The site provides reference information for informational purposes only. Diagnosis and treatment of diseases must be carried out under the supervision of a specialist. All drugs have contraindications. Consultation with a specialist is required!
Svetlana Viktorovna asks:
What contraceptives should you take if you have endometriosis?
Also, with endometriosis, a woman may experience the following symptoms:
- bleeding during menstruation becomes longer and more abundant;
- pain during sexual intercourse;
- pain during bowel movements;
- infertility.
Hormonal contraceptives.
Hormonal contraceptives contain analogues of female sex hormones - estrogen and progesterone. Data contraceptives provide not only a reliable contraceptive effect, but also have a therapeutic effect on the body. Hormonal contraceptives are used in the treatment of diseases such as endometriosis, uterine fibroids, endometrial polyps, etc.The mechanism of action of these hormonal contraceptives is as follows:
- inhibit ovulation;
- thicken cervical mucus in the cervical area;
- block the growth of the uterine mucosa;
- block endometrial metastasis in endometriosis.
1. Combined oral contraceptives. These drugs contain a combination of two hormones - estrogen and progestin. Available in tablet form ( the package contains 21 or 28 tablets), which should be taken daily, starting from the first day of menstruation. With endometriosis, a woman is recommended to take monophasic oral contraceptives ( Yarina, Zhanin, Marvelon, etc.). In the packaging of these drugs, all tablets have the same dose of hormones, unlike biphasic and triphasic drugs.
2. Non-combined oral contraceptives (mini-pills). These drugs contain only one hormone - progestin. The mini-pill package contains 28 tablets, which should be taken daily at the same time and without interruption ( When one package is finished, another one begins immediately). These contraceptives ( micronor, microlute, etc.) is also recommended for use in cases of endometriosis.
3. Depo-Provera injections. This contraceptive also contains the hormone progestin. The hormonal injection is administered intramuscularly by a gynecologist. The validity period of this product is 12 weeks, after which the injection is repeated if desired. Depo-Provera injections are quite effective in treating endometriosis.
4. Hormonal intrauterine device Mirena. This contraceptive contains a synthetic analogue of the female sex hormone progesterone - levonorgestrel. An intrauterine device is a plastic device that is inserted into the uterine cavity by a gynecologist. The spiral acts locally on the uterus, thereby providing both a therapeutic and contraceptive effect.
Hormonal contraceptives for endometriosis are taken:
- when a woman is under 35 years of age;
- with the first or second degree of spread of endometriosis.
- breast cancer;
- genital cancer;
Content
In recent years, modern gynecology has seen an increase in pathologies associated with hormonal disorders. These diseases are often accompanied by menstrual cycle disorders and affect a woman’s reproductive function, which is usually eliminated by the use of hormones. One such disease is endometriosis, which can occur in various forms.
Endometriosis refers to a pathological condition in which the cells that make up the endometrium spread beyond the inner layer of the uterus. The disease is most typical for representatives of the reproductive group, which is fraught with the development of infertility.
Endometriosis is in third place in terms of prevalence among gynecological diseases, and the number of diagnosed cases is steadily growing. This is due not only to a qualitative improvement in diagnosis, but also to an increase in inflammatory processes, deterioration of the environmental situation, and early sexual activity in the absence of adequate contraception.
The mechanism of development of endometriosis is determined by the structure of the uterus, which is represented by:
- endometrium;
- myometrium;
- perimetry.
The source of the disease is atypically located endometrial cells, which first grow and then are rejected under the influence of the hormonal system every physiological cycle. It is the functional layer of the endometrium that is subject to the action of hormones, since its basal component creates the conditions for growth.
With the development of pathology, endometrioid cells penetrate into the middle layer, which is the muscular layer and is called the myometrium. This type of endometriosis is called internal, as well as adenomyosis. This is the most common form of pathology.
The function of the myometrium is to ensure the distensibility of the uterus during pregnancy and contraction during menstruation. The appearance of foci of endometriosis, which look like islands of endometrioid cells, impairs the contractility of the myometrium and causes infertility. This is due to the fact that the altered endometrium cannot facilitate egg implantation.
With further progression of the pathological process, the cells penetrate the perimeter, which is the outer membrane. In the absence of adequate treatment, which usually involves taking hormonal drugs, lesions spread to the tissue of the tubes, ovaries, vagina, and external genitalia.
