Hormonal imbalance can be a symptom of many complex gynecological diseases. What hormone tests need to be taken and what do the results say?

As you know, the cause of many abnormalities in the functioning of the female body is a disruption in the production of hormones. Hormonal imbalance can lead to consequences such as miscarriage or infertility. Therefore, when the first symptoms appear, you need to go to the clinic and get tested for hormones in gynecology.

Causes and symptoms of hormonal imbalance in women

There are many reasons for hormonal imbalance. These include:

• heredity;
• stress;
• puberty;
• kidney and/or liver diseases;
• disruption of the endocrine gland;
• postpartum period;
• abortions.

Symptoms of hormonal imbalance in women are quite varied. They manifest themselves depending on age, the cause of the disorder and many other factors. In general, hormonal imbalance is accompanied by:

• rapid fatigue;
• irritability;
• apathy, depression;
• menstrual irregularities;
• the appearance of acne;
• deterioration of intelligence;
• weight change;
• decreased libido.

Disruption of hormone production can lead to:

• infertility;
• miscarriages;
• obesity;
• development of cancer;
• development of diabetes mellitus.

As you can see, failure of the endocrine glands leads to the development of dangerous diseases. To avoid them, when the first signs appear, you need to contact a gynecologist and get tested for hormones.

What hormones are being studied?

There are a number of hormones that are examined first during the analysis. Here is a list of these hormones:

• Follicle-stimulating hormone (FSH) - this hormone is responsible for follicle growth, progesterone production and the conversion of testosterone into estradinol.
• Luteinizing substances - their function is to mature the egg and fertilize it;
• Estradiol, also known as estrogen - this hormone is involved in most processes and affects the reproductive function;
• Prolactin - the scope of this hormone is conception and lactation;
• Progesterone is a pregnancy hormone. Thanks to it, the egg is attached to the uterus and is retained in it. A deficiency can lead to miscarriage;
• Thyroid-stimulating hormone (TSH) is one of the thyroid hormones that is involved in many processes. Failure in its production leads to infertility.

What does imbalance mean?

Violation of the production of each of the above hormones indicates the development of certain diseases.

• LH - the level of this substance is determined by the phase of menstruation and age. During ovulation, the amount of the hormone reaches its maximum. With the onset of fertilization, its content decreases significantly. Indications for the study of the substance are the absence of ovulation, endometriosis and oligomenorrhea. High levels of the hormone indicate ovarian depletion, pituitary tumor or endometriosis. A reduced amount of the hormone is a symptom of hyperprolactenemia, stress or obesity.
• The blood level of follicle-stimulating hormone should be studied if the patient experiences infertility, miscarriages, or early puberty. High readings indicate dysfunctional uterine bleeding or an ovarian cyst. A low reading may indicate obesity, polycystic ovary syndrome, or lead poisoning.
• A study of the amount of estradiol is prescribed for suspected disorders of puberty, infertility, osteoporosis or hirsutism. An increase in the hormone may be a symptom of an ovarian tumor or hyperestrogenism. A decrease in the hormone is accompanied by the risk of miscarriage.
• The amount of progesterone is studied in case of suspected dysfunctional uterine bleeding, infertility, and also in case of a disrupted cycle. High levels are observed in cases of impaired maturation of the placenta and the development of renal failure. A small number indicates a threat of miscarriage or intrauterine growth retardation.
• The reason for prescribing an analysis for prolactin concentration is mastopathy, anoavulation, oligomenorrhea, hirsutism or obesity. An increased value may be a sign of infertility or a malfunction of the pituitary gland. Sometimes the cause of imbalance is surgery.

FEMALE SEX HORMONES

These biological substances (steroids) are produced by the female sex glands - the ovaries, as well as the adrenal cortex. Hormones influence the following aspects of life:

• fertility;
• formation of primary and secondary sexual characteristics;
• normal functioning of the reproductive system;
• metabolic processes;
• mental and emotional state;
• state of the immune system and others.

