Duphaston with endometrial hyperplasia or Norkolut - how to treat this disease? Endometrial hyperplasia treatment with duphaston What does duphaston give in case of hyperplasia
![Duphaston with endometrial hyperplasia or Norkolut - how to treat this disease? Endometrial hyperplasia treatment with duphaston What does duphaston give in case of hyperplasia](https://i2.wp.com/topginekolog.ru/wp-content/uploads/2018/05/dyufaston-norkolut-2-min-e1527677053893.jpg)
Endometrial hyperplasia is a pathological condition in which an abnormal growth of the uterine layer occurs. The main reason for the start of this process is an imbalance of hormones: a lack of progesterone and an excess concentration of estrogen. It is possible to stop pathological changes with the help of medications that correct the hormonal background.
Norkolut and Duphaston with endometrial hyperplasia contribute to the normalization of progesterone levels, for this reason they are often used in the course of therapy.
It develops for various reasons and is diagnosed in women of any age. At the same time, glandular and fibrous tissues undergo a number of changes. This happens under the influence of the following factors:
- lack of the hormone progesterone, provoked by the individual characteristics of the body or hereditary predisposition;
- age-related hormonal changes (menopause and menopause);
- pathology of the endocrine system;
- recent surgical intervention in the organs of the reproductive system.
Therapy includes tasks such as:
- suppression of the pathological process;
- cure of the disease;
- relief of pain syndrome;
- normalization of the menstrual cycle;
- prevention of the development of malignant tumors.
In the process of conservative therapy, hormonal medications are used. These can be oral contraceptives, gonadotropins, antiestrogen.
Development of pathologies
During the normal course of the menstrual cycle, under the influence of estrogen, the uterine layer changes. This is necessary in order to make it easier for the fetal egg to implant into it. The reproductive organ builds up the endometrium. It becomes thicker and acquires a loose structure, which improves blood circulation. If the fixation of the egg does not occur, under the influence of progesterone, the functional layer is destroyed and exits during the critical days.
In case of successful implantation of the fetal egg, progesterone stimulates the complete maturation of the endometrium. If a hormonal failure occurs in the body, the tissues of the reproductive organ begin to grow abnormally and do not collapse at the right time. As a result, there is a violation of the monthly cycle, excessively heavy menstruation appears and is observed after a delay. Significant blood loss leads to the development of anemia, which is accompanied by dizziness and weakness. Often, at the beginning of the pathological process, it becomes impossible to get pregnant.
How to use Duphaston
Therapy aimed at eliminating hormonal deficiency should be competent and reasonable. Duphaston should be taken with hyperplasia strictly according to the doctor's prescription. The treatment regimen is selected on an individual basis, taking into account the need to preserve reproductive function. In combination with this remedy, suppositories that are inserted into the vagina, and medicines that have a systemic effect can be used.
Treatment with Duphaston involves taking the drug from the 16th to the 25th day of the cycle. In some cases, 1-2 tablets are drunk daily from the 5th to the 25th day.
If the pathology is diagnosed in women during menopause, the daily dose is 2-3 tablets. They are taken from the 5th to the 25th day of the cycle or from the 16th to the 25th.
During the period of age-related restructuring, the reproductive function fades away. The concentration of estrogen gradually decreases, the release of the egg from the follicle becomes impossible. The yellow body develops inferiorly, respectively, progesterone begins to be produced in smaller quantities. At the same time, even a slight concentration of estrogen can lead to pathological changes in the layers of the reproductive organ. This is the reason for the need for hormonal therapy.
The duration of the course of treatment varies from six months to nine months. Every three months, a series of examinations are carried out, according to the results of which the doctor decides on the advisability of further treatment using this drug.
Indications and contraindications for use
Treatment with Duphaston is indicated in the following cases:
- endometriosis and various problems with the layer of the genital organ, including hyperplasia;
- infertility, which arose due to insufficient concentration of luteins;
- the threat of miscarriage or frequent spontaneous abortions provoked by progesterone deficiency;
- dysmenorrhea;
- secondary amenorrhea;
- dysfunctional uterine bleeding.
Despite the high effectiveness of the drug, in some cases it is contraindicated to take it. Among the contraindications are the following:
- liver pathology;
- allergy to active and auxiliary components;
- tendency to itching of the skin;
- excessive body weight.
First stage
Once HPE therapy has been initiated, it is critical to stop the menstrual cycle. Accordingly, they resort to the appointment of oral contraceptives. If the woman's condition does not improve, then it is carried out in order to carry out diagnostic measures. At the same time, tissue samples are taken for subsequent histological examination.
Bleeding is eliminated by the use of hemostatic agents. It is recommended to take painkillers for pain. In some cases, therapy includes blood substitutes, drugs that help normalize the water-salt balance, and vitamin complexes.
They can take on an unusual character, so we recommend that you familiarize yourself with additional information on this issue.
Second phase
After stopping the bleeding, the second stage of therapy for endometrial hyperplasia begins. In this case, hormonal drugs are used that prevent thickening and abnormal growth of the endometrium in the uterus.
Due to the intake of Duphaston, the concentration of progesterone increases. This has a positive effect on the state of the genital organ. Take the drug three times a day. A single dose is 10 mg. Therapy with its use begins on the 5th day of the cycle, and ends on the 25th day.
If the development of the disease is observed in combination with disorders in the endocrine system, then they resort to the additional prescription of drugs from the group of antagonists. Sedatives are taken in the case of the psychosomatic nature of the pathology. Thus, it is possible to eliminate the causes of inflammation and prevent further growth of the endometrium.
Third stage
At the next stage, the main task is to restore the cyclicity. It is extremely important that ovulation becomes regular. Due to this, the cycle is completely restored, and the reproductive system begins to function normally. This point is extremely important in the treatment of hyperplasia.
Duphaston contributes to the normalization of hormone levels, due to which ovulation appears.
