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Svetlana Viktorovna asks:
What birth control should I take for endometriosis?
Also, with endometriosis, a woman may experience the following symptoms:
- bleeding during menstruation becomes longer and more abundant;
- pain during 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. Produced in the form of tablets ( 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, Janine, 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-pill). These drugs contain only one hormone - progestin. Each mini-pill pack contains 28 tablets to be taken daily at the same time and without interruption ( at the end of one package, the reception of another immediately begins). These contraceptives micronor, microlute, etc.) is also recommended for use in endometriosis.
3. Depo-Provera Injections. This contraceptive also contains the hormone progestin. A hormonal injection is administered intramuscularly by a gynecologist. The validity of this remedy is 12 weeks, after which, if desired, the injection is repeated. Depo-Provera injections are quite effective in the treatment of endometriosis.
4. Hormonal intrauterine device Mirena. This contraceptive contains in its composition a synthetic analogue of the female sex hormone progesterone - levonorgestrel. The 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 accepted:
- at the age of a woman up to 35 years;
- with the first or second degree of the 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 disorders and affect the reproductive function of a woman, which is usually eliminated by the use of hormones. One of these diseases is endometriosis, which can occur in various forms.
Endometriosis refers to a pathological condition in which there is a spread of cells that make up the endometrium outside 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 the third most common gynecological disease, and the number of diagnosed cases is steadily increasing. This is due not only to a qualitative improvement in diagnostics, but also to an increase in inflammatory processes, environmental degradation, and early sexual activity in the absence of adequate contraception.
The mechanism of development of endometriosis is due to 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 conditions for growth.
With the development of pathology, endometrioid cells penetrate into the middle layer, which is the muscular membrane 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 uterine extensibility during pregnancy and contraction during menstruation. The appearance of foci of endometriosis, which look like islands of endometrioid cells, disrupts the contractility of the myometrium and causes infertility. This is due to the fact that the altered endometrium cannot contribute to the implantation of the egg.
With further progression of the pathological process, the cells penetrate into the perimetry, which is the outer shell. In the absence of adequate treatment, which usually involves taking hormonal drugs, lesions spread to the tissues of the tubes, ovaries, vagina, and external genitalia.
The form of endometriosis, in which the tissues of the organs of the reproductive female system are affected, 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 periods that nature did not provide. The cause of genital endometriosis is endometrioid cells that penetrate into the tissues of the organs during menstruation.
During menstruation, a reverse or retrograde reflux of some of the bloody secretions containing endometrial cells into the abdominal cavity occurs. This process is observed 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. Engraftment of cells occurs due to immune disorders. 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 detect violations related to the level of sex hormones. In particular, hormones such as LH, FSH, prolactin and estrogens are at a high level. While the hormone progesterone has a low concentration. In this connection, hormonal preparations, for example, Norkolut, are widely used.
Hormonal drugs, in particular, COCs for endometriosis, can achieve the desired values of sex hormones. This is necessary as part of the stabilization of the pathological process of both endometriosis and many other comorbidities.
Often, endometriosis is accompanied by other pathologies that also occur as a reaction to fluctuations in hormone levels. Thus, hormonal preparations, for example, Norkolut, not only create the necessary hormonal background, 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 the types of endometriosis that are most likely to appear in representatives of the same family.
- inflammatory processes. Infections and inflammations negatively affect the hormonal background due to damage to the ovaries, as well as the state of the endometrial tissue.
- Beginning of menstruation before 11 or after 16 years. This factor may indirectly indicate a violation of the production of sex hormones, which provokes the development of endometriosis.
- Unfavorable environmental conditions. Poor environmental conditions worsen the immune system 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 how pathology develops from different points of view.
- One theory is endometrial metaplasia. Its essence is that some organ tissues can turn into a kind of endometrial cells.
- Quite often, the development of the disease is observed after manipulations on the body of the uterus. As a result of violation of the integrity of the inner lining of the uterus, the elements of the endometrium penetrate into the myometrium, and then into the perimetrium. It is not excluded the further spread of the pathological process.
- Sometimes endometriosis is diagnosed in girls before their first period. However, this pathology is combined with anomalies of the genital organs. Perhaps this is a consequence of intrauterine disorders, which led to the laying 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 COC group medications. These drugs create the necessary hormonal background, preventing the development of relapses, in particular, in the postoperative period.
