Hormones are biologically active substances that are produced by endocrine glands. With the blood stream, they are transported throughout the body to ensure its proper functioning. The concentration of these substances in a woman depends on such factors:

1. Times of Day.
2. Age.
3. Day of menstruation.

The result of the study depends on the last indicator most of all. Therefore, a woman must understand on which day of the cycle it is most correct to undergo an analysis. This is especially important during pregnancy planning.

This event plays a very important role in diagnosing infertility in couples. Hormones help the gynecologist calculate the approximate date of ovulation, calculate the optimal time for conception and protect the woman from problems during pregnancy.

If the transcript of the study showed a violation of the norm, this is not a reason to be upset and forget about the desire to have children. By understanding the state of hormones, it will be easier for the doctor to choose the most appropriate treatment for the patient and monitor her health.

In the absence of positive results of treatment, the patient will be offered to try the IVF fertilization technology, which has helped many families to experience parental happiness.

Doesn't depend on cycles

According to the generally accepted standard, the amount of follicle-stimulating hormone should be checked from 3 to 8 or from 18 to 22 days of the menstrual cycle. A man can undergo such an analysis at any time. The material is taken only on an empty stomach, otherwise the result will be unreliable.

The calculation of the quantitative indicator of this substance will be rational when donating blood during the first or second phase of the cycle. Research requires standard preparation: do not eat 12-13 hours before the procedure, donate blood in the morning on an empty stomach.

A prerequisite is to sit quietly for forty minutes before visiting the laboratory assistant. Prolactin is sensitive to emotional arousal, so at the slightest surge it can show the wrong level in the analysis.

Prolactin is very important for a woman's body: it ensures ovulation and stimulates the development of lactation after the birth of a child. In addition, it greatly affects the concentration of FSH. When a woman is pregnant, prolactin prevents the formation of follicles, which is normal.

If a non-pregnant woman has non-standard jumps in the concentration of prolactin, she will not ovulate.

In the female body, prolactin has a different concentration depending on the time of day. During a night's sleep, its performance is increased.

In the period after the morning awakening and before lunch, it drops sharply. After 12-14 hours of the day, the indicators again “creep” up.

The concentration of prolactin in the luteal phase is higher than in the follicular phase.

For greater convenience, we bring to your attention a table with the delivery of an analysis for hormones for cyclic days.

In order to decipher the analysis for hormones to give the most accurate picture of the patient's health status, it is necessary to take biological samples in the morning, from seven in the morning, no later than nine.

Scientists have found that during this period the concentration of any hormones in the blood is as high as possible, which means that the results will be reliable. However, attention is also paid to the following point: no matter what time the tests are taken, you should not try to analyze the result yourself.

Without a special education, it will not be possible to decipher even the hormones handed over at the right time of the day.

If a TSH study is prescribed, which allows you to correctly conclude about the state of the endocrine system, then for such a compound the highest concentration in the blood is typical in the morning from seven to eight.

A gradual decrease is observed up to 11. Unsuccessful timing can provoke an error by a specialist who deciphers the analysis for hormones.

This will not be due to the low level of qualification of the doctor, but it will be due to the peculiarities of the biological rhythm of the human body.

If tests are prescribed for a hormone produced by the organs of the female system, there will almost always be a link to the cyclical work of the body. In this case, it is important to consult a doctor, only after that go to the laboratory.

The period of menstruation is accompanied by a change in hormonal levels. These adjustments are quite specific, so doctors often recommend doing an analysis to get the most complete picture of a woman's health.

The most revealing information is reflected in LH, FSH.

Reasons for the appointment of tests

The nature of LH secretion depends on the phase of ovulation. With puberty, the level of the hormone rises.

The maximum value of LH is diagnosed during ovulation. In pregnant women, the concentration of the hormone decreases.

The doctor pays special attention to the value of the LH / FSH ratio. Normally, before menstruation, the indicator should be 1, a year after the first menstruation - 1-1.5.

An excess amount of estrogen should be a reason for taking serious measures. Too much of this hormone is released into the blood of a woman for completely different reasons.

Hormone analysis taken from a person in order to learn about the state of all systems and organs. I must say that these indicators are needed not only in gynecology, such an analysis is also done for various diseases of other systems. As a rule, during the treatment process, the analysis is repeated several times to understand whether the chosen treatment is working. It should be noted that female beauty, sexual and general health, as well as reproductive function, directly depend on the hormonal level. And when women have problems with the listed indicators, doctors first of all study hormonal state. Disturbed hormone levels can cause infertility, early aging and frigidity in women. In addition, the cause of early and painful menopause also becomes unstable hormonal background.

In gynecology hormonal disorder, which is usually caused by diseases of the mammary glands and thyroid gland, lead to the following diseases:

1. Uterine fibroids.

2. Endometriosis or endometrial hyperplasia.

3. The appearance of all kinds of polyps.

4. Manifestations of polycystic.

5. Violation of the ovaries or dysfunction.

What factors can lead to hormonal disorders.

1. Anomalies that occurred during the period of intrauterine development, that is, when a person was still in the womb, for some reason irreparable changes occurred in the developing organism.

2. The development of diseases of internal organs, especially the ovaries and liver.

3. All problems and diseases associated with the work of the thyroid gland.

4. Violation of the regularity of sexual life, that is, complete and long-term abstinence.

5. Childbirth, which was very difficult, and happened at a relatively young age.

6. All kinds of inflammation of the reproductive organs.

7. Experienced stressful conditions.

In addition, on hormonal background of the human body There are also poor-quality ecological conditions, and an unhealthy approach to life and the presence of bad habits. If a woman leads sedentary work, or this is how her whole life develops, then hormonal disorders also will not keep you waiting. If the body has already started the process of disruption of the endocrine glands, then the signals for this will be as follows:

1. Headaches, permanent.

2. Violation of the menstrual cycle, and any.

3. Problems with conceiving or bearing a child.

4. Incomprehensible jumps in blood pressure.

5. Hot flashes or chills.

6. Insomnia.

It must be understood that female hormone which is produced by the female ovaries and adrenal glands is called estrogen. And a decrease or increase in the level of this hormone in the patient's body, just leads to obvious physiological signs. The main processes for which this hormone is responsible is the ability to conceive in a timely manner, calmly endure, give birth and breastfeed a child. It is clear that any misdirection of these processes and possibilities is directly related to this hormone.

If the level of estrogen in the female body is elevated, then she will be haunted by constant ailments. The nature of these conditions can be different, but the main indicators are pain and noise in the head, manifestations of nausea, thrombophlebitis, dizziness, convulsions, pain in the mammary glands.

If the level of estrogen in the female body is low, then she has the following symptoms:

1. Nervous and irritable states.

2. Violation of the menstrual cycle, that is, at first it is reduced, and then it may disappear altogether.

3. there is a gradual or sharp decrease in sexual desire.

4. Constant, severe headaches.

5. Depressive state.

6. A significant reduction in the volume of the mammary glands.

After estrogen, comes progesterone female hormone produced by the ovaries. He is responsible for the psycho-emotional state of a woman, as well as for the bearing and preservation of the fetus during pregnancy.

Next up is testosterone. male hormone, which are produced in the body of a woman and he is responsible for libido, that is, for sexual desire. Testosterone is produced in small amounts and also affects the quality of the heart and blood vessels, and in addition to the general physical condition of a woman.

Hormone problems can be congenital or acquired. They can be transmitted to the child from parents genetically or occur as a result of abortions, infections, beriberi, respiratory diseases, endocrine pathologies. A huge role in maintaining normal performance is played by lifestyle. Frequent stress, bad habits (alcoholism, drug addiction, heavy smoking, unhealthy diet), constant lack of sleep, overwork, long-term use of oral contraceptives adversely affect the health and reproductive functions of women.

