Hormonal drugs for the treatment of female diseases. Refrat principles of hormone therapy in obstetrics and gynecology

Hormonal preparations are widely used in modern medicine for the treatment of various diseases of the skin, endocrine system, etc. They have also found their application in gynecology.

The chemical structure of female sex hormones was discovered in the 30s of the last century in America, which made it possible to create their artificial counterparts. This was a real breakthrough in gynecology and allowed:

• conduct effective therapy of hormone-dependent diseases: uterine fibroids, endometriosis, endometrial hyperplasia, etc.;
• reduce the number of abortions due to contraception with medications;
• improve the quality of life of women during menopause and after operations to remove the ovaries or uterus in general;
• treat infertility with the help of new reproductive technologies (IVF, etc.).

Hormone replacement therapy

The main purpose of such treatment is to maintain the condition of a woman during menopause, when the reproductive function of the female body decreases and hormonal changes occur. This has a strong impact on the psychological and physical condition of the patient and leads to:

• increased heart rate;
• excessive sweating (accompanied by hot flashes);
• urinary incontinence;
• dryness in the vagina;
• weight gain;
• thinning of bone tissue;
• irritability;
• sleep disorders;
• decrease in performance.

In such cases, the doctor prescribes a drug treatment called hormone replacement therapy. This helps to significantly improve the quality of a woman's life.

Hormonal contraception

Contraception is an important issue affecting all women. Many traditional barrier agents prefer to use hormonal drugs, such as oral contraceptives, spirals, special patches, etc. They have proven their effectiveness and allow you to virtually eliminate the possibility of conception. In addition, they are convenient to use, the main thing is to remember the expiration date of their validity and not to miss it. Many believe that taking such drugs provokes weight gain, but new generation drugs do not have such a side effect. A gynecologist will help you decide on one or another means and select a contraceptive.

Infertility treatment

Unfortunately, not everyone finds it easy to conceive a child. More and more women are now facing the problem of infertility. Through the use of hormonal drugs, artificial insemination became possible. For example, in IVF, superovulation is stimulated with the help of drugs. In addition, thanks to artificial hormones, it is possible to improve the functioning of the ovaries and get rid of other problems that prevent conception (endometriosis, etc.).

Thus, it is difficult to overestimate the importance of the use of hormonal drugs in gynecology. They help to solve many problems and disorders of the female reproductive system (from hot flashes during menopause to infertility treatment). In addition, their use has a positive effect on the condition of hair, skin and nails.

Hormonal preparations for women contain estrogenic and progestogen components, which are a synthetic analogue of female sex hormones such as progesterone and estrogen.

Classification of hormonal drugs

All hormonal drugs can be divided according to the organs in which they are produced:

• pituitary hormones
• Thyroid gland
• Adrenal
• Ovaries, etc.

Female hormonal contraceptives can be divided depending on the method of penetration:

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• Tableted
• Injectable
• plasters
• Rings, etc.

According to the type of hormones, these can be:

• Combined funds
• Monophasic
• Two-phase
• Three-phase
• Non-combined

According to the dose of the contained hormone:

• Low dose
• Medium dosed
• Highly dosed

What are they used for?

Due to the wide distribution of gynecological hormonal preparations, the range of their use is constantly growing.

Currently, the appointment is based on the main goal of both the woman and the specialist:

oral contraception

Monophasic contraceptives

These are drugs that make up the group of the first generation of hormonal drugs.

They got their name from their composition. It contains two main types of hormones - estrogens and progesterone, while their concentration will remain the same throughout each day of the cycle.

That is, in each tablet of the drug, a constant concentration of the substance is maintained. Currently, drugs in this group are most widely used in women, this is primarily due to the ability to control hormonal levels.

Peculiarities:

1. Due to the constant concentration, they help a woman cope with some diseases of the reproductive system, such as endometriosis, algomenorrhea, and hyperpolymenorrhea.
2. In addition, skipping pills will not always be dangerous for the functioning of the ovaries and the subsequent restoration of intake, in this case it will only be possible to increase the dosage due to any other pill from the package.
3. In case of insufficient concentration of incoming funds, the dosage can be increased, also with the available tablets, in some cases it is simply doubled.

They include Rigevidon, Diana-35, Norkolut, Jess.

Biphasic products

This is the group of drugs that are currently not so widely used in gynecology.

Peculiarities:

1. A distinctive feature of these coca is that the composition of the tablets will be different. They will all have the same dosage of the estrogen component, while the amount of progesterone varies depending on the phase of the cycle.
2. Preference in the appointment of these funds is given to those women who have impaired sensitivity to progesterone.
3. In addition, one of the important indications of biphasic contraceptives is an increase in the level of male sex hormones in the blood. Hyperandrogenism can carry varying degrees of severity and manifestations, but with regular use, hormonal drugs are effective.

They include Synovulate, Sequilar and etc.