Symptoms
The clinical picture depends on the degree of prevalence 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 released from the organ.
However, for all types of the disease, an increase in symptoms is characteristic precisely during critical days. This is due to the fact that the foci 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 foci grow and are rejected at the end of the cycle. However, spotting remains in the tissues, causing inflammation and irritation. In some forms of endometriosis, the reaction of the immune system is 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, such as COC and Norkolut.
Symptoms of endometriosis include the following manifestations.
- The occurrence of a small amount of spotting, which appear both a few days before menstruation and after it.
- Pain that increases during menstruation, sexual intercourse, physical activity.
- Usually with endometriosis, there is a change in the duration of the cycle, in particular, its shortening due to hormonal dysfunction.
- Sometimes there may be acyclic bleeding that is not associated with menstruation. As a rule, this symptom indicates a violation of the ratio of certain hormones and the possible development of uterine fibroids.
- One of the most dangerous signs is the appearance of infertility and miscarriage. Reproductive disorders are associated with anovulation, which occurs due to the lack of adequate production of hormones, as well as with changes in the myometrium and endometrium itself.
The symptoms of endometriosis are stopped by taking various hormonal drugs. COCs and other groups of hormonal drugs help stabilize the progression of foci, eliminating pain and other manifestations of hormonal disorders.
Treatment with hormonal drugs
The main treatment for endometriosis is the use of hormonal drugs, such as COCs. It has been proven that properly prescribed hormonal drugs for endometriosis normalize the functioning of the ovaries, inhibit the development of foci and inflammation. Hormones in 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 foci. 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;
- the 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 can be noted:
- the occurrence of failures in the work of the female body;
- the risk of developing thrombosis;
- the possibility of relapse;
- duration of therapy.
In quite rare cases, treatment with hormonal drugs is contraindicated. Common 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 disease.
When taking hormonal drugs, side effects may develop:
- psychoemotional disorders;
- violations in the menstrual cycle;
- migraine;
- weight gain;
- edema;
- bleeding;
- nausea;
- exchange imbalance.
Hormonal drugs include several drug groups.
- Gonadotropin-releasing hormone agonists cause the cessation of menstruation and a decrease in the body's production of the hormone estrogen. However, during treatment with these drugs, menopausal symptoms may occur.
- Antigestagens inhibit the development of endometrioid elements both in the uterine cavity and in the foci. Against the background of admission, there is often an increase in body weight and the appearance of acne.
- Gestagens 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, a course of six months.
When taking the hormones that make up the drug Norkolut, severe headaches, migraines, nausea, thrombosis, and increased fatigue may occur. With Norkolut, it is imperative to exclude malignant tumors of any localization. It is not recommended to skip the prescribed dose of Norkolut.
Doctors have identified contraindications for taking the hormonal drug Norkolut:
- diseases of the liver, kidneys;
- thrombosis in history;
- bleeding from the ureter;
- obesity;
- acute herpetic infection;
- severe allergic reactions.
It should be noted that the hormones that make up the drug Norkolut should not be taken not only during pregnancy, but also during breastfeeding.
- COCs are often prescribed for violations of hormone production. COCs normalize the hormonal background, eliminate the unpleasant manifestations of endometriosis. Some COCs have an antiandrogenic effect and help fight acne, the excess growth of unwanted hair.
COC is used for a long time. The course of COC treatment is designed for six months or more. Thanks to a wide choice of COCs, it is possible to choose the necessary hormonal preparation individually in each individual clinical case.
In the process of treatment with Norkolut, like COCs, it is necessary to undergo an examination.
The appointment of Norkolut, COC and other hormonal substances should be carried out only after a detailed study of the level of hormones: estradiol, progesterone, free and total testosterone, DEA-sulfate, 17-OH-progesterone, AMH, FSH, LH and some others.
Not all women are unequivocal about the fact that the doctor prescribes them 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, which were accompanied by a loss of libido, weight gain, and an increased risk of cancer.
Since then, more effective drugs with minimal side effects have appeared, solving many problems at the same time.
Since endometriosis is a hormone-dependent disease, which is often based on estrogen hypersecretion, hormone therapy for endometriosis allows you to establish the full functioning of the ovaries, reduce the spread of endometriotic lesions.