The form of endometriosis that affects the tissues of the organs of the female reproductive system is called genital. If endometriosis affects the intestines, bladder, kidneys, conjunctiva of the eyes, experts diagnose the extragenital form, however, it is quite rare.
Etiology and pathogenesis
Some experts associate endometriosis with a decrease in fertility, which leads to a natural increase in the number of menstruation, which nature did not provide for. The cause of genital endometriosis is endometrioid cells that penetrate into organ tissue during menstruation.
During menstruation, a reverse or retrograde reflux of some of the bloody discharge containing endometrial cells into the abdominal cavity occurs. This process occurs in every woman. However, not every woman will develop endometriosis.
Why one woman develops endometriosis and another does not is not yet known to science. Cell engraftment occurs due to immune disorders. An adequately functioning immune system does not allow foreign elements to grow into tissues that are unusual for them.
Most women who have been diagnosed with endometriosis have hormonal disorders. Gynecologists identify disorders related to the level of sex hormones. In particular, hormones such as LH, FSH, prolactin and estrogens are at high levels. While the hormone progesterone has a low concentration. In this connection, hormonal drugs, for example, Norkolut, are widely used.
Hormonal drugs, in particular COCs for endometriosis, allow you to achieve the desired levels of sex hormones. This is necessary as part of stabilizing the pathological process of both endometriosis and many other concomitant pathologies.
Often, endometriosis is accompanied by other pathologies, which also arise as a reaction to fluctuations in hormone levels. Thus, hormonal drugs, for example, Norkolut, not only create the necessary hormonal levels, but also treat several disorders at the same time.
Gynecologists also identify factors that may predispose to the progression of various forms of endometriosis.
- The role of heredity. Endometriosis is not a hereditary disease, however, a family predisposition has been established. Scientists have identified types of endometriosis that are most likely to occur in members of the same family.
- Inflammatory processes. Infections and inflammations negatively affect the hormonal background due to damage to the ovaries, as well as the condition of the endometrial tissue.
- The onset of menstruation before 11 or after 16 years. This factor may indirectly indicate a disruption in the production of sex hormones, which provokes the development of endometriosis.
- Unfavorable environmental conditions. Poor environmental conditions worsen immunity and affect the hormonal system, causing the development of benign diseases.
The mechanism of development of endometriosis is not well understood. In modern gynecology, many theories have been developed that can explain from different points of view how pathology develops.
- One theory is endometrial metaplasia. Its essence is that some organ tissues can turn into something like endometrial cells.
- Quite often the development of the disease is observed after manipulations on the body of the uterus. As a result of a violation of the integrity of the inner lining of the uterus, endometrial elements penetrate into the myometrium, and then into the perimeter. Further spread of the pathological process cannot be ruled out.
- Sometimes endometriosis is diagnosed in girls before their first period. However, this pathology is combined with abnormalities of the genital organs. Perhaps this is a consequence of intrauterine disorders, which led to the formation of endometrioid cells in the tissues of other organs.
Treatment of endometriosis necessarily includes the elimination of provoking factors, which can be achieved with the help of hormonal drugs such as Norkolut and medications from the COC group. These drugs create the necessary hormonal levels, preventing the development of relapses, in particular in the postoperative period.
Symptoms
The clinical picture depends on the extent of the pathological process and the individual characteristics of the woman. In general, each type of endometriosis has its own characteristic symptoms, for example, when the conjunctiva of the eyes is affected during menstruation, blood is discharged from the organ.
However, all types of the disease are characterized by an intensification of symptoms during critical days. This is due to the fact that the lesions are exposed to the same effects from the hormonal system as the healthy endometrium in the inner layer of the uterus.
Under the influence of hormones, cells in the lesions grow and are rejected at the end of the cycle. However, bloody discharge remains in the tissues, causing inflammation and irritation. In some forms of endometriosis, the immune system reacts to the formation of adhesions and cysts, which is observed when the ovaries and tubes are affected. These formations lead to infertility and often require surgical excision followed by the use of hormonal drugs, for example, COCs and Norkoluta.
Symptoms of endometriosis include the following:
- The appearance of a small amount of spotting, which appears both a few days before and after menstruation.
- Pain that intensifies during menstruation, sexual intercourse, and physical activity.
- Typically, with endometriosis, there is a change in the duration of the cycle, in particular, its shortening due to hormonal dysfunction.