Tests during pregnancy

Only such a pregnancy can be endured and problem-free, in which the hormonal background of a woman meets the standards. That is why, with the slightest pathological changes, the expectant mother is recommended to be tested for hormones. 7 of them for pregnancy and lactation are the most important:

1. Testosterone. This is a male hormone, which is produced in a small amount by the female body. Its excessive concentration in the blood of a pregnant woman can lead to fetal fading or miscarriage.
2. Follicle stimulating (FSH). Its main task is to influence the growth of the egg. Thanks to him, menstruation and, accordingly, the pregnancy itself become possible. However, when a mature egg is fertilized, the growth of the following follicles slows down significantly. FSH levels should decrease during pregnancy.
3. Estradiol. One of the most important hormones in gynecology. He is responsible for the normal functioning of the female genital organs. During pregnancy, it is aimed at maintaining pregnancy, at normal blood supply to the uterus. The longer the gestation period, the greater should be the level of estradiol.
4. luteinizing hormone (LH). Together with FSH, it makes fertilization possible. Without it, the normal maturation of the egg and its opening for the penetration of sperm would be impossible. During pregnancy, the production of LH does not differ in intensity.
5. DEA sulfate. It does not have much benefit for the female body, but in excess it can significantly harm, in particular, lead to infertility or help terminate a pregnancy.
6. Prolactin. One of those hormones that can play a dual role in a woman's body. The main task of prolactin is to reduce FSH (the hormone that is responsible for the menstrual cycle and preparing the follicle for conception). An excess of prolactin in the body of a non-pregnant woman leads to infertility. In the body of the future mother, it contributes to the preservation of the fetus. Another important task of prolactin is to influence the production of milk after the birth of a baby.
7. Thyroid hormones. In excess, they make pregnancy impossible, and if the conception of the fetus has already occurred, they can even cause a miscarriage or significantly complicate the course of pregnancy.

What tests should be done in case of hormonal failure?

These include:

• stop taking all medications 2 weeks before the blood test. If it is impossible to do this, it is necessary to warn the attending physician about taking the medication;
• refusal to drink alcoholic beverages 3 days before the sample is submitted for analysis;
• quitting smoking on the day of the test;
• abstinence from eating fatty and fried foods 3-5 days before the test;
• sample delivery for analysis should be done on an empty stomach, you should refrain from eating for 8-12 hours, drinking only clean water is allowed;
• compliance with the regime of physical activity. Sports should be abandoned 3 days before the test;
• rest in the waiting room for 10-15 minutes before taking the sample for analysis, you should calm down and take a breath;
• consultation with a doctor in the event that 3-5 days before the test was carried out an ultrasound examination, scanning, x-ray.

The result of hormone tests can vary if taken in different laboratories, so it is recommended to be examined in the same laboratory. If it is necessary to conduct a second study, a blood sample for analysis should be taken at approximately the same time.

It is necessary to take a blood test before you start taking medications or not earlier than 10-14 days after they are discontinued. To assess the effectiveness of treatment when using any drugs, it is necessary to conduct a study 7-14 days after the last dose of the drug.

Thyroid hormones include thyroxine, triiodtryonine, T3, T4, TSH. Donating blood for hormones is always done on an empty stomach. Before taking a sample, it is recommended that you stop taking medications that contain iodine. In addition, before taking the test for thyroid hormones, it is desirable to exclude stressful situations.

Blood donation for free T3 is performed on any day of the cycle on an empty stomach. Before taking blood, the patient is recommended to be at rest for about 30 minutes. Normal T4 levels in men and women are relatively constant throughout life.

TSH (thyroid-stimulating hormone) regulates the functioning of the thyroid gland. It can be taken on any day of the cycle.

In clinical practice, it is planned to check the following sex hormones, which can cause infertility:

• FSH - follicle stimulating hormone. The delivery of this analysis should be carried out on the 3-7th day of the cycle. To determine the possibility of follicle growth, FSH is taken on days 5-8 of the cycle;
• LH - luteinizing hormone. LH in men is responsible for increasing the permeability of the seminiferous tubules for testosterone. LH in women ensures the completion of the maturation of the egg in the follicle and ovulation, the secretion of estrogens and the formation of the corpus luteum. A blood test for LH for women should be taken on days 3-8 of the cycle;
• Prolactin. If the level of prolactin is elevated in a man, his sexual function may be impaired. In women, prolactin is involved in the process of ovulation, it stimulates lactation in the period after childbirth. To determine the level of this hormone, the analysis should be carried out in the 1st and 2nd phase of the menstrual cycle, the sample should be taken only in the morning on an empty stomach. Before taking blood, the patient is advised to spend 30 minutes at rest, since prolactin is a stress hormone, as a result of which a slight exercise or excitement can affect its level;
• Estradiol. In women, analysis can be taken at any phase of the menstrual cycle. Estradiol provides the formation and regulation of menstrual function, the development of the egg in women;
• Progesterone. This hormone is responsible for ensuring the final preparation of the uterine lining so that the embryo can attach itself to it. Progesterone also provides optimal conditions for the normal development of pregnancy. The delivery of the analysis is provided for 19-21 days of the menstrual cycle;
• Testosterone. Testing of this hormone in women can be carried out on any day of the cycle. If a man has a decreased concentration of testosterone in the blood, this entails a decrease in the quality of sperm and insufficient male power;
• DHEA sulfate. If the concentration of the hormone is increased in a woman, this can cause ovarian dysfunction and infertility. Hormone levels can be checked on any day of the cycle.

For the correct taking of a blood test for pituitary hormones and obtaining a reliable reliable result, the sample must be taken on an empty stomach. If possible, a decrease in sexual activity is recommended, physical activity and smoking are prohibited. During the test period, sudden changes in temperature should be avoided.

Polycystic ovaries, mastopathy, anovulation, irregular menstruation, tumors, infertility, miscarriage are only a part of pathological conditions with improper production of sex hormones and other types of regulators.

If there are indications, doctors prescribe tests for hormones in gynecology. It is important to clarify the level of FSH, testosterone, LH, estrogens, hCG, T3, TSH and T4. If you suspect a malignant process, be sure to donate blood for tumor markers. Information about hormonal fluctuations will help you understand what research is needed for accurate diagnosis and competent therapy for pathologies of the reproductive system.

When is it necessary to take gynecological tests?

After examining and talking with the patient during the appointment, the doctor, if available, prescribes additional tests and studies. It is important for a gynecologist to know how significant the deviations of hormone levels from optimal indicators are. Often a woman does not suspect that the cause of reproductive dysfunction or active growth of an ovarian cyst lies in a deficiency or excessive secretion of regulators.

Indications

Tests for hormones are needed by a gynecologist to assess the state of the hormonal background, with fluctuations in which many pathologies of the reproductive sphere develop. The unwillingness of a woman to undergo a comprehensive examination hinders the diagnosis and selection of the optimal treatment regimen.

Some tests are quite expensive, but without determining the concentration of certain regulatory substances, it is impossible to carry out a full-fledged treatment. Often, repeated tests are needed to assess the dynamics of therapy: it is important to check with the doctor the frequency of testing in order to navigate financially.

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Indications for hormonal tests in gynecology:

• suspicion of infertility;
• cysts, ovarian tumors;
• severe obesity in combination with cycle disorders, problems with conception;
• irregular menstrual cycle;
• signs of hyperandrogenism (appearance of male characteristics in women);
• lack of ovulation;
• control of hormone levels during HRT;
• polycystic ovaries;
• suspicion of malignant tumors of the uterus, ovaries;
• deviations in terms of puberty;
• ultrasound revealed endometriosis;
• a delay in the formation of secondary sexual characteristics or the beginning of the process ahead of time;
• specific symptoms indicating the development of pathologies of the genital area;
• pronounced premenstrual or menopausal syndrome;
• there are symptoms of mastopathy.

An analysis for female hormones is taken not only when signs of pathological processes are detected, but also for a preventive purpose. It is important to timely identify deviations in the planning of pregnancy and during the period of gestation.

