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Castration and postkastratsionny syndrome
Castration is a medical operation, as a rule, surgical at which at the person gonads are removed to prevent natural fertilization. Castration is carried out also by means of other methods (hormonal therapy, radiation therapy). Castration should not be confused to a vasectomy (in this case bandaging of semyavyvodyashchy channels is carried out, at the same time change of a hormonal background does not happen), and also to a penectomy (operation at which to the man the penis is removed that conducts to impossibility of commission of sexual intercourse).
Castration at women is a carrying out operation of removal of ovaries in the surgical way or carrying out deep radiation therapy on area of ovaries.
Also, there is a sterilization method which is called "pipe occlusion". In the course of such intervention bandaging of uterine tubes then the woman cannot conceive the child any more is made, and her hormonal background remains normal.
According to historians, castration is considered the first surgery at which anesthesia began to practice.
Features of carrying out castration at men
Synonym of the word "castration" is the term "castration". In the modern world castration of the person is carried out or in the medical purposes, or with the cult purpose. However the last use of castration in modern times meets seldom. Different methods of castration of men practice. In particular, both surgical castration, and radiation, chemical castration can be applied. In need of carrying out castration in the medical purposes radiation or hormonal therapy is applied.
It is accepted to distinguish castration partial (in that case operation leads to the termination or generative, or endocrine function) and full (both functions stop).
Castration of men of mature age is made if the prostate cancer, and also a bilateral tumor of testicles is diagnosed for the man. If removal of testicles is shown to the man, operation which is called an orchidectomy is in that case performed. If the prostate cancer is diagnosed for the patient, then instead of such operation only enucleation — removal of a parenchyma of testicles is carried out. Both operations at patients with cancer of a prostate are performed only after the diagnosis is confirmed by carrying out a biopsy of a prostate.
After the carried-out castration in a man's organism there are certain changes: quickly and actively the hypodermic fatty tissue develops, indumentum which extends on a body on female type grows, the prostate will atrophy and sexual desire decreases.
If castration is carried out to the teenager prior to puberty, then at it the structure of bones considerably changes: tubular bones become long, the skull remains rather small, jaws and superciliary arches are strongly developed. As a result there is a disturbance of interrelation between bodies of endocrine system.
Chemical castration became a peculiar alternative of castration surgical. Its carrying out does not bear such danger to mentality and physical health of the person as castration surgical. This technique is applied most often if the sexual behavior of the man makes danger to the people surrounding it. Sexual function in this case is suppressed by means of a number of medicines. Respectively, after reception of such drugs function at the man is sexual, after a while, is resumed.
For the purpose of carrying out chemical castration in an organism of the man the drug which contains the modified testosterone form is administered. Under its influence production of sperm almost completely decreases. Men's hormone almost completely stops being produced. Therefore, chemical castration also leads to decrease in sexual function.
Features of carrying out castration at women
Castration at women is a removal of ovaries in the surgical way or carrying out deep radiation therapy on area of ovaries. Manipulations are carried out to women whose age did not reach the period of a menstrual pause yet. The surgical method of castration practices at various diagnoses. So, if the cancer of one ovary is diagnosed for the woman, then doctors recommend to remove both at once. If this disease is diagnosed for young girls, the speech can go about preservation of one ovary. Ovaries are removed also at the operation performed at a cancer of a neck of uterus. Also it is reasonable to carry out carrying out surgical castration at some cases of a carcinoma of a mammary gland.
Carrying out beam castration is carried out for the purpose of suppression of hormonal and reproductive functions of gonads. Ovaries at women and testicles at men are for this purpose irradiated.
Radiation of ovaries at women is carried out in the first half of a menstrual cycle. Sometimes after carrying out radiation at women hormonal function of a yellow body still partially remains. Radiation is carried out at oncological diseases of ovaries, and also at some other diseases. Sometimes to women radiation at heavy manifestations of a climax is appointed.
Postkastratsionny syndrome
The state which is defined as a postkastratsionny syndrome is expressed by development of the whole complex of symptoms. The woman in view of a stop of the cyclic changes which happened owing to removal of ovaries has a disturbance of psychological, endocrine and vascular and vegetative character.
Owing to a certain similarity of symptoms of a postkastratsionny syndrome and signs of a climacteric sometimes there is an identification of these states that is not correct. However in this case it is about two absolutely different mechanisms of such syndromes. If the postkastratsionny syndrome proyavltsya as an effect of a sharp stop of function of ovaries, then at development of a menopausal syndrome fading of function of ovaries happens gradually, besides partially this function remains even during a menopause.