- Sometimes acyclic bleeding not associated with menstruation may be observed. As a rule, this sign indicates an imbalance of certain hormones and the possible development of uterine fibroids.
- One of the most dangerous signs is the appearance of infertility and miscarriage. Reproductive function disorders are associated with anovulation, which occurs due to the lack of adequate hormone production, as well as with changes in the myometrium and endometrium itself.
Symptoms of endometriosis can be controlled by taking various hormonal medications. COCs and other groups of hormonal drugs help stabilize the progression of lesions, eliminating pain and other manifestations of disturbances in the production of hormones.
Treatment with hormonal drugs
The main treatment for endometriosis is the use of hormonal drugs, such as COCs. It has been proven that correctly prescribed hormonal drugs for endometriosis normalize the functioning of the ovaries and inhibit the development of lesions and inflammation. Hormones for endometriosis eliminate pain and other symptoms of the disease.
When treated with hormonal drugs, for example, Norkolut, menstruation stops, which leads to a decrease in lesions. This effect also has a positive side for women who are not planning a pregnancy.
The benefits of using hormonal drugs include:
- elimination of pain syndrome;
- possibility of treatment without surgery;
- preservation of reproductive function.
Hormonal treatment of endometriosis has significant disadvantages, which must also be taken into account when prescribing it. Among the disadvantages of hormone treatment for endometriosis are:
- the occurrence of malfunctions in the functioning of the female body;
- risk of thrombosis;
- possibility of relapse;
- duration of therapy.
In quite rare cases, treatment with hormonal drugs is contraindicated. General contraindications to hormone treatment include:
- allergic reactions to a specific hormonal drug;
- endocrine pathologies;
- some diseases of the liver and gastrointestinal tract;
- hematopoietic disorders;
- diabetes;
- kidney diseases.
Side effects may occur when taking hormonal medications:
- psychoemotional disorders;
- irregularities in the menstrual cycle;
- migraine;
- weight gain;
- swelling;
- bleeding;
- nausea;
- exchange imbalance.
Hormonal drugs include several drug groups.
- Gonadotropin-releasing hormone agonists stop menstruation and reduce the body's production of the hormone estrogen. However, when treated with these drugs, symptoms of menopause may occur.
- Antigestogens inhibit the development of endometrioid elements both in the uterine cavity and in the lesions. While taking it, weight gain and acne often occur.
- Progestogens are analogues of the hormone progesterone. Treatment with drugs of this action suppresses the production of the hormone estrogen. Quite often, gynecologists prescribe treatment with the hormonal drug Norkolut. Norkolut is one of the most effective hormonal drugs related to gestagens.
Norkolut blocks ovulation, and therefore this hormonal drug is not used when planning pregnancy. Norkolut should be taken in the second phase of the cycle, usually from the sixteenth to the twenty-fifth day of the cycle in a course lasting six months.
When taking the hormones included in the drug Norkolut, severe headaches, migraines, nausea, thrombosis, and increased fatigue may occur. With Norkolut, it is necessary to exclude malignant tumors of any location. It is not recommended to skip a prescribed dose of Norkolut.
Doctors have identified contraindications for taking the hormonal drug Norkolut:
- liver and kidney diseases;
- history of thrombosis;
- bleeding from the ureter;
- obesity;
- acute herpetic infection;
- severe allergic reactions.
It should be taken into account that the hormones included in the drug Norkolut cannot be taken not only during pregnancy, but also during breastfeeding.
- COCs are often prescribed for disorders of hormone production. COCs normalize hormonal levels and eliminate the unpleasant manifestations of endometriosis. Some COCs have an antiandrogenic effect and help fight acne and excess growth of unwanted hair.
COCs are used for a long time. The course of treatment with COCs is designed for six months or more. Thanks to the wide selection of COCs, it is possible to select the necessary hormonal drug individually for each individual clinical case.
During treatment with Norkolut, like COCs, it is necessary to undergo examination.
The prescription of Norkolut, COCs and other hormonal substances should be carried out only after a detailed study of hormone levels: estradiol, progesterone, free and total testosterone, DHEA sulfate, 17-OH-progesterone, AMH, FSH, LH and some others.
Not all women are unequivocal about the fact that the doctor prescribes hormones for endometriosis as the main drug of the treatment regimen.
Myths and prejudices around the consequences of taking hormones have existed for a long time, since the first oral contraceptives appeared, the use of which was accompanied by loss of libido, weight gain, and an increased risk of cancer.