The essence of therapy is the artificial suppression of menstruation - the physiological process of rejection of the endometrium. Periods completely stop, or they are 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
In order 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 state 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, the spread of endometrioid foci;
- Suppress estrogen hypersecretion by affecting the functioning of the ovaries or the pituitary gland;
- Gently restore the ability to bear children, allowing you to avoid surgery in the early stages;
- Drugs prescribed for the treatment of endometriosis are contraceptives at the same time;
- After the abolition of hormonal pills, the female body quickly recovers, maintaining its fertility, the menstrual cycle remains natural.
Ideal drugs do not yet exist, the method of hormone therapy also has disadvantages:
- If endometriosis is based on causes other than hyperestrogenism, this treatment regimen will be ineffective;
- The course of hormone treatment is quite long, it takes up to 6-12 months, sometimes several years;
- There may be addiction to the drug, develop drug dependence;
- When taking contraceptives, 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, there is a risk of relapse after discontinuation of drugs.
When taking hormonal drugs for endometriosis, you must strictly follow the doctor's recommendations, dosage and frequency of administration.
There are different treatment regimens, the selection of which depends on many factors - the desire of a woman 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 in the circulatory system, the presence of diseases of the heart and blood vessels.
With prolonged use of hormones, side effects may occur, which also refers to the disadvantages of such therapy.
Possible side effects:
- Nausea;
- puffiness;
- Breast engorgement;
- Violation of the functioning of the gastrointestinal tract;
- Weight gain;
- Headache;
- Nausea;
- Development of atrophic vaginitis;
- Depressive mental state.
Most side effects disappear after 1-2 months of treatment.
Are there analogues of hormone therapy in the treatment of endometriosis?
In the presence of serious contraindications to hormone treatment, women are looking for alternative methods of non-hormonal therapy. They use balneotherapy, homeopathy, the use of leeches, physiotherapy methods, computer reflexology.
Patients place their greatest hopes on traditional medicine recipes using medicinal herbs with phytohormones (upland uterus, lovage, celery, red brush, goose cinquefoil 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, the appearance of relapses. These drugs can be used as an additional remedy, but they cannot be a complete alternative to hormonal drugs.
Types of hormonal drugs, their features and a list of names
In hormonal therapy, hormonal preparations of several drug groups are used. All of them perform different functions, they are based on a different active substance.
Hormonal drugs used for endometriosis - names and main groups:
Gestagens.
Reduce the activity of cells in endometriotic foci, inhibit the synthesis of estrogens without suppressing the functioning of the ovaries ( Dufaston, Byzanne, Orgametril, Norkolut, Utrozhestan, Femoston). The drug with progestin Depo-Provera is administered by injection.
Antigonadotropins.
Reduce the level of estrogen and progesterone by blocking their receptors in the endometrioid tissue, inhibit the action of gonadotropin, which inhibits ovulation and leads to endometrial atrophy ( Gestrinone, Danazol).
Gonadotropic releasing hormone agonists.
Stimulate artificial menopause by blocking luteinizing hormone receptors, create hormonal changes in the body ( Buserelin, Zoladex).
Combined contraceptive drugs.
Stop preovulatory growth of the endometrium ( Janine, Clayra, Femodene, Silhouette, Diecyclene), contain a combination of estrogen with progestin, COCs are undesirable for use after 35 years in order 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 that 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 features of the disease, the symptoms of endometriosis will disturb the woman much less often, or disappear completely.
Endometriosis is an abnormal 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, coated tablets, is convenient for oral administration, 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 (tablets with female hormones);
- chemical (suppositories, tampons, vaginal creams).
The best drugs for the treatment of endometriosis are COCs - new generation combined oral contraceptives: Cyproperone acetate, Drospirenone, Gestodene, Desogestrel.
Tablets for age group 35
Thirty-five years is a new stage in a woman's life:
- there is an extinction of the functions of the reproductive system;
- the synthesis of progesterone and estrogen decreases;
- exacerbate many chronic diseases;
- the risk of developing cardiovascular pathologies increases.
But sexual life 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
Contraceptive drugs must meet the following requirements:
- be safe, with a minimum of side effects;
- well tolerated by the body.
