Treatment of endometriosis in women with drugs. Treatment of endometriosis with hormonal contraceptives Treatment of endometriosis with hormonal contraceptives

Endometriosis is an abnormal growth of the endometrium in and outside the genitals. In this case, the disease may be asymptomatic. However, some women suffer from such unpleasant symptoms as:

Collapse

pain in the lower abdomen;
heavy and painful periods;
pain during intercourse;
pain when going to the toilet;
infertility.

The woman, having addressed to the doctor, receives treatment. And now the question arises whether it is possible to combine treatment and the course of the disease with taking birth control pills. If so, how to do it without harm to health?

Whether it is possible to accept?

The essence of endometriosis is mainly hormonal failure. Doctors treat this disease with hormonal drugs. Therefore, you can take birth control pills for endometriosis. But, of course, not those who appointed themselves. After all, there are those drugs that are contraindicated in such a disease.

What are birth control pills?

Features and Benefits

The main feature is that this method of treatment and contraception is not suitable for everyone. Contraceptive hormonal drugs have a number of serious contraindications:

pregnancy;
breast cancer;
cancer of the pelvic organs;
bleeding, the cause of which is unknown;
severe forms of migraine;
diseases of the liver and biliary tract;
cardiovascular diseases;
diabetes;
epilepsy;
thrombosis and predisposition to it.

It is important to remember that if a woman has started drug treatment of endometriosis and has not stopped taking hormonal contraception, at first it is better to insure barrier methods of contraception (condom) in order to avoid unwanted pregnancy and infection in an already inflamed organ.

With endometriosis, hormonal contraceptives will be prescribed to women who are under 35 years old and have a 1.2 degree of the disease. Otherwise, doctors will find another method of treatment, not using hormonal drugs.

What are the benefits of taking birth control pills for endometriosis?

the cycle is stabilized;
pains go away;
flushes of heat, cold are eliminated;
the endometrium decreases, which has grown in the wrong place;
improves women's health in general;
protection against unwanted pregnancy.

How much to take birth control pills is determined by the doctor. In general, 6-15 months is enough to eliminate the effects and symptoms of endometriosis.

How to choose the right one?

The mechanism of operation of contraceptives is as follows:

inhibition of the ovulation process;
thickening of mucus in the cervix;
blocking the growth of mucous membranes;
blocking the growth of the endometrium with endometritis.

Of course, the drugs are serious in their action, so you should carefully consider their correct selection.

After carefully examining the patient, the doctor will decide which of the listed hormonal contraceptives is right for her: COC, mini-drank, spiral, or injection.

The scheme of selection of contraceptives

A visit to a gynecologist and endocrinologist in order to determine chronic diseases, allergies, bad habits and contraindications. Among other things, the doctor must determine the height, weight, age.

The next step is an ultrasound of the pelvic organs to detect diseases that are not visible during a visual examination. It is recommended to do it on the 5th-7th day of the cycle.

Donate blood for hormones.

Donate blood for biochemistry.

Visit a mammologist (remembering that breast cancer is a contraindication for hormonal contraception).

Based on all the tests and examinations, the doctor will determine which phenotype the woman belongs to. There are 3 varieties of them:

Article outline

Endometriosis is a disease in which tissues related to the endometrium grow. The process takes place outside the uterine mucosa. There are several places where endometrioid inclusions can be seen:

The lumen of the fallopian tubes;
The peritoneum of the small pelvis;
Vagina;
Cervix;
Uterus.

In addition, sometimes inclusions may be present in the ovary, as well as in scars formed after caesarean section. The development of the disease runs in parallel with the functioning of the ovaries. The foci of the process may be subject to reverse development due to natural or artificial menopause.

Most often occurs in women after 35-40 years. It should be noted that endometriosis is observed in 50-70% of patients whose main diagnosis is infertility. According to various sources, the percentage of occurrence of this disease in women of childbearing age varies from 10-15% to 30-50%.

Despite the fact that the mechanism of the development of the disease is already considered to be clarified, universal drugs for the treatment of endometriosis in women have not yet been found. This is due to the fact that scientists have not yet been able to find out the reason why it takes this particular form.