Tests for hormones in gynecology are divided into estrogens, gestagens, androgens, their concentration is different in different phases of the menstrual cycle. For one reason or another, disruptions in the functioning of the endocrine system may occur in the female body. One of the main ways to diagnose such disorders is to take a blood test to determine the level of female hormones, which evaluates the functioning of the ovaries and other endocrine glands.

A woman’s appearance, well-being, mood and libido, the condition of her skin, nails and hair depend on her hormonal status. These biologically active substances protect against stress, depression, slow down the aging process, and regulate the processes of reproduction of offspring. Any deviations from the maximum permissible values ​​of hormones in the blood in one direction or another lead to various painful conditions, i.e. hormonal imbalance, which, of course, affects the appearance of the fair sex, regardless of age. A gynecologist-endocrinologist will tell you which test to take for female hormones.

What are the prices for female hormone tests?
Gynecology considers the following to be the main indicators of a woman’s endocrine background: estrogens, progesterone, luteonizing hormone (LH), prolactin, follicle-stimulating hormone (FSH), as well as testosterone and dehydroepiandrosterone sulfate (DHEA-S). The cost of researching certain indicators varies depending on their type. The average price of a blood test for hormones is about 500 rubles. Here is a brief description of each group.

1. Estrogens produced by the ovaries and adrenal glands. They are responsible for the development of secondary sexual characteristics and control the processes of childbirth. Of the estrogens, estradiol is the most important for women. This hormone is responsible for cyclical changes in the vagina and mammary gland. The risk of cardiovascular diseases and osteoporosis depends on its level.
2. Progesterone called the “pregnancy hormone”, produced by the ovaries. It is responsible for preparing the endometrium for embryo implantation, preventing the rejection of the fertilized egg, reducing the contractile activity of the uterus.
3. LH and FSH are gonadotropic hormones secreted by the pituitary gland. They stimulate the growth and maturation of follicles in the ovaries, the formation of the corpus luteum, and, accordingly, the production and maintenance of the concentration of estrogen and progesterone in the blood.
4. Main function prolactin- stimulation of growth, development of the mammary glands, establishment and maintenance of lactation in a nursing mother. It suppresses the production of FSH, thereby delaying ovulation.
5. Hormones DHEA-S and testosterone are androgens. In women, they are synthesized in small quantities by the ovaries and adrenal glands and are responsible for sexual desire and affect the functioning of many systems (musculoskeletal, brain, sebaceous glands). In addition, estradiol is formed from testosterone during metabolism.

When to get tested for female hormones?
In gynecology, indications for diagnosing certain indicators in the blood are determined by the attending physician; most often these are:

• menstrual irregularities;
• painful periods;
• infertility (primary and secondary);
• excess body hair growth;
• acne on the face, acne on the chest, shoulders, genitals;
• excess body weight; deficiency of adipose tissue;
• diseases of the mammary glands;
• miscarriage and recurrent miscarriage;
• some conditions during pregnancy.

Analysis for female hormones

Analysis for male hormones

Thyroid hormone test

Hormone analysis during pregnancy

Red color - it is possible to perform a blood test for hormones in the mode CITO!
The cost of taking blood from a vein is 350 rubles.

HOW TO PREPARE FOR DONATING BLOOD FOR HORMONES

To obtain the most accurate results, there are some general requirements that are quite easy to meet. Stop taking medications for a few days in consultation with your doctor. For three days, eliminate excessive physical and psychological stress. During the day, do not drink alcohol-containing drinks and avoid sexual intercourse. The day before taking samples, limit night and then morning food intake, and you should also not smoke.

Women should take hormone tests on certain days of the menstrual cycle, according to the recommendations of the attending gynecologist. In addition, it is important to remember that blood can be donated for hormonal profiles in the absence of a general infection, for example, ARVI and elevated body temperature.

You cannot ignore any symptoms of ill health or self-medicate. To maintain women's intimate and reproductive health, it is recommended to regularly visit a gynecologist and take hormones for medical reasons.

DONATE BLOOD FOR HORMONES

We are on the map, directions

Often changes in a woman’s well-being, mood and even character are associated with hormonal disorders. And the words “menopause” and “PMS”, alas, often become not only sarcastic explanations of certain unusual reactions and sensations, but their very real causes. Only a qualified, experienced doctor can explain them to you by prescribing hormone tests in gynecology. We will discuss later in our article what hormones gynecologists are interested in and what their deviations from the norm are.