Fourth stage
Due to the fact that the estrogenic effect has been eliminated, the reproductive function is restored, the pathological process is suspended. After ovulation, progesterone begins to be intensively produced, which is necessary for the normal course of the menstrual cycle.
Hyperplasia can cause female infertility. Therefore, after the end of the main therapeutic measures, it is recommended to undergo an examination and ultrasound examination at least once every six months, measure the thickness of the uterine layer and, if necessary, perform curettage. During this period, oral contraceptives may also be prescribed. It should be borne in mind that often their components provoke side effects. The selection of medicines in this group is carried out exclusively by a doctor.
Duphaston's analogs
Norkolut has a similar effect with Duphaston . This drug helps to accelerate the process of estrogen breakdown and thereby reduces the level of their concentration. At the same time, the amount of progesterone increases, and the abnormal growth of endometrial cells stops.
Therapy with Norkolut is carried out according to an individual scheme. Often, in combination with it, antibiotics, immunomodulating agents and vitamin complexes are prescribed. When hyperplasia is detected, the courses of treatment are short and vary from 7 to 14 days. The daily dosage in this case is only 1-2 tablets. After the uterine bleeding decreases, the medication is not stopped. For preventive purposes, it is used on certain days of menstruation.
As a rule, you need to drink tablets from the 15th to the 25th day of the cycle. The doctor should adjust the dosage, choose the dates for the start and end of therapy.
Possible side effects:
- the beginning of hair growth in areas of the skin that were previously free from hairline;
- hair loss in the temples;
- acne in the chin, wings of the nose and forehead;
- oily skin, provoked by the intense activity of the sebaceous glands;
- sudden weight gain.
There are a number of contraindications to the use of Norkolut. It is strictly forbidden to take it in the following cases:
- neoplasms with suspicion of the onset of a malignant process;
- puberty;
- allergy to the components of the drug.
- period of pregnancy;
- a history of liver pathologies;
- blood loss of unknown etiology;
- kidney failure;
- increased blood clotting;
- diabetes;
- increased blood pressure.
Before starting therapy with Norkolut, a comprehensive examination is carried out, including an examination on a gynecological chair, an assessment of the condition of the mammary glands and testing to determine the level of hormones. When a woman is depressed, the drug should be taken with extreme caution. If the desired effect is not achieved, then therapy using this agent is stopped.
One of the important stages in the treatment of uterine layer hyperplasia is hormone therapy. Often, drugs such as Duphaston and Norkolut are prescribed. These medicines are able to quickly normalize the level of hormones and thereby stop the pathological growth of the endometrium. Nevertheless, it is strictly forbidden to make a decision on the use of these funds on your own. Only a doctor should prescribe them and select the dosage.
Content
Endometrial hyperplasia is a pathological condition of the internal cavity of the uterus, characterized by thickening and growth of the mucosa. This disease requires an integrated approach and its treatment.
The process in which treatment takes place consists of certain interrelated stages. Within each stage, drugs are used that are selected individually depending on the type of hyperplasia.
The complex of therapeutic measures consists of four successive stages, each of which plays its specific role. As part of the first stage, stopping bleeding is important. At the second stage, hormone therapy is carried out with drugs. The third stage normalizes the cycle. During the last fourth stage, the patient undergoes systematic examinations, and, if necessary, repeats the course of drug therapy.
Drugs that contribute to the normalization of the endometrium, can be divided into three large groups.
- Combined oral contraceptives. These are single-phase and three-phase drugs that need to be taken for a long time, about six months.
- Pure gestagens. A long-term intake of six months is recommended.
- Antiestrogens. These drugs are intended to be taken within six months.
First stage
At the beginning of treatment, the main goal is to stop bleeding. Accordingly, at the initial stage, the so-called combined oral contraceptives are widely used. In the absence of improvement, a woman is assigned a diagnostic curettage of the mucous layer of the uterus.
Diagnostic curettage is separate and therapeutic. With separate curettage, tissue samples of the mucous membrane of the uterine cavity and cervical canal are taken. With therapeutic diagnostic curettage, benign tumors are removed during the procedure.
In order to stop the bleeding, the patient is given hemostatic drugs. Sometimes the introduction of blood substitutes and medications that improve the water-salt balance is required. The patient was also recommended treatment with vitamins B and C.
Second phase
At the second stage of correction of hyperplasia, hormonal drugs are used. Medicines of this group prevent the thickening and growth of the endometrium. There is a wide range of drugs for hormone therapy, selected individually for each patient based on history and laboratory data. A good effect is produced by progesterone preparations, for example, duphaston or utrozhestan.
Duphaston is a modern effective drug containing the hormone progesterone. This drug must be taken to increase the level of progesterone in the body. Duphaston has no androgenic and estrogenic effects. The drug is used in many conditions, which are characterized by a lack of progesterone in the body. Duphaston is often used in the treatment of hyperplasia of the uterine mucosa and infertility. Dufaston also has a positive effect on cycle disorders and bleeding associated with dysfunction.
Duphaston is a synthetic drug used for hormone replacement therapy. It has a tablet form with the main substance, which has the scientific name dydrogesterone. Despite the synthetic origin, the mechanism of action of duphaston is similar to natural. The drug does not have side effects, unlike other similar synthetic drugs, if taken correctly.
Duphaston has a positive effect on the inner layer of the uterus, while preventing its growth due to high levels of estrogen. The drug does not prevent pregnancy. In this regard, it can be used in planning pregnancy, as well as in its preservation.
Dufaston has a short period of absorption into the blood, after which it is absorbed in the gastrointestinal tract. After some time, the drug is excreted by the kidneys along with urine.
When correcting the state of hyperplasia of the uterine mucosa, Duphaston should be taken at a dosage of 10 milligrams three times a day. This drug is not taken the entire cycle, but only from the fifth to the twenty-fifth day.
