovaries. In some cases, the endometrium grows excessively, then hyperplasia is diagnosed.
Both types of disorders lead to infertility or miscarriages.
Reasons for development
There are several reasons why uterine endometrial hypoplasia occurs. The main factors in the development of pathology are:
- Hormonal disorders - low estrogen levels are provoked by abnormalities in the functioning of the endocrine system or due to the presence of diseases such as cysts, inflammation, etc.
- Poor circulation - the problem appears due to the formation of fibroids, uterine prolapse, cervical bending, vascular and heart diseases.
- Inflammatory or infectious processes in the pelvis - genital infections and chronic inflammation lead to adhesions and scars, as well as changes in cell structure.
- Abortions and frequent curettage - during the procedure, the basal layer is damaged, which subsequently disrupts the development of the endometrium.
- Heredity - congenital disorders cause improper growth of the functional layer.
Other reasons can provoke the development of pathology, for example, vitamin deficiency, stress, taking alcohol or drugs, smoking, and exhaustion of the body.
How it manifests itself
In ordinary life, the hypoplastic endometrium does not manifest itself in any way; the first symptoms appear during the planning period for fertilization. An experienced doctor can determine diseases by how the girl develops, whether she has periods, etc.
The main symptoms of the pathology are:
- Long absence of pregnancy;
- Cases of miscarriage and miscarriages;
- The presence of adnexitis, endometritis and other diseases of the reproductive system;
- Abortion, curettage;
- The appearance of menstruation after 16 years;
- Irregular, scanty menstruation;
- Dissatisfaction with sex life;
- Insufficient hair growth.
The above signs of endometrial hypoplasia should be taken into account, but not guided by them for independent diagnosis. Only after a complete examination can the doctor confirm or deny the presence of pathology.
How to diagnose
Hypoplasia can be suspected during a routine examination. The doctor notices insufficient pubic hair, changes in the shape of the cervix and external genitalia, and signs of immaturity. To confirm the diagnosis, additional examination is carried out, which includes:
- Ultrasound - allows you to determine the thickness of the functional layer and the degree of development of hypoplasia.
- X-ray examination.
- A blood test that determines hormone levels.
- Hysterosalpingoscopy.
- Biopsy of the uterus.
In some cases, the presence of pathology is determined by the presence of adhesions and folds in the uterus. To determine abnormalities in the functioning of the pituitary gland, an MRI of the brain is performed, a smear is taken for sexually transmitted infections, and a blood test is taken to determine glucose levels. After confirmation of hypoplasia, the doctor individually selects the treatment method.
How to treat hypoplasia
Endometrial hypoplasia and its treatment should be determined only by the attending physician. Therapy is selected depending on the stage of thinning of the mucosa. To eliminate the disease, 3 methods are used - surgical, drug and physical therapy.
Often women try to get rid of pathology on their own using folk remedies. Acupuncture, hirudotherapy and other methods aimed at improving blood circulation are also used.
Let's look at all the ways to enlarge the endometrium in more detail, so that a woman can prepare in advance for what awaits her during the therapy period.
Medication
Medicines are used when an imbalance of hormones or sexually transmitted infections that cause inflammation have been detected. The following remedies are used to restore hormonal balance:
- Combined oral contraceptives - necessary to restore endometrial function and hormone levels;
- Homeopathic medicines, for example, Hormel;
- Preparations containing estradiol (Divigel) - promote faster growth of the required amount of tissue;
- Products with progesterone (Duphaston);
Utrozhestan and Duphaston help the mucous membrane to mature, creating good conditions for conception, fertilization and gestation. Hormonal medications reduce the risk of spontaneous miscarriage.
Immunomodulators, antibiotics and agents for restoring vaginal microflora help eliminate pathologies that could cause endometrial hypoplasia. In addition to drug treatment, physiotherapy is prescribed, and in advanced cases, surgery is used.
Physiotherapy is needed to improve blood circulation. For this purpose, gynecological massage, ozokerite therapy, laser exposure, and diathermy are used.
Surgical
The method is used to stimulate the growth of the functional layer. A slight mechanical effect on the uterus is performed using a hysteroscope. In addition, the inner layer can be removed, and then conservative hormonal therapy is prescribed, due to which the endometrium is renewed.
Surgical treatment is prescribed in the following cases:
- Ineffectiveness of drug therapy.
- There are contraindications to taking hormonal drugs.
- Repeated precancerous hypoplasia.
- Atypical hyperplasia during menopause.
Sometimes doctors prescribe cryodestruction, cauterization or laser ablation. During treatment, the pathological area is removed, and a new, healthy endometrium is formed in its place. The treated area is independently removed along with blood clots, the mucous membrane is restored as after menstruation.
Other methods - folk remedies
In the early stages, good results are achieved by non-traditional therapy that improves blood circulation in the pelvis. The most commonly used folk remedies and methods are:
- Mud therapy – clay or mud is applied to the lower abdomen in the form of a compress for 2 hours;
- Medicinal peony tincture - the extract is diluted with water in a ratio of 1:2 and taken 2 ml 3 times a day;
- Hirudotherapy – leeches relieve congestion and activate blood circulation;
- Acupuncture - special needles affect certain points, thereby improving overall health;
- Sage - a decoction is taken orally or used for douching in order to normalize estrogen levels;
- Flaxseed oil – the product is taken on an empty stomach, 1 tbsp;
- Endovasal galvanization - the method activates the pituitary gland area, due to which the cells actively synthesize hormones.
Endometrial hypoplasia and pregnancy
Too thin endometrium negatively affects conception, the process of gestation and the birth of a child. A woman can become pregnant, but this is fraught with the following consequences:
- Early miscarriages.
- Severe toxicosis.
- Ectopic pregnancy.
- The most difficult birth.
During childbirth, labor becomes sluggish, the cervix dilates poorly, and heavy bleeding occurs after birth. Patients diagnosed with endometrial hypoplasia require special monitoring.
Before planning fertilization, it is advisable to cure endometrial pathology in order to avoid complications and negative consequences. With minor deviations, pregnancy and childbirth can proceed normally, but such cases are rare.
Reviews
A woman diagnosed with endometrial hypoplasia is often interested in the opinions of already cured patients. Below are reviews of girls who successfully got rid of pathology.
Irina, 34 years old
My husband and I decided to have a baby, but, unfortunately, nothing worked out. The hospital diagnosed hypoplasia and prescribed treatment. I had a curettage done and was prescribed to take Proginova 6 pieces a day. The new endometrium has already grown, now I am gaining thickness with hormonal drugs. In six months we will try to conceive a child again, I hope everything will work out.
Alena, 29 years old
All year I suffered from constant delays. I was never diagnosed, so I went to another clinic. There they prescribed Duphaston, I drank it and the cycle was restored, but then it went wrong again.
Recently they did an ultrasound and found hypoplasia. It turned out that my endometrium is only 5 mm, which is why my periods are irregular. They prescribed curettage, hormonal therapy and physical therapy.
I am undergoing treatment and my cycle is normal again.
Ekaterina, 32 years old
I couldn’t get pregnant, I went to the hospital, and there I found out that I had hypoplasia and atresia of the follicles. I was prescribed Duphaston, I take it regularly. On the fifth day of treatment, my period started, and after 3 months I became pregnant.
Source: https://MatkaMed.ru/endometrij/gipoplaziya