About the disease

Before starting the treatment of the disease, it is imperative to know why it develops and how it manifests itself. It is worth mentioning how endometriosis is classified. There are three main types of disease:

External genital endometriosis;
Internal genital endometriosis;
Extragenital.

In the first type, endometrial sites are located in most cases on such organs:

The fallopian tubes;
Cervix;
Crotch;
Peritoneum;
Ovaries.

If we are talking about internal genital endometriosis, then such areas are located in the thickness of the muscular walls of the uterus. There is another name for this disease, namely -. The main difference between extragenital endometriosis is the fact that the endometrium grows on other groups of organs (intestines, lungs, navel, and bladder). This type is not so widespread and occurs only in 7-8% of cases.

Now consider the main symptoms of endometriosis of the uterus. Among them it is worth noting the following:

Pain in the pelvic area;
Slight discharge of red or brown color in the period before or after menstruation;
There is an increase in pain in the first days of menstruation;
Urination is accompanied by pain;
Dyspareunia (pain during intercourse);
Prolonged profuse menstrual flow.

In addition, the patient may experience nausea and vomiting. An aggravating factor is an imbalance of sex hormones, as it contributes to the development of a disease such as iron deficiency anemia. Unfortunately, drug correction is not always successful, which leads to anemia.

In the process of the development of the disease, as a result of the growth of the affected organs, serious pain attacks occur. They monthly give specific spotting, including from the mammary glands.

The exact causes of the disease have not been identified, but despite this, experts identify the following factors that could contribute to its occurrence:

Reduced immunity;
Chronic inflammatory processes in the genitals;
Complications after caesarean section;
Heredity;
Elevated estrogen.

What treatments are available

In total, there are three main ways to treat this disease:

Surgical intervention without removal of the organ;
radical surgery;
conservative therapy.

If the patient is a young woman, then in most cases the most sparing treatment regimen is used, namely surgery and hormone therapy. This technique does not inhibit the development of the egg, so the risk of complications is not so great.

However, most patients are more mature (35-40 years old). Treatment of endometriosis in this case is carried out depending on the location of the focus. Therapy is carried out in a complex:

Surgery to remove nodules and cysts, dissection of adhesions and burning of foci;
Intensive therapy with hormonal drugs;
A course of immunostimulants.

In most cases, it is not possible to completely cure endometriosis without surgical intervention, and therefore, experts recommend a complex type of treatment. However, there are cases when it is not recommended to resort to surgery and conservative treatment is performed:

Infertility;
Reproductive age of the patient;
The disease is asymptomatic.

Surgery is performed under the following circumstances:

The woman has a somatic pathology;
The presence of other diseases of the genital organs;
Endometriosis of the scar or navel;
Medicines do not give the desired effect.

In the same turn, cases when urgent radical surgical treatment is required are not excluded:

Severe form of adenomyosis;
Endometriosis of the ovaries;
The previous methods do not lead to recovery.

Only a doctor can announce the desired treatment regimen, do not rush and drink hormonal drugs. In this case, without the recommendations of a specialist, only homeopathic medicines can be used. Homeopathy is a harmless medicine that can normalize a person's hormonal function. Despite this, it is worth taking seriously the choice of such a drug, since they are not universal and will not suit everyone.

Can endometriosis be cured with drugs?

It is not possible to answer this question definitively, since each case of the disease is individual and is treated by different methods. Theoretically, with the help of medications, a patient can be cured of this disease, but this does not happen in every case.

Medical treatment for endothermiosis includes:

Contraceptive pills (Zhanin, Yarina);
Medicines that contain progesterone or its substitutes: Byzanne, Utrozhestan, Dufastan;
Danazol;
Zoladex or other gonadotropin analogues.

It should be noted that each of these groups has a different spectrum of action on the patient's body. What medications to use for the patient, again, should be decided by a qualified doctor.

Hormonal drugs for endomatriosis

Hormones in endometriosis are one of the most important aspects. Hormonal drugs help stop the progression of the disease, as well as suppress estrogen secretion and ovulation.

