Adrenogenital syndrome

Adrenogenital syndrome is characterized by hyperfunction of the adrenal cortex and an increased content of androgens in the body, which causes the phenomenon of virilization. There are congenital and post-pubertal syndromes. Congenital syndrome is a hereditary disease caused by a defect in the enzyme system of 21-hydroxylase or a tumor of the adrenal cortex.

Symptoms, course. With the congenital form of the syndrome, the effect of androgens begins during the period of intrauterine development, at birth it is manifested by the appearance of the urogenital sinus and clitoral hypertrophy. The period of puberty in these children begins early (at 6-7 years) and proceeds through a heterosexual type (male secondary sexual characteristics, absence of mammary glands and menstrual function). Postpubertate form is characterized by hirsutism, oligomenorrhea or amenorrhea, often infertility, atrophy of the mammary glands, a decrease in the size of the uterus and ovaries, mild hypertrophy of the clitoris, i.e., signs of the viral syndrome (see Endocrine and metabolic diseases).

Drugs of glucocorticoid hormones (cortisone, prednisolone, dexamethasone). Dosage depends on the age and severity of the syndrome. The introduction of these drugs normalizes the synthesis of hormones by the adrenal cortex and the function of the hypatalamus-pituitary-ovary system (the appearance of secondary sexual characteristics by the female type, the restoration of the menstrual cycle). With a congenital adrenogenital syndrome, the clitoris is amputated and the artificial entrance to the vagina is formed.

Algodismenorea-painful menstruation. It arises as a result of infantilism, incorrect position of the uterus (hyperanteflexia, retroversion), inflammatory processes in the genitals, endometriosis and other diseases, as well as increased excitability of the central nervous system. It is usually observed in young women (often with infertility). Pain appears several days before menstruation, it is often very strong, which sometimes makes the sick disabled. Pain syndrome is accompanied by a variety of autonomic disorders (headache, nausea, vomiting, dizziness, etc.). The pain stops with the onset of menstruation.

Treatment should be aimed at eliminating the causes that cause pain. With functional algodismorrhea, general restorative treatment with antispasmodics (no-shpa, papaverine, belladonna, atropine) has been shown. As an anesthetic, amidopyrine and analgin are used. Tranquilizers are shown: meprotan (meprobamate), trioxazine, diazepam (seduxen). When inflammatory processes in the small pelvis are carried out physiotherapy treatment; Abdominal-sacral diathermy, mud cure, etc. From hormonal drugs prescribe progesterone, which reduces the excitability of the uterus, 5-10 mg for 8 days before menstruation in / m. Taking into account the increase in the activity of endogenous prostaglandins, prescribe drugs that inhibit their activity (for example, candles with naprosin at 500 mg 1-2 times a day). Endometriosis is treated conservatively or promptly (see Endometriosis).