Since then, more effective drugs have appeared with minimal side effects, solving many problems simultaneously.
Since endometriosis is a hormone-dependent disease, which is often based on hypersecretion of estrogen, hormonal therapy for endometriosis allows for proper functioning of the ovaries and reduces the spread of endometriotic lesions.
The essence of the therapy is to artificially suppress menstruation - the physiological process of endometrial rejection. Menstruation stops completely, or is replaced by bleeding similar to menstruation. As a result, heterotopias do not bleed, they undergo destruction, and the body gets the opportunity to recover.
Pros and cons of hormonal treatment
For hormonal treatment of internal or external endometriosis to be effective, it must be carried out in the early stages of the pathological process. In the later stages of the disease, such drugs are used as preoperative preparation, as well as to stabilize the condition of the female body after the intervention.
Advantages of hormonal drugs for the treatment of endometriosis:
- Eliminate the main symptoms of the disease - pain, bleeding, spread of endometriotic lesions;
- Suppress the hypersecretion of estrogen, affecting the functioning of the ovaries or the functioning of the pituitary gland;
- Gently restore the ability to bear children, allowing surgery to be avoided in the early stages;
- Drugs prescribed to treat endometriosis are also contraceptives;
- After stopping hormonal pills, the female body quickly recovers, maintaining its fertility, and the menstrual cycle remains natural.
There are no ideal drugs yet, and the method of hormonal therapy also has disadvantages:
- If endometriosis is caused by causes other than hyperestrogenism, this treatment regimen will be ineffective;
- The course of treatment with hormones is quite long, taking up to 6-12 months, sometimes several years;
- Accustoming to the drug may occur and drug dependence may develop;
- When taking birth control, it is better not to miss a single day, otherwise breakthrough uterine bleeding will occur;
- In some patients, the main cause of endometriosis is not eliminated, and there is a risk of relapses after discontinuation of drugs.
When taking hormonal drugs for endometriosis, you must strictly follow the doctor's recommendations, dosage and frequency of use.
There are different treatment regimens, the selection of which depends on many factors - the woman’s desire to have a child in the future, the individual characteristics of the body, the presence of contraindications. These include allergies, liver failure, diabetes mellitus, disorders of the circulatory system, and the presence of heart and vascular diseases.
With prolonged use of hormones, side effects may occur, which is also a disadvantage of such therapy.
Possible side effects:
- Nausea;
- Swelling;
- Breast engorgement;
- Dysfunction of the gastrointestinal tract;
- Gaining body weight;
- Headache;
- Nausea;
- Development of atrophic vaginitis;
- Depressive state of mind.
Most side effects disappear after 1-2 months of treatment.
Are there analogues of hormonal therapy in the treatment of endometriosis?
If there are serious contraindications to hormonal treatment, women seek alternative methods of non-hormonal therapy. They use balneotherapy, homeopathy, the use of leeches, physiotherapeutic methods, and computer reflexology.
Patients place their greatest hopes on traditional medicine recipes using medicinal herbs with phytohormones (hogweed, lovage, celery, red brush, bloodroot and other plants).
Unfortunately, the therapeutic effect of such methods is difficult to calculate in advance, and therefore there is always a risk of further development of the disease and relapses. These drugs can be used as an additional treatment, but they cannot be a complete alternative to hormonal drugs.
Types of hormonal drugs, their features and list of names
In hormonal therapy, hormonal drugs of several medicinal groups are used. They all perform different functions and are based on different active ingredients.
Hormonal drugs used for endometriosis - names and main groups:
Gestagens.
Reduce cell activity in endometriotic lesions, inhibit estrogen synthesis without suppressing the functioning of the ovaries ( Duphaston, Visanne, Orgametril, Norkolut, Utrozhestan, Femoston). The progestin drug Depo-Provera is given by injection.
Antigonadotropins.
They reduce the level of estrogen and progesterone by blocking their receptors in endometrioid tissue, suppress the action of gonadotropin, which inhibits ovulation and leads to endometrial atrophy ( Gestrinone, Danazol).
Gonadotropic releasing hormone agonists.
They stimulate artificial menopause by blocking luteinizing hormone receptors, creating hormonal changes in the body ( Buserelin, Zoladex).
Combined contraceptive drugs.