Here is a list of the main groups of drugs for hormone therapy:

Antiprogestins;
Gonadoliberin agonists;
Gestagens and progestogens.

Gonadotropin-releasing hormone agonists

The hypothalamus is responsible for producing natural GnRH agonists to induce the release of pituitary hormones, which in large quantities can neutralize the work of the ovaries. Here are the drugs that are usually prescribed to patients:

Diphereline. It is used for intramuscular injections for the first 5 days.
Decaptil Depot. It is administered under the skin in doses of 3.75 mg every 28 days.
Zoladex. Injections in the abdomen. For 28 days, the active substance is released.
Buserelin. It is injected into the muscle in doses of 3.75 every month.
Lucrin Depot. The medication is injected on the 3rd day of menstruation. The injection is repeated every 28 days.

The impact of these drugs corresponds to the state of menopause. The endometrium stops its development, as estrogen disappears. Pathological areas of the endometrium also do not develop.

This type of treatment takes about 6 months and is quite difficult. From time to time, signs of menopause begin to show themselves. In addition, the bones begin to lose their density, which can lead to fractures.

Gonadotropin inhibitors and antiprogestogens

Inhibitors also treat endometriosis. Such drugs can inhibit the development of endometrial cells. Due to their impact, the ovaries stop their work, and therefore, the production of estrogens also stops. Among the side effects of such drugs, it is worth highlighting:

Accelerated body hair growth;
Excessive weight gain;
Acne.

The most famous drugs in this category:

Danazol;
Mifepristone, Gestrinone.

Gestagens

The essence of the treatment is to take drugs similar to progesterone. The main function of the substance is to suppress the growth of the uterine mucosa. Let's list the main drugs for hormonal therapy based on hormones of this series:

Duphaston. It comes in the form of tablets, which you need to take from the 5th to the 25th day of the menstrual cycle.
. Take 1 whole tablet every day. The drug begins to act after the endometrium stops growing, after which the ovaries cease to function and menstruation stops.
Orgametril. It is used to prevent the development of new foci of the disease, in addition, it reduces the size of old ones. It is necessary to take from the 14th to the 25th day of the cycle 1 tablet daily.

Contraceptives for endometriosis (hormonal oral contraceptives)

The main advantage of hormonal drugs in the treatment of endometriosis is that they can perform several tasks at the same time. Combined oral contraceptives are usually used to prevent pregnancy. They include piece estrogens and gestagens. Thanks to them, the body stops producing hormones on its own and the endometrium stops developing.

The most popular birth control pills for endometriosis:

Jess;
Dimia;
Qlaira;
Yarina;
Diana 35.

The doctor can consult with the patient about which contraceptives are best for her. Using birth control pills, a woman relieves herself of menstruation and evens out her hormone balance. In this regard, estrogen no longer affects the development of the endometrium.

Non-hormonal drugs

Only a specialist can prescribe the correct method of treatment for a patient. Despite this, factors such as pain, weakness, and frequent discharge force the patient to resort to the use of painkillers. You can select a list of basic tools to relieve the feeling of heaviness and inflammation:

ibuprofen;
Papaverine;
Novigan.

To maintain immunity, you can use the following medicines:

Retinol;
Tocopherol;
Cycloferon.

Treating endometriosis without hormones is indicated in the following cases:

The patient is allergic to hormonal drugs;
Tendency to thromboembolism and thrombosis;
Arterial hypertension;
Severe pathologies of the kidneys and liver;
Diabetes;
thyrotoxicosis.

In any case, the choice of non-hormonal treatment should be dealt with by a specialist qualified in this field.

Antibacterial drugs

Antibiotics for endometriosis are taken in such cases:

In parallel with the underlying disease, a fungal infection develops;
There are complications of certain infectious diseases of the genital organs;
The patient had previously had inflammatory pathologies.

In all other cases, antibacterial drugs are not prescribed, since this type of treatment can lead to a large number of complications or side effects. Antibiotics tend to suppress the immune system, which contributes to the further development of endometriosis.

What candles can be used

As you can see, the cures for endometriosis can be different. Another one of them is candles. With endometriosis of the uterus, the following drugs are most often used:

Diclofenac;
Indomethacin;
Anuzol;
Viferon.