The scheme of selection of contraceptives
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 - drugs that suppress the synthesis of progestin (Danazol, Bonzol, Mifegin, Mifepristone).
Effective in the treatment of endometriosis, but give side effects - cause an increase in body weight, depression of the psycho-emotional state.
Danazol, 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, affects the production of follicle-stimulating and luteinizing hormones.
Changing the time of physiological entry of GnRH into the blood leads to disruption of ovulation, 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 the implementation of conception and maintaining the full course of pregnancy.
Hormones are produced mainly by the ovaries, the corpus luteum, partly by the placenta and the adrenal cortex. On their basis, such dosage forms as Duphaston, Ovestin, Progesterone, Zhanin, Yarina are produced.
Oral contraceptives
COCs - combined oral contraceptives with an estrogenic and progestin component, are considered the most harmless for a woman's body:
- reduce FSH (follicle-stimulating hormone) and LH (luteinizing);
- lead to the absence of ovulation, menstruation;
- due to changes in the natural hormonal background, stop the progression of endometriosis.
The drugs are easy to use, 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, diseases of the liver, kidneys, heart pathologies, increased thrombosis, pregnancy or lactation.
Jeanine and Yarina
Zhanin, Yarina are hormonal contraceptives from a German company that have proven themselves well 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 action;
- does not cause an increase in body weight, reduces swelling;
- Jeanine is not prescribed for impaired metabolism (metabolism).
Regulon
For the treatment of endometriosis, if the patient has no contraindications, Regulon tablets are used. Especially well, these contraceptive pills help in the early stages of pathology:
- inhibit ovulation;
- reduce pain syndrome;
- 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 into malignant tumors;
- contains an estrogen analogue;
- does not adversely affect the liver.
The treatment is long. The first results can be observed after six months.
Mirena coil and NuvaRing
For the treatment of endometriosis, in addition to tablets and injections, contraceptives in the form of spirals and special contraceptive rings are used:
- the hormonal intrauterine device Mirena is valid for 5 years, contains a slowly released progesterone hormone, inhibits the spread, as well as the growth of endometriotic foci;
- the NuvaRing ring contains a small amount of hormones, therefore it is considered practically safe, it is administered vaginally, it protects the body from the pathological growth of the endometrium.
Jess
It is prescribed for the treatment of endometriosis in women before menopause. Not intended for pregnant and lactating women. Taking Jess tablets can lead to the development of migraines, nausea, pain in the genitals.
Contraceptive injections
Hormonal contraceptive injections are used not only for contraception, but also for the treatment of endometriosis:
- inhibit the processes of ovulation;
- block the growth and metastasis of the endometrium;
- reduce the likelihood of recurrence of the disease.
Depo Provera injections are most effective in endometriosis. The drug is administered intramuscularly, maintaining its therapeutic effect for up to 12 days. Contraindications: liver disease, epilepsy, cardiovascular pathology.
Utrozhestan and Dufaston
Hormonal herbal preparation, available in capsules for oral or vaginal administration. It is prescribed for the prevention and treatment of endometriosis, helps to maintain pregnancy.
The treatment regimen (at least two weeks) is determined by the gynecologist. Utrozhestan and Duphaston are contraindicated in circulatory disorders, hepatic or renal pathology, neoplasms.
goserelin
Gorezelin is injected with a special syringe into the abdominal cavity every 28-30 days. The course of treatment is determined by a specialist. In the treatment of Goreselin, pain and size, the number of affected areas decreases.
Contraindications: pregnancy, breastfeeding. One of the important side effects is the high likelihood of permanent menopause.
Danazol
Causes atrophy of endometrial tissues, effective in benign breast tumors. Not recommended in pediatric therapy, elderly patients.
With extreme caution, Danazol tablets are prescribed for diabetes mellitus, since the drug reduces the effectiveness of insulin.
Dienogest
Reduces the production of estrogen, promotes atrophy of pathological endometrioid tissue. Treatment with the drug is long-term, at least six months. It has a number of contraindications, 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.
Bysanne
A hormonal drug of a new generation, is an analogue of the female hormone:
- inhibits the production of estrogen;
- reduces inflammation, reduces pain;
- reduces the growth and pathological spread of blood vessels that provide nutrition to the overgrown endometrium;
- normalizes the state 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 the development of a full pregnancy.
