Dexamethasone is used in gynecology for treatment of some types of menstrual disorders and related infertility. In most cases, these violations are innate and begins in utero. However, they are amenable to correction.

What is congenital adrenal hyperplasia

Adrenogenital syndrome - a disease caused by increased function of the adrenal cortex with the secretion of a large number of male sex hormones androgens, which inhibit the secretion of pituitary gonadotropins, which leads to disruption of the menstrual cycle and infertility.

Most often, the disease is hereditary and occurs in several children in the family since the birth. However, congenital adrenal hyperplasia may also occur in tumors of the adrenal cortex, in which case his symptoms appear at any age.

The development of this disease in congenital hyperplasia Hyperplasia - do not be afraid   adrenal cortex caused by inherited disorders of the adrenal hormone synthesis due to deficiency of certain enzymes. In fact, congenital adrenal hyperplasia is the result of dysfunction of the adrenal cortex, at which there is increased formation of some steroid hormones (androgens) and a decrease in the formation of other (glucocorticosteroid hormone cortisol).

The deficit of cortisol Cortisol - the hormone of the adrenal cortex   It leads to an increased release of pituitary adrenocorticotrophic hormone (ACTH), whose function is to stimulate adrenocortical secretion of cortisol for the purpose. This leads to the fact that the production of male sex hormones is further enhanced, and the urine, a large amount of 17-ketosteroids (the figure shows the high level of androgens in the blood).

How does congenital adrenal hyperplasia in women

The disease can manifest itself in several forms, but the main feature of all forms is the emergence of women of secondary male sexual characteristics: low voice, too expressed muscle development, body hair pubic hair of male type, with the advent of increased body hair mustache and beard. Often there is an increase of the clitoris and the cessation of menstruation.

If the disease girl begins in utero, that she often found anatomical changes of the external genitalia. This sometimes causes difficulty in determining the sex of the newborn. In the future, these girls quickly grow to approximately twelve years, after which growth is stopped due to the early closure of growth zones in the tubular bones.

Menstruation in these girls start late (15-16 years). The menstrual cycle is characterized by cyclic, long intervals between periods, the paucity of menstruation.

Based on what the diagnosis

Diagnosis is based on clinical examination and laboratory tests. The main laboratory test confirms the diagnosis of a urine sample for the presence of 17-ketosteroids. We investigate the number of levels of biologically active substances - precursor of androgens (17 UNP, T, DHEA, DHEA-S).

In order to distinguish the tumor from the adrenal cortex hyperplasia, patients underwent a test with dexamethasone. When tumor dexamethasone Dexamethasone - one of the most effective glucocorticosteroids   It does not cause a decrease in the amount of urinary 17-ketosteroids, whereas hyperplasia this figure sharply reduced.

Ultrasound examination indicated the presence of ovarian follicles in the ovaries of varying degrees of maturity, which does not end with the maturation of ovulation Ovulation - How to determine as accurately as possible? . The dimensions of the ovaries may be somewhat larger than the norm.

Treatment adrenogenitelnogo syndrome using deksometazona

Today, congenital adrenal hyperplasia often treated using deksometazona that performs in this case replacement function. Assigned daily administration of dexamethasone in a small dose. The effectiveness of the treatment is carried out using urine 17-ketosteroids. The use of dexamethasone contributes to the normalization of the menstrual cycle, ovulation and normal appearance corresponding menstrual cycle, changes in the mucous membrane of the uterus (by ultrasound). It is also possible pregnancy, in which case the hormonal support of pregnancy continues to term the formation of the placenta (up to 13-16 weeks), which then takes over all functions to support pregnancy.

Women on treatment with dexamethasone are all male secondary sex characteristics.

Dexamethasone treatment of adrenogenital syndrome in women's effective and time-tested.

Galina Romanenko

Utrozhestan - a hormonal drug, which includes the female sex hormone progesterone. Such drugs can be prescribed only after a preliminary examination of the doctor and individually selected dose. The duration of treatment and route of administration of the drug into the body as determined by your doctor.

On the preparation

The active ingredient is utrogestan progesterone - the hormone of the second half of the menstrual cycle. Progesterone inhibits the growth of the endometrium (the mucous membrane of the uterus) and the endometrium to secrete forces - to allocate a secret, rich nutrients necessary for the development of the fetus after pregnancy.

Simultaneously with the beginning of pregnancy, progesterone Progesterone - norm and pathology   suppresses "all efforts" to cut the muscle layer of the uterus and remove the fetus from the uterus, ie the progesterone prevents spontaneous abortions in the first 20 weeks of pregnancy. After this period it is no longer used because of the risk of toxic effects on the liver.

Produced utrozhestan special soft gelatin capsules in which the oil is a homogeneous white suspension.

Sometimes appointed simultaneous reception inside capsules with the introduction of its intravaginal use.

How to take into utrozhestan

In appointing utrogestan inside, a complete survey of the women as utrozhestan has a number of contraindications and side effects. The most serious contraindications for appointment utrogestan inside are increased blood clotting (tendency to thrombosis that progesterone may itself cause), severe liver disease in violation of its functions (utrozhestan can have toxic effects on the liver) and malignant breast diseases and female genitals ( stimulates their growth). There are a number of contraindications for appointment utrogestan inside.

When failure of the second phase of the menstrual cycle can develop diseases such as premenstrual syndrome, dysmenorrhea (painful periods), breast Breast - the mirror Women's Health . Utrozhestan in this case, prescribed orally 100 mg twice a day or 100 mg in the morning and 200 mg in the evening. Treatment is carried out in the second half of the menstrual cycle with a 16-17 25-26 day.

If utrozhestan introduced as part of substitution treatment for women in menopause and during menopause, it is prescribed with estrogen. Utrozhestan in this case 100 mg administered twice a day for two weeks during menopause and 100 mg per day continuously during menopause.

With the threat of miscarriage or for the prevention of recurrent miscarriage utrozhestan appoint two capsules of 200 mg twice daily (400 mg daily). Or another dose chosen doctor individually.

How to enter utrozhestan intravaginal

If utrozhestan assigned intravaginal, the capsule is introduced into the vagina as deeply as possible once or twice per day. If utrozhestan assigned once per day, it is administered in the evening before bedtime. Often, the doctor prescribes the capsules at the same time inside and intravaginal administration. When a large number of vaginally administered progesterone concentrated in the walls of the uterus, which is effective, for example, when threatened abortion.

The indications for use are utrogestan intravaginal menstrual disorders with partial deficiency of progesterone. In this case utrozhestan intravaginally administered at 100 mg capsule twice a day for ten days, as well as inside, with 16-17 25-26 day cycle.

Utrozhestan thus introduced as follows: one capsule 100 mg is administered at night at 13 and 14 days of the menstrual cycle The days of the menstrual cycle: Four phases Then administered at 100 mg twice a day (morning and evening) with 15 to 25 day cycle. From 26 day cycle starts and if a pregnancy dose increased to 100 mg a day, every week, reaching 600-800 mg per day, divided into three doses. Duration of the course - at least two months.

With the threat of miscarriage or habitual abortion utrozhestan administered vaginally for a period not later than the twentieth week of pregnancy at 100-200 mg twice a day, once a day.

Correct reception utrogestan to help this particular woman may appoint a woman to a doctor.

Galina Romanenko