In most cases, such medications are prescribed if the patient wants to achieve the maximum effect of pain relief without taking analgesics in large doses. They are also used for adhesions. The dosage usually depends on the severity of the disease. The method of application is quite simple: suppositories are introduced into the anus, twice a day.

The mechanism of action of contraceptive pills is as follows: each pill contains a dose of estrogen and progestogen, which are similar to natural, but not identical. Entering the body regularly, hormones provoke a decrease in the production of their own by inhibiting the synthesis of FSH and LH by the pituitary gland. As a result, the level of own estrogens and gestagens decreases, ovulation does not occur. This is the main contraceptive effect.

In addition to this, there is a thickening of the cervical mucus, atrophy of the endometrium, as a result of which, in the event of fertilization, the fetal egg cannot attach to the wall of the uterus.

Against the background of taking oral contraceptives, the severity of all symptoms of endometriosis decreases: the pain goes away, the amount of discharge decreases, and the spotting no longer bothers. Therefore, for some time it was believed that birth control pills are one of the options for treating endometriosis and preventing the progression of the disease.

However, recent research has shown that taking birth control pills for endometriosis is not only not recommended, but can also lead to the progression of the disease. Indeed, the symptoms of the disease at the time of taking the medication are reduced.

In the initial stages in young girls, including to obtain a rebound effect - natural stimulation of ovulation after discontinuation of the drug.
If dienogest is included in the composition of oral contraceptives as a progestogen component.

Rebound effect after discontinuation of the contraceptive drug

Recent studies have established that as a treatment for endometriosis, the most effective drug after agonists and antagonists of gonadotropic hormones (they act at the level of the pituitary and hypothalamus) is "Visanne" based on dienogest.

When taking the medicine for 3-6 months, there is not only a decrease in the severity of all symptoms, but also a decrease in the number and size of endometrioid ectopias. And the effect persists for a long time after discontinuation of the drug.

When choosing birth control pills for the treatment of endometriosis, preference should be given to those containing dienogest. These are "Bonade", "Janine" and "Klayra". It is believed that due to dienogest, endometriosis foci will decrease, which will lead to a regression of the disease, although not as intensely as with the Bysanne monodrug.

"Klayra"- a three-phase drug. The action is as close as possible to the natural cycle of a woman. It is believed that adaptation to such a remedy should proceed more smoothly. Also, "Klayra" is recommended for use by women after 35 years of age until the onset of menopause. You need to take at least 3 months.

"Bonade"(a complete analogue manufactured by another company - "Zhanin") ̶ monophasic oral contraceptive. The package contains 21 tablets, after taking which you need to take a break for 7 days, during which the woman has menstrual-like discharge. Each tablet contains the same dose of estrogen (ethinyl estradiol 0.03 mg) and progestogen (dienogest 2 mg).

During addiction to the drug, acyclic spotting is allowed between the expected days of menstruation. Treatment should last at least 3 months, and if necessary or desired, longer.

Treatment of endometriosis with contraceptives should be prescribed only by a doctor. taking into account the clinical form of the disease, its prevalence, as well as the constitution and preferences of the woman. For women after 35-40 years, preference is given to the appointment of "Klayra", young, especially those who have not given birth, - "Zhanina" ("Bonade").

With endometriosis, other methods of protection can be used. For the treatment of pathology and protection against pregnancy, the Mirena intrauterine system can be used. This is a special spiral that contains a microcapacity with a hormone (gestagen), which is released gradually and in doses over a period of 5 years.

The use of popular oral contraceptives ("Regulon", "Jess", "Yarina", "Zoeli", "Silhouette", "Belara", the vaginal ring "NovaRing" and others) with the established fact of the presence of endometrioid foci is inappropriate. This will lead to an improvement in the woman's well-being, but will not stop the progression of the disease.

The use of a conventional coil is not recommended for endometriosis as this may lead to the progression of the disease. Other methods of protection (spermicidal vaginal tablets, coitus interruptus, condoms) do not affect the course of the disease, but only protect against pregnancy.

