Manifestation of post-castration syndrome in women and methods of its correction. Post-castration syndrome after removal of the ovaries See what “Post-castration syndrome” is in other dictionaries

Castration of men- this is the surgical removal of the testes, as well as reversible inhibition of sexual function with medications or radiation. As a result of the intervention, serious changes occur in the man’s body, so the decision to perform castration is made only if there are compelling reasons.

Currently, surgical removal of testicles is performed exclusively for medical reasons. The need for surgery arises in the following cases:

When detecting malignant neoplasms in the testicles.
If there is severe twisting of the vas deferens, and as a result of cessation of blood flow, extensive tissue necrosis develops.
The level of male sex hormones exceeds the norm, and the amount of testosterone can be reduced only by surgical removal of the testes. Typically, the indication for intervention is the presence of hormone-dependent malignant tumors in the prostate.
If one or two testicles have not descended into the scrotum. The presence of testicles in the abdominal cavity significantly increases the risk of malignant tumors in men and negatively affects hormonal balance.
Traumatic injury to the scrotum, in which restoration of the testicles is impossible.
Indications for human castration also include sex reassignment surgery.

The final decision on castration is made only when there are no other options for solving the problem and it is not only about the health, but also about the life of the patient. This is connected both with the psychological aspect (many men develop complexes and neuropsychic disorders), and with physiological changes in the body: the consequences of the intervention affect the appearance, lead to the cessation of prostate function and a decrease in libido, and negatively affect the functioning of some internal organs. organs and systems.

Chemical castration is used in the vast majority of cases as a punishment or preventive measure. Drugs that suppress sexual function are administered to men who have already committed sexual offenses or are prone to sexual violence. The basis for chemical castration is a court decision. This type of punishment is used in many countries, with prisoners given the choice of either voluntarily undergoing the procedure in exchange for early release, or serving the entire, usually long, sentence in prison. Castration without a man's consent is a serious violation of human rights.

Contraindications

Before the procedure, a medical examination is mandatory. This eliminates possible contraindications that can cause serious complications during the operation:

blood clotting disorder;
chronic heart pathologies;
deviations in the functioning of the genitourinary system;
the presence of infectious and viral diseases.

The intervention is performed with caution on mature men. If there is a chance to do without removing the testes, the operation is postponed.

A correct assessment of a man’s condition before medical castration requires special attention. Drugs that are used to suppress sexual function can cause many side effects, including serious health problems.

Methods

In modern medical practice, several types of reversible and irreversible castration of men are used. The choice of method depends on the indications and condition of the body.

Surgical

Surgical removal of the testicles is one of the most common methods of intervention. In medicine, the operation is called orchiectomy; it can be unilateral or bilateral. During the operation, the testes with all membranes and appendages are removed through incisions in the scrotum. All vessels and spermatic cords are carefully tied up with a ligature, then the testicles are cut off and the wound formed on the scrotum is sutured. Castration is carried out mainly under local anesthesia: the anesthetic is injected into the groin area and into the scrotal suture. At the request of the patient and provided there are no contraindications, the intervention can be performed under general anesthesia.

If the indication for castration is prostate cancer, it is possible to remove only the inner part of the testicle (parenchyma) while preserving its membrane. This surgical operation is technically more complex, but it is preferable for men because it makes it possible to achieve a more acceptable cosmetic result.

Chemical

In some cases, chemical castration may be an alternative to testicular removal. This method is suitable for those people who need to reduce the production of sex hormones or who are contraindicated for castration through surgery. Some patients choose this method due to the possibility of preserving the external genitalia.

The method consists of a course of administration of drugs that affect the functioning of the organs of the reproductive system and reduce the concentration of testosterone to a minimum level corresponding to the post-castration state. Chemical castration is a reversible procedure: after stopping periodic courses, the functions of the male reproductive system are restored.

Radial

The technique of radiation castration involves exposing the gonads to ionizing radiation until their functioning completely ceases. In some cases, after cessation of irradiation, partial restoration of testicular function may be observed.

Radiation sterilization is used as one of the methods for treating malignant prostate tumors. The purpose of irradiation is to stop the production of male sex hormones, which provoke intensive tumor growth. Suppression of reproductive ability in this case is just a side effect. Radiation exposure of men for the purpose of stopping exclusively sexual function is not carried out.

Hormonal

This method involves taking drugs with a high testosterone content. As a result of a significant increase in the concentration of the male sex hormone, the production of seminal fluid ceases. Hormonal castration is a reliable method of male contraception. After stopping the use of hormones, spermatogenesis in men is restored. The main disadvantage of too frequent use of hormonal drugs is the high probability of the formation of malignant neoplasms in the testicles.

Vasectomy

One method of sterilizing men is a vasectomy. Some people mistakenly call it castration, but this is not correct. This type of intervention involves artificially creating obstruction of the vas deferens. This may involve ligating the vas deferens with a ligature or cutting off small fragments of them. At the same time, the testes retain their functions and continue to produce male hormones. After a vasectomy, a man retains sexual desire and erection, but due to obstruction of the vas deferens, there will be a complete absence of sperm in the ejaculate.

Surgery is one of the most reliable methods of contraception. It is suitable for those people who have already had children and do not plan to have them in the future or have severe hereditary diseases. If necessary, in the first few years after the procedure, it is possible to restore a man’s reproductive ability.

Vasectomy is voluntary, but its implementation in different countries is limited to certain age limits. When obtaining permission, the presence of children is usually taken into account.

The operation does not disrupt the hormonal balance in a man’s body, and therefore does not have such numerous negative consequences as castration.

Penectomy

In medicine, there are two types of amputation of the external genitalia in men: removal of the testicles is called castration, and complete or partial removal of the penis is called penectomy. This operation is indicated for malignant tumors, mechanical damage with subsequent tissue necrosis, thermal and chemical burns, or for gender reassignment. The intervention is performed under general anesthesia.

In most cases, a partial panectomy allows natural urination to be restored, and the remaining stump may be sufficient for sexual intercourse.

Complexity of the operation

Castration of men is not a complex intervention. During the operation, it is necessary to perform several simple manipulations, and general anesthesia is not even required. In the absence of concomitant pathologies, the procedure proceeds without complications.

The complexity of castration increases when enucleation is performed (removal of the internal tissues of the testicles while preserving the outer membrane) or the man has certain diseases.

How long does the intervention last?

The duration of castration for men depends on the indications and features of the procedure. The usual removal of the testicles, along with the preparation of the surgical field and the administration of anesthetics, takes no more than an hour. More complex manipulations may last slightly longer - up to 3 hours. A vasectomy with cutting or ligation of the vas deferens takes only 15-20 minutes.

