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黃體，懷孕不可或缺的重要激素

出處：網(wǎng)絡(luò)收集 日期：2024-08-27 18:57:26 編輯：秩名

對(duì)于黃體，大家并不陌生，孕激素，這個(gè)重要的激素，就是它分泌的。女性的月經(jīng)周期，以排卵為界限，分為兩個(gè)明顯不同的時(shí)期：卵泡期和黃體期。排卵以前是卵泡發(fā)育成熟階段，稱為卵泡期。排卵以后，排出卵子后的卵泡壁內(nèi)陷，血液填充泡腔，形成血體，此后新生血管長(zhǎng)入，殘留卵泡細(xì)胞增殖，在LH的作用下發(fā)生黃素化，顆粒細(xì)胞和內(nèi)膜細(xì)胞分別轉(zhuǎn)化為顆粒黃體細(xì)胞和卵泡膜黃體細(xì)胞，胞漿中積聚黃色的脂質(zhì)而外觀呈黃色，稱為黃體。黃體會(huì)不斷地發(fā)育，孕激素明顯上升，于排卵后5～10天的黃體高峰期形成峰值，以后略有下降，至黃體退化時(shí)迅速降低，這一階段被稱為黃體期對(duì)于渴望一個(gè)小生命的未準(zhǔn)媽媽來(lái)說(shuō)，黃體是非常重要的。黃體不足會(huì)使子宮內(nèi)膜分泌不良造成著床困難。即使著床了，也由于孕激素支持不足而停育或流產(chǎn)。
 

◎ 什么叫黃體功能異常

 
黃體功能異常主要有以下兩種表現(xiàn)：
 
1、黃體功能不足。有排卵但黃體發(fā)育不良，過早衰退，分泌孕激素不足，有時(shí)不能維持子宮內(nèi)膜，引起不規(guī)則脫落而出血；經(jīng)常出現(xiàn)在經(jīng)前數(shù)日少量陰道出血，基礎(chǔ)體溫測(cè)定高溫期少于12天，或者體溫上升幅度小于0.5℃，或者黃體期體溫波動(dòng)大，內(nèi)膜檢查為腺體分泌不良。
 
2、黃體萎縮不全。雖然黃體發(fā)育良好，但萎縮過程延長(zhǎng)，雌激素、孕激素不能如期撤退，子宮內(nèi)膜不規(guī)則脫落，使出血期延長(zhǎng)，有時(shí)延長(zhǎng)可達(dá)10余天，基礎(chǔ)體溫下降緩慢，甚至月經(jīng)期還維持著高溫。如果在月經(jīng)期第5～6天取內(nèi)膜檢查則似有腺體分泌現(xiàn)象存在。
 

◎ 判斷黃體功能好壞的方法

 
孕激素是黃體產(chǎn)生的，因此黃體的功能可以用分泌孕激素的高低來(lái)衡量。分泌的孕激素高，說(shuō)明黃體功能好，分泌的孕激素低，則說(shuō)明黃體功能不足。如果你想知道自己黃體的狀態(tài)，就必須在黃體期也就是在排卵后的7～8天去做性激素檢查，因?yàn)檫@個(gè)時(shí)候的孕激素水平最高。
 
測(cè)量基礎(chǔ)體溫也可以判斷黃體功能，因?yàn)轶w溫曲線的走向基本上反映了孕激素的波動(dòng)，所以用它來(lái)判斷黃體功能是很正確的。在基礎(chǔ)體溫曲線的走向上，我們可以看出許多問題：當(dāng)高溫比低溫高出0.3℃以上，高溫天數(shù)保持12天，從低溫爬升到高溫很快，在高溫區(qū)的體溫不是上下激烈波動(dòng)時(shí)，說(shuō)明黃體功能很正常！而不符合上述條件之一的，就說(shuō)明黃體功能存在問題。
 

體溫曲線最常見的有3種類型：

 
1、典型的雙相體溫曲線。在排卵后，黃體分泌孕激素，體溫迅速上升0.3～0.5℃，并持續(xù)至下次月經(jīng)來(lái)潮前才下降。
 
2、黃體功能異常的雙相體溫曲線。
 
·體溫上升緩慢；
 
·體溫升高的幅度不足；
 
·黃體期不足12天；
 
·月經(jīng)來(lái)潮后，體溫仍持續(xù)在比較高的水平。
 
3、單相體溫曲線。無(wú)排卵的月經(jīng)周期，缺乏孕激素，體溫雖有波動(dòng)，但無(wú)持續(xù)性的升溫。
 

◎ 發(fā)現(xiàn)黃體不足該怎么辦

 
發(fā)現(xiàn)自己黃體不足，姐妹們都很著急，此時(shí)她們經(jīng)常會(huì)提出一個(gè)問題：吃什么食品能夠補(bǔ)充黃體？沒有一個(gè)醫(yī)生會(huì)給你一個(gè)明確的答案，因?yàn)樵谑称分?，很難找到一種含有孕激素的食品。
 