What hormones are tested for in gynecology?

Estrogen is a female sex hormone produced in the ovaries. The main task of this hormone is to ensure the formation of the reproductive system, an uninterrupted menstrual cycle, the proper functioning of the uterus and the ability to bear a child. However, among other things, it is estrogen that makes a woman a woman in appearance, because thanks to it, a female figure is formed with all its roundness, and the skin has a sufficient level of moisture and elasticity. Another function of estrogen is to protect against the formation of cholesterol plaques. Estrogens are divided into 3 groups: estrons, estrodiols and estriols.

Progesterone, also called the “pregnancy hormone”. Hence its main tasks. Without progesterone, the formation of the corpus luteum of the ovaries and placenta is impossible. At the same time, it is thanks to progesterone that women’s metabolism slows down and excess weight begins to appear. Therefore, the indicators of this particular blood test are very often of interest to representatives of the fair sex.

Follicle-stimulating hormone is produced in the pituitary gland and in women is responsible for the maturation and growth of follicles, the conversion of testosterone into estrogens and the production of estrogens.

Luteinizing hormone is produced not only in women, but also in men. However, a gynecologist-endocrinologist may prescribe such a test for a woman, since it is responsible for the production of progesterone. Luteinizing hormone is produced in the pituitary gland.

Prolactin is also a hormone produced by the pituitary gland. It is necessary for a woman to realize the possibility of lactation, and also promotes the formation and growth of the mammary glands.

Being produced throughout a woman’s life and going beyond the normative values, prolactin can negatively affect women’s health, which we will discuss below.

Free testosterone in women is produced in the ovaries and adrenal cortex. One of the most important functions of the hormone is to ensure the normal course of puberty in adolescents: the development of genital organs (both external and internal), the development of skeletal bones, the muscular system and hair. Despite the popular belief that testosterone is a male hormone, it is also necessarily present in women, albeit not in the same concentration as in men. However, even a slight deviation of female testosterone from the norm causes serious disorders in the body.

Hormone levels in women

Luteinizing hormone has different normative values ​​depending on the age of the patient. So, from the moment of birth until 2 weeks, the level of this hormone in a girl’s blood should not exceed 0.7 mU/l. From one to 3 years, values ​​of 0.9–1.9 mU/l are considered normal, at 4–5 years old - from 0.7 to 0.9 mU/l, 7–8 years old - 0.7–2.0 mU /l, 9–10 years - 0.7–2.3 mU/l. Further, up to 19 years, each year of life corresponds to its own reference value: 11 - 0.3–6.2 mU/l, 12 - 0.5–9.8 mU/l, 13 - 0.4–4.6 mU/l l, 14 - 0.5–25 mU/l, 15 - 0.5–16 mU/l, 16 - 0.6–21 mU/l, 17 - 1.7–11 mU/l, from 18 to 19 years - 2.3–11 honey/l.

In the postmenopausal period, values ​​ranging from 14.2–52.3 mU/l are considered normal.

For estrogen, the norms also differ depending on the age and condition of the woman. So, in girls under 18 years of age, estrogens should not exceed 22 pg/ml (picograms per milliliter). Upon entering childbearing age, normal values ​​can reach 50 pg/ml. This indicator reaches its maximum value during ovulation and reaches 90–300 pg/ml. Subsequently, under the influence of luteinizing hormone, the estrogen level decreases to 11–116 pg/ml. Then the cycle repeats again. And so on until menopause, after which the hormone level normally fluctuates between 5–46 pg/ml.

The levels of progesterone, like the two hormones discussed, are constantly changing in women. In this case, the changes are influenced by the days of ovulation, the menstrual cycle, the timing of pregnancy, and the onset of menopause. Thus, in the first half of the cycle, the reference values ​​of progesterone are within the range of 0.31–2.23 nmol/l. On the day of ovulation, the rate increases to 0.5–9.41 nmol/l. For the second half of the cycle, the normal values ​​​​reduce again to 7.0–56.6 nmol/l. With the onset of menopause, progesterone levels normally do not exceed 0.6 nmol/l.