Only a doctor can say exactly how long the intervention lasts in each specific case after examining the man, assessing his condition and choosing the method of castration.

Preoperative period

Preparation for castration begins several weeks in advance. A man must pass mandatory tests and be examined by several specialists: a cardiologist, a urologist, and a therapist. If necessary, the list of examinations and tests can be expanded. 10-12 days before surgery, you should stop taking medications that reduce blood clotting. During this period, the man must abstain from sexual intercourse. The attending physician can give other recommendations regarding medication and lifestyle during the preoperative period.

For many men, removal of the testes becomes a strong psychological trauma. In this regard, experts recommend undergoing appropriate psychotherapeutic training. Preliminary conversations with a doctor will help a man prepare emotionally for the changes awaiting him and make it much easier to endure castration.

Postoperative period

In cases where all manipulations were carried out correctly, and castration took place without surgical complications, wound healing and recovery occur quite quickly, and the patient does not require special care after the procedure. If a man experiences positive dynamics within 1-2 days, he can return to his usual lifestyle, with the exception of some contraindications: intense physical activity, sudden changes in temperature, bathing and sexual intercourse.

Complications

All types of interventions lead to the development of certain complications and side effects in men. Most of them are observed some time after the procedure, when hormonal changes begin to occur in the body. The patient's condition in the postoperative period largely depends on age (younger men tolerate castration and the possible complications associated with it worse). The restructuring of the body that occurs after castration, as well as the processes caused by the intervention, are known in medicine as post-castration syndrome. It manifests itself in the form of the following symptoms:

4-5 weeks after the intervention, disturbances in the functioning of the cardiovascular system may be observed. Men experience so-called hot flashes with increased heart rate and increased sweating. Many also experience pressure changes accompanied by headaches.
A common consequence of castration is weight gain and female distribution of body fat. Weight gain affects your overall health and condition.
When both testicles are removed from a man, a gradual decrease in potency occurs.
Changes in hormone concentrations lead to calcium metabolism disorders and some diseases of the musculoskeletal system.
Another common consequence is fatigue, chronic fatigue, and memory impairment.
Quite often the functioning of the nervous system is disrupted: sleep disturbances, emotional outbursts, sudden changes in mood, and irritability are observed.

Many, especially young men, experience severe depression associated with decreased sexual desire and developed erectile dysfunction. With a prolonged period of depression, the help of a professional psychologist may be required.

Such conditions should never be ignored. In case of post-castration syndrome, the help of specialists is required: first, a general examination is carried out, on the basis of which the man is prescribed sedatives and restorative drugs, physiotherapeutic procedures, vitamins, tranquilizers and antipsychotics (to eliminate depression, fear and anxiety).

The duration of the course and the list of medications are selected exclusively by the attending physician based on the results of an individual examination of the patient. If the cause of castration is testicular injury, the man may be recommended hormone replacement therapy, which will allow him to return to his normal lifestyle.

In cases where castration was carried out using medications, a man may experience insomnia, skin rashes, excessive sweating, mood swings, and nausea. Many patients experience pain in the spine, joints, and muscles during the course of drug administration. With repeated injections, an increase in symptoms is observed. As a rule, all side effects completely disappear after stopping the injections.

If your health worsens and the problems described above occur after the intervention, you should seek medical help as soon as possible. You should not self-medicate using the advice of incompetent people, video materials and articles from the Internet.

Castration of men, regardless of what methods are used for this, leads to a number of changes in the body. Sometimes, during the recovery process after an intervention, serious complex treatment is required. The most noticeable changes occur if the procedure is carried out before puberty: castration affects not only the functioning of the internal systems of the body, but also the growth of bones and the formation of the skeleton.

In this regard, before carrying out an operation, it is necessary to make sure that it is absolutely necessary: undergo a full examination, consult with several specialists, and only then decide on extreme measures.

Post-castration syndrome is a complex of disorders (vasomotor, neuropsychic, metabolic) that arise after removal of the ovaries in a mature woman.

The essence of post-castration syndrome

The most common and painful symptom of post-castration syndrome is tides, occurring as a result of a sharp expansion of the blood vessels of the skin of the face and upper body. In addition to hot flashes, neurovegetative disorders can manifest as sweating, dizziness, headaches, especially in the occipital region, and insomnia.

The incidence of post-castration syndrome varies , according to the authors, in the range of 50-80%. In some women, its symptoms disappear without therapeutic intervention within two years after removal of the ovaries, in others it lasts much longer. The initial state of the organs that regulate the most important life processes of the nervous and endocrine systems, the age of the patient, as well as the ability of protective and adaptive mechanisms to quickly adapt to the new conditions of the body’s existence play a role in the occurrence of the syndrome. Somatic diseases, as well as factors that adversely affect a woman’s psyche, complicate the course of post-castration syndrome.

The symptoms of the syndrome occur suddenly and at different times after removal of the ovaries. Most often this occurs 2-3 weeks after surgery.

The severity of its course depends to a certain extent on the cause of castration. Thus, with chronic inflammatory disease of the uterine appendages, including the ovaries, the symptoms of the disease are less pronounced. In cases of malignant neoplasms of the uterus or mammary glands, when the ovaries are not involved in the pathological process, their removal leads to a more violent manifestation of the syndrome.

It is believed that young women have a harder time withstanding castration. After the age of 40, in some cases, the disorders inherent in post-castration syndrome do not occur at all (E. Teter, 1968; S. Milku, Danile-Muster, 1973). It is likely that castration performed in women of childbearing age with a preserved menstrual cycle leads to a sharper drop in the amount of estrogen in the body than in women in menopause and menopause. Research by O. N. Savchenko (1964, 1967) showed that in women operated on at the age of 23-35 years, the amount of estrogen excreted in the urine is only 4.6 mcg/day, and at the age of 39-51 years - 7.7 mcg/day. A significant difference was also found in the allocation of individual fractions of estrogens: in young women, estradiol and estrone predominated, and estriol accounted for only 21.8%, while in women of the older group, estriol accounted for 61% of the total amount of estrogens.

A milder course is also observed after castration caused by X-rays or radium rays. It is assumed that in such cases, estrogens can be formed in atretic and primordial follicles, which are less sensitive to radiation exposure than mature ones. This is partly confirmed by the results indicating the presence of estrogenic influence. In the urine of women who have undergone X-ray castration, an increase in the level of gonadotropins occurs no earlier than after 6-12 months.