對(duì)黃體不足的姐妹，醫(yī)生常會(huì)采取激素療法，既然你的黃體產(chǎn)生的孕激素不足，那么就從體外補(bǔ)充它。有的姐妹接著會(huì)問，進(jìn)行了激素療法，是不是以后黃體功能就此解決了呢？不是。所謂激素療法，只是解決了這屆黃體的問題，隨著這一屆黃體的消失，作用也就消失了，下一屆黃體怎么樣，誰(shuí)也說(shuō)不清楚。如果下一屆的黃體功能還是不足，那么，這種治療還得繼續(xù)。
 
所以，西醫(yī)的激素療法只是個(gè)治標(biāo)的方法。
 
要加強(qiáng)黃體必須從頭做起，我的觀點(diǎn)是：有一個(gè)發(fā)育良好的卵泡，才有一個(gè)良好的黃體。
 
但是相信這一觀點(diǎn)的人好像并不多，因?yàn)檫€有不少姐妹在不斷地詢問，如何治療黃體不足？而沒有重視如何加強(qiáng)卵泡發(fā)育。我現(xiàn)在引用美國(guó)費(fèi)雷德里克森醫(yī)學(xué)博士的話來(lái)增強(qiáng)這一說(shuō)法的權(quán)威性，他說(shuō)：黃體正常功能需要良好的排卵前的卵泡發(fā)育。
 
大家為此一定要把注意力放在卵泡良好發(fā)育上面，到了黃體階段，木已成舟，再怎么治也只是修修補(bǔ)補(bǔ)而已。我們要調(diào)整整個(gè)內(nèi)分泌系統(tǒng)，讓卵泡正常發(fā)育成熟起來(lái)，這才是解決黃體問題的根本。
 

◎ 如何有一個(gè)良好的排卵前的卵泡發(fā)育

 
卵泡從初級(jí)卵泡發(fā)育成為熟卵泡需要有一個(gè)合適的內(nèi)分泌環(huán)境。現(xiàn)代醫(yī)學(xué)對(duì)女性的性激素變化已經(jīng)有了充分的研究，發(fā)現(xiàn)和生育有直接關(guān)系的激素有6項(xiàng)之多，這就是大家熟悉的性激素6項(xiàng)：雄激素、泌乳素、孕激素、卵泡刺激素（FSH）、黃體生成素（LH）和雌二醇（E2）。在這6項(xiàng)之中再進(jìn)行分析，發(fā)現(xiàn)雄激素和泌乳素是個(gè)不變的常數(shù)，只要低于某一個(gè)數(shù)值，就與卵泡發(fā)育無(wú)關(guān)；而孕激素雖然有變化，但是大量出現(xiàn)在排卵以后，在排卵前是很少存在的，因此也和卵泡發(fā)育無(wú)關(guān)；最后剩下的只有3項(xiàng)激素：LH、FSH和E2 ，它們與卵泡的發(fā)育息息相關(guān)。
 
FSH稱為卵泡刺激素，LH稱為黃體生成素，E2是雌二醇——雌激素中活性最強(qiáng)的部分。這些激素的命名是很科學(xué)的，顧名思義，就知道它們的作用。
 
卵泡開始階段就是在FSH的刺激下啟動(dòng)的，啟動(dòng)的時(shí)間是在女性的月經(jīng)階段，接著卵泡在FSH和雌激素的共同參與下逐步發(fā)育成熟。
 
姐妹們一般在月經(jīng)的第3天去檢查激素，這個(gè)時(shí)候雌激素很低，但是不要緊，雌激素在整個(gè)卵泡期肯定是一天比一天高的，到了排卵前的50～80小時(shí)到達(dá)高峰。這個(gè)雌激素的高峰十分重要，當(dāng)它到達(dá)200pg/ml以上，就產(chǎn)生了正反饋，使垂體分泌大量的FSH和LH，于是卵泡就出現(xiàn)了量變到質(zhì)變的過程——排出卵子。接著，卵巢中黃體出現(xiàn)了，黃體的維持就依靠LH持續(xù)旺盛的分泌。
 
我已經(jīng)多次提到200pg/ml這個(gè)數(shù)據(jù)了，請(qǐng)大家注意，它有一個(gè)專用名稱，稱為雌激素的閾值，所謂“閾”就是門檻的意思，說(shuō)明它具有非同尋常的意義。一旦超過了這個(gè)值，就會(huì)對(duì)垂體產(chǎn)生正反饋?zhàn)饔?，假如在這個(gè)高水平上維持50～80小時(shí)，就會(huì)引發(fā)LH和FSH升高，LH和FSH的升高，將啟動(dòng)卵母細(xì)胞的有絲分裂，為卵泡破裂和顆粒細(xì)胞黃素化做準(zhǔn)備。
 
我猜想，知道雌激素有個(gè)閾值的姐妹不會(huì)很多，而了解自己雌激素是不是越過了這個(gè)門檻的則更少。因?yàn)榇蠖鄶?shù)醫(yī)院做這項(xiàng)激素的時(shí)間是在月經(jīng)的第3天，這個(gè)時(shí)期的雌激素很低。而僅僅根據(jù)這個(gè)數(shù)據(jù)，就想去正確預(yù)測(cè)今后的變化，是非常困難的。
 
所以我們總結(jié)出，要想有一個(gè)良好的排卵前的卵泡發(fā)育，女性體內(nèi)必須有良好的雌激素分泌。

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