Three-phase contraceptives

This is one of the latest generations of medicines, which is currently prescribed to women quite widely, but due to certain characteristics, they may have certain difficulties in taking them.

Peculiarities

1. A distinctive feature of this group of drugs is their complex composition, which contains two island types of hormones, these are progesterone and estrogens.
2. At the same time, the concentration of these drugs in tablets will differ depending on the day of the cycle, which is why taking them for many women causes great difficulties due to the possible skipping of tablets, which turns out to be quite difficult to restore.
3. In addition, the undoubted advantage is the ability to fully adjust the drugs to the menstrual cycle, as a result, the number of side effects associated with the intake is significantly reduced.

Due to the high affinity with the normal menstrual cycle, they are recommended for young girls under 18 years of age, or for women over 35, when adjusting the drug to the cycle is very important.

But it must be remembered that due to the possible skipping of tablets, as well as the complex chemical composition, the risk of an unplanned pregnancy can increase several times. In addition, the amount of intermenstrual bleeding associated with improper intake increases.

These drugs are currently Tri-regol, Tri-merci, as well as Qlaira.

Pros and cons of COC

Currently, doctors of many specialties, as well as women themselves, have been arguing for a long time about the effectiveness, positive and negative aspects that are associated with taking combined hormonal drugs. Most people have mixed opinions.

At the same time, combined oral contraceptives are actively used by gynecologists, and the range of application is not limited to preventing unwanted pregnancy. But at the same time, drugs of this group cannot be prescribed en masse.

This is due to the fact that they, like other drugs, have a number of side effects and contraindications. Therefore, before taking, you should carefully talk with your doctor.

pros

• This is to prevent unwanted pregnancy. Many women use funds for this purpose. And with a properly selected drug, it will be absent, as well as subject to regular intake. This allows a woman to realize her plans and opportunities at the present time in the absence of a negative impact on her sexual life and reproductive system, avoiding unwanted abortions.
• The second positive aspect of taking combined oral contraceptives is the ability to control the menstrual cycle. This is especially important for women who have previously had failures, as well as a tendency to delays and rhythm disturbances. You can not only be sure of the time of their onset and therefore carefully predict important events in life, as well as other procedures, but also, if necessary, shift the date of the planned menstruation. Under the supervision of a doctor, a woman can delay, accelerate or even prevent the onset of menstruation in a given cycle. This is achieved by stopping or vice versa by changing the cyclical intake of active and inactive tablets.
• Also, many hormonal preparations for women are used to provide a cosmetic effect. This is true in women suffering from androgenic disorders in the body, which is expressed by hormone-dependent alopecia, manifestations on the skin in the form of acne, etc., as well as the growth of unwanted hair on the surface of the body, where normally they should not be. Already after a few months, the woman notes a positive trend in achieving a cosmetic defect. It should be remembered that drugs for this purpose should be prescribed only by a gynecologist, after a thorough hormonal study, but never by a cosmetologist or dermatovenereologist.
• There is also a version that hormonal drugs for women can prolong the reproductive age and delay the onset of menopause. This is achieved with a properly selected concentration of hormones, which leads to the occurrence of a lack of ovulation. Thanks to a similar mechanism, the ovarian reserve in the ovary is preserved and a woman may not enter menopause for a long time after stopping the intake. But to implement such an effect, you can not use low-dose drugs for a certain group of women, as well as mini-drinks, since they are not able to suppress ovulation. In addition, the reception should be long and regular and be at least 5 years. This is especially important for women who have prerequisites for the onset of early menopause.

Minuses

• First of all, this is the fact that hormonal preparations for women used to prevent unwanted pregnancy do not protect against sexually transmitted infections. This is true if a woman takes them in the absence of a regular sexual partner. In such situations, a condom should also be used.
• The likelihood of developing the initial stages of addiction to drugs, which can be very scary for a woman. This group should include headaches, pain in the mammary glands, their cutting and feeling of swelling, dizziness, migraine and, in rare cases, disorders of the gastrointestinal tract. Such changes are usually reversible and therefore they do not pose a serious danger.
• Weight gain. This is one of the most pressing questions women ask. In fact, body weight is added, but this occurs due to the development of a slight swelling of internal tissues under the influence of progesterone, as well as due to increased appetite. In most cases, a similar symptom is quickly and independently eliminated after discontinuation of the drugs.
• development of cellulite. This is a serious cosmetic defect that can frighten a woman and prevent her from starting to receive funds. A similar effect is also created due to the accumulation of excess fluid, but as a rule, a similar problem already exists in the woman's body, only during the period of cocaine intake it is aggravated.
• The risk of developing arterial hypertension, as well as thrombosis and thromboembolism. These problems may arise due to the development of blood clotting, which leads to a violation of its rheological properties. In addition, such a clinic often develops against the background of severe varicose veins.
• With prolonged and uncontrolled intake, especially against the background of the presence of predisposing factors or existing problems, toxic effects on the liver and biliary tract may occur.
• The risk of developing malignant tumors on the cervix or mammary glands arising at the beginning of the reception against the background of cervical erosion or fibrocystic lesions of the mammary glands with a predominantly nodular component.
• In addition, it is the regularity of reception. For some women, the hormone regimen is a significant problem.