In the first years after castration, neuro-vegetative disorders, mainly hot flashes, predominate. Subsequently, trophic changes in tissues and shifts in neuro-endocrine correlation develop. A sharp decrease in the amount of estrogen leads to atrophic processes in the reproductive system. With age-related decline in ovarian function, atrophic changes primarily occur in the external genital organs and gradually spread to the internal genital organs. After surgical castration, the uterus first atrophies, and the process of reverse development spreads simultaneously to the myometrium and endometrium. The cervix decreases in size, takes on a conical shape, the glands disappear, and the cervical canal closes. The cytological picture of the vaginal contents changes: the number of superficial cells, especially eosinophilic ones, decreases; after six months, intermediate and even basal cells are found. The pH of the vaginal environment increases, the vagina narrows, its mucous membrane becomes dry and easily vulnerable. Subsequently, the process of atrophy also affects the external genitalia. The glandular tissue of the mammary glands is gradually replaced by adipose tissue.

There is a tendency towards the occurrence of cardiovascular diseases (Novotny and Dvorak, 1973). Metabolic processes are disrupted. Body weight increases, mainly due to the deposition of fat in the abdomen and thighs. I. G. Grigorieva (1972), having examined 177 women castrated at childbearing age, with a duration of time elapsed after castration of 5-28 years, found hypercholesterolemia in 74% of cases, obesity in 55%, and hypertension in 61%. In the group of women aged 40-54 years, the frequency of hypertension was statistically significantly higher (57.2%) than in people of the same age group with natural menopause (17.9%). One of the types of metabolic disorders due to castration is osteoporosis - the formation of bone tissue defects mainly in the area of the Div-Dvn vertebrae.

Pathogenesis

The pathogenesis of post-castration syndrome is complex and has not yet been fully studied. Removal of the ovaries introduces dissonance into the system of endocrine glands. This primarily concerns the hypothalamic-pituitary region. As a result of castration, the functional state of the hypothalamic nuclei, which take part in the formation of pituitary tropic hormones, is disrupted. Experimental studies have established an increase in the anterior lobe of the pituitary gland and the appearance of specific eosinophilic cells in it, which are called “castration cells.” Their formation is explained by an increase in the function of the anterior pituitary gland, but the cells appear provided that the connection between the adenohypophysis and the cerebral cortex is maintained, which indicates the presence of a certain relationship between the cerebral cortex and the gonads.

In response to a significant decrease in the amount of estrogen in the body, the release of FSH increases. According to V. M. Dilman (1968), after bilateral oophorectomy, the excretion of gonadotropins increases by more than 2 times. The effect of castration on serum levels in women was reported by Czygan and Maruhn (1972). On the 2-4th day after extirpation of the uterus and appendages and bilateral oophorectomy, both before and after the onset, the FSH level increases significantly, and on the 6-8th day the LH level increases. According to Aukin et al (1974), as time increases from the moment of castration, the release of gonadotropins in the urine progressively increases. However, it is not yet clear whether this is a consequence of overproduction of FSH or the excess is formed as a result of the fact that its use by the ovaries has ceased. There have been cases where, despite a high titer of gonadotropins in the urine, post-castration syndrome did not develop and, conversely, in patients with a severe form of the syndrome, a small amount of gonadotropins was detected in the urine. There is an assumption that hot flashes occur not so much due to an increase in the release of FSH, but as a result of a decrease in the amount of LH. The administration of human chorionic gonadotropin (LH) can reduce neuro-vegetative changes.

Probably, after castration, the release of not only gonadotropic, but also other tropic hormones of the pituitary gland, including adrenocorticotropic and thyroid-stimulating, is disrupted.

Manifestations of post-castration syndrome such as arthrosis and diabetes are common. It has been suggested that there is a possibility of the formation of excess growth hormone and its role in the pathogenesis of these disorders (S. Milku, Danile-Muster, 1973). Some women experience thyrotoxicosis, which is explained by increased production of thyroid-stimulating hormone by basophilic cells of the adenohypophysis.

With the help of numerous studies and clinical observations, a close connection has been established between the ovaries and the adrenal cortex, so castration cannot but affect the condition of the adrenal glands. Their bark contains small amounts of steroids, similar in their action to sex hormones. The administration of female experimental animals causes an increase in the concentration of corticosteroids in the blood (A. V. Antonichev, 1968). Zondek and Burstein (1952) noted a cyclical pattern in the urinary excretion of corticoids in guinea pigs that is closely related to the astral cycle; During estrus, corticoid excretion increases. After ovariectomy, low and acyclic secretion is observed. The administration of estrogen causes an increase in the amount of corticoids in the urine in both unspayed and castrated females. The authors believe that they stimulate the release of adrenocorticotropic hormone by the pituitary gland. After removal of the ovaries, hypertrophy of the adrenal cortex occurs. The relationship between its functional state and the severity of post-castration syndrome was shown by I. A. Manuilova (1972). The development of the syndrome is accompanied by a relative decrease in the function of the adrenal cortex and a weakening of the body’s compensatory reactions. In patients who do not have hot flashes, as well as with the reverse development of post-castration syndrome, as a rule, an increase in the function of the adrenal cortex, mainly glucocorticoid, is found.

If, with age-related decline in ovarian function, the body gradually gets used to new hormonal conditions, then as a result of surgical castration, the characteristic symptoms increase very quickly. Therefore, in establishing homeostasis after castration, the state of protective and adaptive mechanisms is especially important.

The sympathetic-adrenal system takes an active part in adaptation processes. Perhaps the occurrence of post-castration disorders is associated with irritation of the sympathetic nervous system as a result of hyperfunction of the adrenal medulla (M. G. Futorny, I. V. Komissarenko, 1969). This assumption is confirmed by the studies of I. A. Manuilova (1972), who studied the excretion of catecholamines (adrenaline and norepinephrine). The author found in almost all the examined patients an increase in the content of adrenaline in the urine and a decrease in the concentration of norepinephrine, which is an indicator of activation of the sympathetic-adrenal system. Particularly high numbers of adrenaline excretion were obtained in patients with a severe form of post-castration syndrome, which is probably due to stronger irritation of the hypothalamic nuclei.

Many authors consider the main cause of post-castration syndrome to be the disappearance or significant decrease in the amount of estrogens, based on the fact that their exogenous administration eliminates hot flashes. However, it is not. With the removal of the ovaries, the amount of estrogen hormones decreases sharply in all women, and post-castration disorders do not develop in all cases. In addition, I. A. Manuilova (1972) did not find a strict parallelism between the level of estrogen and the severity of post-castration syndrome. There was also no relationship between the level of estrogen excretion, the nature of the cytological picture of the vaginal smear and the duration of the operation.