Depo Provera
A hormonal drug that exhibits high antitumor activity. It is often prescribed as an additional therapeutic agent in the treatment of endometrial cancer.
Contraindicated in bronchial asthma, thrombosis, thromboembolism, diabetes mellitus, diseases of the cardiovascular system, pregnancy, lactation.
Side effects: causes emotional disturbances, insomnia, dizziness, weight gain, reduces the likelihood of pregnancy for a long time.
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;
- solution for injection, administered only in a medical institution.
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 mellitus, arterial hypertension.
Diferelin
Synthetic drug for subcutaneous or intramuscular injection. The duration of treatment is from 3 to 6 months.
The drug causes an artificial menopause, which is difficult for some women to tolerate because of the appearance of hot flashes, weakness, fatigue.
Treatment with Diphereline inhibits further growth of the endometrium, avoiding surgical treatment. After stopping the drug, the menstrual cycle is restored, the chances of pregnancy increase.
Zoladex
Drug for subcutaneous administration. It 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.
It is not prescribed during pregnancy, lactation, with hypersensitivity to the components of the drug.
When taking the medicine, there may be a cessation of menstruation, a decrease in bone mineralization, restored after the end of Zoladex.
The drugs prescribed for the treatment of the endometrium contain hormones in their composition, 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 so, about a third of women who do not receive any treatment go away on their 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. There are three types of management of endometriosis in world gynecology:
Observation without treatment: this tactic is not suitable for everyone, but only if endometriosis was detected by chance (for example, during an ultrasound scan or surgery for another reason), the foci of endometriosis are small and do not bring any inconvenience.
Drug treatment: the most common treatment tactic. 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 disruption of the internal organs. Also, an operation may be required if it has developed as a result of endometriosis.
What medications are used to treat endometriosis?
The main drugs for endometriosis that gynecologists prescribe are hormones and affect the level of the body's own hormones. We will talk about 4 groups of drugs that are used most often in the treatment of endometriosis:
Analogues of gonadotropins: Buserelin, Zoladex
Contraceptive pills (oral contraceptives, OK): Janine, Yarina
Medicines containing progesterone and its analogues: Utrozhestan, Duphaston, Byzanne
Each of these groups of drugs affects the body differently.
Contraceptive pills (Zhanin, Yarina) and endometriosis
Your gynecologist may prescribe birth control pills (OCs) to treat endometriosis: Janine, Marvelon, Regulon, and others. These drugs contain different doses of hormones, so be sure to consult a gynecologist before starting the medication.
Birth control pills help reduce the pain of endometriosis shortly before and during menstruation. For successful treatment of endometriosis, it is necessary to take OK for at least 6 months. If the effect is noticeable (pain disappears), then your gynecologist may advise taking OK for another 3-6 months. As a result of such treatment, areas of endometriosis can noticeably decrease in size.
Utrozhestan, Duphaston and endometriosis
Preparations containing progesterone (female hormone) or its analogues, such as Utrozhestan, Dufaston, Depo-Provera, Byzanne and some others, give a good effect in the treatment of endometriosis. These drugs reduce the production of estrogen in the body, which inhibits the growth of the endometrium (both in the uterus and in endometriosis foci). It is better to prepare in advance for long-term treatment, since the course of taking these drugs can be delayed for 6-9 months.
Danazol and endometriosis
Danazol is a synthetic hormone that, at the time of administration, suppresses the production of female sex hormones, helping to reduce the foci of endometriosis. For the appearance of the therapeutic effect of Danazol, it is necessary to take it for at least 3-6 months.
This drug was previously widely used in the treatment of endometriosis, but in some countries doctors are beginning 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 chest, excessive 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 at the same time devoid of its side effects.
Buserelin, Goserelin (Zoladex) and endometriosis
Analogues of gonadotropin-releasing hormones, which include Buserelin, Goserelin (Zoladex), Sinarel and others, suppress the work of the ovaries and reduce the level of female sex hormones in the blood. During treatment, you will not have periods, and you may also experience menopausal symptoms (hot flashes, mood swings), but this can be corrected by additional intake of small doses of hormones.
The course of treatment of endometriosis with these drugs is no more than 6 months. After the end of the medication, the ovaries begin their work again, so you do not have to worry that they will never "turn on" again.
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