Stories from our readers!
“The gynecologist advised me to take natural remedies. We opted for one drug - which helped to cope with hot flashes. It’s such a nightmare that sometimes you don’t even want to leave the house for work, but you have to ... As soon as I started taking it, it became much easier, you even feel that some kind of internal energy appeared. And I even wanted to have sexual relations with my husband again, otherwise everything was without much desire. "

What are mini pills?

mini pili - This is a separate group of drugs that are used to protect women from unwanted pregnancy.

They belong to the hormonal preparations of oral contraception. Currently, it is an alternative to oral contraceptives, but there are differences in their composition.

The main component of these hormonal preparations is gestagen(progestin, acting as an analogue of the progesterone type, which is produced in the corpus luteum in one of the phases of the menstrual cycle).

Advantages and disadvantages

1. Among the shortcomings can be identified insufficient contraceptive efficacy. This is due to the fact that the contraceptive effect of this dose of hormones is much less compared to conventional means and the effect on the body is significantly reduced.
2. The advantage of their composition is a much lower dosage compared to conventional hormonal preparations for women. Their dosage should not exceed a third of the prescribed in standard preparations. It is thanks to this property that the likelihood of developing a side effect that occurs with the estrogen component is significantly reduced.

Preparations of this group are allowed to be taken if the main group of hormonal contraceptives is contraindicated.

Mechanism of action

Mechanism of action:

1. The mechanism of their action is achieved due to the fact that progesterone, which is part of the composition, is able to act on the mucus of the cervix, which leads to a change in its properties. This is manifested in the development of thickening, which will create a mechanical obstacle to the further advancement of spermatozoa.
2. At the same time, there is an effect on the egg, which is manifested by a decrease in the speed of its movement through the fallopian tubes in the woman's body.
3. It also affects the state of the endometrium. It changes its properties and becomes less differentiated and more subtle. Such a development of it becomes insufficient so that later, even with the fertilization that has occurred, the fetal egg is attached to the uterine cavity.

Application features

In the body of a woman, there is a significantly greater release of a hormone that promotes the onset of ovulation. Therefore, with prolonged and systematic use, there may be a lack of ovulation.

In most cases, you can still notice the onset of the ovulatory cycle, that is, the likelihood of pregnancy is not excluded.

For the development of such contraceptive effects in these hormonal drugs, all the rules of admission should be followed. It should be regular use, as well as the duration of the intake.

DID YOU KNOW?

The disadvantage of most drugs are side effects. Often, drugs cause severe intoxication, subsequently causing complications in the functioning of the kidneys and liver. To prevent the side effects of such drugs, we want to pay attention to special phytotampons.

Of the most common drugs in this group, we can distinguish Microlute, Lactinet, Norkolut and others.

These hormonal preparations are taken by women after the onset of 35 years, as well as nursing mothers.

For the latter group, the issue of hormonal contraception remains relevant and rather controversial, since the effect of funds on the child through transmission through breast milk should not occur. In addition, mini-pills are taken by women who, among contraindications, have the use of drugs with an estrogen component.

In the presence of contraindications, in which combined oral contraceptives are contraindicated, mini-pills are allowed. This is especially true for diabetes.

Hormonal preparations for women after 40 years

Many women in the modern world, at the onset of this age, prefer the use of hormone therapy.

The main indication for their use will be the prevention of pregnancy. Since at this age it can cause serious concern both on the part of the woman and on the part of the fetus.

After 40 years, the risk of developing a child with chromosomal pathologies increases several times.

In addition, hormonal preparations also have such positive effects as reducing the possibility of developing an oncological process both in the uterus and ovaries, as well as coping with the severity of some chronic pathologies.

At this age, preference should be given to hormonal preparations that will either contain only progesterone or low-dose estrogen in combination with progesterone.

Preference should be given to drugs with a low dosage of hormones, as they will help reduce the risk of developing hyperplastic processes in the endometrial tissue, which in some cases leads to the development of abnormal uterine bleeding.

Among the drugs are such as Jess or Jess plus, Marvelon, Janine and Diana-35. But special attention should be paid to the correct selection of funds, since there is a high risk of complications in this period. In some cases, this can prevent the risk of early menopause.

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Hormonal preparations after 50 years

This age is rather doubtful regarding the choice of hormonal preparations by specialists. This may be due to the fact that there is still a possibility of pregnancy, since even with violations of the regularity of the cycle, ovulation can occur.