Removal of the ovaries entails changes in the central nervous system, which was shown in an experiment by I.P. Pavlov. In the experiments of B. A. Vartapetov and co-authors (1955), the course of experimentally induced neurosis in dogs always worsened after castration. Removal of the ovaries in women entails changes in higher nervous activity, expressed in a weakening of inhibitory processes and a slowdown in differentiation processes.

Electroencephalographic studies in patients with a severe form of post-castration syndrome indicate a sharp excitation of the subcortex and an increase in the activating influence of the reticular formation on the cerebral cortex, as a result of which it is also involved in the pathological process (I. A. Manuilova, 1972).

Not only bilateral removal of the ovaries, but also unilateral oophorectomy in some cases leads to the development of vegetoneurosis, obesity, and menstrual dysfunction (A. P. Galchuk, 1965; N. I. Egorova, 1966; F. E. Petersburgsky, 1968; A. E. Mandelstam, 1970, etc.). N.V. Kobozeva and M.V. Semendyaeva (1972) observed neuro-endocrine disorders that arose in the first 6 months after surgery in almost all women who underwent unilateral oophorectomy.

There are many reports of the occurrence of disorders similar to post-castration in patients after removal of the uterus with preservation of the ovaries. These disorders vary in nature, time of onset, intensity and duration. Their frequency, according to the literature, ranges from 47 to 82%. Hysterectomy causes more pronounced functional disorders than supravaginal amputation, which some authors explain by the exudative process in the stump area that often develops after surgery, which also involves the ovaries, resulting in their function being disrupted. According to M. L. Tsyrulnikov (1960), functional disorders after supravaginal amputation of the uterus occur in 40.9% of women, and after its complete removal - in 75%.

Perhaps among the causes neuro-vegetative syndrome After removal of the uterus, the disruption of the normally existing close relationship between the ovaries and the uterus, which is the point of application of the action of sex hormones, is of a certain importance. Probably, the limitation of the sphere of influence of ovarian hormones due to the removal of the organ that consumes them, as well as the switching off of a larger or smaller number of interoreceptors causes certain shifts in neuro-endocrine relationships. The importance of the uterus in the regulation of the gonadotropic function of the pituitary gland and the reproductive cycle is shown by experimental studies by O. P. Lisogor (1955). Mechanical irritation of the uterine mucosa leads to an increase in the content of gonadotropic hormones in the pituitary gland, an increase in frequency and prolongation of estrus. In many women, after diathermocoagulation of the cervix in the first half of the menstrual cycle, the content of pregnanediol in the urine significantly increases, which can be explained by a reflex effect on the adenohypophysis and ovaries (M. A. Pugovishnikova, 1954).

The influence of ovarian hormones extends to all parts of the reproductive system, providing their inherent functions. Violation of the integrity of the reproductive apparatus and interoceptive connections at any link can lead to functional changes not only in the genital organs, but also in other organs and systems of the body. In this regard, the observations of S. N. Davydov and S. M. Lipis (1972) are interesting. They showed that with unilateral tubectomy, 42.3% of women developed hot flashes, sweating, increased excitability, sudden palpitations, and insomnia, and with bilateral tubectomy, similar phenomena, that is, symptoms of post-castration syndrome, were observed in 60% of women. In addition, these patients experienced an increase in body weight, diffuse enlargement of the thyroid gland, and painful engorgement of the mammary glands in the premenstrual period.

Treatment

Treatment methods for post-castration syndrome are diverse and include various methods of influencing both individual organs and the entire body as a whole in order to slow down the development of changes that inevitably occur after the operation of removing the ovaries, and to enable compensatory mechanisms to equalize the disturbed balance.

Based on modern ideas about the pathogenesis of post-castration syndrome, treatment should be comprehensive: restoratives and sedatives, vitamin therapy, hormone therapy. One of the elements of treatment is the impact on the patient’s psyche. In some cases, a change in situation, introduction to regular work or its resumption have a beneficial effect. Particular attention should be paid to the hygienic regime, including gymnastics and water procedures.

Vitamins are widely used in the treatment of patients with post-castration syndrome. There are reports that vitamin B1 reduces the secretion of FSH (M. Yules, I. Hollo, 1963). Vitamin Be has the same effect. A good therapeutic effect was obtained as a result of a course of treatment with vitamins and PP with a 2% solution of novocaine (K.N. Zhmakin, I.A. Manuilova, 1966). Vitamins and novocaine are administered intramuscularly in one syringe; Duration of treatment - 25 days. In combination with other methods, multivitamin preparations in the form of pills can be prescribed.

I. A. Manuilova (1972) noted a much longer course of post-castration syndrome in patients treated with sex hormones. With long-term administration of both estrogens and androgens, the production of glucocorticoids and estrogens decreases, which may be associated with the development of functional inertia of the adrenal cortex.

When prescribing hormonal therapy, it is necessary to take into account the patient’s age and the nature of the disease, which required the use of such an extremely radical method of treatment as castration. If it was performed for a malignant neoplasm of the genital organs or mammary glands, then hormonal therapy is contraindicated regardless of age. If the operation was undertaken for other indications, then in young women (up to approximately 38-39 years of age), combinations of estrogens and progestins are used as replacement therapy, introducing them cyclically until the endometrium loses the ability to respond in the form of menstrual-like bloody discharge.

Replacement therapy involves reproducing the endometrial cycle by administering estrogens and progestins. To do this, estrogens are first used to produce changes in the endometrium similar to the proliferative phase. Subsequent administration of progestins should ensure secretory transformations of the endometrium. There are various options for sex hormone therapy regimens. Prescribe 1 ml of 0.1% estradiol dipropionate once every 3 days (5-6 injections in total) or 0.1% sinestrol solution or 10,000 units of folliculin daily. After this, 10 mg of progesterone is administered daily for 7 days. Long-acting preparations are more convenient - 1 ml of 0.5% diethylstilbestrol propionate once every 7 days (2-3 injections in total), then 2 ml of 12.5% oxyprogesterone capronate. When removing the ovaries while preserving the uterus, it is recommended to administer 100,000 units of estrogen and 30-40 mg of progesterone monthly (S. Milku, Danile-Muster, 1973). Currently, combinations of estrogens and progestins are used, including long-acting ones. In some cases, this makes it possible to restore not only the menstrual cycle, but also its rhythm (Schneider, 1973), but long-term results in terms of the duration of the therapeutic effect, which largely depends on the ability of the endometrium to respond to exogenous hormonal stimulation, are still unknown.

