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The paper evaluated the effect of hormone therapy on menstrual function in 160 reproductive-age women with adenomyosis combined with endometrial hyperplasia, comparing progestogen monotherapy for 6 months, a GnRH agonist (a-GnRH) for 6 months, and a phased complex regimen combining a-GnRH for 6 months with an immunomodulator followed by progestogen in the second menstrual cycle phase for another 6 months. Menstrual blood loss volume was assessed at 3, 6, and 12 months using menstrual blood loss maps and a special scoring scale. The authors report that progestogen and a-GnRH monotherapy normalized blood loss and menstrual function by 3 months, but that during the 12-month follow-up blood loss increased in those groups and polimenorea was marked in three women. The phased complex therapy normalized blood loss indicators by the 3rd month with a tendency toward decrease over 12 months, with a reported 4-fold reduction from baseline. This paper is centrally about adenomyosis—specifically menstrual function and blood loss under hormonotherapy in women with adenomyosis plus endometrial hyperplasia.
Abstract
The objective: to study the effect of hormone therapy on menstrual function of women with adenomyosis in combination with endometrial hyperplasia. Patients and methods. We evaluated the effects of hormone therapy in 160 women of reproductive age with adenomyosis in combination with endometrial hyperplasia: I group – 60 women used the progestogen (6 months); II – 60 women, took an agonist of gonadotropin-releasing-hormone – а-GnRH) (6 months), III – 40 women who received the complex therapy including а-GnRH during the first 6 months and immunomodulator intramuscularly every other day No. 20, with subsequent use of tablets of 0.15 g of 1 times a week (course - 6 months), then for the next 6 months was used progestogen in the second phase of the menstrual cycle from 16 to 25 day. Evaluation of indicators of health status were performed after 3, 6 and 12 months of therapy. Assessment of volume of menstrual blood loss was performed using maps of menstrual blood loss and were assessed on a special scale. The total rating for the month, which exceeded 100 points, consistent with menstrual blood loss greater than 80 ml. Results. The influence of hormonal monotherapy progestogen and а-GnRH on menstrual function of women with adenomyosis in combination with endometrial hyperplasia during the follow-up throughout the year. The assessment of indicators of volume of blood loss with the help of monitoring charts. Developed a comprehensive hormone therapy for women of reproductive age with combined benign uterus pathology and the evaluation of its impact on indicators of volume of blood loss and menstrual function of women. Conclusions. Monoterapia by the progestogen and а-GnRH for 6 months of treatment normalizes the indicators of volume of blood loss and menstrual function of women, and the 12-month follow-up in women of these groups also increased the volume of blood loss and each 3 women is marked polimenorea. Developed a comprehensive phased hormone therapy for women with adenomyosis in combination with endometrial hyperplasia normalizes on the 3rd month of treatment indicators of blood loss and has a tendency to decrease during the 12 months of observation (the volume of menstrual blood loss has decreased in 4 times from initial). Key words: complex therapy, adenomyosis, endometrial hyperplasia, gestagene, а-GnRH, menstrual function, volume of blood loss.
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- Menstrual function in women with adenomiosis in combination with the hyperplastic processes of endometry on the background of hormonotherapy
Menstrual function in women with adenomiosis in combination with the hyperplastic processes of endometry on the background of hormonotherapy
HEALTH OF WOMAN. 2017.4(120):115–117; doi 10.15574/HW.2017.120.115
Benyuk V. A., Kurochka V. V., Benyuk S. V., Altibaeva D. M.
A.A. Bogomolets National Medical University, Kiev
The objective: to study the effect of hormone therapy on menstrual function of women with adenomyosis in combination with endometrial hyperplasia.
Patients and methods. We evaluated the effects of hormone therapy in 160 women of reproductive age with adenomyosis in combination with endometrial hyperplasia: I group – 60 women used the progestogen (6 months); II – 60 women, took an agonist of gonadotropin-releasing-hormone – а-GnRH) (6 months), III – 40 women who received the complex therapy including а-GnRH during the first 6 months and immunomodulator intramuscularly every other day No. 20, with subsequent use of tablets of 0.15 g of 1 times a week (course – 6 months), then for the next 6 months was used progestogen in the second phase of the menstrual cycle from 16 to 25 day. Evaluation of indicators of health status were performed after 3, 6 and 12 months of therapy. Assessment of volume of menstrual blood loss was performed using maps of menstrual blood loss and were assessed on a special scale. The total rating for the month, which exceeded 100 points, consistent with menstrual blood loss greater than 80 ml.
Results. The influence of hormonal monotherapy progestogen and
а-GnRH on menstrual function of women with adenomyosis in combination with endometrial hyperplasia during the follow-up throughout the year. The assessment of indicators of volume of blood loss with the help of monitoring charts. Developed a comprehensive hormone therapy for women of reproductive age with combined benign uterus pathology and the evaluation of its impact on indicators of volume of blood loss and menstrual function of women.
Conclusions. Monoterapia by the progestogen and а-GnRH for 6 months of treatment normalizes the indicators of volume of blood loss and menstrual function of women, and the 12-month follow-up in women of these groups also increased the volume of blood loss and each 3 women is marked polimenorea. Developed a comprehensive phased hormone therapy for women with adenomyosis in combination with endometrial hyperplasia normalizes on the 3rd month of treatment indicators of blood loss and has a tendency to decrease during the 12 months of observation (the volume of menstrual blood loss has decreased in 4 times from initial).
Key words: complex therapy, adenomyosis, endometrial hyperplasia, gestagene, а-GnRH, menstrual function, volume of blood loss.
REFERENCES
1. Benyuk VA, Golota VYa, Dyndar OA, Usevych IA. 2006. The Role of GNRH agonists in treatment of endometriosis. Archive of science.-pract. Conf. «Problems achievements and prospects of development of biomedical Sciences» 142:237.
2. Grischenko VI, Shcherbina MO, Potapov LV, Lipko OP. 2002. Use of differentiated therapy in the treatment of patients with common forms of genital endometriosis. Journal of sciences and research 2(26):8-9.
3. Dubenko DI, Kurochka VV, Savenko IV, Gaponova KV, Lastovecka LD. 2012. The efficiency of combination hormonal therapy in women of reproductive age with benign uterine pathology. Ukrainian scientific medical youth magazine. Special issue 2:235.
4. Kucherenko SN. 2002. Differentiated hormone therapy of adenomyosis with consideration of the peculiarities of hormonal disorders and clinico-morphological criteria of the process. Women's Health 3(11):30-36.
5. Tatarchuk TF, Burlaka OV, Korinna KO. 2005. Drug therapy berprestasi processes of endometrium. Medicine and life: 100-101.
6. Andreotti RF, Flescher AS. 2005. The sonographic diagnosis of adenomyosis. Ultrasound Q. 21(3):167-170. https://doi.org/10.1097/01.ruq.0000174751.34633.9a
7. Afonso JS, Sumxes Sergio S. 2005. Adenomiosis: pathohysiology, diagnosis and treatment (review). Wu Hysteroscopy at Fri. 12(2):1-52.
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