And in the absence of contraceptive methods, the risk of developing an unwanted pregnancy in this period is high. In addition, many women are already menopausal and the funds are selected taking into account this state of the body.

In this case, hormone replacement therapy is selected, aimed at preventing the development of complications associated with the development of menopause in a woman.

Among oral contraceptives, preference is given to drugs that have a fairly small dose of hormones. They allow you to prevent not only the onset of pregnancy, but also to cope with certain types of diseases. In addition, the risk of side effects is minimal.

The only point that deserves attention is a thorough study of all contraindications, since at this age most women have various kinds of pathologies from the reproductive system.

Among these drugs, it should be noted Silest, Triquilar, Marvelon and Tri-Regol.

In some cases, preference is already given to hormone replacement therapy, especially if signs of the onset of menopause are already noted. In this case, they help to cope with the development of complications that occur with a lack of hormones.

These can be both synthetic hormonal preparations, which are aimed at the complete replacement of the hormonal background, and herbal preparations containing phytoestrogens. The latter group does not have a strong enough hormonal effect on the body, but helps to somewhat reduce the severity of the manifestations of menopausal disorders.

Hormone Replacement Therapy

Efficiency

This is currently one of the most popular groups of drugs that are used by women to maintain hormonal levels.

These drugs are prescribed exclusively by a specialist, after a complete treatment. It is recommended to start treatment with hormonal drugs from this group 1-2 years before the expected onset of menopause, when a woman can notice the appearance of precursors.

Harbingers of menopause:

1. disruptions in the menstrual cycle, a change in their nature;
2. frequent headaches;
3. mood changes;
4. jumps in blood pressure;
5. intermittent hot flashes or chills.

In some cases, the reception may begin after the onset of menopause, this may be with its early onset, as well as with the artificial creation of such a situation. The course of treatment with such means is long and continuous.

Hormonal drugs used to replace your own during menopause have a number of side effects, but nevertheless they help to cope with severe complications associated with the onset of menopause. The risk of developing osteoporosis, arterial hypertension, atherosclerosis decreases, in addition, the number of heart attacks and strokes associated with the onset of menopause decreases.

Such hormonal preparations for women mainly contain a combination of estrogens and progesterone, some may have only an estrogen component.

Contraindications

Has the following contraindications:

Phytohormones

These are herbal preparations, which are analogous to synthetic agents. They are extracts from various plants, in particular, it can be extracts of soybeans, clover, legumes and cereals.

They are produced in various dosage forms, among which there may be drops, tablets, etc.

The main mechanism of their action is to compensate for the lack of female sex hormones in the body. A similar effect is created due to estrogen, which enters the bloodstream and helps to partially maintain the concentration of hormones.

This is necessary at the moment when a woman begins to notice signs of the onset of menopause, which are expressed by violations of the cyclical nature of menstruation, deterioration in well-being, the appearance of hot flashes, as well as jumps in blood pressure and other manifestations.

Application Features:

1. It is necessary to start taking phytohormones until the moment of complete cessation of menstruation.
2. In some cases, it is allowed to use them after the onset of menopause.
3. The course of therapy is usually long and includes a daily intake.
4. They cannot fully compensate for the lack of hormones, but they are able to slightly maintain the level.
5. In addition, they cannot be used as full-fledged substitutes for therapy.
6. The main advantage of phytohormones is that they have a minimal amount of side effects. Also, they are not addictive.

This group includes tools such as Klimadinon, Qi-Klim, Menopace, Klimaksan, Remens and others.

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Modern gynecology cannot do without the use of hormonal drugs. At the same time, the appointment of hormonal drugs often scares people, since a lot of unreliable or outdated information is spread about them. We will try to understand the need for the use of these drugs and dispel the most common myths about hormone therapy.

Likbez

Hormones are special chemical mediators that regulate the functioning of the whole organism. The main part of the hormones is produced in the endocrine glands: the thyroid and parathyroid glands, the pituitary gland, the adrenal glands, the pancreas, the ovaries in women and the testicles in men. Hormonal preparations are nothing more than synthetic analogues of our natural hormones.

Hormone therapy has been used in obstetrics and gynecology for a relatively long time and brings quite impressive results, especially today, with the advent of new highly effective hormonal drugs devoid of the serious side effects of their predecessors.

Hormone therapy is necessary in the following cases.

1. In improving the quality of life of women in peri- and postmenopause, as well as after surgical removal of the ovaries.

2. In providing highly effective contraception, which has significantly reduced the number of abortions and their complications.

3. In the development of new reproductive technologies, such as IVF, ICSI, etc.

4. In the conservative treatment of gynecological diseases: uterine fibroids, endometriosis, endometrial hyperplasia and polyposis, polycystic ovary syndrome, menstrual disorders, etc.