After bilateral oophorectomy with removal of the uterus, the goal of treatment is to relieve vasomotor disorders and prevent the atrophic process in tissues and osteoporosis. For this purpose, both estrogenic hormones and their combinations with progestins or androgens are used. Doses are selected individually.

Long-acting estrogen preparations are recommended for young women to prevent vasomotor complications. The administration of 2 ml of 0.6% dimestrol solution has a therapeutic effect for several months. The most convenient use of estrogen drugs orally in the form of tablets. Treatment begins with small doses: ethinyl estradiol is prescribed at 0.01-0.02 mg; synestrol - 0.5-1 mg/day; octestrol - 1 mg; the dose of diethylstilbestrol is two times less; sigetin has a weak estrogenic effect, inhibits the gonadotropic function of the pituitary gland, it is used orally at 0.01-0.05 g 2 times a day, the course of treatment is 30-40 days.

Ohlenroth et al (1972), determining the content of estrogen in the urine of women with ovaries and uterus removed after administration of estriol, came to the conclusion that the hormone should be administered 2 times a day orally in an amount of 1-2 mg or 1 time a day intramuscularly.

Ta-Jung Lin et al (1973) studied colpocytological changes in castrated women with an atrophic type of vaginal smear under the influence of an estrogenic drug (Premarin), which was administered at a dose of 1.25 mg daily for 21 days, followed by a 7-day break. Every 2 months there was a one-month break. The hot flashes disappeared on the second day, but resumed immediately after stopping treatment. In the vaginal smear, basal cells disappeared, the number of intermediate cells increased, and cells of the superficial layer were found in very small quantities.
The authors did not establish a connection between the nature of vaginal contents and the clinical manifestations of post-castration syndrome.

Estrogenic hormones are widely used to treat post-castration metabolic disorders. Rauramo (1973) reports their beneficial effect on skin trophism in castrated women. Using autoradiography, thinning of the epidermis and a decrease in its mitotic activity that developed as a result of castration were detected. The use of estriol succinate and estradiol valerate led to the restoration of the thickness of the epidermis and the activation of mitotic processes in it. For atrophic disorders in the tissues of the vulva and vagina, globulin containing 2000 units of folliculin is prescribed after 2-3 days, and folliculin ointment (S. Milku, Danile-Muster, 1973).

The administration of estrogens (agofollindepo Spof) has a pronounced therapeutic effect in the treatment of patients with coronary atherosclerosis and dyslipoproteinemia that developed after castration. The content of serum lipids such as cholesterol and 6-lipoproteins is normalized (Novotny Dvorak, 1973).

Combined treatment with estrogens and androgens is used in a ratio of 1: 20 and 1: 10 - 1 ml of 0.1% estradiol dipropionate or 10,000 units of folliculin along with 2 ml of 1% testosterone propionate. Injections are given once every 3 days (3-5 injections), and then the intervals are increased to 10-12 days. In this case, after 2-3 months, the phenomena of post-castration syndrome completely disappear (G. A. Kusepgalieva, 1972) and proliferation of the vaginal epithelium is observed according to the type of the middle follicular phase with the initial atrophic type of smear.

Most women, after stopping hormones, very quickly experience hot flashes and other post-castration disorders again. Therefore, hormonal therapy must be carried out over a long period of time. Implantation of crystalline estrogens into the subcutaneous fatty tissue, the resorption of which occurs in approximately 4-6 months, carries the risk of hyperplastic processes in the endometrium and. In this case, it is impossible to stop further absorption of the hormone.

Ovarian transplants also function for a limited time (6-12 months), and the results of their use are not always satisfactory. The possibility of ovarian tissue transplantation is currently being studied. To reduce the intensity of immunological reactions in the recipient's body, Yu. M. Lopukhin and I. M. Gryaznova (1973) used amniotic membranes as a semi-permeable membrane. The graft took root in all patients and was actively functioning for 6-10 months.

For the treatment of neuro-autonomic disorders, thyroid preparations that have a sedative and antigonadotropic effect can be used (S. Milku, Danile-Muster, 1973).

Long-term hormonal treatment, in addition to monitoring the hormonal balance of the body (using mainly colpocytological studies), also requires periodic determination of liver function, body weight, the state of the blood coagulation system, and blood pressure.

Post-castration syndrome(lat post after + castratio castration; synonym castration syndrome) is a symptom complex that develops after the cessation of endocrine function of the testicles in men and ovaries in women during the reproductive period and is characterized by specific metabolic-endocrine, neuropsychic and other disorders. The syndrome caused by the cessation of the endocrine function of the gonads (or their hypofunction) in the pre-pubertal period is called eunuchoidism (see. Hypogonadism).

Post-castration syndrome in men is the result of traumatic, surgical or radiation castration, as well as destruction of testicular tissue due to acute and chronic infectious diseases. In response to sudden loss of endocrine function testicles dysfunctions of the hypothalamic, endocrine and neurovegetative regulatory systems develop (see. Autonomic nervous system,Hypothalamic-pituitary system). A sharp tension in the hypothalamic systems, which activate the gonadotropic function of the pituitary gland, is accompanied by an increased release of gonadotropic hormones (see. Pituitary hormones). Other hypothalamic regulation systems are involved in the process, primarily sympathoadrenal system. A sharp decrease in androgen concentrations (see. Sex hormones) in the blood is manifested by a number of specific endocrine and metabolic disorders.

Pathological changes caused by castration include the phenomena of demasculinization: a change in the nature of hair growth, a decrease in muscle volume, redistribution of fat deposits in the subcutaneous tissue according to the eunuchoid type, the progression of obesity due to the loss of the anabolic and fat-mobilizing effects of androgens. Osteoporosis is observed.

The main method of treatment post-castration syndrome in men, androgen replacement therapy is used. The most common treatment is with long-acting sex hormones - sustanon, testenate, etc.; short-acting drugs and oral drugs (methyltestosterone, testobromlecite) are less effective. Depending on the clinical symptoms, sedatives, cardiovascular, antihypertensive and other drugs are also used. The duration and intensity of androgen replacement therapy depend on the severity of the manifestations of androgen deficiency and the age of the patient. The main contraindication for androgen therapy is prostate cancer.

The prognosis depends on the individual characteristics of the patient. In most cases, it is possible to gradually reduce the vegetative-vascular and neurotic manifestations of the syndrome. Endocrine metabolic disorders with post-castration syndrome require long-term replacement therapy.