Any medical drug has a side effect, otherwise it would simply not be effective. Of the side effects of duphaston, some undesirable reactions of the nervous system can be noted, such as headache or migraine, insomnia and weakness. It is not excluded manifestations from the hormonal system, manifested by the sensitivity of the nipples and uterine bleeding of a breakthrough nature. When taking duphaston, individual intolerance and allergies are possible. In such cases, as a rule, the use of Duphaston is not recommended.
Since dufaston is a drug that affects the hormonal system of a woman, it should be taken only as directed by a doctor. In a pharmacy, the drug can be purchased by prescription from a gynecologist.
An analogue of duphaston is utrozhestan. It also contains progesterone, but not synthetic, but natural. Unlike dufaston, utrogestan is much more difficult to tolerate by patients and has a number of adverse reactions. In this connection, its use in the form of candles is often recommended.
Sometimes endometrial hyperplasia is combined with abnormalities in the endocrine system. For the treatment of comorbidities in this area, special drugs from the group of agonists are prescribed. There are frequent cases of the psychosomatic nature of the disease, which are corrected by taking sedatives. In the treatment of hyperplasia, combined oral contraceptives are also used. Modern drugs of this group are single-phase and three-phase.
Third stage
The third stage aims to restore ovulation. When regular ovulation is achieved, the woman's menstrual cycle is also restored, which is especially important in reproductive age. It is known that without ovulation, pregnancy is impossible. Accordingly, the restoration of monthly regular maturation of the dominant follicle and the subsequent release of a mature egg is one of the most important reasons for the treatment of endometrial hyperplasia. The growth of the endometrium occurs due to a high level of estrogen with a simultaneous drop in progesterone, which is the so-called pregnancy hormone. In the treatment of hyperplasia, the hormonal background is restored, which contributes to the appearance of ovulation. Thus, these independent processes can be called interdependent.
Fourth stage
The patient at least once every six months is examined by a gynecologist, which includes an examination, ultrasound with a mandatory measurement of the thickness of the endometrium, if necessary - curettage. The use of combined oral contraceptives and vitamins is also recommended.
Because endometrial hyperplasia is a hormone-dependent disease, the occurrence of relapses is not excluded. The asymptomatic course of the disease contributes to the fact that it often remains undiagnosed in time.
Hormonal and surgical treatment
Treatment of hyperplasia of the uterine mucosa stops pathological processes in the endometrium. As a result, thickening and growth of the endometrium does not occur.
The choice of medicines for treatment and their dosage depends on many factors:
- severity of growth and symptoms of the disease;
- form of hyperplasia;
- the age of the patient;
- history features.
Treatment of hyperplasia in women of reproductive age is directed to the use of medications. Hormone therapy is widely used. Treatment of hyperplasia in this case includes the use of drugs containing progesterone and, in particular, dufaston. If the patient is planning a pregnancy, drugs that stimulate ovulation are used.
For women aged before and after menopause, drugs have been developed that inhibit the growth of estrogens. It should be noted that effective hormonal therapy is quite difficult to choose, since aged women are usually diagnosed with comorbidities. The treatment takes place under constant ultrasound monitoring and the use of diagnostic curettage.
In gynecological practice cases of recurrence of endometrial hyperplasia are not uncommon. This is due to insufficient hormone therapy or due to the involvement of inflammatory processes.
Amputation of the uterus is recommended for an atypical form of growth of the uterine mucosa. However, at the initial stages of the disease, especially in patients of reproductive age, conservative treatment with hormonal drugs is possible. They necessarily include progesterone preparations. Usually, with hyperplasia, duphaston is recommended for women, as it is easier to tolerate and has fewer side effects. With atrophy of the endometrium or frequent relapses of the disease, amputation of the body of the uterus is indicated.
Collapse
Endometrial hyperplasia is a pathological condition in which one of the layers of uterine tissue is actively growing. This happens as a result of a hormonal imbalance, when the estrogen content increases so much that it activates the pathological division of tissues (this also happens only at a certain ratio with progesterone in the body). Therefore, this condition is also treated with the help of hormonal drugs. They are different in composition, principle of action, efficiency and price. Drugs for the treatment of endometrial hyperplasia will be discussed in the material.
Kinds
Drugs for the treatment of endometrial hyperplasia are divided into several groups. A suitable group and the actual necessary drug can only be prescribed by a doctor. Often drugs are used in combination. The purpose of their use is to normalize the hormonal balance, reduce the estrogen content in the blood (or influence the level of other hormones just to normalize the ratio).
There are the following types of funds:
- COCs or multicomponent (combined) contraceptives (oral contraceptives) are drugs that include more than one hormonal component. Such hormones with endometrial hyperplasia align and lead to a normal level of the ratio of gestagen and estrogen, stopping growth;
- Gestagens. These drugs are used less often. This hormonal treatment of endometrial hyperplasia is also aimed at normalizing the estrogen-progestin balance, but without affecting the estrogen content;
- Gonadotropin-releasing hormone (GnrH) agonists not only help treat uterine changes, but can also positively affect the autonomic system. Often used in combination with gestagens;
- Progesterone. These funds for endometrial hyperplasia after curettage and before it are rarely prescribed. Their influence on the growth of pathological tissues is controversial. However, it is known that sometimes after a progesterone surge during pregnancy, the pathological process stops.
Glandular hyperplasia of the endometrium, like any other type of it, requires the use of additional therapy. These are local remedies for normalizing the microflora of the vagina, for the prevention of inflammatory diseases, etc.
Sometimes combination medications are needed. For example, Linda.
Hormonal
In the treatment of endometrial hyperplasia, mainly combined or non-combined oral contraceptives are used. They are taken in a long course of 12 to 24 weeks. During this time, the balance of hormones in the body normalizes, and the negative process stops. Then the degradation of pathological tissues begins (in most cases), and they are destroyed.
After that, the condition and well-being improves. Severe or unpleasant symptoms disappear, menstruation becomes regular, etc. The regimen may be different.
Due to these properties of hormonal drugs, doctors believe that taking birth control pills is a good prevention of endometrial hyperplasia.
As alternative drugs, those based on herbs are sometimes used. For example, Cyclodinone, Indinol forto.
