Endometriosis is a rather mysterious disease until now. There are many forms of endometriosis. Endometriosis affects not only the sexual organs (in this case it is called genital), but the rest (extragenital). When people speak of endometriosis uterus, the mean adenomyosis. Adenomyosis of the uterus can be of several types. Not so rare and focal adenomyosis.

The most common focal adenomyosis observed in premenopausal women (45-50 years). Treatment of focal adenomyosis is no different from other forms of treatment of endometriosis uterus, and it is the same for a long and complicated.

What is the focal adenomyosis

As noted above, adenomyosis is a form of endometriosis, wherein endometriotic foci or heterotopia, positioned in the uterus. If the diffuse form of adenomyosis in the pathological process involved the entire wall of the uterus, then the focal form of adenomyosis affects only certain sections. As a result, the germination of endometrial lesions in the uterine wall formed passages, which in severe severity of illness can penetrate the entire thickness of the uterine wall with access to the pelvic area (fistulas).

Causes

The reasons for both diffuse and focal adenomyosis similar. These include:

• Regular stress;
• genetic predisposition;
• too active lifestyle (work, plus the house, plus sports);
• abortion and diagnostic curettage of the uterus Curettage - how dangerous it is? ;
• pathological delivery;
• constant insolation (visit tanning salons, the obsession with sunbathing);
• intrauterine intervention (cesarean section and other operations in the uterus).

The mechanism of development

Pathological childbirth or abortion, which were accompanied by complications in the form of inflammation of the uterus, leading to disruption of the structure of the uterine mucosa, as well as the surrounding areas of the muscular layer. Furthermore, the functional connections are broken in the uterus - ovary, leading to breakdown of follicular maturation and ovulation Ovulation - How to determine as accurately as possible? . As a result, the endometrium (lining of the uterus) develop hyperplastic processes, which account for about producing diagnostic curettage Scraping - heavy and unsafe procedure . During dilatation and curettage is often disturbed connective tissue basis basal (sprout) layer of the endometrium, as well as adjacent areas of the muscular layer. The result is that viable cells endometrium penetrate the muscular layer, and wherein acclimatized.

The clinical picture

Clinical manifestations of focal adenomyosis form similar to other forms of adenomyosis. The first patient complained of the emergence of spotting Spotting - it is important to rule out pathology   for two or three days before menstruation and during the same time and after. Also, patients concerned about heavy periods and pain. Pain increases as the disease progresses. By the nature of the pain aching or pulling, are located in the abdomen, and are associated with the menstrual cycle (or appear worse before menstruation). The pain may radiate to the lumbar region. Also, patients complain of dyspareunia (pain occurring during sexual intercourse). Often there intermenstrual spotting, leading to uterine bleeding. Spotting before and after menstruation the cause of anemia. Severe anemia appears pale skin, weakness, headaches and dizziness, decreased blood pressure. All of these symptoms dramatically reduce performance. Long-term course of the disease, which often leads to infertility.

Treatment

Treatment of focal adenomyosis long, until menopause. The main element in the treatment of focal adenomyosis are hormones. Women of reproductive age prescribed oral hormonal contraceptives. In parallel, immunotherapy and treatment to resorption of adhesions. When bleeding appoint hemostatic agents.

Anna Sozinova

  Mikomaks used to treat fungal infections, such as vaginal candidiasis Thrush - vaginal candidiasis: when to go to the doctor? , Oropharyngeal candidiasis (oral thrush, stomatitis), esophageal candidiasis (Candida esophagitis) and other infections caused by a Candida (e.g., urinary tract infections, abdominal inner cladding) or cryptococcal meningitis Meningitis - an inflammation of the meninges . This drug kills fungus, preventing their further reproduction. Mikomaks also used for the prevention of candidiasis in patients receiving bone marrow transplant.

Mikomaks sold only by prescription.

Before taking mikomaks

Before you start taking this medicine, you need to weigh all the associated risks and benefits. Often the patient is taking an appropriate decision, together with your doctor - he may refuse to take the medicine if it considers, for example, that it can cause very serious side effects. So, before taking mikomaks, you need to consider the following:

• Allergies

Tell your doctor if you have had previous allergic reactions to mikomaks (or fluconazole, its active ingredient) or any other medicines. Doctors also need to know if you are allergic to any other substances - such as pollen, food, and so on.

• Children

The studies did not reveal any problems that could restrict the use of mikomaks for the treatment of children aged 6 months to 13 years. However, the efficacy and safety of this medication for children younger than 6 months has not yet been confirmed.

• The elderly

Until now, it was not revealed any specific problems with the reception mikomaks elderly. However, as in old age there is an increased likelihood of age-related disorders of the liver, you may need a dose adjustment mikomaks considering this feature.

• Gestation

Mikomaks may cause serious harm to the developing fetus. The appointment of the drug to pregnant women is only possible if the treatment is necessary to prevent serious complications in patients.

• Breast-feeding

According to currently available scientific data, the reception mikomaks during breastfeeding exposes children to minimal risk. However, if possible, should be used instead mikomaks safer drugs.

