scholarly journals Hormonal Therapy in Women of Reproductive Age with Endometriosis: an Update

2019 ◽  
Vol 15 (2) ◽  
pp. 276-281
Author(s):  
A Gheorghisan-Galateanu
Author(s):  
L. V. Demyanenko ◽  
L. M. Semenyuk ◽  
T. Yu. Yuzvenko

Aim — to identify the relationship between androgen deficiency and the development of endometrial hypoplasia in women of reproductive age, to develop an algorithm for the diagnosis and treatment of this category of women. Materials and methods. Examination of patients with androgen deficiency revealed 48 patients with endometrial hypoplasia based on the ultrasound markers. After examination for CD138 and detection of chronic endometritis during the study, 9 patients were excluded. At the second stage, an immunohistochemical examination was performed for the expression of receptors for estrogen, progesterone and androgens. According to the results, the patients were divided into 2 groups: the first group (24 patients) with a high level of expression of androgen receptors and the second group (15 patients) with a low level of expression of androgen receptors. Theexpressionof receptors to estrogens and progesterone was on medium level and comparative in both groups. Both groups of patients underwent hormonal therapy for 3 months: estradiol valerate 1 g per day in a continuous mode and 200 mg of micronized progesterone from the sixteenth to twenty-fifth days of the menstrual cycle. Additionally, patients of the first group received dehydro­epian­drosterone(DHEA)in a dose of 25 mg per day continuously in the form sublingual spray. Results. According to the data of ultrasound examination in the first group of patients, the endometrium corresponded to normal parameters both during treatment and 1 and 3 months after stopping treatment. At the same time, in the second group of patients, there was an improvement in the thickness (more than 7 mm) and structure of the endometrium during treatment and the absence of these effects after the termination of hormonal therapy. Considering the recommendations of the Association of Endocrinologists on the superiority of non-tablet forms of androgen preparations in the treatment of androgen deficiency and having a positive and long-term effect when taking sublingual DHEA, it is possible to recommend adding the above form of DHEA to systemic therapy of endometrial hypoplasia against the background of androgen deficiency. Conclusions. Women with androgen deficiency are more likely to have concomitant endometrial hypoplasia. Immunohistochemical examination of the endometrium of women of reproductive age with androgen deficiency in 24 patients (61.5 %) revealed a high level of expression of androgen receptors. The effectiveness of therapy for endometrial hypoplasia in women with androgen deficiency with addition of androgens to the standard regimens is more effective and has a long-lasting effect. The combination of estrogen-gestagenic therapy and androgens has a positive effect on the gestational potential of the endometrium in women of reproductive age with androgen deficiency.


2021 ◽  
Vol 50 (3) ◽  
pp. 100-102
Author(s):  
V. I. Konovalov ◽  
M. A. Zvychayny

The aim of the study was to investigate the effect of endometriosis and somewide-spread contemporary methods of its conservative hormonal and operative treatment on the life quality of women of reproductive age. 546 women, aged 20-40, were examined: 371 patients with initially diagnosed endometriosis, 64 after conservative hormonal therapy, 111 after efficient surgical interventions and 30 healthy women (a control group). The following conclusion has been made: endometriosis arising at the reproductive age greatly deteriorates the life quality of women as compared to the healthy ones but none of the studied methods of its conservative hormonal therapy and efficient surgical treatment enables its rehabilitation.


2018 ◽  
Vol 0 (41) ◽  
pp. 38-41
Author(s):  
А. Г. Корнацька ◽  
Г. В. Чубей ◽  
М. А. Флаксемберг ◽  
О. О. Ровенько

2020 ◽  
pp. 10-14
Author(s):  
N. V. Spiridonova ◽  
A. A. Demura ◽  
V. Yu. Schukin

According to modern literature, the frequency of preoperative diagnostic errors for tumour-like formations is 30.9–45.6%, for malignant ovarian tumors is 25.0–51.0%. The complexity of this situation is asymptomatic tumor in the ovaries and failure to identify a neoplastic process, which is especially important for young women, as well as ease the transition of tumors from one category to another (evolution of the tumor) and the source of the aggressive behavior of the tumor. The purpose of our study was to evaluate the history of concomitant gynecological pathology in a group of patients of reproductive age with ovarian tumors and tumoroid formations, as a predisposing factor for the development of neoplastic process in the ovaries. In our work, we collected and processed complaints and data of obstetric and gynecological anamnesis of 168 patients of reproductive age (18–40 years), operated on the basis of the Department of oncogynecology for tumors and ovarian tumours in the Samara Regional Clinical Oncology Dispensary from 2012 to 2015. We can conclude that since the prognosis of neoplastic process in the ovaries is generally good with timely detection and this disease occurs mainly in women of reproductive age, doctors need to know that when assessing the parity and the presence of gynecological pathology at the moment or in anamnesis, it is not possible to identify alarming risk factors for the development of cancer in the ovaries.


2015 ◽  
Vol 98 (2) ◽  
pp. 114-118
Author(s):  
A.Y. Senchuk ◽  
◽  
I.О. Doskoch ◽  
I.V. Chibisova ◽  
S.V. Moskalenko ◽  
...  