Combined contraceptives
These are products that contain progesterone and estrogen and affect the mutual effect of these hormones on the body. COCs are used as contraceptives. Instructions for use as contraceptives are usually also suitable for the treatment of hyperplasia.
- Regulon with endometrial hyperplasia is widely used. It is almost always prescribed, except for cases with childbearing and breastfeeding, as well as allergies to the composition of the drug. The main side effect is malfunction of the gastrointestinal tract, but more serious consequences are possible, such as inhibition of kidney function. Duration of application from 3 months and above. It is taken one tablet per day at the same time, from the first day of the menstrual cycle;
- Yanina is a remedy similar to the previous one. It has a similar composition, principle of action and recommendations for use. The following contraindications can be distinguished: migraines, kidney and liver diseases, pregnancy, lactation. How to drink this remedy? Just as in the situation with Regulon, a new pack of funds should be started from the first day of menstruation. The duration of the reception is about six months;
- Jeanine is a low-dose COC that has a minimum of side effects. It is necessary to drink it in the same way as the previous remedies. The duration of the reception is also similar. It is effective in the treatment of adenomatosis, and when areas of hyperplasia are located in foci. Due to low dosages with cystic hyperplasia, it is ineffective;
- Yarina with endometrial hyperplasia is also popular, it is prescribed at any stage of the disease and has a pronounced antiandrogenic effect. Contraindications to taking Yarina are diabetes mellitus, thrombosis, pregnancy, lactation, intolerance to the components. Drink the drug from the first day of the menstrual cycle. How much you need to do this depends on the condition of the patient, but usually not less than six months;
- Qlaira with endometrial hyperplasia is prescribed less frequently due to the low dosage of the active substance. There are 26 tablets in a pack. Means Klayra drink one piece a day from the very beginning of the monthly cycle.
In addition to these funds, Jess is actively prescribed for endometrial hyperplasia, Marvilon, Zoely, Non-Ovlon. Femoden and its analogue Femoston are also used.
Gestagens
Treatment with Duphaston and other pure gestagens is quite effective. But more often, doctors give preference to combined drugs. Gestagens are prescribed only to certain types of patients. For this, the following drugs are selected:
- Dufaston with endometrial hyperplasia, as well as with an irregular cycle, etc., is taken for a period of at least six months. It has few contraindications (in fact, only individual intolerance and pregnancy), it is non-aggressive for the body. How to take Duphaston? It is available in tablets, the dosage of which is prescribed by the doctor individually. It is important to remember that the treatment of endometrial hyperplasia with Duphaston requires the use of contraceptives, since the drug itself does not protect against pregnancy;
- Norkolut is another similar remedy. In fact, it is an analogue of the first drug. Under their action, endometrial hyperplasia is equally effectively resolved, and Duphaston is prescribed more often only because of the smaller number of contraindications. What exactly to choose, Duphaston or Norkolut, the doctor decides individually in each case. Norkolut should be taken for at least six months at the dosage prescribed by the doctor;
- Visanne with endometrial hyperplasia has a similar principle of action, is well excreted, but mainly by the kidneys, therefore it puts a burden on them. Contraindications are age up to 18 years, with neoplasms and bleeding from the uterus. You can start drinking it in the dosage prescribed by the doctor from any day of the menstrual cycle, but the main thing is not to take breaks, otherwise severe bleeding will develop.
But not only Visanne and Norkolut are highly effective in endometrial hyperplasia. In addition to these basic drugs, specialists may prescribe other gestagens. For example, Depo Provera.
Separately, you can consider the Mirena spiral. This is an intrauterine contraceptive. Such a spiral dosed releases a hormone into the uterus. Although it is quite expensive and can only be installed by a specialist, Mirena is popular for endometrial hyperplasia, as it has a validity period of more than five years. The Novaring contraceptive ring has a similar effect on endometrial hyperplasia.
Divigel is used for topical application.
AGNrG
Analogues of releasing hormones of the hypothalamus have a pronounced positive effect. Usually, these medicines are prescribed:
![](https://i2.wp.com/vashamatka.ru/wp-content/uploads/2017/07/preparaty-dlya-lecheniya-giperplazii-endometriya.png)
Treatment regimens with such drugs may be different. They can be taken by injection (some types) or by mouth. There are regimens that require only a few periodic injections.
Progesterone
Most often, the drug Utrozhestan is prescribed from this group. It is effective for endometrial hyperplasia, the doctor will tell you more about how to take it.
Utrozhestan with endometrial hyperplasia is prescribed in the form of tablets or vaginal suppositories at a dosage of 200-300 mg per day. It contains pure progesterone and excipients. Contraindications include thrombosis, vaginal bleeding, suspicion of malignant tumors or their presence, intolerance to components. Such a tool costs from 410 rubles.
←Previous article Next article →The site is a medical portal for online consultations of pediatric and adult doctors of all specialties. You can ask a question about "treatment of endometrial hyperplasia with duphaston" and get a free online consultation with a doctor.
Ask your questionQuestions and answers on: treatment of endometrial hyperplasia with duphaston
2012-01-09 11:41:31
Egan asks:
Hello. I am 27 years old, married for 1 year. The first time I was able to get pregnant only in the 11th month of marriage, there was a miscarriage in the 3rd embryonic week. An endometrial polyp was found. A month after the miscarriage, on the 7th day of the cycle, a hysteroscopy was performed (histology resp.: focal hyperplasia of the endometrial polypoid gland), after surgery. gave only antibiotic and antifungal prep. after the restoration of the cycle, they prescribed to drink 10 mg of Duphaston from the 16th day of the cycle for 10 days 3 months and they said that it is possible already from the next cycle to get pregnant .. now 19 days have passed after the operation, while I wait .. I read on the Internet that "The most effective method for treatment of endometrial hyperplasia in reproductive age is combined oral contraceptives (estrogen-gestagenic drugs) for 6 menstrual cycles. What should I do now, I really want a baby, but I also worry about my health (9 years ago I had a fibroadenoma in my right mammary gland, they removed it, after 4-5 months on my left 2 pieces there are still no changes.) the fact that my hormones are in order, the only thing is that prolactin was elevated (I think this is due to that pregnancy), next. cycle again. I don’t know why these things appear in me, probably a tendency .. That’s why I’m afraid .. What should I do after a hysteroscopy in order to get pregnant, bring a healthy baby and so that these polyps do not reappear ... I beg you to direct me on the right path .Thanks in advance...