Hormone Replacement Therapy

Hormone therapy is necessary to maintain a woman's health during menopause, when the reproductive function of the body decreases and the ovaries stop producing hormones. Deficiency of the hormone estrogen provokes violations of the psycho-emotional and physical condition. The severity of symptoms depends on the genetic factor, lifestyle, and the presence of chronic diseases. The most common include increased heart rate, increased sweating (accompanied by hot flashes), urogenital symptoms (urinary incontinence, dry vaginal mucosa, the so-called senile colpitis), weight gain, decreased bone density (osteoporosis), as well as irritability, insomnia, decreased performance. Often a woman has problems in her sexual life: libido decreases, discomfort during sexual intercourse (dyspareunia) worries.

The basis of hormone replacement therapy is to compensate for the lack or absence of ovarian hormones with medications similar in structure and effect, which significantly improves the patient's quality of life. HRT includes, as a rule, the intake of estrogens and progestogens, in some cases, androgens are additionally prescribed.

Hormonal contraception

Hormonal contraception (oral contraceptives, hormone-containing spirals, patches, implants, injectable contraceptives) is a highly effective method of preventing unwanted pregnancy. For contraceptive purposes, synthetic analogues of estrogens and progesterone and their derivatives are used. In addition to the main protective function, these drugs normalize the menstrual cycle, reduce the likelihood of benign tumors (uterine fibroids, endometriosis, ovarian cysts), and also have a therapeutic effect in the presence of data and other gynecological diseases (polycystic ovary syndrome). The choice of this or that drug is based on a set of criteria, such as age, the state of the hormonal background of the woman, the presence of bad habits (smoking), and must be agreed with the doctor, including to exclude contraindications.

Hormones in the treatment of infertility

Currently, the treatment of infertility and miscarriage is one of the priority areas of obstetrics. The importance of hormonal drugs in the IVF program is difficult to overestimate. Assisted reproductive technologies have become widespread and give a high percentage of positive results, that is, pregnancies, primarily due to the success of pharmaceutical companies in the development and production of high-tech analogues of endogenous hormones. Thanks to them, it is possible to stimulate superovulation for the development of several dominant follicles. Such an effect of hormonal drugs as inhibition of ovarian function is also used in IVF protocols to suppress their own gonadotropins and create an optimal background for stimulation with exogenous gonadotropins. After the transfer of the embryo into the uterine cavity, it is necessary to use progesterone preparations, since its deficiency reduces the likelihood of implantation and can lead to abortion in the early stages. In addition, thanks to artificial hormones, it is possible to improve the functioning of the ovaries and get rid of other problems that prevent conception (endometrial polyps, endometriosis, etc.).

Major misconceptions

Hormones are prescribed only for very severe diseases

For the appointment of hormones, there is no need to wait for severe, advanced stages of the disease. Moreover, competent and timely hormonal correction can get rid of the problem or stop its development when using minimally effective doses and in the shortest possible time.

If you do not take a hormonal pill in time, nothing bad will happen.

Hormonal drugs, especially contraceptives, must be taken strictly by the hour. For example, a hormonal contraceptive pill is valid for 24 hours, that is, it must be taken once a day to maintain an effective concentration of the substance in the blood serum. Being late for more than 12 hours can dramatically reduce the contraceptive effect, spontaneous ovulation and the onset of an unplanned pregnancy are possible.

If you take hormones, they accumulate in the body

It is fundamentally wrong, since the requirement of strict intake of hormonal medication is precisely due to the fact that when it enters the body, the hormone immediately breaks down into chemical compounds, and they, in turn, are excreted from the body.

Hormonal preparations are not prescribed during pregnancy

Discharged. If a woman had hormonal disorders before pregnancy, then during the bearing of the fetus she needs drug support so that the level of sex hormones is normal and the child develops normally. If necessary, other hormones are also prescribed: thyroid hormones - for hypothyroidism, corticosteroid hormones - for some systemic diseases, to suppress the androgens of the adrenal cortex, insulin - for diabetes, etc. Refusal of therapy during pregnancy due to fear of harming the fetus is not has a scientific basis, on the contrary, the fetus suffers in the absence of the necessary correction.

Hormonal drugs have many side effects, primarily weight gain

The drugs of the first and second generation of contraceptives could indeed cause the effect of weight gain due to the high content of hormones. Currently, manufacturers produce microdosed contraceptives with a modified structure of active substances, which practically does not provoke weight fluctuations. In addition, you need to understand that there are practically no drugs without side effects, and it is necessary to distinguish side effects that do not require discontinuation of the drug. For example, slight dizziness in the first month of taking, slight (plus or minus 1 kg) fluctuations in weight, or swelling of the mammary glands when taking contraceptive hormones are considered normal. Hormonal preparations are prescribed for a sufficiently long period, the body adapts by the end of the first or second months, and most women do not feel any discomfort.