For the treatment of endometriosis, other groups of hormonal agents are also used, which do not provide a reliable contraceptive effect, so they cannot be called contraceptives:

Gestagens:, "Susten". On the contrary, they favor the onset of pregnancy. Drugs similar to them, Novinet, Depo-Provera, with prolonged use, can suppress ovulation and thus prevent pregnancy, but it is difficult to find out exactly when this happens. Receiving "Visanna" also does not protect against pregnancy.
Agonists and antagonists of gonadotropic hormones ("Zoladex", "Bucerelin",) already on the 2nd month of admission, as a rule, lead to the absence of ovulation. However, fertility (the ability to conceive) is often restored immediately after the effect of the drug wears off. This is usually one month if the next injection is not given.

Considering that all these drugs do not provide reliable protection against pregnancy, it is recommended to use additional methods of protection during treatment, since the effect of these drugs on the developing fetus has not been established, teratogenic (causing defects) effects are not excluded.

Prescribing birth control for endometriosis, the doctor pursues several goals at once:

reduce the severity of pain during sexual intercourse, during menstruation;
eliminate prolonged spotting on the eve and after menstruation;
reduce the number of critical days and the amount of blood lost.

The impact on these factors leads to an improvement in the quality of life of a woman.

Read more in our article on birth control for endometriosis.

Read in this article

How birth control pills work

Under the concept of contraceptives, in most cases, oral contraceptives are meant. These are pills that were primarily invented to prevent unwanted pregnancies.

The mechanism of action of contraceptive pills is as follows. Each contains a dose of estrogen and progestogen, which are similar to natural, but not identical. Entering the body regularly, hormones provoke a decrease in the production of their own by inhibiting the synthesis of FSH and LH by the pituitary gland.

As a result, the level of own estrogens and gestagens decreases, ovulation does not occur. This is the main contraceptive effect. In addition to this, there is a thickening of the cervical mucus, atrophy of the endometrium, as a result of which, even in the event of fertilization, the fetal egg cannot attach to the wall of the uterus due to its changes.

Are they used to treat endometriosis?

It has long been noticed that against the background of taking oral contraceptives, the severity of all symptoms of endometriosis decreases: the pain goes away, the amount of discharge decreases, and the daubing on the eve and after menstruation no longer bothers. Therefore, for some time it was believed that birth control pills are one of the options for treating endometriosis and preventing the progression of the disease.

However, recent studies have provided data that have refuted the prevailing opinion. It turns out that taking birth control pills for endometriosis is not only not recommended, but can also lead to the progression of the disease. Indeed, the symptoms of the disease at the time of taking the medication are reduced.

However, there are some exceptions. Birth control pills can be prescribed for endometriosis in the following cases:

In the initial stages in young girls, including to obtain a rebound effect ̶ natural stimulation of ovulation after discontinuation of the drug.
If dienogest is included as a progestogen component in oral contraceptives.
If endometriosis is only suspected, but does not have significant clinical manifestations.

The best birth control pills for endometriosis

Recent studies have found that as a treatment for endometriosis the most effective drug after agonists and antagonists of gonadotropic hormones(they act at the level of the pituitary and hypothalamus) is "Visanne" based on dienogest.

In numerous observations, it has been reliably proven that when taking the drug for 3-6 months, not only does the severity of all symptoms decrease, but also the number and size of endometrioid ectopias decrease. And, most importantly, the effect persists for a long time after the drug is discontinued.

Therefore, when choosing birth control pills for the treatment of endometriosis, preference should be given to those that contain dienogest. These are Bonade, Janine and Qlaira. It is believed that due to dienogest, endometriosis foci will decrease, which leads to a regression of the disease, although not as intensely as with the Byzanne monopreparation.

The effectiveness of "Visanna" in the treatment of endometriosis

"Klayra" ̶ three-phase drug. The action of the drug is as close as possible to the natural cycle of a woman. The package contains 3 types of tablets with different doses of estrogen and progestogen components. It is believed that adaptation to such a drug should go more smoothly, and Qlaira is also recommended for use by women after 35 years of age until menopause.

There is only an assumption that treatment with this oral contraceptive is effective for endometriosis. There are no reliable studies on this. You need to take the drug for at least 3 months.