Stops preovulatory growth of the endometrium ( Janine, Qlaira, Femoden, Silhouette, Diecyclen), contain a combination of estrogen and progestin; COCs are not recommended to be used after 35 years of age to avoid the formation of blood clots. The drug Diane 35 is used for endometriosis combined with hyperandrogenism.
Non-combined oral contraceptives.
Monophasic contraceptives.
All tablets contain an equal dose of the hormone, which does not change throughout the cycle ( Yarina, Marvelon, Rigevidon). The drug Jess from this group is not indicated for women over 40 years of age.
If the doctor selects hormonal therapy taking into account all the characteristics of the disease, the symptoms of endometriosis will bother the woman much less often, or will disappear completely.
Endometriosis is a pathological growth of endometrial tissue in or outside the uterus. One of the therapeutic methods for this pathology is the use of birth control pills not only to prevent pregnancy, but also to treat endometriosis.
To treat endometriosis, gynecologists prescribe injections, intrauterine devices, or birth control pills that can be taken at home.
The form of capsules and film-coated tablets is convenient for oral administration and has fewer undesirable effects and side effects.
Varieties
Traditionally, all contraceptives for the treatment of endometriosis are divided into groups:
- mechanical (condoms, caps, spirals);
- biological (pills with female hormones);
- chemical (suppositories, tampons, vaginal creams).
The best drugs for the treatment of endometriosis are considered to be COCs - new generation combined oral contraceptives: Ciproperone acetate, Drospirenone, Gestodene, Desogestrel.
Tablets for age group 35
Thirty-five years is a new stage in a woman’s life:
- the functions of the reproductive system decline;
- the synthesis of progesterone and estrogen decreases;
- many chronic diseases are getting worse;
- the risk of developing cardiovascular pathologies increases.
But sexual activity still continues, therefore, in order not to harm the female body after 35 years, it is recommended to take reliable contraceptives.
How to choose the right one
Contraceptive drugs must meet the following requirements:
- be safe, with a minimum of side effects;
- well tolerated by the body.
Contraceptive selection scheme
The scheme for selecting contraceptives for the treatment of endometriosis is compiled individually for each woman. This takes into account:
- age, characteristics of premenstrual or postmenstrual syndrome;
- features of the menstrual cycle;
- type of constitution of a woman, features of secondary sexual characteristics;
- the presence of concomitant, general and gynecological diseases.
Antiprogestins
Antiprogestins are drugs that suppress progestin synthesis (Danazol, Bonzol, Mifegin, Mifepristone).
They are effective in the treatment of endometriosis, but have side effects - they cause weight gain and depression of the psycho-emotional state.
Danazol and Mifepristone belong to the group of potent drugs, therefore they are used only in a hospital setting.
Gonadotropin-releasing antagonists
Gonadotropin-releasing hormone (GnRH) is produced by cells of the hypothalamus and affects the production of follicle-stimulating and luteinizing hormones.
A change in the time of physiological entry of GnRH into the blood leads to disruption of ovulation and the menstrual cycle. Created analogues of this hormone - Diferelin, Buserelin, Zoladex - are prescribed for the treatment of many female pathologies, for example, endometriosis.
Gestagens
Gestagens are a group of the most important steroid hormones, the action of which is aimed at achieving conception and maintaining the full course of pregnancy.
Hormones are produced mainly by the ovaries, the corpus luteum, partly the placenta and the adrenal cortex. Based on them, such dosage forms as Duphaston, Ovestin, Progesterone, Zhanin, Yarina are produced.
Oral contraceptives
COCs are combined oral contraceptives with estrogen and progestin components, considered the most harmless for the woman’s body:
- reduce FSH (follicle-stimulating hormone) and LH (luteinizing hormone);
- lead to the absence of ovulation and menstruation;
- due to changes in natural hormonal levels, the progression of endometriosis is stopped.
The drugs are easy to use and are available in different price categories, so they are available to women of any income.
Like any dosage forms, they have some contraindications: they are not prescribed for diseases of the endocrine system, liver disease, kidney disease, heart pathologies, increased thrombus formation, pregnancy or lactation.
Janine and Yarina
Zhanin, Yarina - hormonal contraceptives from a German company, which have proven themselves in the treatment of endometriosis. The drugs are almost identical in composition, but still have some differences:
- Yarina is a newer development, has a faster absorption period (about 1.5 hours);
- has fewer contraindications, has a prolonged effect;
- does not cause weight gain, reduces swelling;
- Janine is not prescribed for impaired metabolism (metabolism).