Symptoms of deviations

A woman should visit a gynecologist, take tests for sex hormones when specific signs appear:

• menstruation became abundant / scanty, appear less than 16 days after the previous one, 36–40 days later, or completely disappeared;
• during monthly bleeding, severe pains that were not there before are disturbing;
• the breast swells not only closer to menstruation, but the entire period of the cycle;
• pulling / shooting / aching or other types of pain in the lower abdomen appeared;
• outside the period of menstruation, vaginal discharge of a brown hue was noted, or the volume of the secret increased sharply, the color / smell changed, bloody clots appeared in the whites;
• in a short time, the weight has increased rapidly or, conversely, a noticeable depletion has been noted;
• for six months, in the absence of contraception, conception does not occur;
• in early pregnancy, the lower abdomen hurts, traces of brown color remain on the linen. Signs point to a progesterone deficiency and a threatened miscarriage.

It is important to know other symptoms of hormonal failure and the development of endocrine pathologies:

• obesity;
• thinning, hair loss;
• causeless nervousness, anxiety;
• increased appetite;
• unquenchable thirst;
• a sharp impairment of vision, hearing, changes in the condition of the skin;
• frequent urination;
• an increase in the volume of the thyroid gland;
• apathy, loss of strength, constantly want to sleep;
• headache often;
• worried about heart palpitations and high blood pressure;
• changes in appearance are observed: palms, lateral sections of the tongue thicken, protrusion of the eyes occurs, fat deposits appear on the waist or abdomen;
• hair is actively growing on the body and face;
• chest hurts and swells.

What tests to take

The list of studies is determined by the gynecologist depending on the nature of the pathological process and the alleged disease. If infertility is suspected, it is often necessary to take hormone tests to clarify the level of not only steroids, but also thyroid hormones that affect the entire body and reproductive system.

Types and functions of sex hormones:

• progesterone. The second name is "pregnancy hormone". Responsible for the level of fertility, ensures the implantation of the embryo and the correct course of pregnancy. The corpus luteum hormone inhibits the activity of oxytocin, prevents uterine contractions to preserve the fetus;
• follicle stimulating hormone. An important regulator controls the proper growth of the egg. FSH deficiency negatively affects the functionality of the ovaries and the onset of ovulation;
• testosterone. The male sex hormone in a low concentration is needed by women for the good condition of the skin, bones, nails, muscles. Androgen provides sexual desire, the ability to conceive. Testosterone deficiency negatively affects the maturation of follicles in the ovaries;
• luteinizing hormone. The study of the level of LH allows you to understand whether ovulation has occurred or not. Violation of hormone secretion is a sign of improper functioning of the endocrine system, a tumor process in the pituitary gland;
• estrogen. A group of hormones, the most active fraction is estradiol. Functions: controls the timely formation of sexual characteristics according to the female type, strengthens the walls of blood vessels, prevents the development of osteoporosis, maintains the optimal thickness of the endometrium. Estradiol affects the water-salt balance, lowers the level of bad cholesterol, stabilizes the concentration of other hormones throughout the cycle.

• with a delay in the next menstruation, the possible development of pregnancy, you need to donate blood for beta-hCG. An excess of the concentration of chorionic gonadotropin by more than 2 times compared to the norm for non-pregnant women indicates a successful conception, if the indicators are normal (no more, then menstruation will appear in a few days);
• when planning a pregnancy, you need to donate blood not only for LH, hCG, FSH, testosterone, progesterone, estrogens, but also to determine the Rh factor and blood type in future parents. Mandatory tests for syphilis, AIDS, blood for PCR to detect latent infections. It is important to pass the TORCH-complex. You also need a urinalysis, a study of blood composition, determination of hemoglobin values, ESR and leukocytes.

Problems with conception, the menstrual cycle, libido, weight stability, immunity, general well-being often appear with a deficiency or excess of thyroid hormones: thyroxine and triiodothyronine. In violation of the synthesis of T3 and T4, the level of thyroid-stimulating hormone of the pituitary gland (TSH) changes, which disrupts the physiological processes in the body, including the organs of the reproductive system.

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results

With a transcript sheet, you need to visit the doctor who sent you for analysis again. On the Internet, you can find many sites on medical topics with a large amount of information about the causes of deviations in hormone levels, but only a doctor can make an accurate diagnosis. Additional information is often beneficial, but sometimes women misinterpret the results, attribute non-existent diseases to themselves. When evaluating test data, it is important to consider many factors.

You need to find a gynecologist who you can trust in order to avoid unnecessary expenses, to be confident in the actions of the doctor. You can not be careless about the treatment of pathologies of the reproductive system: you must fully follow the instructions of the specialist.

To get accurate results, you need to follow the rules:

• Take an analysis for hormones on the day of the cycle indicated by the gynecologist: the regulators have maximum values ​​in different phases of the cycle.
• Be sure to come to the laboratory in the morning, 10-15 minutes earlier, so that you can relax and calm down. It is impossible to receive food and liquid before the analysis.
• Alcohol, sexual intercourse, physical activity, stress should be excluded for two days before blood sampling. Do not smoke for at least 3-5 hours before the test.
• The doctor should be aware of all hormonal drugs and other drugs that a woman takes in courses or for a long time (from hypertension, angina pectoris, diuretics). The best option for accurate results is to stop oral contraceptives and other types of hormonal drugs 20-30 days before the study.

Video about what tests for hormones are taken in gynecology and about the features of preparing for the study:

On what day of the cycle to take hormones? Gynecological hormone tests

When planning a pregnancy, a woman must visit a doctor. The specialist at the reception will tell you what readings you need to take in order to be sure that the body is ready. Of course, the patient will be explained on which day of the cycle to take hormones and which ones will have to. However, pregnancy is not the only reason when you need to take tests for hormones. Let's consider different situations.

And what is it?

Hormones are called such active compounds of natural origin, which are produced by the cells of our body. The components enter the circulatory system, there is a reaction with receptors at the cellular level, due to which the metabolism and the physiological functionality of the body are controlled. It is necessary to take tests for female hormones in order to get an accurate idea of ​​\u200b\u200bthe possible violations that occur in the condition of a particular person. This helps to determine the presence of a number of diseases, to identify their causes. In particular, infertility always requires a detailed hormonal study to assess the woman's condition.

The accuracy and correctness of the result are ensured by the correct preparatory measures, a good choice of the moment for passing the analysis. Each hormone, as doctors were able to identify in the course of special studies, has a specific production cycle. To get the most useful information from a human health study, it is necessary to know the cycle of a particular compound and choose the moment for the study, taking into account the concentration of hormones on the days of the cycle. Some mistakenly think that only female cyclical menstruation is supposed, but in fact the concept is somewhat broader.

Features of the regulation of sexual function

Indeed, it is important to take into account the menstrual cycle, when the peculiarities of the hormonal background are revealed in relation to a wide variety of active compounds, not only regulating sexual function. A detailed study of the situation and attention to all important aspects become the key to a successful result. When prescribing a specific event, the doctor will definitely explain to the woman on which day of the cycle it will be necessary to undergo the procedure, and also tell how the level of hormones changes on the days of the cycle, which indicators are within the normal range, which ones indicate the presence of deviations.

As can be seen from practice, most often studies are carried out on the 6-7th day of a new cycle. Such timing is a key requirement for detecting blood concentrations:

The information on which day of the cycle to take the hormone FSH, LH is general, in each individual case the doctor can make small adjustments based on the condition of the patient who sought medical help. Also, the specialist will tell you how to properly prepare for the study.

Timing Features

Often, studies are prescribed for 3-8 days of a new cycle. The exact decision always remains with the doctor, who knows exactly which days of the menstrual cycle to take hormones. If at the same time as a woman, her constant sexual partner is being tested, there are no such strict restrictions for a man regarding the possible timing of taking biological samples. Delivery is allowed at a convenient time - when it pleases a person.