Drug Interactions

Acceptance of these drugs at the same time mikomaks not recommended; if the patient needs to take any of the following medicines, your doctor may prescribe another medicine instead mikomaks: alfuzosin, astemizole, bepridil, cisapride, citalopram, clozapine, krizotinib, dasatinib, domperidone, dronedarone, granisetron, lapatinib, levometadil, Lumefantrine, mesoridazine, mifepristone Mifepristone: medical termination of pregnancy by the French pharmacists , Nilotinib, ondansetron, pimozide, quetiapine, salmeterol, sorafenib, sparfloxacin, sunitinib, terfenadine, thioridazine, vardenafil ziprasidone.

Acceptance of the following drugs together with mikomaks usually not recommended, but sometimes it's necessary; generally, in such cases, the doctor changes the dose and / or frequency of medication .  Medicines ,  which is undesirable ,  but in some cases it is allowed to take simultaneously with mikomaks: acenocoumarol ,  amiodarone ,  amisulpride ,  amitriptyline ,  anisindione ,  apomorphine ,  aprindine ,  arsenic trioxide ,  atorvastatin ,  azithromycin ,  cerivastatin ,  chloral hydrate ,  Chloroquine ,  chlorpromazine ,  Ciprofloxacin ,  clarithromycin ,  clomipramine ,  clopidogrel ,  Colchicine ,  desipramine ,  dicumarol ,  droperidol ,  enflurane ,  eplerenone ,  ergotamine ,  erythromycin ,  everolimus ,  Fentanyl ,  flecainide ,  fluoxetine ,  formoterol ,  foscarnet ,  gemifloxacin ,  halofantrine ,  haloperidol ,  halothane ,  gidrohinidin ,  ifosfamide ,  iloperidone ,  imipramine ,  isradipine ,  levofloxacin ,  Lopinavir ,  mefloquine ,  Nevirapine ,  nitrofurantoin ,  nortriptyline ,  Octreotide ,  ofloxacin ,  paliperidone ,  pentamidine ,  phenindione ,  phenprocoumon ,  probucol ,  procainamide ,  prochlorperazine ,  Promethazine ,  quinine ,  rifabutin ,  risperidone ,  sodium phosphate ,  solifenacin ,  spiramycin ,  sulfamethoxazole ,  telithromycin ,  tetrabenazine ,  trifluoperazine ,  vasopressin ,  warfarin ,  zotepine

Simultaneous application mikomaks and the following drugs may increase the likelihood of side-effects, but in some cases a combination of these drugs may be needed to a patient, and it can take them regularly being watched by a doctor: alfentanil, amlodipine, carbamazepine, celecoxib, cimetidine, cyclosporine, etravirine, felodipine, losartan, methadone, midazolam, nicardipine, nifedipine, omeprazole, phenytoin, prednisone, rifampicin, rosuvastatin, tipranavir, tretinoin, vincristine.

Contraindications

• Mikomaks contraindicated in case of hypersensitivity to fluconazole Fluconazole - used with caution . With few exceptions, it should not be taken by pregnant or lactating women.
• Heart disease - taken with caution. Mikomaks in people with heart disease can result in an increase in heart rate.
• Liver disease - taken with caution as mikomaks can aggravate symptoms.
• Mikomaks should also be taken with caution in the presence of kidney disease.

Overdose

The main symptoms of overdose are mikomaks:

• Irrational fear, suspicion, or a change in mental status;
• Auditory or visual hallucinations.

If you experience any of these symptoms should immediately seek medical care.

Dosage regimen

• Cryptococcal meningitis

Adults and adolescents - 400 mg on the first day followed by 200 mg once a day for at least 10-12 weeks. If necessary, your doctor may increase the dose.

Children from 6 months to 13 years - the dose is calculated according to body weight, and it should identify the doctor. Mikomaks usual dose for children is 12 mg per kilogram of body weight for the first day and then 6 mg per kg of body weight once a day for 10-12 weeks.

Children under the age of 6 months - a decision on the possibility of the drug and the amount of the dose the doctor will determine in each particular case.

• Esophageal candidiasis

Adults and adolescents - 200 mg on the first day, then 100 mg once a day for at least three weeks.

Children aged 6 months to 13 years - the standard dose is 6 mg per kilogram of body weight for the first day and then 3 mg per kg of body weight once a day for 3 weeks.

• Oropharyngeal candidiasis

Adults and adolescents - 200 mg on the first day followed by 100 mg per day. The course of treatment is not less than two weeks.

Children aged 6 months to 13 years - usually the dose is 6 mg per kilogram of body weight for the first day and then 3 mg per kg of body weight once a day for two weeks.

• Urinary tract infections and peritonitis

Adults - from 50 to 200 mg per day.

Children - Dose is determined by your doctor.

• Vaginal candidiasis

Adults - a one-time 150 mg of the drug.

Children - Dose is determined by your doctor.

• Prevention of candidiasis in bone marrow transplantation

Adults - 400 mg once a day.

Children - Dose is determined by your doctor.