"Bonade" (a complete analogue produced by another company ̶ Janine)̶ monophasic oral contraceptive. The package contains 21 tablets, after taking which you need to take a break for 7 days. During this, a woman has menstrual-like discharge. Each tablet contains the same dose of estrogen (ethinyl estradiol 0.03 mg) and progestogen (dienogest 2 mg).

Habituation to the drug allows the appearance of acyclic spotting between the expected days of menstruation. Treatment should last at least 3 months, and if necessary or desired to have permanent reliable contraception - longer.

The use of oral contraceptives involves taking pills daily at a strictly fixed time, otherwise protection against pregnancy is reduced.

Watch this video about which hormonal drugs are used in the treatment of endometriosis:

How to choose contraceptives for contraception

Treatment of endometriosis with contraceptives should be prescribed only by a doctor, taking into account the clinical form of the disease, its prevalence, as well as the constitution and preferences of the woman.

The choice of oral contraceptives is small. Women after 35-40 years of age give preference to the appointment of "Klayra", young women, especially those who have not given birth - "Zhanina" ("Bonade").

With endometriosis, other methods of protection can be used. For the dual effect of treating pathology and protecting against pregnancy, an intrauterine system can be used. This is a special spiral that contains a microcapacity with a hormone (gestagen), which is released gradually and in doses over a period of 5 years. The convenience of the Mirena Navy is as follows:

Expert opinion

Daria Shirochina (obstetrician-gynecologist)

The use of a conventional spiral is not recommended for endometriosis, as this can provoke the progression of the disease. Other methods of protection (spermicidal vaginal tablets, coitus interruptus, condoms) do not affect the course of the disease, but only protect against pregnancy.

What hormonal drugs do not protect against pregnancy

For the treatment of endometriosis, other groups of hormonal agents are also used, which do not provide a reliable contraceptive effect, so they cannot be called contraceptives. Namely:

Gestagens̶ "Utrozhestan", "Dufaston", "Susten" - on the contrary, favor the onset of pregnancy. Drugs similar to them, Novinet, Depo-Provera, with prolonged use, can suppress ovulation and thus prevent pregnancy, but it is difficult to find out exactly when this happens.

Agonists and antagonists of gonadotropic hormones("Zoladex", "Diferelin") already on the 2nd month of admission, as a rule, lead to the absence of ovulation, as a result of which pregnancy becomes impossible. However, fertility (the ability to conceive) is often restored immediately after the effect of the drug wears off. Usually it is 1 month if the next injection is not made.

Given that all these drugs do not provide reliable protection against pregnancy, it is recommended to use additional methods of protection during treatment. Since the effect of these drugs on the developing fetus has not been established, teratogenic (malformation) effects cannot be ruled out.

What effect to expect

When prescribing contraceptives for endometriosis, the doctor pursues several goals at once, trying to choose the best from the entire arsenal. Namely:

Reduce the severity of pain during sexual intercourse, during menstruation.
Eliminate prolonged spotting on the eve and after menstruation.
Reduce the number of critical days and the amount of blood lost.

The impact on these factors leads to an improvement in the quality of life of a woman. By prescribing drugs of the usual contraceptive series, it is possible to achieve an improvement in the woman's well-being, but only for the duration of treatment. The use of drugs based on dienogest is more effective and the result obtained remains for some time.

Contraceptives for endometriosis should be chosen based on the stage of the disease, the woman's complaints, and the results of the examination. It is most rational to use drugs with dienogest in the composition (Bonade, Janine, Qlaira), as well as the Mirena Navy. When prescribing, it is necessary to take into account contraindications, possible side effects.

Useful video

Watch this video about when and how to treat endometriosis:

Endometriosis is a gynecological pathology in which there is an overgrowth of endometrial cells outside the uterus. This disease affects women of childbearing age. The list of pills for endometriosis is very wide. The choice of drugs is strictly individual and should be carried out under the supervision of a physician.

Spiral "Mirena"

The main active ingredient is levonorgestrel. Included in the group of gestagenic drugs. The main advantage of the remedy is that the required level of the active substance is maintained daily in the uterine cavity.