If tests for female hormones that are not related to pregnancy are prescribed, then you can (usually) take them at a convenient time, without reference to the menstrual cycle. This applies to TSH, T3, T4. Similar requirements are imposed on the study of the concentration of testosterone in the blood. However, many modern doctors believe that studies of biological samples taken on the 5th day of the cycle give the best results. What hormones are passed: all produced by the thyroid gland. It is not necessary to observe the interval from 5 to 8 days; in each specific situation, the doctor evaluates how reasonable it will be to wait for this particular period. If information is required urgently, then they can appoint a study as quickly as possible, if it is possible to wait, then they select the date, focusing on the menstrual cycle.

Daily cycle

In order to decipher the analysis for hormones to give the most accurate picture of the patient's health status, it is necessary to take biological samples in the morning, from seven in the morning, no later than nine. Scientists have found that during this period the concentration of any hormones in the blood is as high as possible, which means that the results will be reliable. However, attention is also paid to the following point: no matter what time the tests are taken, you should not try to analyze the result yourself. Without a special education, it will not be possible to decipher even the hormones handed over at the right time of the day.

If a TSH study is prescribed, which allows you to correctly conclude about the state of the endocrine system, then for such a compound the highest concentration in the blood is typical in the morning from seven to eight. A gradual decrease is observed up to 11. Unsuccessful timing can provoke an error by a specialist who deciphers the analysis for hormones. This will not be due to the low level of qualification of the doctor, but it will be due to the peculiarities of the biological rhythm of the human body.

How to submit correctly?

In order for hormone tests when planning pregnancy to give the most accurate result, it is necessary to refrain from food and bad habits for several hours before taking samples. Fasting is required in the morning, but often nighttime is also recommended. In some cases, the condition is not met. This is typical for women experiencing a difficult pregnancy, as well as people who find themselves in an emergency situation.

In order for the result to be correct, it is necessary to prevent excitement before the delivery of biological samples. Doctors usually recommend that women who are scheduled for gynecological hormone tests come to the clinic in advance so that they can sit for at least a quarter of an hour while waiting for an appointment and calm down during this time. Excitation, overstrain, nervous state can adversely affect the results, and medical conclusions will be unreliable.

What else influences?

When planning to take tests for hormones in gynecology, you need to remember that physical activity can affect the level of concentration of compounds. If a study is scheduled, both nervous emotional experiences and exercise, weight lifting should be carefully avoided. It is necessary to plan your day well so that you do not have to rush to the hospital - this can also affect the result. It is unacceptable to take tests if infection is detected, the temperature rises, inflammation begins.

A variety of negative factors can have an unpredictable effect on the results, even if the woman knew exactly which day of the cycle to donate hormones, followed the doctor's recommendations for choosing the time. You need to understand that alcoholic beverages also correct the processes occurring in the body, therefore, one day before the analysis, you should not eat anything alcoholic. A week before the study, they refuse any antimicrobial drugs that strongly affect the hormonal background.

How to submit correctly?

Depending on the prescribed studies, the doctor will tell you on which day of the cycle to take hormones, and also explain how the procedure itself takes place. The level of many active components produced in the human body is interconnected, therefore, the deficiency or excess of one hormone provokes a violation of the concentration of another, which generally causes large-scale disruptions in the activity of organs and internal systems.

If a hormonal study is prescribed to check the endocrine system, first of all, the level of TSH is studied. Donate blood if the patient has:

• violation of the heart rhythm;
• decrease in sexual activity;
• inability to get pregnant;
• violation of the mental progress of the child;
• depression states;
• hypothyroidism;
• hyperprolactinemia.

Hormonal studies during gestation

The key to successful gestation is the control of the woman's health. This is especially true in the first three months, until the end of the tenth week, since during this period the rudiments of the future nervous, hormonal system are laid. The life of a child during this period is especially closely dependent on the state of health of a pregnant woman. TSH during pregnancy increases, decreases. You can suspect a decrease below the norm by the urge to vomit. There are general normative values ​​for the level of the hormone in the blood. They are individual for each specific woman, and yet the generally accepted boundaries have been established by doctors.

If the doctor explained on which day of the cycle to take hormones, and the woman carefully followed the rules for preparing for the study, and yet the result turned out to be very different from the established average standards, this may be a reason to worry and take measures to maintain the pregnancy. Deviations from the average values, as a rule, indicate the insufficiency of the functioning of the endocrine system. Based on the information received, the doctor assumes what kind of failures are observed and prescribes additional studies.

Adolescence

The complexity of the study is due to instability, so it is not clear on which day of the cycle to take hormones: the body has not yet developed cyclicity as such. Normally, the system becomes stable only by the age of twenty. If a hormonal study is prescribed, tests can be taken on different days of the cycle. If the average cycle is 28 days, then, for example, TSH studies are done on the 21st day. But if the duration reaches 32 days, then the tests are taken on the 25th day. The need for such a study arises with the following disturbing symptoms:

• too much weight;
• wrong growth;
• hair grows too actively;
• puberty is not correct.

Tests in the elderly

A specific study may be prescribed for a variety of symptoms. So, the hormones of the endocrine system are checked if a woman notes:

• anemia
• chilliness;
• sweating;
• problems in the functioning of the gastrointestinal tract;
• increase in pressure;
• sudden weight loss;
• failure of the functioning of the cardiac system;
• weakness of muscle tissues;
• slow or too strong mental reactions (up to hysteria);
• violation of the physical functionality of the body.

There is no link to cyclicity, the analysis is taken at any convenient time, chosen by the doctor based on taking into account the individual characteristics of the patient's body.

Some analyzes

Often, a doctor prescribes an anti-Mullerian hormone test for a woman. On which day of the cycle to take it, the doctor will tell you at the reception. Normally, this is the interval from the third to the fifth day. Such a study can be prescribed at a very different age (up to menopause), since normally the compound should be produced by the female ovaries. If a dysfunction of this organ or incorrect activity is suspected, specific studies are carried out.

In a healthy woman, the concentration of this hormone in the blood decreases with age. Depending on the results, the doctor can determine how many oocytes are in the patient's ovaries. The indicator is somewhat similar to FSH, but gives a more accurate idea of ​​the state of the woman's body. Telling which hormones are taken on the 3rd day of the cycle, the doctor necessarily pays attention to AMG, especially if IVF is planned. In order for the results to be correct, you need to come to the hospital after a short fast, you can’t train shortly before the delivery of biological fluids. Physical, emotional, mental stress can distort the results.

Some hormones and analysis features

If tests for thyroid-stimulating, gonadotropic, adrenocorticotropic hormones are prescribed, such tests do not depend on menstrual cycles. The doctor chooses the best date, assessing the condition and individual characteristics of the patient's body. Luteinizing most accurately can be examined on days 6-7 of the female cycle. Normally, on the 3rd day of the cycle, the follicle-stimulating hormone will show the most accurate results. For this compound, the study period is from the third to the eighth day, the second block of days is 19-21.

To study for prolactin, you will have to come to the hospital in the first or second phase of the cycle. Thyroid hormonal analyzes are carried out in the first phase.

Doesn't depend on cycles

Such hormones, the date of analysis of which the doctor chooses, evaluating various factors (but the menstrual cycle does not play a role) include:

Completing the list

Testosterone is a hormone responsible for sexual characteristics characteristic of the strong half of humanity, but it is produced in the body of all people. To check how adequate the concentration of the compound in the female circulatory system is, a study is usually prescribed for the first phase of the cycle. Progesterone is detected a week before the start of a new cycle. If it was not possible to “catch” this period, the day is counted. from the moment the cycle begins and donate blood for research.

It is extremely important to identify the characteristics of women's health analyzes related to the activity of the ovaries. First of all, the attention of doctors is riveted to estradiol, due to which the genital organs can develop and function normally. The study of the characteristics of the glands responsible for the production of hormonal compounds is prescribed for 6, 7, 17 days.

