Preparations for the treatment of giparandrogenii

Antagonists of gonadotropin-releasing hormone

Drugs in this group that suppress the secretion of LH and FSH hormone production by the ovaries limit to a greater extent than combined oral contraceptives .  In the treatment of hyperandrogenism usually use the same doses of antagonists of gonadotropin-releasing hormone, and for the treatment of endometriosis .  Sometimes patients during treatment develop osteoporosis - in many cases it does not pass even six months after discontinuation of the drug .  In this case, it can be assigned to hormone replacement therapy, or receiving conventional combined oral contraceptives .  Some of the side effects that can be caused by drugs from the class of antagonists of gonadotropin-releasing hormone: hot flashes, fatigue, asthenia, headache, lack of appetite, anemia, bone pain, constipation, frequent urination, dermatitis, dizziness, nausea and vomiting, gastroenteritis, dizziness, depression, hematuria, sweating .

Glyukortikoidy

Hyperandrogenism caused by excessive activity of the adrenal, respond well to treatment with corticosteroids such as dexamethasone Dexamethasone - one of the most effective glucocorticosteroids   or prednisolone Prednisolone - against inflammation, allergy and pain, but with complications . These drugs are used with variable success in the treatment of women with hyperandrogenism, causing a variety of disorders, most often - hirsutism. Glucocorticoids have antiinflammatory properties and have an impact on the metabolic processes. Their side effects can be adrenal suppression, insomnia, dizziness, acne, osteoporosis, myopathy, delayed wound healing.

Drugs that increase insulin sensitivity

It was found that the hyperinsulinemia reduces the amount of male sex hormones produced by the ovaries, as well as reduced secretion of SHBG. Consequently, artificial reduction of insulin levels using drugs that increase insulin sensitivity (such as metformin) must reduce the overall level of insulin in the blood. However, it is not able to show that this type of medication is more effective than oral contraceptives. Some research suggests that drugs that increase insulin sensitivity, significantly relieve the symptoms of hirsutism, but in a series of experiments to confirm this was not possible. In addition, while several studies have found that anti-androgens significantly more effective drugs that increase insulin sensitivity.

Metformin may cause side effects such as fatigue, diarrhea, flatulence, muscle weakness, muscle pain, upper respiratory tract infection, hypoglycemia, various disturbances in the gastrointestinal tract, nausea and vomiting, chills, dizziness, bloating, constipation, heartburn, indigestion.

Preparations for topical application are often prescribed to women suffering from hirsutism. Drugs of this type, such as eflornithine, do not affect the level of male sex hormones in the body, but they gradually slow the growth of hair and make the hair less stiff and dark. As a rule, an ointment used to inhibit the growth of hair on the face and neck - in other parts of the body hair removal has been used successfully.

In 30% of patients the result of applying eflornithine becomes noticeable only after two months, others have more improvement comes after a long period of time. Typically, the ointment applied to the skin twice a day; it should not be washed off within four hours after application.

Dopamine receptor agonists. Patients who have hyperandrogenism diagnosed with hyperprolactinemia often prescribed receiving dopamine receptor agonists (such as bromocriptine or cabergoline). Medicines of this type normalize the menstrual cycle, and relieve the symptoms of hirsutism. They can have a positive impact on some of the other signs of hyperandrogenism.

Bromocriptine may cause side effects such as nausea, hypotension, headache, dizziness, abdominal cramps, constipation, drowsiness, constant fatigue, weakness, insomnia, arrhythmia, rash. Side effects of cabergoline may be headache, dizziness, constipation, asthenia, abdominal pain Abdominal pain: Types and Symptoms Depression Depression - a little more than a bad mood , Vision problems.

A month after the beginning of the medical treatment the patient should undergo another examination, the doctor can assess the effectiveness of therapy, to identify possible side-effects and, if necessary, revise the treatment plan. Over the next months, the patient should go to the doctor regularly - up until her condition stabilizes. Thereafter, it is recommended to undergo medical examination once a year.

Forecast

In most cases, have to treat hyperandrogenism throughout life. There are some cases where the patient, who has been associated with hyperandrogenism of PCOS, fully recovered after a significant weight loss. Most patients, however, will have to continue therapy until the end of life - is the only way to control the symptoms of excess male hormones.

Diagnosis giparandrogenii

• Laboratory tests

Laboratory analysis is an important step in the diagnosis of disorders related to hyperandrogenism - such as hirsutism. Although in most cases the cause of elevated levels of male hormones is PCOS, some women identified androgensekretiruyuschie neoplasms - in such cases, timely diagnosis and treatment can save the patient life. When violations, non-hazardous to life too late initiation of treatment can lead to irreversible androgenization.

Some doctors prescribe tests to determine the levels of androgens only to women who have experienced moderate or severe hirsutism Hirsutism - when femininity leaves . An exception can be made if the symptoms of hirsutism appeared suddenly, and if there are any signs that indicate the presence of underlying disease.

• Testosterone levels

Total testosterone levels in women with PCOS is often slightly elevated, so the upper limit of normal at the same violation - 2 ng / dL (8.92 nmol / L). Exceeding the upper limit may indicate the presence of ovarian tumors Ovarian cysts and tumors: diagnosis and treatment   or gipertekoz.

• The level of dehydroepiandrosterone sulfate (DHEAS)

DHEAS is produced almost exclusively by the adrenal glands, so it is a good marker of activity. A slight increase in DHEAS levels typical for women with PCOS. If DHEAS levels exceed 700 ng / dL, suggesting the presence of adrenal neoplasms. In this case, for further diagnostics, or those using medical imaging techniques.

• Standard 17-hydroxyprogesterone

Determining the level of 17-hydroxyprogesterone is appointed for the diagnosis of nonclassical forms of congenital hyperplasia Hyperplasia - do not be afraid   the adrenal glands, which often leads to hyperandrogenism. If the level of 17-hydroxyprogesterone than 2 ng / dL are assigned additional diagnostic procedures.

• The level of thyroid stimulating hormone

Patients who identified hyperandrogenism, be sure to check for hyperthyroidism and hypothyroidism. They may be a subclinical thyroid dysfunction, which may become the cause of menstrual disorders. To evaluate the function of the thyroid gland, usually appointed by the tests to determine the level of thyroid stimulating hormone (TSH).

• Prolactin levels

That hyperprolactinemia Hyperprolactinemia: determine the cause   associated with hyperandrogenism, specialists known for a long time. In addition, elevated levels of prolactin may be observed in patients with hypothyroidism. If high levels of prolactin thyroid function is normal, the patient can be administered a magnetic resonance imaging (MRI) of the pituitary gland to exclude tumors in this part of the brain - they sometimes can stimulate the secretion of prolactin.

Other diagnostic procedures

• Ultrasonography

Many experts appointed ultrasonography (US) of the pelvic organs of women who have observed certain signs of hyperandrogenism. Using ultrasound can diagnose PCOS and ovarian neoplasms.

PCOS usually diagnosed when a woman in at least one detected ovarian follicles 12 and a diameter greater than 10 mm - provided that no other pathologies. The presence of large, complex ovarian cysts may be a sign of a tumor secreting androgens.

• Computed tomography (CT) and MRI

If you suspect an adrenal neoplasm women appointed by CT or MRI. With both of these imaging techniques are usually unable to distinguish between benign adenomas from malignant neoplasms. CT reveals a tumor in the adrenal glands, the diameter of which is less than 5 mm, and the MRI can determine whether the tumor germinated in blood vessels.