Responsible Feskov Alexander Mikhailovich:
Hello dear Egan! You need to come for a consultation with Professor Feskov Alexander Mikhailovich. During the consultation, you will have an ultrasound scan, an analysis of your medical history, an examination of your ovarian reserve, and a plan for your treatment will be determined. You may need a hormonal correction (you indicated an increase in prolactin levels). Please take with you the results of all previous examinations, as well as your husband's spermogram, if he had one.
2016-10-20 21:12:23
Elena asks:
Hello, please comment on the results of the ultrasound. Day 12 of the cycle: the body of the uterus is in its normal position, the boundaries are clear, the contours are even. The shape is ordinary, the dimensions are ordinary 51 * 45 * 52. Myometrium is not changed. The endometrium is 11 mm, the boundaries are clear, the contours are even, the echostructure is not changed, it corresponds to phases 1-2. The uterine cavity is not deformed, not expanded. Hyperechoic formation 8*4 mm, Doppler bonuses of blood flow. The right ovary is 32*19, the structure is normal, the left ovary is 28*19, the structure is normal. Pathological formations are not determined, there is no free liquid. The conclusion is the policy of the endometrium. The next ultrasound on the 6th day of the cycle: uterus 55*41*57. Myometrium is not changed. The uterine cavity is not expanded. Endometrium 5 "1 mm. The echo structure is not changed, corresponds to the 1st phase of the cycle. The right ovary is 23 * 17 * 16. The volume is 3.3 cm3 of the usual structure. The follicular apparatus is pronounced. The left is 25 * 14 * 11. 2 cm normal structure, the follicle apparatus is expressed.Pathological formations in the pelvic cavity and free fluid are not detected.The next ultrasound: 13th day of the cycle.Uterus 55*41*57.Myometrium is not changed, the uterine cavity is not expanded.Endometrium is 12 mm, echo the structure is changed - an area of increased echogenicity along the anterior wall without blood flow lonuses.Right ovary 23*17*16, volume 3.3 cm3 of normal structure, follicle apparatus is pronounced.Left 25*21*20, volume 5.5 cm3 Dominant follicle 22 mm In the pelvic cavity, vein expansion up to 6.3 mm Free fluid in the pelvis is not detected Conclusion: focal endometrial hyperplasia Varicose veins of the small pelvis 1 degree Ultrasound control 2 months after treatment with duphaston From the symptoms : spotting 1-2 days, then monthly 3 days, on the 2nd day with small clots. Pulls the lower abdomen in the middle of the cycle. Monthly painless practically, regular, cycle 28-30 days. When examined by a doctor: the uterus is dense, which caused the appointment for an ultrasound scan. What is the further tactics of examination and treatment? I read that with endometrial hyperplasia, the endometrium does not exfoliate and is higher than the norm on the 5-7th day of the cycle, and during this period I have the norm.
Thank you.
Responsible Bosyak Yulia Vasilievna:
Hello, Elena! According to the ultrasound findings, I do not find any endometrial hyperplasia, the thickness corresponds to the day of the menstrual cycle. The only thing that needs to be rechecked is the presence of a polyp. Theoretically, on ultrasound after the end of menstruation (on the 6th day of m.c.), it should be visualized, but it all depends on the qualifications of the specialist conducting the examination. If the issue of pregnancy planning is relevant for you, then I advise you to undergo a diagnostic hysteroscopy. She will accurately answer the question of whether endometrial hyperplasia is present or not.
2015-07-10 14:23:38
Olesya asks:
The answer to your question
June 30, 2015
Olesya asks:
but there must be a reason!
June 29, 2015
Reproductologist, PhD
consultant information
hormone tests:
my hormone levels are 5 DC
FSH 9.77 at a rate of 3-14.4
ATA - 19.4
I think progesterone is low in the first phase. maybe this is the issue??? Can, actually progesterone poprinimat continuously? I am very afraid that the GE will return. the last hystera was held on 06/16/2015.
July 09, 2015
Palyga Igor Evgenievich answers:
Reproductologist, PhD
consultant information
Hello Olesya! According to ultrasound, the diagnosis of “endometrial hyperplasia” can be suspected after passing the examination in the first phase of the m.c. (immediately after the end of menstruation) On the 11th day of m.c. an endometrial thickness of 6-8 mm is considered normal. After the last hysteroscopy, did the histologist diagnose FGE or are you just waiting for the conclusion? If there is no specific conclusion of histology yet, then we are talking about nothing. I do not see any indications for the use of IVF today. If your husband's spermogram is excellent, you are ovulating, the fallopian tubes are passable (by the way, have you checked them?) and hyperplasia is not confirmed histologically, then you need to try to get pregnant on your own. How long have you been living an open sex life with your new husband? If the ZhGE is confirmed again, then I would advise taking COCs (the same Yarina) for a period of 3 months and, against the background of cancellation, plan a pregnancy.