Gender and cyclicity

If tests are prescribed for a hormone produced by the organs of the female system, there will almost always be a link to the cyclical work of the body. In this case, it is important to consult a doctor, only after that go to the laboratory. The period of menstruation is accompanied by a change in hormonal levels. These adjustments are quite specific, so doctors often recommend doing an analysis to get the most complete picture of a woman's health. The most revealing information is reflected in LH, FSH.

When do they do it?

The study of the hormonal background is not among the planned ones, the analysis is done only if there are obvious indications for such an event. More often, blood is taken for study if a disease is suspected or when planning a pregnancy, carrying a fetus. A comprehensive study in some cases helps to formulate the diagnosis as accurately as possible. This is especially true for difficult situations.

Condition analysis is necessary in the following cases:

• a sharp, strong fluctuation in weight without obvious reasons for this;
• inflammatory processes affecting the skin;
• amenorrhea;
• violations of the cycle;
• inferiority of puberty;
• development with a delay in secondary signs of gender.

Both an excess and a lack of hormonal components in the body can lead to the most unpredictable and unpleasant consequences. If pathological processes are suspected, it is important to diagnose in time, on the basis of which therapy is prescribed to restore the normal functionality of the hormone-producing organs.

Tests for hormones in gynecology: when and how to take?

Hormones are biologically active or signal chemical compounds. They are of organic origin. They are produced by living cells, in frequency by cells of the human endocrine glands. These substances are a humoral (blood-borne) regulator of metabolic processes, they are involved in the work of all organs and systems, in particular, organs that perform a reproductive function.

A whole complex of hormones produced by the ovaries, thyroid gland, adrenal glands, and the pituitary-hypothalamar system directly affects reproductive function. To check their content in the blood, laboratory diagnostic methods are used.

In order for the results to be reliable, several rules must be observed. For example, to donate blood for hormones in gynecology, a woman will also have to take into account the day of the menstrual cycle (MC).

What hormones do we give?

The female reproductive system is a delicately balanced mechanism. This is partly why he is extremely vulnerable. The balance of hormones "plays the first violin" in this system, and a whole series of tests is given to check its condition:

• Female sex hormones.
• androgenic hormones.
• Active substances of the thyroid gland.
• HCG (human gonadotropin, surrenders in case of a delay in menstruation and suspicion of pregnancy).

There is the largest group of active substances that may need to be analyzed to diagnose the pathology of the female genital organs, during preconception preparation and after conception. These are the so-called "female hormones":

Less "saturated" composition of biologically active compounds of androgenic profile. These are total and free testosterone, DEGA sulfate, cortisol.

The functional state of the endocrine gland called thyroid is characterized by:

1. Thyroid stimulating hormone (TSH).
2. Thyroxine free/general.
3. Antibodies, indicating autoimmune processes, to thyroglobulin and thyroid peroxidase.

These groups do not include all female or male hormones, but only those associated with the sphere of reproduction.

Basic rules for the delivery of hormones

To test the hormonal balance of the female body, you need to donate biological material (in this case, venous blood) for research. You need to prepare for the procedure, and not only mentally. The content of hormones is affected by:

• Flights.
• Climate change.
• Excessive physical activity during the menstrual period.

A recent abortion, STIs, hunger, taking anabolic drugs, excessive intake of dietary supplements and medicines without a doctor's prescription can have no less impact. Also, the culprit of all the ills of mankind is stress. Especially in conjunction with work "at night", it also occupies not the last place in a series of factors affecting hormone levels. It is better to exclude all these factors before donating biological material.

To avoid inaccuracies, there are several rules accepted in the medical environment that describe when to donate blood and how to do it correctly:

• Donate blood in the morning (before 11.00).
• On the analysis go on an empty stomach.
• After sexual fasting (at least one day before the procedure).
• For knocking, you need to abandon thermal procedures (bath, sauna).
• In the evening before donating the biomaterial, physical activity should be avoided.
• At least a day, you need to try to limit the influence of stressors and ensure yourself a good sleep for 8 hours.
• A week before donating blood, you need to stop treatment with any hormonal agents, including anti-inflammatory ones, and stop using hormonal contraceptives.

When donating biomaterial for thyroid hormones, there are no other restrictions. But sex hormones require blood donation on certain days of the cycle. On which day of the cycle to take tests depends on the hormone itself:

• At its beginning (2-3) the day is surrendered to AMN.
• On the 5th day surrender: LH, FSH
• 17-hydroprogesterone - for 3-5 days.
• In the middle (7-9 days) you need to take: testosterone, DEGA-sulfate, cortisol, 17-hydroprogesterone.
• At the end of the cycle, progesterone is taken. Although there is a slight discrepancy in the timing of the delivery of this hormone, which women find in search of answers to their questions. It is often recommended to go for an analysis from the 19th to the 23rd day of the MC, provided that the woman has a standard cycle. But it is better to take it on the 7th day after ovulation (that is, 5-7 days before the onset of menstruation).
• During the entire cycle, you can take estradiol.

This information is for a normal and stable cycle. Before taking tests, it is better to consult a gynecologist and clarify for yourself on which day of the cycle to take hormones.

The rules to be followed do not depend on the age of the patient. Bioactive substances in the human body are produced in accordance with its biorhythms.

You need to consult a doctor, if only because the date of delivery of some hormones remains a controversial issue to this day. First of all, this concerns estradiol: some experts vote for 5 days from the beginning of the cycle, others for its end. And still others assure that you can take tests regardless of the day of the cycle, you just need to specify it (the day of the cycle). This also applies to androgens - they can be taken on any day, but it is better on the day indicated above.

female hormones

Estradiol

This active substance is produced not in one organ, but in the corpus luteum of the ovary, the maturing follicle and, oddly enough, in adipose tissue. It is also synthesized by the adrenal glands (bark). And during pregnancy, the placenta produces. Its secretion is influenced by FSH, prolactin and LH. The regularity of the cycle and the normal timely development of the egg is possible thanks to this hormone.

During the MC, the body experiences 2 peaks of its concentration. The first occurs a day and a half before ovulation, when there is a significant release of this substance into the blood. At the end of ovulation, the level drops, and then estradiol enters the blood again. A new smaller peak is observed, then the concentration of the hormone decreases until the end of the luteal phase.

Important is not only the quantitative indicator of the content of this substance in the blood plasma, but also the ratio of estradiol-testosterone.

Main gestational estrogen

It is this name among experts that estriol was awarded. Due to the presence of this active substance in the blood, milk ducts develop and blood circulation in the uterus is harmonized.

An analysis for estrogen, more precisely, for this estrogen, is of great importance for prenatal diagnosis. Estriol is produced by the placenta and partly even by the fetus. Therefore, changes in its concentration are direct evidence of violations of the fetoplacental system or fetal development.

main hormone of pregnancy

In a certain amount, it is produced by the adrenal cortex, mainly synthesized by the ovaries (namely the corpus luteum), and in the gestational period - by the placenta. And this steroid is called progesterone.

Progesterone prepares a woman's body for pregnancy - it prepares the mucous layer of the uterus for the implantation of the embryo. After conception, it provides the possibility of maintaining the pregnancy. It also takes part in many complex processes in a woman's body (the most frequently mentioned is its effect on myometrial tone). Without progesterone, the uterus will contract intensively, which will lead to the expulsion of the fetus and the cessation of gestation.

A change in the concentration of this biologically active compound in the blood plasma can be caused by certain medications and pathological conditions:

1. The increase makes one suspect: a corpus luteum cyst, the onset of gestation, disruption of the adrenal glands, placental insufficiency, menstrual disorders, uterine dysfunction with bleeding.
2. A decrease in the concentration of progesterone indicates amenorrhea or functional insufficiency of the corpus luteum or placenta, chronic inflammation of the reproductive organs and uterine bleeding.