Expert opinion
Borovikova Olga
The principle of action is based on the fact that the endometrium becomes immune to the action of estradiol, which leads to a decrease in the manifestations of the disease. Most women have no side effects. The effectiveness of the drug is evidenced by its constant use in the gynecological practice of foreign countries.

In addition to endometriosis, Mirena is prescribed for the purpose of contraception or prevention. idiopathic menorrhagia. The spiral has contraindications, so before using it is necessary to consult a specialist.

Bibliography:

Baskakov V.P. (1995). "The state of the reproductive function of women with endometriosis". "Problem. reproductions".

Demidov V. N., Gus A. I. (2002). "Modern principles of ultrasound diagnosis of genital endometriosis (to help the practitioner)". "Scientific Center for Obstetrics, Gynecology and Perinatology (Dir. - Academician of the Russian Academy of Medical Sciences V. I. Kulakov)".

Endometriosis is a fairly common disease among women of childbearing age. With this pathology, the endometrium grows beyond its normal localization.

The cause of this overgrowth is most often a hormonal imbalance, combined with an insufficient work of the immune system. It is because of this that hormonal drugs for endometriosis are considered the main treatment.

Features of endometriosis

When a woman enters reproductive age, her uterus begins to experience cyclical changes associated with the activity of sex hormones. With the normal activity of the hormonal system, a balance is maintained between the sex hormones. At the beginning of the cycle, estrogens predominate, which promote the growth of the endometrium and bring it to a certain thickness, and then progestogens come into play, which stop its growth.

The reason for the development of endometriosis is a violation in this well-established balance of hormones. Or the body begins to produce too much estrogen, which will contribute to the abnormal growth of the endometrium. Either the body produces extremely few gestagens and they are not able to stop the growth of the endometrium. That is why most often the doctor prescribes hormones for endometriosis as a method of treatment.

However, despite the knowledge of the mechanisms of the development of pathology, doctors have not yet been able to determine the exact cause of its occurrence.

There are risk factors that can increase the likelihood of endometriosis. It:

hereditary predisposition;
food;
absence of children;
early puberty;
inflammatory diseases of the reproductive system;
various irregularities in the menstrual cycle.

Goals of medical treatment of endometriosis

The main goal of hormonal treatment of endometriosis is to suppress the concentration of estrogen. This can be achieved in several ways. Some hormonal drugs act on the ovaries, which are responsible for the production of estrogen, others on the pituitary gland, which is also involved in the production of hormones.

Since the disease endometriosis has various symptoms, drug treatment will be aimed at combating them. The gynecologist prescribes immunostimulating drugs, vitamins, painkillers and anti-inflammatory drugs.

Hormonal treatment of endometriosis must comply with the principles of cyclicality and constantly monitoring the state of the pathology. The fact is that such treatment does not allow you to get rid of the disease forever. And as soon as a woman stops taking hormonal drugs, endometriosis returns.

The main methods of hormonal treatment of endometriosis

The main way to treat this disease with hormonal drugs is to block the production of female sex hormones or prevent ovulation. The main methods of treatment are the following.

Imitation of pseudo-pregnancy. Hormonal preparations containing estrogen and progestin in their composition imitate the onset of pregnancy in the body and thus block ovulation. Progestin can also be used alone for treatment, as it can cause atrophy in endometrial tissue.
Imitation of pseudomenopause. The drugs used reduce the level of sex hormones to the lowest possible value.
Blocking current ovulation. In this regimen for the treatment of endometriosis, drugs are used that contain a synthetically made drug, which in its properties resembles androgen, a male sex hormone. Such drugs have a good ovulation blocker, but at the same time they have a lot of side effects.

What kind of hormonal pills for endometriosis, as well as injections or spirals for treatment, can a doctor prescribe?