2016 ◽  
pp. 108-111
Author(s):  
T.F. Tatarchuk ◽  
◽  
D.G. German ◽  

The article presents the comparative analysis of the state of the cervix in women with endometrial polyps and micropolyps. Patients and methods. The study involved 130 patients aged 18-35 years: 70 patients with endometrial polyps (group I), 30 patients with micropolyps (group II) and 30 patients of the control group (group III). Results. According to the anamnesis of women in the I group were significantly more frequent diseases of the cervix, which corrected physical surgery methods, in particular cryodestruction. In group II, the representatives of these indicators were similar to healthy. Normal colposcopic picture met significantly less frequently in patients and I, and II group. The differences in the incidence of HPV high oncogenic risk in all groups were not statistically significant. Conclusion. Destructive methods used in the detection of any changes in the cervix are often overly aggressive, form scars and contributing to inflamaciones process. In the chain of events leading to the formation of PE, cervical pathology and its correction can take the basic place. Key words: endometrial polyp, micropolyps, chronic endometritis, uterine cervix, colposcopy.


2016 ◽  
pp. 191-108
Author(s):  
A.A. Sukhanova ◽  
◽  
Yu.M. Melnik ◽  
O.O. Karlova ◽  
◽  
...  

The aim of the study: to study the efficacy and safety of use Mastofemin in the treatment of various forms of mastitis in women of reproductive age. Materials and methods. The study included 62 women of reproductive age (mean age of 33.5±2.3 years) who were screened in the Kiev city center reproductive and perinatal medicine. Women were divided into 2 groups. The first (main) group consisted of 32 patients who received the proposed treatment using herbal remedies Mastofemin 1 capsule 2 times per day for 3 months; 30 patients of the second (control) group were under observation and received no treatment. These groups were representative and homogeneous on age, clinical symptoms and sonographic characteristics. The clinical method included evaluation of complaints of patients, anamnesis, presence of concomitant gynecologic pathology, inspection, palpation of the lymph nodes and the breast and obtaining a discharge from the nipples to conduct cytological examination, which allowed excluding from the study women with suspected malignancy of the process. All the patients were performed ultrasound examination of the breast. The review was supplemented with vaginal gynecological examination and ultrasound examination of small pelvis organs to assess the condition of the uterus and its appendages, the diagnosis of gynecological diseases. Results. Summarizing obtained in this study results one should stress the positive long-term effect of applying Mastofemin for the treatment of proliferative changes of the breast in women of reproductive age. This is manifested by a decrease in the intensity of clinical signs of mastitis, consistent with the results of sonographic control. Established positive dynamics in the treatment of cystic mastitis, dectective and when combined cystic mastopathy with dectective. In the control group of patients for a given observation period (6 months) no significant changes in clinical signs of mastitis and sonographic characteristics. Regression of disease has not occurred in any of the patients, in 2 patients increased sensitivity of the breast after 6 months moved to the soreness. Sonographic characteristics of mastitis during the observation period did not change. Thus, the use of Mastofemin aimed at pathogenetic treatment of mastitis and prevention of breast cancer. Conclusion. Application of Mastofemin during the treatment of mastitis in women of reproductive age significantly improves the clinical condition of patients; reduce the subjective and objective symptoms of the disease. The positive effect of the treatment with Mastofemin proved in the case of the treatment of sonographic following forms of mastitis: cystic mastopathy, cystic mastopathy with dectectasy. Mastofemin may be the drug of choice for complex conservative monotherapy in women of reproductive age with proliferative changes in the breast, and can also be used as part of complex treatment in patients with diffuse changes of the breast when combined with hyperplastic processes of the myometrium and endometrium. Keywords: mastopathy, breast gland, herbal medicine, herbal remedies, Mastofemin.


2016 ◽  
pp. 85-89
Author(s):  
О. Shapoval ◽  

The objective: to study the prevalence of ovarian endometriosis in women of reproductive age, the features of clinical and ultrasound picture of endometriosis. Patients and methods. The study involved 22 patients with endometriomas, the control group – 50 women gynecological and somatically healthy. Results. The incidence of ovarian endometriomas in the structure of benign tumor-like formations of ovaries is 0.62%. In 72.73% of ovarian endometriomas occur on a background of concomitant gynecological pathology. Clinically, in 77.27% of cases there is a pain syndrome, in 59.09% – algomenorrhea, in 13.64% – infertility; 18.18% of cases endometriomas remain «dumb» and proceed with the erased clinical picture. Sonologically in patients with endometriomas adenomyosis, endometrial hyperplasia, changes in the contralateral ovary are determined. Conclusion. Without additional methods of diagnostic gynecological examination may identify the 3 cm tumor-like formation of the ovary with different characteristics, which does not allow to differentiate endometrioma from inflammation, functional and ovarian tumors. Ultrasound can diagnose pathological ovarian formation of 1 cm, detailing the nature of the cyst. Key words: endometriosis, reproductive age, retrospective analysis, ultrasound.


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