Doctor, I have been living with my new husband without protection since December 2013. Simple glandular hyperplasia of the endometrium was confirmed by histology. It was not visible by ultrasound. Focal form. Growing polyps are questionable. Micropolyp of the cervix. The pipes are passable. And the endometrium - put inflammation of the stroma. Receptors respond to both hormones - estradiol and progesterone. I drink janine. And they put me back - I asked for an aggravation. Now treated with antibiotics. And a physio was appointed. Jeanine, I know sometimes they drink without a break for all 3 months. Are you going to take a break? Should I go to Eco after - despite the fact that everything seems to be OK, there has been no pregnancy since 2010. I will be 34 this year
Responsible Palyga Igor Evgenievich:
Hello Olesya! In the presence of endometritis (inflammatory process of the endometrium), it is necessarily treated by antibiotic therapy. Physiotherapy won't hurt either. Take COC for 3 months according to the scheme (you do not need to take it continuously). If you live with your husband for more than a year with an open sexual life and do not get pregnant, then it is still rational to plan IVF, although you can try to get pregnant on your own after a course of treatment for endometritis against the background of the abolition of COCs. If it does not work out, then the IVF option remains.
2015-06-30 01:37:53
Olesya asks:
Question - Hello!
I am 33 years old. want to get pregnant. but my diagnosis is endometrial glandular hyperplasia.
I am currently collecting documents for IVF, but they told me that with such a diagnosis, IVF is not accepted. according to the analyzes - ovulation monthly (confirmed by tests, folicolometry and the presence of VT in all cycles of observation), AMH and FSH are normal, in the middle of it. There are no signs of hyperplasia on ultrasound. discovered it in 2012 during hysteroscopy and laparoscopy. The diagnosis was made - FGE, Endometriosis, endometrial polyp. was treated with Differelin No. 3. Ik for 6 months. after this time, the husband's viable sperm disappeared - 3% of the total was normal, planning was postponed, and the HGE returned already for the third cycle - the thickness of E at 21 d.c was already 18 mm. accordingly, B failed.
everything was removed. in June 2015, she also did a hysteroscopy on the 11th day of the MC - the endometrium was 6-8 mm at a rate of up to 4 mm.
accordingly, again endometrial hyperplasia, though this time without polyps.
monthly regular, go day-to-day. there are no bleedings, all hormones are normal - even insulin has already been checked. with and without load.
I'm just desperate! I can not find the cause of this hyperplasia. now I have a new husband, his SG is excellent, without deviations.
I understand that these are the consequences of an abortion 10 years ago.
but there must be a reason!
Here, I'm waiting for the results of immunohistochemistry. really, it won't do anything for me?
treatment was prescribed - Yarina 3-27 DC. 3 months. The gynecologist-endocrinologist is against - he says that treatment with duphaston 16-25 DC is enough. By the way, they never treated me with gestagens - they immediately drove me to the IR.
I read that you need to drink DUF with 3 DC ...
anyway, what else to explore? what treatment strategy to choose?
June 29, 2015
Palyga Igor Evgenievich answers:
Reproductologist, PhD
consultant information
Hello Olesya! The first question is what is your weight and height? Is there excess weight? The cause of endometrial hyperplasia lies in the endocrine factor - the level of estrogens. Fat is a depot of estrogen, therefore, with excess weight, a similar pathology can be observed. The tactic of treatment is usually the following - cleaning with the further appointment of hormone therapy, COC, for example, to adjust the hormonal background. You can prescribe gestagens (the same duphaston), virtually such issues are not resolved. Definitely, until the problem with the endometrium is resolved, you will not be accepted into the IVF program.
I answer - my height is 175 cm, weight 60 kg. As you can see, we are not talking about obesity at all.
hormone tests:
my hormone levels are 5 DC
LH - 9.97 with a norm of 1.1 - 11.6
FSH 9.77 at a rate of 3-14.4
Estradiol 57.8 - at a rate of 0-84
Prolactin (it happens to me, jumps, which, however, does not affect ovulation in any way) - 471 at a rate of 95-700.
testosterone - 0.61 at a rate of 0-4.3
progesterone 0.62 at a rate of 1.05 - 3.83
TSH - 1.37 at a rate of 0.4 - 4.0
free thyroxine 14.5 at a rate of 10-24.5.
DHEA - 2.13 at a rate of 0.95 - 11.6
SA -15-3 - 14.4 at a rate of 9.2-38
SA-125 - 18.4 at a rate of 1.9-16.3
insulin - 4.56 pir normal 0-29.1
ATA - 19.4
on the 21st day of the cycle (cycle 26-27 days) - 67.8 at a rate of 10-89
for 2 DCs (they said it was on that day to take it) - AMH - 5.51 with a norm for women of 1.5 (0.08-10.6). prognosis - the risk of developing ovarian hyperstimulation at more than 3.0
I think progesterone is low in the first phase. maybe this is the issue??? Can, actually progesterone poprinimat continuously? I am very afraid that the GE will return. the last hystera was held on 06/16/2015.
Responsible Palyga Igor Evgenievich:
Hello Olesya! According to ultrasound, the diagnosis of “endometrial hyperplasia” can be suspected after passing the examination in the first phase of the m.c. (immediately after the end of menstruation) On the 11th day of m.c. an endometrial thickness of 6-8 mm is considered normal. After the last hysteroscopy, did the histologist diagnose FGE or are you just waiting for the conclusion? If there is no specific conclusion of histology yet, then we are talking about nothing. I do not see any indications for the use of IVF today. If your husband's spermogram is excellent, you are ovulating, the fallopian tubes are passable (by the way, have you checked them?) and hyperplasia is not confirmed histologically, then you need to try to get pregnant on your own. How long have you been living an open sex life with your new husband? If the ZhGE is confirmed again, then I would advise taking COCs (the same Yarina) for a period of 3 months and, against the background of cancellation, plan a pregnancy.
2015-06-26 00:41:54
Olesya asks:
Hello!
I am 33 years old. want to get pregnant. but my diagnosis is endometrial glandular hyperplasia.