Gonadotropin-releasing hormone agonists

Natural agonists in the body produce the hypothalamus. They stimulate the pituitary gland to produce hormones. A sufficient amount of these hormones reduces the production of estrogen, neutralizing the activity of the ovaries. With a diagnosis of endometriosis, treatment with such hormonal drugs can compensate for the lack of gonadotropin-releasing hormone agonists in the body. From this group are usually prescribed:

Difelin - intramuscular injections;
Decapeptyl Depot - subcutaneous injections;
Zoladex is a subcutaneous injection in the abdomen, which is done once a month;
Buserelin - intramuscular injections;
Lucrin-depot is a drug in the form of an injection, which is done once every 28 days.

All these medicines bring the body into a state that is similar to menopause. Menstruation stops, and, consequently, the endometrium stops its development, including in the places of its pathological growth.

Treatment with such hormonal injections usually lasts for six months and does not reflect very well on the woman's condition. She begins to fully feel all the "charms" of the onset of menopause: irritability, insomnia, dry mucous membranes, decreased libido, and so on.

Also, women treated with these drugs should take non-hormonal contraceptives. Since there is a very high risk of birth defects in the fetus if pregnancy occurs while taking these drugs.

Gonadotropin inhibitors and antiprogestogens

Such hormonal tablets are prescribed for endometriosis to suppress follicle-stimulating hormone (FSH), luteinizing hormone (LS) and progesterone. Preparations:

Danazol and its analogues Danoval, Danol, are produced most often in the form of capsules taken orally,
Mifepristone or Gestrinone are pills that prevent the production of progesterone.

The hormonal drugs included in this group affect the functioning of the ovaries, thereby interfering with the production of estrogens and inhibiting the growth of endometrial cells, including pathological ones.

Side effects of these medications can include weight gain, increased hair growth, and acne.

Gestagens

Hormonal treatment of endometriosis may include the use of progesterone analogues. Such drugs will suppress the growth of the mucosa:

Duphaston is a gentle remedy that comes in the form of tablets and is taken during the menstrual cycle;
Orgametril helps prevent the appearance of new pathological foci, and also helps to reduce the size of existing ones, but is effective only in the initial stages of endometriosis;
Byzanne - when taking these pills, the growth of the endometrium first stops, then the work of the ovaries stops, menstruation stops;
The Mirena spiral helps with mild forms of pathology, it is introduced into the uterus and due to the presence of levonorgestrel in the composition, which begins to be released upon administration, the growth of the endometrium is inhibited. Such a spiral is considered an excellent tool for the treatment of uterine bleeding in endometriosis and reduces pain.

Combined oral contraceptives

Hormonal drugs of this type for endometriosis are usually multi-tasking. They will protect against unplanned pregnancy, and also, due to the content of synthesized sex hormones in their composition, reduce the production of natural hormones by the body.

Thus, the synthesized estrogens and gestagens help to stop the growth of the endometrium. Combined oral contraceptives must be used without interruption for about six months to achieve a positive effect.

As a rule, for the treatment of endometriosis, the doctor prescribes hormonal oral contraceptives in combination with non-steroidal anti-inflammatory drugs, the most famous of which is Ibuprofen. The most commonly used medications are:

Jeanine;
Jess;
Yarina;
Qlaira;
Diana 35;
Dimia.

While the patient takes 1 tablet per day, her menstrual flow does not begin, and the hormonal balance returns to normal. This means that estrogen will no longer have the same effect on the excessive growth of the endometrium. But this method of treatment is only suitable for a small spread of endometriosis.

It should also be remembered that the combined use of estrogen and progestin can cause side effects. The most serious side effects of taking combined oral contraceptives are an increase in blood pressure and the formation of thrombosis, which in turn greatly increases the risk of a heart attack or stroke.

Side effects during treatment

Hormonal preparations in the form of tablets, injections and spirals are good for the treatment of endometriosis. However, before starting such treatment, all possible risks to the body should be assessed. Hormonal drugs can cause the following conditions:

liver disease;
increased blood clotting;
decrease in the number of platelets and leukocytes in the blood;
cancerous tumors;
pathology of the mammary glands;
cervical dysplasia;
allergic reactions.

Treatment of endometriosis with hormones allows women to feel relief after a short time. But different hormonal drugs have different effects on a woman's body. And at the same time they have different side effects.

Therefore, before starting treatment with hormonal pills or using a spiral, you must carefully study all the risks together with your gynecologist.