Hormones can always find an alternative

Not always. There are situations when hormonal drugs are indispensable. Let's say a young woman (up to 50 years old) had her ovaries removed, as a result she began to age quickly and lose her health. In this case, her body until the age of 55–60 needs mandatory support with hormone therapy. Of course, provided that the underlying disease (due to which the ovaries were removed) has no contraindications to such an appointment.

Hormonal drugs should not be taken for a long time

The main requirement is the correct selection of a hormonal drug. You can take a well-chosen drug, subject to annual control, for years without interruption. Long-term intake not only does not have a harmful effect on the body, but, on the contrary, helps to establish the menstrual cycle, prevents the development of benign diseases of the mammary glands, endometriosis, fibroids, ovarian cysts, and also improves the quality of hair and skin.

The use of hormonal drugs is one of the basic methods of treatment in clinical gynecology. After all, it is endocrine regulation that ensures the functional activity and health of the female reproductive system, and also affects the state of many other target organs. Therefore, tableted hormonal preparations with estrogen can be prescribed even if the patient does not have gynecological complaints.

What are estrogens?

Estrogens are female sex hormones and are of steroid origin. These include three biologically active substances of similar structure and action: estrone, estradiol and estriol. They can, if necessary, transform into each other, although not all biochemical transformations are reversible. The main and most active sex hormone in humans is estradiol.

Basically, female hormones estrogens are of ovarian origin, produced in the first half of the menstrual cycle by granulosa and, to a lesser extent, interstitial cells. Part of the hormones is also synthesized in the adrenal cortex, in the corpus luteum formed after ovulation, in the placenta (during pregnancy, starting from its 2nd trimester). In addition, the estrogen-secreting role of subcutaneous fat has been proven. But all these additional sources still cannot provide a hormone level sufficient to compensate against the background of turning off the ovaries.

When do you need pills to increase estrogen levels?

Currently, estrogen-containing drugs are used for replacement, contraceptive and therapeutic purposes. They can be prescribed by a gynecologist, endocrinologist, reproductologist. In some cases, the primary recommendation on the advisability of their use is given by a therapist, cardiologist, vertebrologist, which is usually due to the development of quite serious complications of severe hypoestrogenism. In this case, the issue of hormone replacement therapy is usually decided on a commission basis.

In general, preparations containing estrogens may be recommended in the following cases:

1. In pathological clinically significant conditions directly related to physiological menopause.
2. and early onset of menopause. The reason for this may be emaciated ovary syndrome, partial resection of the appendages, the effects of radiation and chemotherapy.
3. Post castration syndrome. It is a consequence of oophorectomy (removal of the ovaries), which is often performed as part of a complex radical surgical treatment for oncogynecological diseases.
4. Hypogonadism, often due to chromosomal abnormalities.
5. Hypogenitalism, insufficient development (infantilism) of the external and internal genital organs.
6. Osteoporosis.
7. Alopecia and other pathological conditions in women due to hyperandrogenism of any origin.
8. Acne (severe forms of the disease that are not amenable to other therapy).
9. The need for contraception. Protection from pregnancy can be carried out both at the request of the woman, and on the recommendation of a doctor. For example, contraceptive pills with estrogen are often prescribed after an abortion, missed pregnancy, and surgical interventions on the organs of the reproductive system.
10. Some forms.
11. With the planned IVF with donor native oocytes, to synchronize the cycles of the donor and the female recipient.
12. With a number of pathologies of pregnancy: overmaturity, weakness of labor.

It is necessary to use estrogenic drugs strictly in accordance with the doctor's recommendations. Failure to comply with the dosage, duration and regimen of their administration is fraught with the development of pathological changes in target organs.

Estrogen therapy in menopause

Normally, the ovaries produce a sufficient amount of sex hormones throughout the entire reproductive period, starting from the girl's entry into puberty. And a pronounced progressive decrease in estrogen levels means the extinction of the generative (childbearing) function and is the cause of the development of key clinical signs of menopause.

Quite often, the onset of physiological or iatrogenic (associated with medical intervention) menopause is accompanied by severe discomfort and even the formation of clinically significant disorders. And this may require medical correction.

With menopause, estrogens in tablets are used for replacement purposes. The grounds for their appointment to elderly women may be:

1. Severe vegetative disorders, significantly worsening the patient's quality of life.
2. Osteoporosis. Taken tablets with estrogens during menopause can significantly reduce the risk of pathological fractures, which are most often observed in the femoral neck and thoracolumbar vertebrae.
3. Persistent and often recurrent infectious and inflammatory conditions of the urogenital region. Severe estrogen deficiency is accompanied by atrophy of the mucous membranes of the vagina, vulva and urethra, weakening of the strength of the urethral sphincter, vaginal dysbiosis. All this makes the lower urinary tract vulnerable to infection.
4. The need to mitigate and contain the progression of cardiovascular pathology in the menopause (arterial hypertension, endocrine cardiomyopathy, atherosclerosis).