Pregnant women have different progesterone levels. For the first trimester it is 8.9–468.4 nmol/liter, for the second – 71.5–303.1 nmol/liter and in the third, the reference values ​​of progesterone are within the range of 88.7–771.5 nmol/liter.

The normal prolactin level in non-pregnant women is 4–23 ng/ml. This normal value is typical throughout life until the onset of menopause. Variations in these values ​​are possible only in relation to the days of the menstrual cycle, and this, as a rule, is taken into account by the gynecologist-endocrinologist when considering test results. With the onset of pregnancy, prolactin begins to be produced slightly more and values ​​falling in the range of 34–386 ng/ml are considered normal.

The behavior of testosterone in the female body is interesting because its levels change throughout the day.

In the morning, testosterone values ​​are highest, while in the evening they are significantly lower. During reproductive age, testosterone levels are higher than with the onset of menopause. Testosterone levels are noticeably higher after exercise.

Also, along with these factors, there is a dependence of testosterone levels on the phases of the menstrual cycle. Thus, with the onset of adolescence and beyond, testosterone values ​​from 0.45 to 3.75 nmol/l are considered normal. In the follicular phase, acceptable levels are 0.45–3.17 pg/ml; on the day of ovulation it is 0.46–2.48 pg/ml; at the end of menstruation it is 0.29–1.73 pg/ml.

An increase (and often significant) in testosterone values ​​is observed in women with the onset of pregnancy.

Causes and symptoms of deviations from the norm

The gynecological aspect of the hormonal life of the female body is very important, since quite often it is the basis for explanations of certain changes in the health status and quality of life of patients. Let's look at how exactly hormonal disorders manifest themselves and what their causes are.

Excess estrogen in women is a cause for serious concern. There can be quite a few reasons for this. These include:

• the onset of pregnancy;
• addiction to smoking and alcohol;
• avitaminosis;
• use of oral contraceptives;
• high physical activity.

External manifestations of increased estrogens include instability of mood, pain and profuseness of menstrual bleeding, the appearance of bleeding between menstruation, pain in the lower abdomen and headaches. The broad symptoms of an excess of these hormones also include sleep disturbances, excess weight, hair loss, swelling of the mammary glands, swelling of the arms and legs, and acne.

Separately, we can highlight psychological symptoms, such as: mood swings, melancholicity, short temper, increased anxiety, a feeling of weakness, decreased sexual desire, and sometimes memory impairment.

The well-known menopausal hot flashes, sweating and emotional instability may also be associated with increased estrogen during this period.

The normative values ​​of follicle-stimulating hormone in a woman change over the course of the monthly cycle. Thus, in the first half, the reference indicators belong to the range of 2.8–11.3 mU/l, on the day of ovulation - 5.8–21 mU/l and then drop again to 1.2–9 mU/l.

An increase in progesterone in women indicates the occurrence of a disease or pregnancy. However, an excess of the hormone can also be observed during the period of ovulation, which is considered normal. At the same time, in the absence of natural normal reasons for an increase in progesterone, its excess may indicate trouble. What sensations might lead you to believe that you have more progesterone than you need?

These are, first of all, menstrual irregularities, headaches, mood swings, increased sweating, nagging and cramping pain in the lower abdomen, as well as bleeding, vaginal dryness, sometimes a feeling of bloating and swelling of the mammary glands.

A lack of follicle-stimulating hormone in the female body can manifest itself as scanty discharge during menstruation, and also occur against the background of atrophy of the mammary glands and genital organs, infertility and in the absence of ovulation. Hormone deficiency can be associated with excess weight and polycystic ovary syndrome, with dysfunction of the hypothalamus.

An increase in the level of follicle-stimulating hormone can be caused by dysfunction of the ovaries, a neoplasm in the pituitary gland, alcohol abuse, as well as the consequences of X-ray irradiation and the presence of endometrioid cysts. In this case, women may not have periods and experience uterine bleeding that is not related to menstruation.