Norms for women of reproductive age FF 0.3–2.2 nmol / l; OF - 0.5–9.4 nmol/l; LF - 7.0–56.6 nmol / l.

luteinizing hormone

LH is a pituitary gonadotropic glycoprotein. It is produced by the pituitary gland cyclically, the peak of its concentration falls on the ovulatory period, then its content decreases sharply.

The entire luteal phase passes under the auspices of a low concentration of this hormone. In the follicular phase, the LH level is slightly higher. Normally, in the gestational period, the content of this active substance decreases.

Level changes can indicate both serious pathologies and stress:

• The content of LH increases with functional insufficiency of the gonads, SIA (ovarian exhaustion), PCOS (polycystic ovaries), pituitary neoplasm, endometriosis, renal failure.
• The concentration of the hormone decreases with pituitary-hypothalamar hypofunction, some genetically determined diseases, obesity, anorexia nervosa.

The normative data for this active substance are FF 1.68–15.00 mU/ml, OP 21.90–56.60 mU/ml, and LF 0.61–16.30 mU/ml.

The reason for the decrease in LH concentration, which is not associated with the disease, may be stress and smoking. And growth can be due to a strict diet (starvation) and serious sports training.

Prolactin

Another pituitary hormone, the anterior lobe of the pituitary gland is responsible for its synthesis. Its concentration fluctuates over 24 hours (with an increase during sleep).

From the end of the 2nd month of pregnancy, prolactin rises, and this is normal. Its constant elevated content outside of pregnancy is called hyperprolactemia, and it indicates an abnormal functioning of the gonads. When the concentration of this biologically active compound in the blood plasma changes, the development of the follicle is disrupted, and ovulation does not occur.

In the gestational period, the concentration of prolactin reaches its maximum in the period from 20 to 25 weeks, its level decreases by childbirth. During this period of a woman's life, prolactin suppresses the production of FSH. Prolactin is essential for the normal formation of lung tissue in the fetus.

Out of gestation, in the follicular phase, the concentration of the hormone is lower than in the luteal phase. The norm is its content in the blood in the range of 109-557 mU / l.

Follicle stimulating hormone

The active substance that stimulates the growth of follicles enhances estrogen genesis - all this is FSH. Its standards: FF 1.37–9.9 mU/ml; OF: 6.17–17.2 mU/ml; LF: 1.09–9.2 mU/ml. At the same time, a layer of endometrium grows in the uterus.

An increase in its level is possible with:

• Hypogonadism.
• Polycystic or ovarian failure.
• With cirrhosis and other severe liver diseases.

The critical level of FSH, which reaches the concentration of this active substance by the middle of the MC, promotes ovulation.

Inhibin B

Selectively inhibits the synthesis of follicle-stimulating hormone, produced by the ovaries. With age, the plasma concentration of this active substance falls (when the number of follicles maturing in the ovaries falls to a certain limit). This causes an increase in the concentration of follicle-stimulating hormone.

17-hydroprogesterone

Otherwise, this hormone is called 17-OH-progesterone, is produced by the ovaries and is subject to cyclical fluctuations associated with menstruation. The given analysis is considered normal at: FF 1.24–8.24 nmol / l .; LF 0.99–11.51 nmol/l.

Its peak values ​​are observed in the same period as the peak for LH, that is, in the middle of the cycle. Then there is a drop in the concentration of this active substance and a peak of smaller amplitude, coinciding with an increase in the concentration of progesterone and estradiol.

Plasma levels of this hormone are higher during gestation.

Anti-Müllerian hormone

Produced by cells of the stratified epithelium of the follicle (granulosa). The norm is 2.1-7.3 ng / ml.

This indicator is used in the diagnosis of endometriosis, polycystic ovaries. A significant decrease in it indicates a low probability of pregnancy (if IVF was used).

Androgen hormones

Sex hormones (female and male) are produced in the organisms of both sexes, but in different concentrations. Androgens, like female sexual biologically active compounds, are involved in the process of ovulation, maintaining pregnancy and a number of metabolic processes.

1. Testosterone (total 0.38–1.97 nmol/l and free less than 4.1 pmol/l) has a quantitative peak in the luteal phase. It is a steroid hormone responsible for the development of secondary sex characteristics. Produced by the adrenal glands (bark) and ovaries. Testosterone regulates the amount of gonadotropic pituitary hormones and is involved in the process of follicle regression. If testosterone is high, this leads to impaired ovulatory function and early self-abortion.
2. Cortisol is considered to be the main catabolic: a protein degrader and a factor contributing to the accumulation of fats. It raises blood sugar levels. Cortisol is a stress hormone, it is designed to mobilize the body's energy resources (break down proteins into amino acids, turn glycogen into glucose). It is produced by the adrenal cortex and is normally contained in an amount of 138-635 nmol / l.

DEHA-sulfate (DEA-SO4) - is produced by the adrenal cortex and is a precursor of placental estrogens. A change in the content of this active substance in the blood plasma serves as a diagnostic sign of various diseases:

1. An increase signals an oncoprocess in the adrenal cortex, hypothalamic-pituitary syndrome, ectopic tumors that produce ACTH, placental insufficiency and the threat of fetal loss. In a woman, an increase in the indicator of this substance is possible with hirsutism.
2. A decrease in indicators may indicate intrauterine infection, hypoplasia of the adrenal glands (their cortex) in the fetus, and treatment with gestagens.

During pregnancy and after a woman leaves childbearing age, its concentration decreases.

Hormone tests are considered normal at 0.9–11.7 µmol/L.

Thyroid hormones

In some cases, the obstetric and gynecological history requires the intervention of an endocrinologist who deals with thyroid problems. Because a deviation from the norm of the concentration of hormones produced by this gland can significantly impair the health of the mother and child. This can even lead to infertility, developmental anomalies and severe pathologies of the fetal central nervous system, its intrauterine death.

Hormones studied include:

• T4 (general) - a stimulator of protein synthesis (the norm of T4 is total 55–137 nmol / l).
• T3 (total) - its predecessor (the norm of T3 is total 1.08–3.14 nmol / l).
• TSH (glycoprotein that stimulates the production of T3). High levels of TSH during pregnancy are normal. Low TSH can signal hypothyroidism, injury, or hypofunction of the pituitary gland. But there may be an increase in TSH due to stress, excessive exercise, thyroid hormone therapy, and for a number of other reasons. Normally, plasma contains 0.4-4.0 mU / l.

If necessary, the doctor may prescribe tests to determine the concentration of other hormones of cortecotropin (ACTH), a globulin that binds sex hormones. Or insulin, ATTH (normal 0–18 U / ml) or ATPO in the norm they should be<5,6 Ед/мл.

The norms indicated for all hormones are given for women of reproductive age over 18 years of age.

Analyzes in gynecology

You begin to be tormented by vague doubts that your hormonal background is not in order: hair in the wrong places, an enlarged thyroid gland, weight changes, oily skin, etc. malnutrition and lifestyle, a hereditary trait. I want to find the culprit - the wrong hormone - and fight it with a pill. Take a pill and forget the problems. Of course, this is much easier than dieting or exercising or regularly visiting a beautician, etc. Those hormones that are made in the nearest available laboratory are surrendered - a certain random set of indicators without taking into account the day of the cycle and daily biorhythms. If it turns out to be normal, bewilderment arises - what is the matter then? Questions begin from the series “I checked everything - everything is fine, what should I do?”

In fact, all tests require clear indications. For each clinical situation, there is a specific examination plan, which includes a set of tests - in a certain order, subject to certain conditions. Only then the results of these tests will really help your doctor, otherwise he will put aside all the papers you brought and write a new list, and you will worry about the lost time, money and blood (in the literal sense of the word).

