Throughout their lives, women of different ages may experience various menstrual cycle disorders, and a significant number of women face challenges when planning a pregnancy. Why is this happening? There are numerous reasons, but a quick internet search will often lead a woman seeking answers to articles about “ovarian dysfunction,” which may confuse her even more. Let’s break it down: what is it, and how should it be understood?
What is Ovarian Dysfunction
In the past, the term “ovarian dysfunction” encompassed a wide range of various disorders, not always limited to gynecological issues. Today, the concept of “ovarian dysfunction” is no longer used. It is neither a diagnosis, a syndrome, nor a symptom. Does that mean ovarian problems don’t exist? Not exactly. There are numerous diseases and conditions that can negatively affect ovarian function, leading to ovulatory dysfunction, such as anovulation (absence of ovulation), oligoovulation (reduced frequency of ovulation), and decreased ovarian reserve.Depending on the specific condition, symptoms and hormone levels will vary, so different approaches to diagnosis and treatment are needed. A well-collected medical history and accurate diagnostics can help identify the cause of ovarian dysfunction and select the most appropriate treatment option.
Main Causes of Ovarian Dysfunction
As we have already clarified, what used to be commonly referred to as “ovarian dysfunction” is now a more structured issue. In this article, we will discuss the causes of the most common disorders—ovulatory dysfunction and premature ovarian insufficiency.
Conditions and diseases that often cause ovulatory dysfunction include:
- PCOS (Polycystic Ovary Syndrome)
- Thyroid disorders (hypothyroidism or hyperthyroidism)
- Hyperprolactinemia (elevated prolactin levels for various reasons)
- Metabolic syndrome, obesity
- Stress, depressive disorder, anxiety disorder, or mixed anxiety-depressive disorder
- Malnutrition, underweight
- Use of medications (COCs, progestins, antidepressants, etc.)
- Perimenopause
- Congenital adrenal hyperplasia (CAH), non-classical form of CAH
- Hormone-active adrenal tumors
- Somatic diseases such as tuberculosis, diabetes, etc.
- Disorders of the hypothalamic-pituitary system due to trauma or infection.
Premature ovarian insufficiency (POI) is caused by somewhat different factors:
- Genetic causes (Turner syndrome, Fragile X syndrome/Martin-Bell syndrome)
- Autoimmune diseases (autoimmune thyroid disease, rheumatoid arthritis, Sjogren’s syndrome, adrenal insufficiency, ulcerative colitis, Crohn’s disease, celiac disease)
- Exposure to toxic substances, metabolic causes
- Medical interventions such as chemotherapy, uterine artery embolization, partial or complete removal of an ovary.
There are also cases in clinical practice where the cause of hormonal disturbances remains undetermined. In such cases, it is referred to as idiopathic forms of ovulatory dysfunction or premature ovarian insufficiency.
Symptoms That May Indicate Ovarian Dysfunction
Given the wide range of conditions associated with ovarian dysfunction, the symptoms can vary significantly. Here are some key signs to look out for:
- Menstrual cycle irregularities (shortening/lengthening of the cycle, irregular periods, amenorrhea—absence of menstruation)
- Abnormal uterine bleeding
- Excessive hair growth on the body in a male pattern
- Hair loss on the scalp
- Problematic skin (acne, seborrhea)
- Genital dryness, changes in urinary frequency, night sweats, hot flashes in women under 40
- Excess weight or, conversely, underweight
- Decreased libido
- Dyspareunia (painful intercourse)
In some women, the duration of their menstrual cycle may appear completely normal, but ovulation does not occur. The egg does not mature in the ovary and is not released from the follicle. Naturally, pregnancy under such conditions is impossible. The key to helping a woman with ovarian dysfunction lies in thorough and professional examination.
Diagnostic Methods
The process begins with a consultation with a doctor, where the patient’s medical history is discussed, including past and chronic illnesses, harmful habits, reproductive history, and family history, particularly regarding any genetic conditions. The next step is a physical examination, where the specialist assesses the woman’s body composition, fat tissue, skin condition, and hair growth patterns.
Laboratory and instrumental diagnostic methods play a crucial role in diagnosing ovarian dysfunction:
- Pelvic ultrasound with transvaginal access, including antral follicle count
- Hormone level assessments (FSH, LH, estradiol, prolactin, and, if indicated, androgens and cortisol)
- Thyroid function evaluation (hormonal testing, specific antibody screening, and thyroid ultrasound)
- Karyotyping
- Genetic counseling and testing
- Glucose and lipid level assessment
- MRI or CT scans if indicated
- Consultations with related specialists: endocrinologist, reproductive specialist, cardiologist, and general practitioner.
Modern Treatment Methods
The treatment approach is based entirely on the underlying cause of the disorder identified during the examination, so the methods of treatment will vary. These may include:
- Hormonal therapy, such as medications to reduce prolactin levels, hormone correction for thyroid disorders, hormone replacement therapy, anti-androgens, and more.
- Metabolic therapy.
- Surgical treatment.
- Vitamin therapy.
- Psychotherapy.
We must always take a woman’s reproductive plans into account because if she is planning a pregnancy, the approach will differ. In certain cases, where the woman is not interested in pregnancy at the time of consultation or is considering delayed motherhood, we can offer the option of egg cryopreservation.
Potential Complications and Consequences of Untimely Treatment
The most frightening consequence for many women is infertility. However, there are many other risks, such as:
- Cardiovascular risks
- Metabolic risks
- Cognitive impairments
- Sexual dysfunction
- Risk of early loss of bone mineral density
- Oncological risks (for example, endometrial cancer)
Preventive Measures for Regulating Ovarian Function
There are no guaranteed measures to protect a woman from ovulatory dysfunction or premature ovarian failure. However, following certain recommendations can help reduce the risk of developing these conditions:
- Adhering to healthy eating principles and maintaining appropriate physical activity
- Maintaining a healthy weight range
- Avoiding smoking, psychoactive substances, and minimizing alcohol consumption
- Timely supplementation of vitamin and mineral deficiencies
- Reducing stress, ensuring adequate sleep, and following a balanced work-rest schedule
Don’t forget about annual check-ups with your gynecologist. In some cases, your doctor may recommend more frequent visits.
It’s important to pay attention to symptoms, as mentioned earlier, starting from adolescence. Ovarian dysfunction can also be suspected in young girls, and in such cases, consultation with a pediatric gynecologist or endocrinologist may be necessary.
Conclusions
Now you know that ovarian dysfunction is not a standalone condition and that you won’t find this term in any global guidelines or English-language literature. Instead, you will find extensive information about ovulatory dysfunction and premature ovarian insufficiency.
Depending on the diseases and pathological conditions that lead to these changes, different approaches are used for diagnosis and treatment. Our specialists will help you find the best solution tailored to your health and specific needs.