If testosterone is elevated, then most likely there are some disruptions in the maturation of the egg. External signs of this disorder are also often noticeable: masculine features, oily skin, acne, baldness of the scalp, along with the appearance/increase in the amount of hair in places not typical for the female body. The manifestation of aggressiveness and nervous excitability, hypersexuality are also typical against the background of increased testosterone in women.

In this case, there is a decline in the functions of the ovaries and, accordingly, the woman’s reproductive ability, up to the development of infertility.

Deviations from the norm of luteinizing hormone in women are grounds for the doctor to assume some kind of pathology. This is often caused by polycystic ovary syndrome, pituitary tumor, ovarian wasting syndrome during early menopause, and even malnutrition. Factors influencing an increase in the level of luteinizing hormone in the blood may also be taking hormonal drugs in high doses.

If we have a deviation of the luteinizing hormone indicator towards underestimation, then the reasons for this may be:

• obesity;
• increased concentration of the hormone prolactin;
• pituitary dwarfism (dwarfism);
• Simmonds disease;
• absence of menstruation during the reproductive period, not associated with pregnancy and lactation (secondary amenorrhea);
• consequences of surgical operations, stress;
• side effect when treated with steroids and anticonvulsants, taking contraceptives.

How to prepare yourself for hormone tests

Analysis of hormones in gynecology is usually called hormones of the reproductive panel. Blood for hormones in gynecology, as a rule, needs to be donated on certain days of the menstrual cycle and on the eve of donation, certain rules must be followed in order for the results to be objective, otherwise the studies have to be repeated. Thus, preparing for hormone tests is very important.

Before taking a blood test for prolactin, physical activity, intimate contacts, and smoking are unacceptable. Blood is also donated on an empty stomach.

Tests for follicle-stimulating and luteinizing hormones, estrodiol and prolactin must be taken in the first half of the monthly cycle.

Days 22–24 of the cycle are considered most suitable for taking a blood test for progesterone.

In addition to the hormones described above, a gynecologist-endocrinologist, in order to assess your hormonal levels, can also prescribe a woman to take tests for thyroid hormones and some others.

In contact with

Tests in gynecology

You begin to be tormented by vague doubts that your hormonal levels are not in order: hair in the wrong places, an enlarged thyroid gland, weight changes, oily skin, etc. I don’t want to think that this could be an age-related variant of the norm, a consequence of stress, a result poor nutrition and lifestyle, a hereditary trait. I would like to find the culprit - the wrong hormone - and fight it with a pill. Take a pill and forget your problems. Of course, this is much easier than sticking to a diet or exercising or regularly visiting a cosmetologist, etc. The hormones tested are those that are made in the nearest accessible laboratory - some 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? The questions begin in 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 will the results of these tests really help your attending physician, otherwise he will put aside all the papers you brought and write a new list, and you will worry about lost time, money and blood (in the literal sense of the word).

In addition, during the course of his work, each doctor, receiving results made in different laboratories, and comparing them with what he sees - with complaints, with treatment results - 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 tests and treat who knows what. And precisely because the attending physician, and not the laboratory, is responsible for the patient’s health, a decent attending physician refers to those laboratories whose results he trusts. Of course, it can be difficult to distinguish this motive from a simple desire to make money from tests, and here the question arises about personal trust in the attending physician. And if you trust him, know that such behavior is often in your interests. Therefore, it is always better not to wander around laboratories and take tests yourself, and then come to the doctor with a stack of papers; and first find your attending physician, who will already write a list of tests that he considers necessary, and a list of laboratories where he advises taking these tests. The examination algorithms given below are given as a guide, for the concept 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 physician.

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

So, the examination algorithms required in the following situations:

I just want to get tested for hormones

(determination of hormonal status)

1.On days 5-7 of the cycle(1 day of menstruation - 1 day of cycle) 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 retaken. The diagnosis of hyperprolactinemia, for example, requires three measurements of elevated prolactin levels.

2. It makes sense to take it 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 days 20-23).

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

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

Delayed menstruation

1. Home pregnancy test

In the morning urine sample, it is indicative only from the first day of delay. False negative results 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 the ovary):

3. Blood on

If negative- wait for your period, it will come soon.

