In humans, all processes are regulated by hormones. Not an exception and this hormone as prolactin. When increasing its formation in women many problems, until the development of infertility. Hyperprolactinaemia acts not only as an independent disease, but also can be a symptom of a plurality of concomitant somatic diseases and conditions. Elevated levels of prolactin usually evidence of serious problems in the body and requires immediate treatment.

A bit of prolactin

Prolactin - a hormone whose main function is to regulate the process molokoobrazovaniya and participation in the reproductive system. Furthermore, prolactin stimulates growth of the mammary glands, is involved in water-salt metabolism and promotes the synthesis of male testosterone and sperm formation.

The production and release of prolactin occurs mainly in pituitary tissue. Also, small amounts of prolactin synthesized endometrial, breast, and placenta, intestinal cells. On prolactin affects estrogen, for example, during pregnancy, prolactin levels increased by 5-20 times in the period from 8 to 25 weeks. The rate of prolactin in women is 40-530 IU / L.

Hyperprolactinemia

Hyperprolactinemia - is to increase the level of prolactin in blood. There are physiological and pathological hyperprolactinemia. Physiological hyperprolactinemia occurs during pregnancy, lactation period, during sleep Dreams: how to understand our dreams When physical exercise, during sexual intercourse and the use of protein.

Causes of pathological hyperprolactinemia

Pathological hyperprolactinemia divided into organic and functional. Organic hyperprolactinemia is caused by anatomic or functional abnormalities in the hypothalamus-pituitary:

• dysfunction of the pituitary gland;
• inflammation in the hypothalamus, the pituitary gland;
• pituitary tumors;
• acromegaly, Cushing's disease.
• Reasons functional hyperprolactinemia:
• hypothyroidism;
• some form of menopause, premenstrual syndrome;
• polycystic ovaries;
• chronic stress How to beat stress? Create an oasis ;
• renal insufficiency;
• bronchial cancer;
• hyperandrogenism;
• surgery, herpes and injuries to the chest;
• frequent scraping of the uterine cavity Curettage - how dangerous it is?   and manual examination of the uterus;
• drugs (tranquilizers, antihistamines, reserpine, estrogen, prostaglandins, drugs and antiemetics).

The clinical picture of hyperprolactinemia

When hyperprolactinemia galactorrhea may occur, the severity of which varies from individual drops of colostrum to the jet separating milk. When elevated levels of prolactin observed changes in polycystic ovaries. Possible hyperplastic changes in the mammary glands (mammary augmentation). Also, hyperprolactinemia is always accompanied by dysfunction of the ovaries, which can manifest itself in the form of anovulation, inadequate luteal (second) phase of the menstrual cycle, irregular menses, or amenorrhea. In connection with pathological galactorrhea and menstrual irregularities observed infertility, decreased libido, frigidity Frigidity pathology or liberation? Often - obesity. Hyperprolactinaemia on the background of hypothyroidism is manifested by weakness, fatigue, mental retardation reaction, chilliness, constipation, drowsiness, dry skin and brittle nails. Sometimes the first sign of latent hypothyroidism is galactorrhea.

Pituitary adenoma appears blurred vision and headaches.

Diagnosis and treatment of hyperprolactinemia

To determine the increased level of hyperprolactinemia is necessary to conduct the following activities:

• determining the level of prolactin in the blood;
• kraniogramme (X-ray of the skull);
• Computed tomography or magnetic resonance imaging;
• fundus examination;
• functional tests with thyrotropin, tserukalom, Parlodel.
• Treatment of patients with hyperprolactinemia and various disorders of menstrual function depends on the cause of the disease.

Anna Sozinova

Diagnosis of endometriosis today conducted carefully, as a very important time to identify all foci of the disease, which may be located in different tissues and organs. Only after the establishment of the final diagnosis the doctor decides how to treat this disease.

Basic principles of diagnosis of endometriosis

The diagnosis of endometriosis gynecologist may suspect after detailed questioning (anamnesis) examination and woman. But this is not always possible, and sometimes endometriosis, as well as many other gynecological diseases are asymptomatic. Therefore, preventive examinations of women always spend ultrasonography (US) of the pelvic organs, including vaginal probe. Sometimes one of the study sufficiently to reveal endometriosis in the body of the uterus and the ovaries.

In addition, it conducted radiological, endoscopic and laboratory tests that help identify endometriosis.

US

Ultrasound with vaginal probe reveals the structural changes in the mucous membranes and muscle of the uterus. Such studies are the best reason in the second half of the menstrual cycle (25 Day), when all the violations are more pronounced.

On US clearly visible increase in uterine size, density of different parts of the body tissue of endometriosis uterus (endometriosis development areas in its muscular layer), the clarity of the contours, the presence or absence of capsules and identified education (when the capsule have uterine fibroids and endometriosis is absent).

It is the first ultrasound examination, which allows the doctor to make a plan for further diagnostic studies.

X-ray studies

Informative method is hysterosalpingography Hysterosalpingography - effective examination of the uterus   - X-ray examination of the uterus with appendages using a contrast agent for assessing the extent of endometriosis in the wall of the uterus and the fallopian tubes, as well as to assess the degree of tubal patency.

Sometimes, to clarify the extent of endometriosis held computer and magnetic resonance imaging (CT and MRI). Especially informative MRI technique that allows you to identify and diffuse and nodular endometriosis, uterine body.

Endoscopic examinations

By endoscopic methods of investigation include hysteroscopy - adherence to the internal state of the wall of the uterus using a special optical device - hysteroscope. This method can detect diffuse forms of endometriosis, uterine body. Furthermore, during research can well see the mouth of the fallopian tubes. Hysteroscopy allows you not only to identify certain changes in the uterine wall, and classify them according to the stage of proliferation process. This allows the physician to determine the future strategy of diagnosis and treatment.

But this method is not perfect: no signs of endometriosis Symptoms of endometriosis - can be very different   does not rule out the presence of lesions in the deeper layers of the myometrium (muscular layer of the uterus).

Laparoscopy - the most informative method of research in endometriosis

Laparoscopy refers to endoscopic methods of investigation. But unlike hysteroscopy Hysteroscopy - examination of the uterus inside   This study is being conducted in violation of the integrity of the skin. For laparoscopy on the anterior surface of the abdominal wall make a few small holes, through which under the control of the doctor (everything that happens can be seen on the monitor) are special tools to examine the state of the body and, if necessary, to take biopsies for histological examination.

That is the main diagnostic laparoscopy study of endometriosis, if the patient will have surgery. Moreover, operations with endometriosis also conducted using a laparoscope - it minimizes trauma to the tissues and the development of adhesions.

Laboratory research

When taking biopsy during diagnostic hysteroscopy or laparoscopy tissue to be investigated in the histology laboratory. Under the microscope, examined thin slices of tissue and identify them typical of endometriosis changes. Furthermore, histological studies confirm or rule out malignancy.

Work is also a blood test for Ca - 125 - carbohydrate (carbohydrate) antigen 125, which is the main marker of ovarian cancer and its metastases. In addition, this figure increased and endometriosis Endometriosis - a serious problem with serious consequences But not so much as in cancer, - up to 35 IU / ml. The analysis allows to establish the severity of the disease and to assess the effectiveness of the treatment.

Galina Romanenko