I am currently collecting documents for IVF, but they told me that with such a diagnosis, IVF is not accepted. according to the analyzes - ovulation monthly (confirmed by tests, folicolometry and the presence of VT in all cycles of observation), AMH and FSH are normal, in the middle of it. There are no signs of hyperplasia on ultrasound. discovered it in 2012 during hysteroscopy and laparoscopy. The diagnosis was made - FGE, Endometriosis, endometrial polyp. was treated with Differelin No. 3. Ik for 6 months. after this time, the husband's viable sperm disappeared - 3% of the total was normal, planning was postponed, and the HGE returned already for the third cycle - the thickness of E at 21 d.c was already 18 mm. accordingly, B failed.
everything was removed. in June 2015, she also did a hysteroscopy on the 11th day of the MC - the endometrium was 6-8 mm at a rate of up to 4 mm.
accordingly, again endometrial hyperplasia, though this time without polyps.
monthly regular, go day-to-day. there are no bleedings, all hormones are normal - even insulin has already been checked. with and without load.
I'm just desperate! I can not find the cause of this hyperplasia. now I have a new husband, his SG is excellent, without deviations.
I understand that these are the consequences of an abortion 10 years ago.
but there must be a reason!
Here, I'm waiting for the results of immunohistochemistry. really, it won't do anything for me?
treatment was prescribed - Yarina 3-27 DC. 3 months. The gynecologist-endocrinologist is against - he says that treatment with duphaston 16-25 DC is enough. By the way, they never treated me with gestagens - they immediately drove me to the IR.
I read that you need to drink DUF with 3 DC ...
anyway, what else to explore? what treatment strategy to choose?
Responsible Palyga Igor Evgenievich:
Hello Olesya! The first question is what is your weight and height? Is there excess weight? The cause of endometrial hyperplasia lies in the endocrine factor - the level of estrogens. Fat is a depot of estrogens, therefore, with excess weight, a similar pathology can be observed. The tactic of treatment is usually the following - cleaning with the further appointment of hormone therapy, COC, for example, to adjust the hormonal background. You can prescribe gestagens (the same duphaston), virtually such issues are not resolved. Definitely, until the problem with the endometrium is resolved, you will not be accepted into the IVF program.
2014-01-30 11:16:57
Love asks:
Good afternoon I have a question. I am 23 years old, a year ago I was diagnosed with endometrial hyperplasia, endometriosis is questionable. After a month of treatment with contraceptives, the endometrium returned to normal, but the diagnosis of endomenriosis was confirmed. Drank 9 months. contraceptives, and tried to get pregnant on the abolition of 1 month. It didn't work, because ovulation was late (as it turned out later, according to tests and ultrasound, ovulation on days 15-16 at 29 days cycle). Then a break of 2 months. I did an ultrasound in July 2013 (diagnosis of diffuse adenomyosis). Planned from August to November. My husband is all right (although 37 years old), I passed on hormones. At the reception of duphaston, which was prescribed based on the results of ultrasound, the level of progesterone was increased by 2.5 times, DHA-C was also significantly increased (I found out only at the end of November). After taking dexamethasone, DHA-C is normal. Dufaston did not drink. I handed over again for progesterone, and he was already elevated without duphaston. All the rest (FSH, LH, 17-OH progesterone, testosterone) are normal. The first month I drink only dexamethasone 1/2 tablet at night, because. all other hormones are normal. This month I noticed that there are no acne on my face that break out before menstruation and my stomach hurt only 3 days a week before the expected period (in the evening it will grab a little and release it immediately), earlier 10 days before the month. terrible pains began. I feel my period soon, again it didn’t work, probably what to do next, I really want a child.
2013-03-20 19:02:00
Julia asks:
Hello! Please tell me, my husband and I are planning a pregnancy, pregnancy has not occurred for five years. I had a hysteroscopy and was diagnosed with a glandular endometrial polyp, complications: a symptom of menorrhagia, the conclusion after hysteroscopy: endometrial hyperplasia; histological conclusion: endometrium with a picture of nonspecific endometritis. The treatment was prescribed for 10 days duphaston from the 16th day of the cycle, buserelin-depot 3.75 IM on the 2nd day of the cycle, once every 28 days, 6 months. The doctor said to try to get pregnant and if it doesn’t work out in half a year for laparoscopy. And I read that against the background of buserelin they don’t get pregnant, menstruation stops. Please tell me, can you plan this drug intermittently and during interruptions? And during treatment, do I need to protect myself? And what will happen if I still become pregnant during treatment? Thank you in advance.
Responsible Palyga Igor Evgenievich:
Buserelin turns off your own hormonal levels, so it is impossible to get pregnant during treatment. After discontinuation of the drug for another 1-2 mts. Your hormonal background will be restored. Then you can plan a pregnancy. It is not rational to use the drug with interruptions, there will be no effect, it is not necessary to protect yourself.
2013-02-17 06:53:52
Natasha asks:
I am 40 years old, 5 years ago, after a delay, my periods went very strong and did not stop, they did a cleansing, the analysis showed cystic endometrial hyperplasia, they prescribed depo-prover 150 3 pieces once a week, I recovered by 10 kg, my blood pressure was 90 to 60 all my life - it became 120 to 80. I have a daughter of 20 years old, after childbirth there was erosion - they were cauterized in the old fashioned way, in 2002 there was cervical dysplasia - they did cryo. , In 2010, I donated hormones: on day 22, m.c.-progesterone 0.27 at a rate of 3.28 -38.63 in the luteal phase, was treated with tazalok, duphaston for 3 months, lutein. c, - progesterone 0.17. I constantly do ultrasound, I donate cytology - it did not show hyperplasia, in 2009 ultrasound showed fibrooma along the posterior wall of the uterus 10 by 9 mm, in January 2013 ultrasound showed an intramural node along the posterior wall up to 18 mm, Monthly once or twice per year with delays, usual.
In December 2012, again, there were a lot of cleanings, there were a lot of polyps, cytology showed a spiky endometrial polyp. Menstruation never came, on January 29, a daub began, a week ago regulon 12.02-3 tablets, 13-2, 14-one drink one at a time until the end of the pack ...
They offer Mirena, is it possible in my situation after conization, with HPV type 18, 45, with fibrooma?