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

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

If home pregnancy test positive, An ultrasound with a vaginal probe still needs to be done to understand the location of the pregnancy (uterine or extra-uterine) and its viability (there is a heartbeat or not). When the test is positive, pregnancy is always visible on an ultrasound with a vaginal probe. 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 spent with an undiagnosed ectopic or frozen pregnancy.

Absence of menstruation for several months, irregular cycle

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

2.After excluding pregnancy - (cm)

3.Computer or magnetic resonance tomography of the sella turcica(exclusion of pituitary tumor)

Selection 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. Assessment of follicle growth, endometrium, presence of ovulation, formation of the corpus luteum and endometrial maturation. Exclusions of possible pelvic diseases diagnosed by ultrasound. Only with a vaginal sensor.

4.Definition hormonal status

5. Examination therapist, control of blood pressure and vein condition.

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 are no problems.

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

If they are positive, it is currently impossible and needs to be adjusted. If negative, repeat this test once a month, starting at 8 weeks of pregnancy.

If a woman has 1 group, and a man has any other; a woman has 2, and a man 3 or 4; for a woman it is 3, and for a man it is 2 or 4 - incompatibility in blood groups is possible. Group antibody analysis, like the test 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 the acute stage, planning in this case must be postponed until recovery. If there are no antibodies to rubella IgG , you need to get vaccinated and after it protect yourself for another 3 months. Do not ask your parents if you have had rubella; it is impossible to know for sure - it can occur under the guise of an acute respiratory infection and vice versa. Only a blood test for antibodies can provide accurate information.

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

6. Ultrasound of the pelvic organs (cm)

7. Basal temperature chart. From 6 to 8 am, at the same time, without getting out of bed, with a mercury thermometer for 5 minutes in the rectum. All deviations from this regime and special circumstances (medicines, ailments, sleep disorders, menstruation, sex life, bowel movements, etc.) should be noted in a special column.

8. In case of irregularity of the menstrual cycle, deviations in the schedule or ultrasound, complaints of oily skin, excess hair, overweight or underweight, menstrual irregularities (pain, profuseness, scarcity..), as prescribed by a doctor- blood test for hormones (see. determination of hormonal status).

9. (cm)

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

11. (hemoglobin, erythrocytes, leukocytes, platelets, ESR, color index, leukocyte formula). Blood from a finger.

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

Pregnancy

Since 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 a uterine developing (heartbeat +) pregnancy. Control of development, compliance with deadlines, exclusion of developmental defects, placental insufficiency, threat of miscarriage. After 8 weeks - with a regular sensor. Not harmful.

2. General clinical blood test (cm)

3. General urine analysis (cm)

4. Urinalysis according to Nechiporenko , if there are doubts about 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 taken it yet), , (Anyway)

8. Antibodies to Rhesus and group antibodies in case of incompatibility, starting from 8 weeks.

9. Daily urine on 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 an advantage over individual hormone blood tests, which measure individual hormone levels over time and are thus less sensitive. Daily urine on 17-KS allows you to catch any fluctuations in any male hormones during the day. 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. Next, the whole 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. Next, 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 written down on a piece of paper along with your full name. The contents of the container are mixed and poured into a small jar, like a regular urine test. The 17-KS level will be recalculated 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.

The 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. In case of unfavorable and questionable indicators + the presence of risk factors (age, genetics, medical history, etc.), according to indications - amniocentesis or cordocentesis- collection of fetal cells for chromosomal analysis. This is the same study to accurately determine gender.

2. Ultrasound with a vaginal sensor 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 fetal development retardation, according to indications - dopplerometry(a type of ultrasound with determination of the degree of blood flow).

From 33 weeks

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

Examination after a frozen or interrupted pregnancy

1. see preparing for a planned pregnancy. The search for causes is limited to histological and chromosomal analysis of the removed material. If interrupted in the early stages, there is a high probability of simple natural selection, and you should not look for reasons that might not exist, but simply prepare for the next pregnancy - this will prevent recurrence.