It should be understood that hormonal preparations prescribed to a woman are not intended to eliminate estrogen deficiency, but only to partially correct it. Therefore, even against the background of constant intake of estrogen in tablets, the hormonal background of a woman of menopausal age will not be the same as in the reproductive period.

Contraindications

Contraindications for taking estrogen-containing drugs include:

• benign neoplasms of the genital organs;
• neoplasms of the mammary glands,;
• malignant neoplasms (including organs not related to the reproductive system);
• endometritis;
• hyperestrogenia within the climatic period;
• and the associated tendency to menorrhagia, metrorrhagia, polymenorrhea.

The use of hormonal drugs requires not only a preliminary examination of a woman to exclude possible contraindications. It is also necessary to regularly monitor her condition, which will allow the doctor to identify emerging side effects and timely adjust the therapeutic regimen.

Side effects

Adverse events while taking estrogen-containing tablets may be associated with hyperplastic processes in target organs, as well as with the consequences of changes in metabolism and the hemostasis system.

Possible side effects include:

• thrombotic and thromboembolic complications (the likelihood of their development increases if a woman has concomitant varicose veins and changes in blood viscosity);
• migraine-like pain;
• affective instability;
• a tendency to edema, which is due to a change in mineral metabolism with sodium and water retention;
• increased risk of developing endometrial cancer, and a number of other organs;
• the development of cholecystitis and cholangitis, which is associated with a change in the metabolism of cholesterol and an increase in its concentration in the excreted bile;
• liver failure;
• dyspeptic manifestations in the form of nausea, vomiting, changes in appetite, discomfort in the abdomen;
• engorgement of the mammary glands.

The appearance of any changes in well-being while taking estrogen-containing drugs requires a visit to a doctor.

What drugs contain estrogen?

The list of drugs containing estrogens is quite wide. Currently, products of natural origin (isolated from the urine of animals) and synthetic analogues of sex hormones are being produced. In addition, they are divided into conjugated and non-conjugated, monocomponent and combined. They can be based on any of the three estrogens.

In a separate group, there are funds containing the so-called phytoestrogens - estrogen-like substances of plant origin.

Tablets containing estrogen-containing drugs include:

• all combined oral contraceptives (monophasic and 2 - 3-phase), including low-dose;
• Estriol and its analogues (Ovestin, Ovepol);
• estradiol (Proginova, Klimara, Estrimax, Estrofem) and ethinylestradiol (Microfollin).

The choice of the drug is carried out by the doctor. This takes into account many factors: the objectives of therapy, the presence of concomitant diseases, the state of target organs, the age of the patient, etc. Unauthorized replacement of the drug recommended by the doctor and correction of the treatment regimen increase the risk of complications.

For other ways to increase estrogen levels, as well as a description of the most common drugs, read the article on.

Anti-inflammatory drugs in gynecology are used to treat candidiasis, lesions of the uterine neck, fibroids, inflammatory processes in the appendages and other purely female diseases. This group of drugs is distinguished by a wide range, allowing the specialist to choose the drug that is optimal for each specific case, taking into account the individual characteristics of the patient.

Characteristics of drugs

Anti-inflammatory drugs are a group of drugs whose action is aimed at stopping inflammatory processes with the concomitant elimination of pain, swelling and other characteristic symptoms. Efficiency lies in the ability to suppress the processes of formation and transformation of arachidonic acids, which provoke the development of inflammation.

Anti-inflammatory drugs, according to the international classification, are divided into the following pharmacological groups:

1. Antibiotics.
2. Glucocorticosteroid preparations, which are natural or synthetic hormones of the adrenal cortex (the funds are indicated exclusively for the treatment of hormonal diseases and are not used in the gynecological field).
3. Antimycotics.
4. Non-steroidal anti-inflammatory drugs.
5. Biostimulants.

Anti-inflammatory drugs used in the gynecological field are available in the following forms:

1. Injections.
2. Rectal suppositories.
3. Vaginal suppositories.
4. Tablets.

The most popular are rectal and. The choice of a particular drug, its form and dosage are determined by the specialist individually in each case. This takes into account factors such as the age and general health of the patient, the presence or absence of concomitant pathologies, the type of disease, its severity and the form of the course.

Indications for use

Anti-inflammatory drugs are prescribed to patients in the presence of diseases:

1. Colpitis.
2. Candidiasis.
3. Cervical erosion.
4. and fallopian tubes.
5. Vaginal dysbacteriosis.
6. Acute infectious lesions of the female genitourinary system.
7. Bacterial vaginosis.
8. Dysmenorrhea.
9. Gynecological diseases of a viral or fungal nature.
10. Diseases of the pelvic organs in a chronic form.
11. Disorders of sexual function.
12. Reproductive disorders.
13. Endometriosis.
14. Algodysmenorrhea.
15. Inflammation of the ovaries.
16. Dysplasia of the cervix.