After at the woman ovaries are removed, certain disturbances of a hormonal background are shown. Estrogen level in an organism considerably decreases, at the same time secretion of gonadotrophins increases. However the postkstratsionny syndrome is shown not at all women.
At a razvitiipostkastratsionny syndrome at the patient, as a rule, bark of adrenal glands begins to develop less glucocorticoids and androgens. Owing to depression of function of bark of adrenal glands standard metabolism considerably raises and disturbances in work of a thyroid gland are shown.
If castration was carried out to the young woman, then the postkastratsionny syndrome at it will develop much later. But at the same time it should be noted that the postkastratsionny syndrome at young women proceeds much more difficult and hard. But the heaviest is the current of a postkastratsionny syndrome at those patients to whom diagnosed mental disorders earlier, and also for the women suffering from chronic infectious diseases and intoxication of an organism.
According to medical statistics, the postkastratsionny syndrome at women develops approximately in 60 — 70% cases. But for a year there is syndrome involution therefore in a year this syndrome is diagnosed only for a quarter of the women who transferred castration.
At the same time approximately at every fourth woman who transferred removal of ovaries, the postkastratsionny syndrome proceeds very hard within several years. It happens also that after relative normalization of a condition of the woman certain symptoms are again shown as a result of strong overfatigue, stresses or development of a number of diseases.
Syndrome symptoms
The Postkastratsionny syndrome is shown by different symptoms. In this case an important role is played by age of the patient, a state of her health, compensatory reactions of an organism. Generally at the woman psychological, vascular and vegetative, endocrine frustration are shown.
Among the most common vegetovascular symptoms it should be noted so-called inflow, often shown perspiration, strong heartbeat. After castration such symptoms are shown approximately in 2-4 weeks and reach peak two-three months later after carrying out operation. One of the most common symptoms at a postkastratsionny syndrome is the periodic headache which arises generally in a nape and temples. Except a headache often the woman suffers from sharp heartaches, a hypertension.
It is important to consider that there is a number of symptoms which even specialists sometimes mistakenly take for other, independent diseases. In this case it is about pain in heart, obesity, back pains, joints, a headache, dizziness, faints, paresthesias in extremities.
It is noted that at women at whom ovaries at climacteric age were removed much more mental and nervous breakdowns meet more often, the hypertension often develops. Among nervous breakdowns are often noted manifestation of an asthenic syndrome. At many women the constant feeling of fatigue, weaknesses arising without communication with intellectual and physical tension is shown. One more symptom – decrease in memory which is expressed in decline in the ability to remember events from the present: for example, the woman does not remember contents of just watched movie or the book. Often sick the periodic feeling of a depression, indifference to the things interesting earlier disturbs. So resistant indifference is in certain cases felt that the patient even has suicide intentions.
As exchange and endocrine disturbances which arise as a castration effect at women development of obesity and atherosclerosis is often observed. Endocrine disturbances are expressed also by changes in a reproductive system of the woman: it reduces mammary glands, hair on a pubis and armpits drop out, periods can stop completely, sexual sensitivity decreases.
Most often at a postkastratsionny syndrome at the patient one type of disturbances – either exchange and endocrine, or vegetovascular is more expressed.
On the expiration of several years the woman sometimes has complications after castration, in particular osteoporosis can develop. This illness is connected with too intensive removal of salts of calcium from the woman's organism as consequences of insufficient amount of estrogen. As a rule, after castration the woman suffers from osteoporosis of tubular bones. Developments of this disease periodically result very strong pain. Besides, women are also often tormented by the back pains which are not connected with a certain disease of a backbone.
If the postkastratsionny syndrome is shown as an effect radiation, then its current will differ from a state after surgical castration. At most of the patients who passed through radiation procedure the postkastratsionny syndrome develops. But at the same time symptoms of such state in this case are expressed less clearly.
Diagnosis and treatment
Diagnosis of a poskastratsionny syndrome is based on information from the anamnesis which confirms removal of ovaries or the carried-out radiation.
At a postkastratsionny syndrome complex therapy which includes administration of drugs, the functions of certain departments of a brain which are responsible for normalization practices. In an initiation of treatment the doctor surely appoints a sick course of therapy sedative and fortifying means. In this case it is about physiotherapy exercises, UF-radiation, hydrotherapeutic procedures, etc. At complex treatment of such state there are also neuroleptics and tranquilizers, vitamins. Such treatment continues about one month. Often to women with such diagnosis appoint the substituting hormonal therapy which is carried out cyclically throughout a long time.
But most of doctors try to carry out a certain psychotherapeutic training of the woman for the future changes in an organism even before operation on removal of ovaries. The patient has to realize operation effects, know about loss of certain functions after an operative measure.
Section: Gynecology