Post-castration syndrome in women reproductive age develops mainly after total or subtotal oophorectomy. Its frequency among women who have undergone these surgical interventions reaches 80%, in 5% of cases post-castration syndrome proceeds severely, with loss of ability to work. Loss of ovarian hormonal function causes complex adaptation reactions in the neuroendocrine system. A sudden decrease in the level of sex hormones leads to a disruption in the secretion of neurotransmitters in the subcortical structures of the brain, which ensure the coordination of cardiovascular, respiratory, and temperature reactions. This causes pathological symptoms very similar to those of climacteric syndrome. Disturbances in the secretion of neuropeptides of the hypothalamus (lyuliberin, thyroliberin, corticoliberin, etc.) alter the function of the endocrine glands, especially the adrenal glands, in the cortex of which the formation of glucocorticoids is enhanced. After castration, androgens from the adrenal cortex are the only source of estrogen synthesis. A decrease in the formation of androgens leads to a decrease in the synthesis of estrogens and aggravates the processes of maladaptation of the body. In the thyroid gland, the synthesis of T 3 and T 4 is disrupted. In the pathogenesis of osteoporosis, which is an obligatory consequence of castration, the leading role is played by a decrease in the level of estrogen and testosterone, which have an anabolic effect and contribute to the retention of calcium by bone tissue. Resorption of calcium from bones and an increase in its level in the blood cause a decrease in the secretion of parathyroid hormone from the thyroid gland. The content of calcitonin, the formation of which is stimulated by estrogens, also decreases. A decrease in the level of calcitonin and parathyroid hormone suppresses the process of calcium incorporation into bone tissue and promotes its leaching into the blood and excretion in the urine.

The main clinical manifestations of P. Vegetative-vascular symptoms are present - hot flashes, facial flushing, sweating, palpitations, hypertension, pain in the heart, headaches. The frequency and intensity of hot flashes, as with menopausal syndrome, is considered an indicator of severity post-castration syndrome. Metabolic and endocrine disorders include obesity and hypercholesterolemia. Changes in hormonal balance cause lipid metabolism disorders and the development of atherosclerosis. Metabolic disorders also include strophic changes in the external and internal genital organs, bladder, and urethra. The development of colpitis, similar to senile, the appearance of cracks, leukoplakia, and kraurosis of the vulva are noted. Atrophic changes occur in the mammary glands, in which glandular tissue is replaced by connective and fatty tissue. Trophic disorders include osteoporosis. In this case, the main complaints are local pain in the lumbar and (or) thoracic spine, pain in the knee, wrist, shoulder joints, and aching muscle pain. The risk of bone fractures increases sharply.

Clinical symptoms P, p. develop within 2-3 weeks after surgery and reach full development after 2-3 months. In the first two years, neurovegetative symptoms predominate. Psycho-emotional and metabolic-endocrine disorders are also noted. All women develop osteoporosis, which progresses even after other symptoms have reversed. Heaviness post-castration syndrome clearly correlates with the premorbid background (frequency of infectious diseases in history, diseases of the hepatobiliary system, gynecological diseases). The diagnosis is made based on typical clinical symptoms and medical history.

In treatment, the main place should be occupied by drugs containing estrogens. You can use oral contraceptives (bisecurin, non-ovlon, ovidone, etc.), as well as three- and two-phase drugs (see. Contraception), which should be taken in a cyclic mode recommended for contraception. These drugs are used for 3-4 months, followed by a month or 2-3 week break, depending on the woman’s condition and the resumption of her symptoms. post-castration syndrome. In addition, restorative therapy, vitamins B, C, PP are recommended. According to indications, tranquilizers (mezapam, phenazepam, etc.) are prescribed. In the first month after the operation, physiotherapeutic methods of treatment begin to be used: microwave therapy with centimeter waves on the area of the adrenal glands, which is combined with hardening and tonic procedures (rubbing, dousing with cool water, coniferous, sea, sodium chloride baths). Sanatorium-resort treatment is recommended in the climatic zone familiar to the patient.

The prognosis is favorable, especially if therapy is started in a timely manner.

Bibliography: Gynecological endocrinology, ed. K.N. Zhmakina, s. 436, M., 1980; Mainwaring U. Mechanism of action of androgens, translated from English, M., 1979; Smetnik V.P., Tkachenko N.M. and Moskalenko N.P. Climacteric syndrome, M., 1988.

A number of gynecological problems require a radical approach. It is most often used for malignant neoplasms that threaten not only a woman’s reproductive function, but also her health in general. Oncology is an indication for surgical removal of the ovaries and uterus, and sometimes both organs at once. The procedure for complete excision of the gonads is called oophorectomy. It is also used as hormonal therapy for breast cancer.

If the operation is performed on a woman of reproductive age, then such a radical approach is often accompanied by the development of complications, united under the concept of post-castration syndrome. It is associated with significant changes in the functioning of both the genital organs and the nervous system. Hormonal changes lead to psychological and vegetative disorders, as well as other serious problems. Moreover, such a disease is characteristic not only of the fair sex. In men, removal of the testes is accompanied by changes in the activity of the central nervous system. Since it is impossible to restore the previous hormonal characteristics after castration, treatment is aimed only at correcting unpleasant symptoms. Over time, the body gets used to new working conditions.

Causes of post-castration syndrome

The pathogenesis of the development of the disease is associated with metabolic changes and transformations in the function of the hypothalamus and pituitary gland, which normally control the functioning of the gonads. The main indication for castration is malignant neoplasms of the reproductive organs. Ovariectomy is also performed in premenopausal women. It is preventive in nature, as it reduces the likelihood of breast and uterine cancer.

Most often, post-castration syndrome in gynecology is associated with a patient’s history of endocrine diseases. These include transformations in the functioning of the thyroid and pancreas. During surgical removal of the ovaries, metabolic disruptions only worsen, which contributes to the development of complications.

There are also problems not related to surgical treatment. In such cases, the occurrence of symptoms of post-castration syndrome is provoked by disturbances in the functioning of the follicular apparatus in women. The ovarian tissue does not perform its natural function, ovulation does not occur, and the production of hormones, in particular estrogens, is disrupted. It is hypoestrogenism that is the main triggering factor for the development of castration syndrome in women. Moreover, similar transformations occur in the body of representatives of the fair sex normally, during menopause. However, in the physiological process, the shutdown of the ovaries occurs gradually, although in such cases the development of unpleasant complications is possible. It is the sharp decline in estrogen concentration that causes disruption of the central nervous system and the formation of post-castration syndrome.