Thanks in advance for your reply,
Responsible Wild Nadezhda Ivanovna:
Good afternoon, "mirena" is a levonorgestrel system, i.e. synthetic progesterone, which is injected into the uterine cavity and acts there for 5 years. It has a therapeutic and contraceptive effect. For the presence of HPV, I recommend being examined at this hour, especially for viral load. Perhaps the body has coped and perhaps the virus is no longer there. If it is determined, then it is necessary to undergo a course of treatment with subsequent control. After that, you can put the VMK "Mirena". Before setting up the Mirena IUD, take regulon. In parallel - examine the mammary glands - mammography.
2013-01-27 10:48:36
Natasha asks:
Good afternoon!!!
I am 40 years old, 5 years ago, after scraping, I was diagnosed with glandular cystic endometrial hyperplasia and I pierced Depo-Provera 3 times a week. Menstruation did not normalize, as before hyperplasia, there are delays of 1,2,3 months, 2 years back, conization of the cervix was done - there was dysplasia, there is a 18.45 type of papilloma virus. Hyperplasia was treated - saw 3 months of duphaston, tazalok, and now again the delay was 3 months - as a result, again cleaning - multiple spiky polyps ... handed over several times hormones on cycle day 22.20-07.10.2010-LH-10.9, FG 5.33, prolactin-12.81, estradiol-294, testosterone-0.460, progesterone-0.24 at a rate of luteal phase 3.28-38.63 ... on 08.06.2012 - at 20 d.c. LH-13.14, FG-9.9, prolactin-23.41, estradiol-197, testosterone-0.210, progesterone-0.17!!!
on ultrasound they found a nodular fibromyoma 7 weeks-18 mm .. suggest Mirena, what to do, help !!!
Progestogens are considered topical modern drugs included in the complex treatment of endometriosis. The most famous of them is Duphaston. It is produced in the Netherlands in the form of coated tablets.
This remedy contains 10 mg of the active substance - dydrogesterone (an analogue of progesterone). It is recommended for use for the treatment of a number of problems of the female genital area with hormonal disorders. How is Duphaston prescribed and how does it help with endometriosis?
How does it work?
Dydrogesterone in terms of the molecular structure and its pharmacological properties is considered the closest analogue of natural progesterone. At the same time, the activity of the drug during oral administration exceeds endogenous progesterone by 20 times.
When ingested, the drug affects the endometrium selectively, and helps reduce the likelihood of developing its hyperplasia.
It increases the concentration of progesterone in the second phase of the cycle and thereby reduces the active influence of estrogens, namely this mechanism underlies the development of endometriosis. Even prolonged use of the drug in maximum doses does not give an androgenic effect.
Duphaston does not affect the blood coagulation rate, and helps maintain the beneficial effect of estrogen on lipid levels. It does not affect glucose metabolism and does not impair liver function.
The therapeutic effect is without suppression of the ovulatory process and does not violate the cyclic changes in the woman's body.
Does Duphaston help with endometriosis? Experts believe that any form of progesterone deficiency in the body is considered an indication for the use of Duphaston or similar drugs.
This medicine allows you to increase the likelihood of conception and helps to maintain pregnancy in the early stages, with a disease such as adenomyosis. This medicine also helps:
- Reduce the contractile force of the myometrium;
- Reduce pain (often present in endometriosis);
- Normalizes blood circulation in the uterus;
- It does not allow the formation of prostaglandins (mediators of the inflammatory reaction);
- Carry a fetus in the first weeks of pregnancy;
- Reduces the likelihood of formation of atypical cells.
Can Duphaston be used for endometriosis and other pathologies? At the moment, it is recommended as a modern remedy with a minimum number of side effects, which allows not only to stop the symptoms of the disease, but also to prevent further growth of the myometrium.
How to apply?
![](https://i2.wp.com/cistitus.ru/wp-content/uploads/2017/12/dyufastend/preparat.jpg)
The instructions have a clear description of how to use Duphaston for endometriosis. With this pathology, 2-3 tablets per day are prescribed, divided into three doses from 5 to 25 days of the cycle. There is another scheme when the remedy should be drunk in the same dosage, but constantly.
In some cases, bleeding or bloody discharge may occur during the first treatment regimen. The use of the drug in the maximum daily dosage (30 mg) most often eliminates this symptom. Drinking the drug Duphaston with endometriosis should be from 6 to 9 months to obtain the effect.
Another treatment option with this remedy is to alternate it with other hormones. Duphaston with endometrial hyperplasia in the amount of 20 mg (these are 2 tablets) per day is taken for two weeks from the middle to the end of the cycle, and at the beginning of the first two weeks, only estrogen products are used.
This kind of therapy does not allow pregnancy to occur, and therefore it is chosen if the woman does not plan to become a mother.
Dufaston with an endometrial polyp also has its effect, since the appearance of the growth is also due to the excessive influence of estrogens. And after hysteroscopy, its use will help prevent the development of new formations.
Side effects
When endometriosis is treated with Duphaston, you need to understand that it, like other drugs, has contraindications:
- Liver failure;
- Individual intolerance to the active substance;
- Tendency to thrombosis and embolism;
- Severe extragenital endometriosis;
- Dubin-Johnson syndrome (enzymopathic jaundice);
- Rotor syndrome (hereditary bilirubinemia).
Duphaston in the treatment of infertility is also used during pregnancy, but strictly according to indications. Since dydrogesterone penetrates into milk during lactation, its use is not indicated during the feeding period.
In mild to moderate liver diseases, Duphaston is taken with great caution in adenomyosis. The same recommendation exists for patients with renal and cardiovascular insufficiency, epilepsy, and diabetes mellitus.
![](https://i2.wp.com/cistitus.ru/wp-content/uploads/2017/12/dyufastend/grudbol.jpg)
Side effects of the drug may be as follows:
- Uterine bleeding;
- Discomfort in the mammary glands;
- Indigestion (diarrhea or constipation);
- jaundice, abdominal pain;
- Headache;
- Decreased mood and depression.
Much less common are allergic reactions (rash, Quincke's edema), hemolytic anemia, and edema.