Regulon
To treat endometriosis, if the patient has no contraindications, Regulon tablets are used. These birth control pills help especially well in the early stages of pathology:
- inhibit ovulation;
- reduce pain;
- reduce blood loss and stop the growth of the uterine mucosa.
Qlaira drug
The drug is characterized by high efficiency:
- prevents the transition of endometriosis to malignant formations;
- contains an estrogen analogue;
- does not have a negative effect on the liver.
The treatment is long-term. The first results can be observed after six months.
Mirena spiral and NuvaRing ring
For the treatment of endometriosis, in addition to tablets and injections, contraceptives in the form of spirals and special contraceptive rings are used:
- the Mirena hormonal intrauterine device is valid for 5 years, contains the slowly released progesterone hormone, inhibits the spread and growth of endometrial lesions;
- The NuvaRing ring contains a small amount of hormones, therefore it is considered practically safe; it is inserted vaginally and protects the body from pathological growth of the endometrium.
Jess
Prescribed for the treatment of endometriosis in women before menopause. Not for pregnant and lactating women. Taking Jessa tablets can lead to the development of migraines, nausea, and pain in the genitals.
Contraceptive injections
Hormonal contraceptive injections are used not only for contraception, but also for the treatment of endometriosis:
- inhibit ovulation processes;
- block the growth and metastasis of the endometrium;
- reduce the likelihood of relapse of the disease.
Depo Provera injections are most effective for endometriosis. The medicine is administered intramuscularly, maintaining its therapeutic effect for up to 12 days. It has contraindications: liver disease, epilepsy, cardiovascular pathologies.
Utrozhestan and Duphaston
Hormonal herbal preparation, available in capsules for oral or vaginal administration. Prescribed for the prevention and treatment of endometriosis, helps maintain pregnancy.
The treatment regimen (at least two weeks) is determined by the gynecologist. Utrozhestan and Duphaston are contraindicated in case of circulatory problems, liver or kidney pathology, or neoplasms.
Goserelin
Goreselin is injected with a special syringe into the abdominal cavity every 28-30 days. The course of treatment is determined by a specialist. When treated with Goreselin, pain, size, and the number of affected areas decrease.
Contraindications: pregnancy, breastfeeding. One of the important side effects is a high likelihood of permanent menopause.
Danazol
Causes atrophy of endometrial tissue, effective for benign breast tumors. Not recommended for pediatric therapy or elderly patients.
Danazol tablets are prescribed with extreme caution for diabetes mellitus, as the drug reduces the effectiveness of insulin.
Dienogest
Reduces estrogen production, promotes atrophy of pathological endometriotic tissue. Treatment with the drug is long-term, at least six months. It has a number of contraindications and side effects, like other hormonal drugs.
When prescribing Dienogest, one must take into account its incompatibility or changes in pharmacotherapeutic activity when combined with certain dosage forms, for example, Rifampicin, Indinavir.
Byzanne
A new generation hormonal drug is an analogue of the female hormone:
- inhibits estrogen production;
- reduces inflammation, reduces pain;
- reduces the growth and pathological spread of blood vessels that provide nutrition to the enlarged endometrium;
- normalizes the condition of the endometrium.
Taking Visanne tablets is contraindicated in diabetes, atherosclerosis, cardiovascular pathologies, pregnancy or lactation. Advantages - does not inhibit the likelihood of conception and development of a full pregnancy.
Depo Provera
A hormonal drug that exhibits high antitumor activity. It is often prescribed as an additional treatment in the treatment of endometrial cancer.
Contraindicated in bronchial asthma, thrombosis, thromboembolism, diabetes, diseases of the cardiovascular system, pregnancy, lactation.
Side effects: causes emotional disturbances, insomnia, dizziness, weight gain, and for a long period reduces the likelihood of pregnancy.
Buserelin
Normalizes hormonal balance, affects the endometrium, causing its degradation and thinning. The drug is available in two forms:
- nasal spray, the use of which is recommended at home;
- injection solution administered only in a medical facility.
The spray should be used every day during the course of treatment, injections are administered once every four weeks, which makes the use of this form more convenient for patients.
Contraindications: pregnancy, lactation, severe forms of diabetes, arterial hypertension.
Diferelin
Synthetic drug for subcutaneous or intramuscular administration. The duration of treatment is from 3 to 6 months.