In addition, each doctor during his work, receiving made in different laboratories, and comparing them with what he sees - with complaints, with the results of treatment - draws a conclusion about the reliability of some laboratories. And about the unreliability of most others. Naturally, a real doctor cannot prescribe treatment based on unreliable analyzes and treat who knows what. And precisely because the attending physician, and not the laboratory, is responsible for the health of the patient, a decent attending physician sends to those laboratories whose results he trusts. Of course, it is difficult to distinguish this motive from a simple desire to make money on tests, and here the question is about personal trust in the attending physician. And if you trust him, know that such behavior is more often in your interests. Therefore, it is always better not to wander around the laboratories and take tests yourself, and then come to the doctor with a bunch of papers; but first to find His Attending Doctor, who will already write a list of tests that he considers necessary, and a list of laboratories where he advises to take these tests. The examination algorithms given below are given as a guide, for an idea of ​​what needs to be done in a given situation, so that you know where to run if you don’t have a doctor yet and no one really tells you anything. But no algorithm is a dogma and cannot take precedence over the individual prescriptions of a personal attending physician.

And of course, this is just an examination algorithm, and not a guide to self-diagnosis and self-treatment. Only a doctor can interpret all the received tests.

So, the survey algorithms required in the following situations:

I just want to pass "on hormones"

(determination of hormonal status)

1.On day 5-7 of the cycle(menstrual day 1 - cycle day 1) the following hormones: LH, FSH, DHEA-S, DHEA, 17-hydroxyprogesterone, and free T4.

Stress hormones: prolactin, LH - can be elevated not due to hormonal diseases, but due to chronic or acute (going to the hospital and donating blood from a vein) stress. They need to be resubmitted. For the diagnosis of "hyperprolactinemia", for example, it is necessary to measure elevated prolactin levels three times.

2. it makes sense to take only in the middle of the second phase of the menstrual cycle. After 3-5 days of a stable rise in basal temperature, with an ultrasound picture of the second phase (corpus luteum in the ovary and mature endometrium), progesterone can be taken (with a regular 28-30 day cycle - on day 20-23).

All hormones are taken strictly on an empty stomach, like any blood tests.

If it is not possible to donate the right hormones on the right days of the cycle, it is better not to donate at all than to donate on other days of the cycle. The analysis will be completely uninformative.

Delayed menstruation

1. Home pregnancy test

In the morning portion of urine, it is indicative only from the first day of delay. False negatives are more common than false positives.

If negative:

2. Ultrasound with a vaginal probe

If the ultrasound picture is mature second phase of the cycle(thick mature endometrium, corpus luteum in ovary):

3. Blood on

If negative- wait for menstruation, it will be soon.

If doubtful- retake after 48 hours. With a developing uterine pregnancy, the indicator will increase by 2 times.

If the ultrasound no picture of the second phase, then this is not pregnancy, and it is far from menstruation. This is ovarian dysfunction, you need to go to the gynecologist with it and figure it out - whether to wait or help with vitamins, herbs, hormones, etc.

If positive home pregnancy test, Ultrasound with a vaginal probe still needs to be done to understand the localization of pregnancy (uterine or extra-) and its viability (heartbeat is / is not). When the test is positive, pregnancy is already always visible on ultrasound with a vaginal probe. The heartbeat is visible from 5 weeks (from 1 day of the last menstruation with a regular cycle). Frequent ultrasounds at any stage of pregnancy, including early ones, are absolutely harmless. Much more dangerous are the extra days lived with an undiagnosed ectopic or missed pregnancy.

Absence of menstruation for several months, irregular cycle

1. Exclusion of pregnancy (see the algorithm for delayed menstruation)

2. After the exclusion of pregnancy - (cm)

3.Computer or magnetic resonance tomography of the Turkish saddle(excluding pituitary tumor)

Choice of hormonal contraception

2. Hemostasiogram and (blood coagulation parameters: fibrinogen, prothrombin index, APTT, AVR, thrombotic potential index, platelet aggregation level, fibrin degradation products..)

3.Ultrasound of the pelvic organs 2 times per cycle - after menstruation and before the next menstruation. Evaluation of the growth of the follicle, the endometrium, the presence of ovulation, the formation of the corpus luteum and the maturation of the endometrium. Exclusions of possible diseases of the small pelvis, diagnosed by ultrasound. Vaginal probe only.

4.Definition hormonal status

5. Examination at therapist, control of arterial pressure and a condition of veins.

Preparing for a planned pregnancy (first or subsequent)

1. Hike to dentist, therapist

2. ,

3. , both spouses

If a woman has a positive Rh factor, there is no problem.

If a woman has a negative Rh factor - antibodies to the Rh factor(even if the man is also negative).

If they are positive, it is currently impossible and needs to be corrected. If negative - repeat this analysis once a month, starting from 8 weeks of pregnancy.

If a woman has 1 group, and a man has any other; a woman has 2, and a man has 3 or 4; in a woman 3, and in a man 2 or 4 - incompatibility by blood types is possible. Analysis for group antibodies, as well as an analysis for antibodies to the Rh factor, is carried out once a month, starting from 8 weeks of pregnancy.

4. - quantitative analysis (with titer). Presence of antibodies IgG means immunity to these infections, and is not an obstacle to pregnancy. Availability IgM means an acute stage, planning in this case must be postponed until recovery. If there are no antibodies to rubella IgG , it is necessary to be vaccinated and after it to be protected for another 3 months. Do not ask your parents if you had rubella, it is impossible to know for sure - it can occur under the mask of acute respiratory infections and vice versa. Only a blood test for antibodies can give accurate information.

5. Tests for infections : regular smear, PCR for latent infections - both. See article ""

6. Ultrasound of the pelvic organs (cm)

7. Basal body temperature chart. From 6 to 8 in the morning, at the same time, without getting out of bed, with a mercury thermometer for 5 minutes in the rectum. All deviations from this regimen and special circumstances (drugs, ailments, sleep disorders, menstruation, sexual activity, stool disorders, etc.) should be noted in a special column.

8. With irregular menstruation, deviations on the chart or ultrasound, complaints of oily skin, excessive hair growth, overweight or underweight, menstrual disorders (soreness, profusion, scarcity ..), by doctor's prescription- a blood test for hormones (see. determination of hormonal status).

9. (cm)

10. Definition , antibodies to chorionic gonadotropin, antibodies to phospholipids- factors of early miscarriage.

11. (hemoglobin, erythrocytes, leukocytes, platelets, ESR, color index, leukocyte formula). Finger blood.

12. (the morning portion of urine is completely collected, while it is important that the analysis does not include discharge from neighboring organs).

Pregnancy

Since the establishment(test, blood test), then once a trimester is mandatory, once every 4-6 weeks is desirable, in case of violations - 2 weeks after the correction.

1. ultrasound. Establishment of uterine developing (palpitations +) pregnancy. Control of development, compliance with the terms, exclusion of malformations, placental insufficiency, threats of miscarriage. After 8 weeks - a conventional sensor. Not harmful.

2. General clinical blood test (cm)

3. General urine analysis (cm)

4. Urinalysis according to Nechiporenko if there is any doubt in the overall analysis.

At the same time, the average portion of morning urine is collected in a jar.

5. Hemostasiogram, coagulogram (cm)

6. Lupus anticoagulant, antibodies to phospholipids, to hCG .

7. Antibodies to, (if you haven't submitted yet) , (Anyway)

8. Rh antibodies and group antibodies in case of incompatibility, starting from 8 weeks.

9. Daily urine for 17-KS .

17-ketosteroids are metabolic products of male sex hormones. This analysis allows you to evaluate the total level of all male hormones per day. This is its advantage over a blood test for individual hormones, which determines the level of individual hormones for a certain time and is thus less sensitive. Daily urine for 17-KS allows you to catch any fluctuations per day of any male hormones. Although this analysis is older and less user-friendly, it is much more informative.

3 days before collection and on the day of collection, coloring foods (yellow, orange, red) are excluded from food: carrots, beets, red apples, citrus fruits (all including juices, salads, sauces, soups, etc.), vitamins. Otherwise, the indicator will be overestimated.