The disease may also be associated with hysterectomy - surgical removal of the uterus. It is performed for severe endometriosis, ruptures and cancer of the organ. It is important to know that such radical methods are resorted to only in cases where conservative treatment does not give the desired effect.

Symptoms of the pathological condition

The clinical picture of the disease is specific. The main signs of the disease are:

Vegetative-vascular disorders, which occupy a leading position among the symptoms of post-castration syndrome. “Hot flashes” occur, characterized by heat and sweating, the heart rate increases, and drops in blood pressure also occur. Many patients complain of dizziness and migraines.
Endocrine changes are among the common manifestations of post-castration syndrome. They arise due to the close connection of the endocrine glands with each other. Metabolic transformations increase the risk of developing diabetes mellitus and obesity, and also lead to increased deposition of cholesterol in the lumen of blood vessels.
Dystrophic processes of the reproductive system, which are a natural reaction of the body to a decrease in estrogen levels. They are manifested by dryness of the vaginal mucous membranes, the appearance of dysbacteriosis and discomfort during sexual intercourse.
Psycho-emotional and cognitive disorders associated with malfunctions of the central nervous system, which are also caused by changes in a woman’s hormonal levels. Patients suffer from insomnia, depression, increased irritability and tearfulness.

Common complaints during post-castration syndrome are pain in the spine, mainly in the lumbar region. These symptoms develop when osteoporosis occurs, which is associated with calcium metabolism disorders.

The intensity of the consequences of oophorectomy also depends on the patient’s medical history. If there are previous gynecological and endocrine ailments, the risk of developing complications and worsening the woman’s well-being increases.

Diagnostics

If there are characteristic symptoms of the disease and previous surgical intervention, confirming the problem is not difficult for doctors.

Initially, the patient is examined in a gynecological chair. Castration syndrome in women is manifested by dryness of the mucous membranes, their redness and thickening. Over time, the integument, on the contrary, becomes pale and thinned. In many cases, an imbalance in the microflora of the genital tract is also detected, which is accompanied by pathological discharge, a pungent odor and itching.

One of the specific tests that can confirm the development of the disease is blood tests. The most informative is measuring the level of gonadotropins and pituitary hormones. Thyroid function and glucose concentration are also assessed.

If the patient has complaints about disorders of the cardiovascular system, an ultrasound examination is performed. Carrying out an ECHO and taking an ECG is important in the further symptomatic treatment of post-castration syndrome.

Before using hormone replacement therapy, bacteriological tests of genital tract secretions, general blood tests and examination of the mammary glands are also carried out.

The tactics to combat the problem are determined by the doctor based on the diagnostic measures performed. Both the severity of pathological changes and the individual characteristics of the patient are important. Treatment is mainly symptomatic, since it is not possible to restore normal functioning of the reproductive system after removal of the ovaries. Both medications and physiotherapeutic procedures are used. Traditional methods also have good reviews.

The basis of pharmacological support for patients with severe symptoms is hormone replacement therapy. Treatment of post-castration syndrome in women in this case comes down to increasing the level of estrogen, which is key in the development of complications. The duration of use of oral contraceptives, as well as the order of their administration and the specific drug is chosen by the doctor. There are also contraindications to the use of these funds. These include diseases of the mammary glands, liver and disorders of the blood coagulation system. At the same time, the use of hormonal medications can only facilitate the restructuring of the body to a new type of work, but does not in any way restore the function of the reproductive system. Monotherapy is indicated more when the uterus is removed. If a hysterectomy has not been performed, then they resort to the use of two- or three-phase medications, which have a combined effect on the body.

Among the recommendations for the treatment of post-castration syndrome is the use of vitamin complexes. They allow you to normalize metabolic processes and facilitate the functioning of the central nervous system. These drugs are often combined with antiplatelet therapy if indicated. The use of sedatives, antipsychotics and tranquilizers is also widespread. They contribute to the restoration of a normal psycho-emotional state, greater resistance to stress, and also help fight insomnia. Traditional methods are based on the use of decoctions and infusions of plants that have a calming effect.

Physiotherapeutic methods such as massage, galvanization and the use of microwaves also have a therapeutic effect. These techniques help women cope with stress and also normalize the functioning of the central nervous system.

The symptoms that form post-castration syndrome in women have much in common with the clinical manifestations of menopause. In medicine, when organs of the reproductive system are removed, it is customary to talk about surgically induced menopause. At the same time, doctors recommend preparing for such a process:

Constant communication with the doctor is important. The specialist will explain everything in detail so that the patient has no questions or uncertainty about her own condition.
It is better to start adjusting your lifestyle before the operation, since in this case the adjustment will not cause so much stress.
Patients will also need help from loved ones and relatives during the rehabilitation period, both physical and emotional. After surgery, a woman is prohibited from lifting heavy objects. It is recommended to exercise extreme caution when driving vehicles.
Communication with other patients who have also undergone a similar procedure greatly facilitates psychological recovery after surgery. In some cases, to correct the emotional state, they resort to the use of medications.

Prognosis and prevention

The course and outcome of the problem depend on the intensity of the manifestation of clinical signs. If you consult a doctor in a timely manner, you can cope with the disease in the shortest possible time. The prognosis is cautious with a significant degree of severity of vegetative and mental disorders. In such cases, therapy can be serious and lengthy.

As a rule, it is not possible to avoid the manifestation of post-castration syndrome after an oophorectomy or removal of the uterus. However, following the doctor’s recommendations will prevent the occurrence of more severe and dangerous complications. Moderate physical activity and a balanced diet are important. The diet should include a large amount of vegetables and fruits, as well as foods rich in calcium. This approach allows you to normalize the functioning of internal organs and reduce the risk of developing dysbiosis and osteoporosis. Reducing the impact of stress also has a positive effect on women's well-being during this difficult period.

Currently, castration of men is carried out in most cases for medical reasons. In some countries, chemical castration and sometimes surgical removal of the testicles are used as punishment for sex offenders. Serious changes occur in the bodies of castrated men and a number of complications may develop, so any method of castration can be used only if there are good reasons for this and there are no other options for solving the problem.

How and why is castration performed?

Before studying the procedure for chemical or surgical castration of men, it is necessary to understand what it is and what castration can be. Thus, a distinction is made between partial and complete castration. After partial castration in men, either endocrine or generative function disappears. Complete leads to the cessation of both functions.