The drug causes artificial menopause, which is difficult for some women to tolerate due to hot flashes, weakness, and fatigue.
Treatment with Diferelin inhibits further growth of the endometrium and avoids surgical treatment. After stopping the drug, the menstrual cycle is restored and the chances of pregnancy increase.
Zoladex
Drug for subcutaneous administration. Reduces the concentration of the hormone estradiol in the blood serum, prevents the development of uterine fibroids, leads to thinning of the inner muscular layer of the uterus, therefore it is effective for endometriosis.
Not prescribed during pregnancy, lactation, or in case of hypersensitivity to the components of the drug.
When taking the medicine, there may be a cessation of menstruation and a decrease in bone mineralization, which is restored after stopping Zoladex.
Drugs prescribed for the treatment of endometrium contain hormones, so self-medication is unacceptable.
Only a specialist, a gynecologist, will help you choose the forms that will be the safest for a particular patient.
Yes, and even more than that, in about a third of women who do not receive any treatment, it goes away on its own. This is due to the work of the immune system, which can recognize the “unnecessary” endometrium and destroy it.
How is endometriosis treated?
Based on the above, endometriosis does not always need to be treated. In world gynecology there are three types of management of endometriosis:
Observation without treatment: this tactic is not suitable for everyone, but only if endometriosis was discovered by chance (for example, during an ultrasound or surgery for another reason), the foci of endometriosis are small and do not cause any inconvenience.
Treatment with medications: the most common treatment strategy. We will talk about it in more detail below.
Surgical treatment (surgery): usually prescribed if drug treatment has not helped or endometriosis has led to serious problems with the functioning of internal organs. Surgery may also be required if endometriosis develops.
What medications are used to treat endometriosis?
The main medications for endometriosis that gynecologists prescribe are hormonal and affect the level of the body's own hormones. We will talk about 4 groups of drugs that are most often used in the treatment of endometriosis:
Gonadotropin analogues: Buserelin, Zoladex
Birth control pills (oral contraceptives, OK): Zhanin, Yarina
Medicines containing progesterone and its analogues: Utrozhestan, Duphaston, Visanne
Each of these groups of drugs affects the body differently.
Birth control pills (Zhanine, Yarina) and endometriosis
Your gynecologist can prescribe birth control pills (OC) for the treatment of endometriosis: Janine, Marvelon, Regulon and others. These medications contain varying doses of hormones, so be sure to consult your gynecologist before starting to take the medication.
Birth control pills help reduce pain associated with endometriosis shortly before and during your period. For successful treatment of endometriosis, it is necessary to take OCs for at least 6 months. If the effect is noticeable (pain disappears), then your gynecologist may advise you to take OK for another 3-6 months. As a result of this treatment, areas of endometriosis may noticeably decrease in size.
Utrozhestan, Duphaston and endometriosis
Preparations containing progesterone (female hormone) or its analogues, such as Utrozhestan, Duphaston, Depo-Provera, Visanne and some others, give a good effect in the treatment of endometriosis. These medications reduce the body's production of estrogen, which inhibits the growth of the endometrium (both in the uterus and in areas of endometriosis). It is better to prepare in advance for long-term treatment, since the course of taking these drugs can last for 6-9 months.
Danazol and endometriosis
Danazol is a synthetic hormone that, while taken, suppresses the production of female sex hormones, helping to reduce foci of endometriosis. For the therapeutic effect of Danazol to appear, it must be taken for at least 3-6 months.
This drug was previously widely used in the treatment of endometriosis, but in some countries doctors are starting to abandon Danazol for several reasons. First of all, these are the side effects of Danazol, which include increased blood pressure, menstrual irregularities, weight gain, swelling and pain in the breasts, excess hair growth on the face and body, acne, hair loss and others. Secondly, new drugs have appeared in the arsenal of gynecologists that are as effective as Danazol, but without its side effects.
Buserelin, Goserelin (Zoladex) and endometriosis
Analogues of gonadotropin-releasing hormones, which include Buserelin, Goserelin (Zoladex), Sinarel and others, suppress ovarian function and reduce the level of female sex hormones in the blood. During treatment, you will not have periods, and you may also experience symptoms of menopause (hot flashes, mood swings), but this can be corrected by taking additional small doses of hormones.
The course of treatment for endometriosis with these drugs is no more than 6 months. After you stop taking the medication, the ovaries start working again, so you don’t have to worry that they will never “start” again.
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