On the day of collection, the first morning portion of urine is not collected. Further, all day, all night and the first morning portion of the next day (at the same time as the day before, i.e. so that exactly 24 hours pass between two morning portions) are collected in one large container. Further, the volume of daily urine is carefully measured with a measuring cup (the accuracy of the analysis depends on the accuracy of the volume) and is recorded on a piece of paper along with the full name. The contents of the container are mixed and poured into a small jar, like a regular urine test. The level of 17-COP will be converted to the total daily volume indicated on the piece of paper.

10. - smear and PCR (cm)

11. TTG, St. T4.

At 15-16 weeks additionally:

1. Markers of some defects and placental insufficiency: free estriol, and 17-hydroxyprogesterone.

Analyzes are interpreted together with each other and with ultrasound data, real deviations are changes several times compared to the norm. The significance of these parameters is indirect. With unfavorable and questionable indicators + the presence of risk factors (age, genetics, history, etc.), according to indications - amniocentesis or cordocentesis- sampling of fetal cells for chromosomal analysis. This is the same study for the exact determination of gender.

2. Ultrasound with a vaginal probe to determine the length of the closed part of the cervix - diagnosis of isthmic-cervical insufficiency.

In the second and third trimester

If there are signs of possible placental insufficiency, intrauterine growth retardation, according to indications - dopplerometry(a type of ultrasound with the determination of the degree of blood flow).

From 33 weeks

CTG (cardiotocography) - determination of the state of the fetus by analyzing its cardiac activity and motor activity. The only study that allows you to determine the condition of the fetus, and not the mother's body. It is necessary to come to CTG not on an empty stomach, in a normal, well-fed and alert state, because during the child’s sleep, the indicators will be underestimated, and the examination time will have to be extended (normally 40-60 minutes).

Examination after a frozen, interrupted pregnancy

1. see preparation for a planned pregnancy. The search for causes is limited to histological and chromosomal analysis of the removed material. When interrupted in the early stages, there is a high probability of manifestation of simple natural selection, and one should not look for reasons that might not have been, but simply prepare for the next pregnancy - this will be the prevention of recurrence.

2. Examination of spouses compatibility by HLA system.

3. Spermogram

It is given after 3-5 days of abstinence from sexual activity, alcohol and overheating (sauna, bath, hot bath), against the background of relative well-being (out of illness, lack of sleep, stress, etc.), only with the help of manual masturbation in clean dishes without traces of protein ( not necessarily sterile). Can be collected at home and brought to the laboratory at body temperature (armpit, etc.) within 1 hour.

4. Analysis of the immune and

5. Genetic examination - karyotype, carriage of pathological genes, medical genetics consultation

Infertility (non-pregnancy within a year of regular unprotected intercourse)

1. Spermogram(cm)

2. Ultrasound of the pelvic organs vaginal probe (cm)

3.Measurement basal body temperature (cm )

4. Definition hormonal status(cm)

5. Hemostasiogram, coagulogram(cm)

6. Definition lupus anticoagulant, antibodies to human chorionic gonadotropin, antibodies to phospholipids.

7. TORCH

8. : regular smear, PCR for latent infections. (cm)

9. Hysterosalpingography - Checking the patency of the fallopian tubes.

It is done on the 18-21st day of the regular menstrual cycle (in the middle of the second phase). The whole cycle in which the HSG is done, from the very beginning, must be strictly protected and not hope that since nothing has worked so far, it will not work any further. An x-ray of the uterus in early pregnancy is an absolute indication for its termination. Three days before the GHA, you need to prepare for it - no-shpa, valerian; the day before to make an enema, in the morning - a light breakfast. Get ready for the sensations, as during menstruation.

10. Determination of antisperm antibodies in semen (MAR -test), cervical fluid (during ovulation), if necessary - in the blood, postcoital test.

11. Laparoscopy. To exclude endometriosis, accurately check the patency of the tubes, diagnose unexplained infertility - a combination of diagnosis and treatment. It is better to carry out in the first phase of the cycle. General anesthesia.

Hair growth on the face and body in the wrong places.

(Misplaced places in a woman are hips, shoulders, abdomen, chest, cheeks. Excessive hair growth on the lower leg, forearm, pubis and upper lip is not associated with male hormones, this is a constitutional and genetic sign).

1. On the 5th-7th day of the cycle, the following hormones: testosterone, DHEA-S, 17-hydroxyprogesterone, cortisol. Ideally, free testosterone and teroid-binding globulin.

2.Ultrasound with a vaginal probe. Rule out polycystic ovary syndrome.

Hair loss

1. Determination of hormonal status (cm).

2. Detailed biochemical blood test

3. General clinical blood test

4. Analysis of hair for mineral composition

Overweight or underweight

1. (cm)

2. Biochemical analysis of blood with an emphasis on lipid spectrum glucose on an empty stomach, liver parameters(bilirubin total, direct, total protein, albumin, AlAT, AsAT, gamma GT), as well as test for glucose tolerance.

Checking the condition of the thyroid gland

(unfavorable heredity, suspicions of thyroid pathology, deviations in the analysis of TSH and St. T4)

1. Retest hormones TSH, and

2. Antibodies to thyroid peroxidase and thyroglobulin

3. Ultrasound of the thyroid gland .

(The main of these analyzes is the first one. With an unimpaired hormonal function of the thyroid gland, the presence of antibodies or ultrasound signs of thyroiditis are not indications for treatment).

Pain, engorgement, induration in the mammary glands, discharge from the nipples

1. Ultrasound of the mammary glands (if you are under 35) or mammography if more.

2. Definition hormonal status(cm)

3. Re-elevated prolactin levels CT scan(and better Magnetic resonance imaging) of the skull (the area of ​​the Turkish saddle) to exclude the pathology of the pituitary gland. X-ray of the Turkish saddle is uninformative and cannot replace MRI.

4. Mammologist's consultation

Menopause - soon or already, selection of menopause replacement therapy, monitoring its effectiveness

1.Definition hormonal status(cm). The test for is to level up

2.Blood chemistry with a focus on lipid spectrum(total cholesterol, HDL, LDL, VLDL, triglycerides), fasting glucose, liver parameters(bilirubin total, direct, total protein, albumin, AlAT, AsAT, gammaGT) and kidney(urea, residual nitrogen, ).

3.Sample on glucose tolerance.

4.Ultrasound of the pelvic organs vaginal probe (cm).

5. Examination by a therapist, control blood pressure.

6. General clinical analysis of blood (cm)

7. Hemostasiogram and coagulogram (cm)

8. Mammography

9. Examination for :

- two-photon densitometry or dual-energy x-ray absortometry.

- Definition in the blood bone remodeling markers: hydroxyproline, pyridinoline, deoxypyridinoline, N-body-peptide-NTX , bone isoenzyme of alkaline phosphatase, osteocalcin.

Determination of the content of calcium and phosphorus in the blood is uninformative, as well as radiography of bones.

endometriosis

1. Ultrasound with a vaginal probe on the eve of menstruation. This is how endometrioid cysts of the ovaries and the internal uterus (adenomyosis) are diagnosed. For differential diagnosis with other ovarian cysts, repeated ultrasound is necessary.

2. Hysteroscopy- to confirm adenomyosis.

3. Laparoscopy- for the diagnosis (and immediately treatment) of external genital endometriosis of the peritoneum.

Ovarian cysts, tumors, formations

1. Repeated ultrasound. Functional cysts disappear on their own within 3-4 months.

2. Tumor markers ( , and etc). The analysis is non-specific, only a sharp excess of the indicators by several times matters. They will also be elevated with functional ovarian cysts.

3. Determination of hormonal status (cm).

The last point in all algorithms is the consultation of the attending physician and his interpretation of the results. Further examination and treatment tactics depend on the results of the basic algorithm.

Malyarskaya MM, obstetrician-gynecologist