Adult men are castrated if bilateral testicular tumors and prostate cancer are detected. If the patient is indicated for surgical removal of eggs, such an operation is called orchidectomy. Patients with prostate cancer do not have their entire testicles removed, but instead undergo an enucleation procedure, which removes the testicles. Both complete removal of eggs and removal of testicular parenchyma alone can be performed only after confirming the presence of prostate cancer using a biopsy.

Castration leads to a number of changes in the male body:

A man’s subcutaneous fat tissue begins to actively and quite quickly develop, and he gains weight.
Hair growth and its distribution according to the female type are noted.
Sexual desire decreases sharply.
The prostate gland atrophies.

If castration was performed before the onset of puberty, the boy experiences a noticeable change in bone structure, namely:

His tubular bones lengthen.
The size of the skull remains relatively small.
There is a pronounced development of the brow ridges and jaws.

Both as a result of chemical castration and after a surgical procedure, the functioning of the endocrine system in the male body is disrupted.

Castration for medical reasons

As noted, one of the indications for castration is prostate cancer. The tumor in most cases begins to develop under the influence of testosterone and dihydrotestosterone. These hormones promote the growth of normal and pathogenic cells. And it is lowering testosterone levels that is one of the main treatment options for prostate cancer.

Surgical removal of eggs can reduce testosterone concentrations by 85-95%. The operation can be performed under general, local or epidural (when an anesthetic is injected into the spinal cord through the spine) anesthesia. The specific option is selected together by the doctor, anesthesiologist and the patient.

However, in the case of prostate cancer treatment, complete surgical removal of eggs is in most cases replaced by an enucleation procedure, during which only their parenchyma is removed.

Preparation and performance of surgical castration

Before performing surgical castration, the doctor must verify the presence of cancer using a biopsy. In addition, the patient undergoes a number of additional tests and undergoes special examinations, namely:

General urine and blood tests.
Biochemical blood test, which allows you to determine the concentration of bilirubin, urea, creatinine, total protein, etc.
Blood test for various forms of hepatitis, syphilis, HIV/AIDS.
Fluorography and electrocardiogram.
If there is such a need, the man is referred to a consultation with a therapist and other doctors.

Some time before the operation (usually 1-2 weeks, the doctor will tell you the specific period), the patient should stop taking medications that affect blood clotting processes. The doctor will tell you about the specifics of taking other medications and life in general during the preparatory period during a personal consultation, taking into account the individual characteristics and needs of the patient.

Surgical castration is a relatively simple procedure. After anesthesia and other preparatory measures, the doctor makes an incision in the skin and subcutaneous tissue in the scrotum area, after which he dislocates the testicle and spermatic cord into the incision. The stitching, ligation and dissection of the ligament descending the testicle are performed. The vas deferens, after preliminary removal from the spermatic cord, is ligated and dissected. After this, surgeons perform stitching, ligation and dissection of the remaining elements of the spermatic cord. Finally, stitches are applied.

There is also a more complex type of surgical operation, which allows you to preserve the protein membrane of the testicles and provides a more acceptable cosmetic result. The operation takes a little time. Complications during the operation practically do not appear. In most cases, patients are sent home on the day of surgery.

Features of chemical castration

Chemical castration is a kind of alternative to surgical procedure. The main advantage of chemical castration is that it does not cause such serious damage to a person’s physical and mental health as surgery. This technique is most often used to punish sex offenders or when there are suspicions that a man’s sexual behavior may be dangerous to other people.

The main purpose of chemical castration is to suppress sexual function. After some time, sexual function is restored. The procedure is carried out by introducing into the man's body a drug containing a modified form of testosterone. This drug almost completely reduces sperm production. Testosterone production stops. As a result, chemical castration leads to a decrease in sexual function, but is temporary and less radical than surgical intervention.

Complications after castration

Many men develop the so-called after castration. post-castration syndrome. It is expressed by a whole list of complexes. Endocrine, vascular-vegetative and neuropsychic disorders are noted.

It manifests itself in the form of various symptoms, the nature and severity of which largely depends on the age of the patient, his state of health and the compensatory reactions of the body.

Thus, the most common vegetative-vascular disorders include the so-called. hot flashes, palpitations, excessive and frequent sweating for no particular reason. After castration, these symptoms begin to appear on average after 1 month and reach their peak within 2-3 months after surgery. In addition, one of the most common symptoms of the post-castration period is periodic headaches, occurring mainly in the temples and back of the head. In addition to headaches, high blood pressure and pain in the heart appear.

It is necessary to take into account the fact that there is a whole complex of symptoms that sometimes even doctors mistakenly mistake for the manifestation of other diseases. In the case of post-castration syndrome, such manifestations are pain in the heart, rapid weight gain, pain in the joints, lower back and head, fainting, dizziness, etc.

Adult men who have undergone surgical castration often develop nervous and mental disorders, and almost always develop hypertension.

Many men constantly feel weak and tired, and they may experience physical and mental stress for no reason. Another characteristic symptom of post-castration syndrome is memory impairment. It becomes more difficult for a man to remember current events, to the point that he will not be able to remember the events of a book he has just read or a feature film he has watched. Many patients periodically experience depression, they become indifferent to what was interesting to them before castration. For some, the state of indifference reaches such an extent that thoughts of suicide begin to appear.

Among metabolic and endocrine disorders, atherosclerosis and obesity develop most often. In addition, hair loss or the beginning of its growth according to the female type, the appearance of fat deposits according to the female type, and sexual desire decreases.

In most cases, in men with post-castration syndrome, one type of disorder characteristic of this condition is more pronounced.

Treatment of post-castration syndrome

First of all, the doctor must make sure that the cause of the existing manifestations is post-castration syndrome and not other diseases. To do this, the patient’s medical history is studied, and he may be referred for tests and additional examinations. It all depends on the individual characteristics of the man in each specific case.

Treatment of post-castration syndrome is necessarily comprehensive. It should include taking medications that help normalize the function of certain parts of the brain. The order of treatment may vary. As a rule, it all starts with a course of sedatives and restoratives. The patient must undergo physical therapy, undergo sessions of water procedures, ultraviolet radiation, etc. In addition, complex therapy necessarily includes vitamins, tranquilizers and antipsychotics. The duration of treatment depends on the severity of the patient's condition. Long-term hormonal therapy may be prescribed. You can start taking any medications only as prescribed by your doctor.

Many experts strongly recommend appropriate psychotherapeutic preparation of a man for the changes awaiting him even before castration. The patient should know what he needs to be prepared for after such a procedure. It is important to consult a doctor in a timely manner, because... Some men in this state have thoughts of suicide.