Nowadays there are several groups of hormonal drugs that suppress the development of areas of endometriosis. At various forms and prevalence of the disease and the different ages are assigned different drugs or combinations thereof. What and how to assign women with the disease resolves doctor.

The operating principle of hormonal drugs for endometriosis

The effect of all groups hormonal drugs in this case is reduced to the suppression of female sex hormone estrogen. It estrogens are the "culprits" uncontrolled proliferation of the mucous membrane of the uterus (endometrium), and then extended its rejection, which occurs during penetration of endometrial cells in other organs and tissues with the formation of endometriosis there.

Inhibits the action of estrogen can be radically, that is, by inhibiting the development of the menstrual cycle for some time. This is achieved by using drugs - synthetic analogues of gonadotropin-releasing hormone of the hypothalamus (GnRH agonists). You can also suppress estrogen production by using inhibitors of pituitary gonadotropins, synthetic analogues of progesterone Progesterone - norm and pathology   and hormonal contraceptives.

The action of GnRH agonists

This group of drugs include Diferelin Diferelin - antitumor agent , Dekapeptil, nafarelin, buselerin, zolodeks depot, lyukrin Depot and others. Normally undulating selection Riesling-hormones of the hypothalamus stimulates the release of pituitary hormones. But after prolonged application in sufficient doses, after a short initial period of stimulation of the pituitary gonadotrophic function, these drugs have a suppressive effect on the secretion of gonadotropins followed by suppression of ovarian function.

Long-term treatment reduces the concentration of pituitary gonadotropins (TG), which reduces the performance of estrogen to levels consistent state after removal of the ovaries, which prevents the development of endometrial growths in different organs.

However, these drugs have a drawback - they can cause osteoporosis - leaching of bone calcium, which leads to an increased brittleness. Therefore, for too long they tend not to appoint, limited, usually three months. During this time, endometriosis can be reduced.

The effect of inhibitors of production of pituitary gonadotropins (TG)

For drugs in this group include, for example, danazol. It causes a reversible suppression of TG products. Danazol inhibits proliferation and causes atrophy of normal and ectopic (located in other tissues and organs) of endometrial tissue, reduces blood loss during menstruation, suppresses ovulation Ovulation - How to determine as accurately as possible? , Turns off the function of the ovaries, causing atrophy areas of endometriosis. But this drug has the potential to cause side effects of the male sex hormone that is the hormonal changes characteristic of the male body: increased body hair, acne, weight gain, and so on.

Action progestogens

Progestin - a synthetic analogue of the female hormone progesterone. The introduction of these drugs inhibit the overgrowth of the mucous membrane of the uterus (endometrial proliferation) and transforms it into a phase of secretion. This group of drugs include djufaston, which can be administered for long periods of time without any negative consequences.

But the drugs of this series are mainly effective in the treatment of endometriosis, mild to moderate.

Recently, for the treatment of endometriosis using intrauterine hormonal contraceptive MIRENA, which includes the progestogen levonorgestrel. Mirena has mainly local gestagenic action, which allows the use of progestins in a very low daily dose. High concentrations of progestogen in the endometrium make the endometrium unresponsive to estrogen, suppressing thus its proliferation.

The action of combined hormonal contraceptives

Combined hormonal contraceptives (HC) contain small doses of hormones - synthetic analogues of estrogen and progesterone that support artificial menstrual cycle. This inhibits the action of its own hormones, which leads to suppression of the proliferation of sites of endometriosis. In endometriosis HA for therapeutic purposes shall be appointed for three menstrual cycles in a row (three packs of pills for 63 days), followed by the seven-day break.

The long interval between the rejection of the endometrium results in suppression of the development of endometriosis. Such treatment is often used after surgical treatment - removal of endometriosis in order to prevent recurrence of the disease.

The drug, which is necessary for the treatment of women with endometriosis Endometriosis - a serious problem with serious consequences He picked only her doctor.

Galina Romanenko

Endometrial hyperplasia, adenomyosis - are diseases which are based on the excess in the body of female hormones estrogen. And in fact, in both cases under the action of estrogen occurs overgrowth of the mucous membrane of the uterus (the endometrium).

Why develop hormonal diseases such as endometrial hyperplasia and adenomyosis

Endometrial hyperplasia of the uterus is called overgrowth (proliferation) of the inner lining of the uterus (endometrium) in the first half of the menstrual cycle under the influence of excess female hormone estrogen.

Typically, this condition is noted, either absolute or relative lack of another female sex hormone - progesterone, which supports the second half of the menstrual cycle, estrogen and inhibits the secretion of growth of the endometrium.

Lack of progesterone and estrogen excess leads to long-term proliferation of the endometrium. When hormonal support stops a thick layer of epithelium is rejected, accompanied by heavy bleeding. Sometimes estrogen allocated waves for a long time, which leads to not so abundant, but prolonged bleeding.

Contributing factors contributing to the development of endometrial hyperplasia, are serious emotional and informational load, stress, traumatic brain injury, brain disease, endocrine disorders (eg, obesity, diabetes), chronic inflammation of the female genital organs, tumors (eg, uterine fibroids ), polycystic ovary syndrome, heavy births, induced abortions, and so on.

Adenomyosis - is a form of endometriosis characterized by the growth of endometrial tissue in the muscle layer of the uterus (myometrium). One reason is adenomyosis growth (proliferation) endometrial exposed too much estrogen. But for the development of endometriosis requires additional conditions: decreased immunity (normal immune cells destroy the cells of the endometrium, trapped in other tissues), violation of the permeability of the basal (not rejected during menstruation, which is then recovered the rest of the endometrium - functional) layer of the endometrium. Violations of the permeability of the basal layer of the endometrium may have a genetic or congenital in nature and can occur under the influence of high pressure in the uterus for violations of the outflow of menstrual blood.

The main symptoms of endometrial hyperplasia and endometriosis

The main symptom of endometrial hyperplasia is a lengthening of the menstrual cycle in combination with strong menstrual bleeding (menorrhagia). Sometimes the bleeding is not overly abundant, but long - this suggests that estrogens are allocated relatively long in small portions. Characteristic and acyclic bleeding - metrorrhagia.

Regular significant blood loss leading to iron-deficiency anemia. The symptoms of this deficiency anemia are fatigue, weakness, fatigue, decreased performance, pale skin and mucous membranes, headaches, dizziness, and sometimes - fainting.

Endometrial hyperplasia is often accompanied by infertility or miscarriage Miscarriage - why you lose the most precious thing? . Women with endometrial hyperplasia identified and other endocrine diseases - obesity, diabetes Diabetes - threatening and incurable disease , Thyroid disease Thyroid disease - women at risk , The adrenal glands. pituitary and so on. In these diseases are the hallmarks of high blood pressure and disorders of the liver.

The characteristic symptoms of adenomyosis Adenomyosis: Symptoms - what to expect from the body?   are menstrual and intermenstrual bleeding, iron deficiency anemia and severe pain in the abdomen, which begin a few days before menstruation and end a few days after they started.

Diagnostics

Suspicion of these hormone-dependent disease already appears on the basis of complaints of the sick woman and her gynecologist examination. After that, the study taking swabs from the vagina, cervix and urethra, blood on hormones, ultrasound is performed, if necessary - the diagnostic hysteroscopy, x-ray, magnetic resonance imaging. To identify possible pockets of extragenital endometriosis conducted a full examination of all internal organs.

Treatment of endometrial hyperplasia and adenomyosis is conducted only after a complete examination and final diagnosis. Typically, this is a long process that requires careful execution of a woman doctor's appointments.

Galina Romanenko