2. Examination of spouses software compatibility HLA system.

3. Spermogram

Gives up after 3-5 days of abstinence from sexual activity, alcohol and overheating (sauna, steam 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). You can collect it at home and bring it to the laboratory at body temperature (armpit, etc.) within 1 hour.

4. Analysis of immune and

5. Genetic testing - karyotype, carriage of pathological genes, consultation with a medical geneticist

Infertility (failure to become pregnant within a year of regular unprotected sexual activity)

1. Spermogram(cm)

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

3.Measurement basal 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 days 18-21 of the regular menstrual cycle (in the middle of the second phase). The entire cycle in which HSG is performed, from the very beginning, must be strictly protected and not hope that since nothing has worked so far, it will not work in the future. An X-ray of the uterus in the early stages of pregnancy is an absolute indication for its termination. Three days before the HSG, you need to prepare for it - no-shpa, valerian; Do an enema the day before, and have a light breakfast in the morning. Prepare for sensations like during menstruation.

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

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

Hair growth on the face and body in inappropriate places.

(The wrong places for a woman are the hips, shoulders, abdomen, chest, cheeks. Excessive hair growth on the lower leg, forearm, pubis and upper lip is not associated with male hormones, it is a constitutional and genetic trait).

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

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

Hair loss

1. Determination of hormonal status (cm).

2. Detailed biochemical blood test

3. General clinical blood test

4. Hair analysis for mineral composition

Overweight or underweight

1. (cm)

2. Biochemical blood test with emphasis on lipid spectrum glucose on an empty stomach liver parameters(total bilirubin, direct, total protein, albumin, ALT, AST, gammaGT), and also test for glucose tolerance.

Checking your thyroid condition

(unfavorable heredity, suspicion of thyroid pathology, abnormalities in TSH and free T4 tests)

1. Retest TSH hormones, and

2. Antibodies to thyroid peroxidase and thyroglobulin

3. Ultrasound of the thyroid gland .

(The main one of these tests is the first. If the hormonal function of the thyroid gland is not impaired, the presence of antibodies or ultrasound signs of thyroiditis are not indications for treatment).

Pain, engorgement, thickening of the mammary glands, nipple discharge

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

2. Definition hormonal status(cm)

3. With repeated elevated prolactin levels CT scan(and better Magnetic resonance imaging) of the skull (area of ​​the sella turcica) to exclude pathology of the pituitary gland. X-ray of the sella turcica is not very informative and cannot replace MRI.

4. Consultation with a mammologist

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

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

2.Blood chemistry with an emphasis on lipid spectrum(total cholesterol, HDL, LDL, VLDL, triglycerides), fasting glucose, liver parameters(total bilirubin, direct, total protein, albumin, ALT, AST, gammaGT) and kidney(urea, residual nitrogen, ).

3. Test for glucose tolerance.

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

5. Examination by a therapist, control blood pressure.

6. General clinical blood test (cm)

7. Hemostasiogram and coagulogram (cm)

8. Mammography

9. Examination for :

- two-photon densitometry or dual-energy X-ray absortiometry.

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

Determining the content of calcium and phosphorus in the blood is not informative, just like x-rays of bones.

Endometriosis

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

2. Hysteroscopy- to confirm adenomyosis.

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

Ovarian cysts, tumors, formations

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

2. Tumor markers ( , and etc). The analysis is non-specific; only a sharp increase in indicators by several times is significant. They will also be increased with functional ovarian cysts.

3. Determination of hormonal status (cm).

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

Malyarskaya MM, obstetrician-gynecologist

Hormones for gynecology are necessary for every representative of the fair sex. The state of hormonal levels is a fundamental factor in women's health. Deviations lead to poor health, prolonged illness, deterioration in appearance and mood. Having children and maintaining youth also depend on hormones. It will not be possible to track their levels in the blood without special laboratory tests. Based on the results, the gynecologist and endocrinologist may prescribe corrective therapy.

What are the dangers of hormonal imbalance in women?

The list of sad consequences of hormonal imbalances includes:

• infertility;
• miscarriages;
• uterine fibroids;
• polyps and
• disruption of the menstrual cycle;
• obesity;
• lack of sexual desire.