Indications for the appointment of anti-inflammatory drugs are:

1. Menstrual disorders.
2. Painful menses.
3. Excessive dryness of the vagina.
4. Postponed surgical interventions in the gynecological field.
5. Pain in the lower abdomen.

Benefits and contraindications for use

In modern medicine, there are a large number of different methods used to combat gynecological diseases. Drug therapy based on the use of anti-inflammatory drugs is widely popular due to its effectiveness and high efficiency. The benefits of these funds include:

1. Elimination of pain associated with a number of gynecological diseases.
2. A high degree of effectiveness in terms of eliminating painful symptoms.
3. Removal and relief of the development of the inflammatory process.

Despite the widespread use of anti-inflammatory drugs in the gynecological field, in some cases it is strictly not recommended to use them, since this can cause serious damage to health. The main contraindications include:

1. Pregnancy.
2. Tendency to allergic reactions.
3. Individual intolerance to certain drugs or their individual components.
4. lactation period.
5. Renal failure.
6. Hepatic pathologies.
7. hemorrhagic stroke.
8. Ulcerative lesions of the stomach or duodenum.
9. The patient is under 16 years of age.
10. Diseases of the cardiovascular system in a chronic form.
11. Bronchial asthma.
12. Mental disorders.
13. Parkinson's disease.
14. epilepsy.
15. thrombocytopenia.
16. Hemorrhagic diathesis.
17. arterial hypertension.

Possible Side Effects

Today, drugs are characterized by minimal toxic effects, and if the treatment process is carried out under medical supervision, then the danger to the patient's health is very insignificant. But the manifestation of side effects is still possible. The most common may be:

1. Increased risk of intestinal bleeding.
2. Nausea.
3. Attacks of vomiting.
4. Dizziness.
5. Headache.
6. Painful sensations in the abdomen.
7. Allergic skin rashes.
8. Diarrhea.
9. Violations in the functioning of the gastrointestinal tract.

In order to avoid possible side effects and to prevent health problems, the drug, its dosage and duration of the therapeutic course should be prescribed by a qualified gynecologist. Following medical recommendations will minimize the risks.

Medicines for gynecological diseases

The following types of anti-inflammatory drugs are used for treatment:

1. Suspensions.
2. Non-steroid drugs.
3. Antibiotics.

Suspensions. Rectal and vaginal suppositories are one of the most popular anti-inflammatory drugs used in gynecology. This is due to their effectiveness, rapid action and a minimum of side effects. Most often, suspensions are prescribed for gynecological diseases of a bacterial or fungal nature, inflammatory processes in the uterus, appendages, ovaries and vagina. The most popular and effective in the treatment of female ailments are considered to be drugs:

1. Diclofenac.
2. Voltaren.
3. Movalis.
4. Flamax.
5. Hexicon.
6. Ginalgin.
7. Klion-D.
8. Metronidazole.
9. Mykozhinaks.
10. Terzhinan.

Possible side effects of suspensions include:

1. Flatulence.
2. Nausea.
3. Feeling of itching and burning.
4. Constipation.

The use of rectal suppositories is contraindicated in ulcerative lesions of the gastrointestinal tract, with cracks, inflammation and bleeding of the anus.

Non-steroidal drugs have analgesic, anti-inflammatory, capillary-protective and antiplatelet effects. In gynecology, these drugs are used for painful menstruation, inflammation of the genital organs, urogenital infections, adhesive lesions of the uterus and endometriosis.

Preparations of this pharmacological group are used as an anesthetic when taking a biopsy, treating uterine pathologies, and establishing or removing an intrauterine device.

In most cases, gynecologists prescribe the following nonsteroidal drugs to patients:

1. Indomethacin.
2. Meloxicam.
3. diclofenac,
4. Celecoxib;
5. Piroxicam.
6. Nurofen.
7. Rapten.
8. Ketoprofen;
9. Rapid;
10. Novigan.

The use of non-steroidal drugs is contraindicated in peptic ulcer and other pathologies of the gastrointestinal tract. Disturbances in the functioning of the digestive system are one of the most common side effects caused by these drugs.

Antibiotics in the gynecological field are used to treat various kinds of inflammatory processes, colpitis, erosive lesions. The drugs are prescribed after surgical interventions of a gynecological nature. Antibiotics are also prescribed for such diagnoses as gonorrhea, endometritis, tuberculosis of the uterine appendages and perimetritis.

The most common include:

1. Biomycin.
2. Penicillin.
3. Cephalosporin.
4. Streptomycin.

Antibiotic therapy has a lot of contraindications and side effects, it is used exclusively as directed by a doctor and takes place under his strict control.

Anti-inflammatory drugs in gynecology are characterized by a wide range of applications and have a high degree of effectiveness in the treatment of a number of diseases.

To achieve favorable results of the therapeutic process, the choice of the drug, its dosage and duration of administration should be carried out only by a doctor.