The choice of treatment is determined primarily by the spread of disease process, the patient's age and condition of her reproductive functions. It is important not only to achieve reduce the severity of symptoms and subsequently restore the fertility and prevent relapses. How to treat adenomyosis doctor determines the terms of an integrated approach, which involves a combination of several methods.
Basic approaches to hormone replacement therapy
The leading method of medical treatment of adenomyosis
Adenomyosis - treatment should be individualized
It is a hormone therapy. The goal of such therapy is considered to be the impact of hormones on the level of central regulatory mechanisms to trigger the principle of mutual communication endometriodnyh regression of lesions. If the pathological process extends to the adjacent organs, it is possible to combine the appointment of hormonal drugs to surgery.
Selection hormonal agents depends largely on the patient's age. In identifying the disease in younger women, especially young women, we can recommend the appointment of the scheme contraceptives (or CCO). This method is not only independent, it is used for the preparation of the patient before surgery. Preference is given to those drugs that are low dosage:
Jeanine - not only contraception but also protection against acne
A positive result can be achieved by the duration of reception of at least six months (average of six months to one year). Standard treatment regimens represent 07.21.21, while allowed the individualization of the regime, depending on the clinical situation.
Possibilities of conservative therapy
As a remedy for adenomyosis appointed progestin drugs, hormone agonists central. During long-term administration of progestogens a decrease in the severity of clinical symptoms, pathological centers have evolved over time reverse development. The preferred considered the appointment of natural analogues of progestogens, which has fewer side effects and is well tolerated by patients during long-term therapy. Didrogesteron (or drug "Duphaston") was adopted taking into account the phase character of the menstrual cycle at a dose of 30 mg per day. The dose may vary as determined by the peculiarities of the disease.
Due to the pronounced therapeutic effect of the drug of choice for adenomyosis inhibitors are considered the central production of hormones. The drug "danazol" causes reversible changes in the secretion of pituitary hormones, after the abolition of a gradual recovery of hormonal relationships and ovulation
Ovulation - How to determine as accurately as possible?
. There is a maximum allowable daily intake, which should not be exceeded in the course of treatment (up to 800 mg). It is possible to recommend a treatment regimen for a gradual increase in the dose, depending on the symptoms.
Inhibit the production of gonadotropin-releasing hormone drug "gestrinone." It can also be effectively used for medicinal purposes for a long time when adenomyosis. The frequency of administration is regulated individually, often assigned treatment dose twice a week. During the first month of treatment, some patients noted the appearance of discharge from the genital tract meager character (like "spotting"). If in a subsequent character of the discharge does not change, it is necessary to conduct a survey to exclude concomitant adenomyosis disease that has not been identified previously.
How to determine the indications for hospitalization
Adenomyosis has a variety of clinical manifestations, which are largely determined by the degree of severity of the disease. If the measures of the conservative therapy does not bring relief, increases the severity of pain, there is a need for hospitalization of the patient to decide on surgical treatment. Preparations for the planned rapid intervention should be carried out in a hospital. The effectiveness of treatment depends on the conduct in the period after the operation of the complex rehabilitation.
Rehabilitation treatment should include:
- physiotherapy treatments that improve pelvic blood flow, metabolic processes at the cellular level
- appointment of immunomodulating agents
- Vaginal microflora and restore
- normalization of the menstrual cycle (cycle must always be two-phase)
Surgical correction may also include the operation to restore a woman's reproductive function. Adenomyosis can often cause infertility, so for many women is the issue of fertility in the first place. Best results are obtained when the first stage of the disease, when the process is not common. With progression of the severity of the disease there is a reduction in the incidence of a positive result.
The success of the surgery is estimated for the first five years after surgery. Relapses of adenomyosis in the meantime developed almost 20% of cases. The highest percentage of cases, relapse occurs within the first year, so mandatory postoperative hormone therapy is conducted. Timely administration of hormone therapy affects the quality of life of women, as the marked decrease in the severity of pain and the amount of blood loss during menstruation.
If the background of the complex therapeutic measures in patients with adenomyosis
Adenomyosis - avoid constant stress
pain persists, it shows a survey of doctors of related disciplines in order to avoid urinary tract abnormalities or diseases of the digestive tract. Often the intensity of pain and persistent nature is reflected in the psycho-emotional state, so in this situation can not do without consulting a psychiatrist.