Often, it is the study of hormonal levels that makes it possible to detect an ectopic pregnancy in time and prevent its disastrous consequences.

Causes of hormonal imbalances

Problems with hormones can be congenital or acquired. They can be transmitted to a child from parents genetically or arise as a result of abortions, infections, vitamin deficiencies, respiratory diseases, endocrine pathologies. Lifestyle plays a huge role in maintaining normal indicators. Frequent stress, bad habits (alcoholism, drug addiction, heavy smoking, unhealthy diet), constant lack of sleep, overwork, and long-term use of oral contraceptives negatively affect a woman’s health and reproductive functions.

When is a hormone test prescribed in gynecology?

Hormonal examination of women is prescribed when symptoms appear:

Gynecological examinations and tests can identify many diseases in the early stages. They are also used in preparation for pregnancy, for diagnosing it, monitoring fetal development, before prescribing contraceptives and certain medications.

The basis of the examination is blood. After its laboratory analysis, ultrasound diagnostics is carried out. Laparoscopy or hysteroscopy may be prescribed.

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What does a hormone test in gynecology show?

Gynecology and a woman's general health depend on several hormones. Each of them is responsible for its own functions. Which ones are taken in a particular case depends on the preliminary questionnaire and examination. In doctor's prescriptions you can find a list of the following names.

1. . Produced by the ovaries. Responsible for the formation and functioning of the reproductive system. Allows you to have a menstrual cycle, bear children, creates a feminine body type, and protects against excess cholesterol. Helps the uterus function, maintains the correct level of moisture and elasticity of the skin. It is divided into 3 forms: estrone, estriol, estradiol. Most often, the analysis takes into account estradiol, which is most important for sexual development.
2. . Responsible for the mammary glands, their growth, condition, lactation after the birth of a child. Increases in diseases of the ovaries, kidneys, immunity, thyroid gland, vitamin deficiencies, stress, breast injuries, after abortion. Excess leads to tumors, cysts, frigidity and infertility.
3. . Without it, normal estrogen production is impossible. Forms ovaries. With a lack of FSH, delayed sexual development, infertility, inflammation of the ovaries, and frigidity occur.
4. . Pregnancy hormone. The indicator rises with its onset and falls before childbirth. Responsible for the health of the adrenal glands and ovaries.
5. . Guarantees the correct functioning of the reproductive system and ovulation. Jumps with polycystic diseases, early menopause, hypofunctions. A decrease indicates the presence of injuries, tumors, excessive stress and poor nutrition. Problems with it lead to difficulties with conception.
6. . Thyroid hormone. Its level changes throughout the day. When there is an excess, the thyroid gland enlarges, which leads to many disorders of the body.
7. . The main male hormone. Women have it in low concentrations. When it rises, problems with skin and hair begin.

Each type is corrected with its own therapy.

On what days to donate blood for hormones in gynecology?

When to donate blood depends on the hormone being tested. Each of them has a maximum concentration at a certain time in the menstrual cycle. Only analysis taken according to the schedule can be checked against the norm. Otherwise, the result will be unreliable.

To obtain an accurate result, there is a set of rules that must be followed:

• Time . It is best to donate blood in the morning, since at this time the value is “clean” from external influences and is reflected reliably. The day of the cycle is also important, as shown in the table above;
• Hungry stomach . Foods and drinks (even pure water) can change hormonal levels. It is necessary to go to the laboratory on an empty stomach, without provoking an increase or decrease in indicators;
• Lack of sports . The day before donating blood, you should avoid activities: cycling, rollerblading, gym training, swimming, running. It is especially important when identifying deviations in testosterone, since it jumps first under load;
• Elimination of alcohol and nicotine . You should not even use alcohol-containing drugs;
• Elimination of hormonal medications . Birth control pills and hormone-containing medications should be stopped a week before the expected test. If the course cannot be canceled or suspended, it is necessary to notify the supervising doctor in advance about these circumstances.

Treatment of hormonal abnormalities in gynecology is carried out comprehensively with medications, lifestyle adjustments, and habits. Self-diagnosis and self-medication can lead to disastrous results. During therapy, tests are repeated several times to monitor progress.