Endometriosis is a diagnosis that is known to many women firsthand, and even more women are not even aware of the presence of this anomaly in their body. The disease is very insidious, in particular due to the fact that it disguises itself as other ailments, and may not manifest itself at all. One of its most unpleasant consequences can be infertility. In this article we will talk about problems, diagnostics, which hormones are given in case of endometriosis and modern methods of treating the disease.
What is endometriosis?
The inner walls of the uterus are covered with a special layer of cell tissue called endometrium. In the case when structural units of a similar type are distributed in parts of the body outside this organ, they begin to abnormally divide and increase in size, and the disease develops. Such formations are most often found in the pelvic area, including the bladder and intestines.
Rarely, abnormal tissue growth is diagnosed in the liver, brain, lungs, and scars after surgery. For the most part, pathologies are benign and do not develop into cancer. The main problem is that as the size increases, the formation begins to put pressure on the surrounding organs, and while inside them, it can lead to obstruction. Also, in obedience to the female monthly cycle, the mucous membrane inside the uterus at some point begins to exfoliate, leading to bleeding. As a result, cysts, scars and adhesions are formed.
The exact cause of this disease is unknown. There are several theories related to the appearance of pathology, including retrograde menstruation and coelomic metaplasia, but none of them has been proven.
Changes and malfunctions in the body associated with hormones with myoma and endometriosis are very similar to each other. In addition, these two diseases have possibly identical causes, such as sexually transmitted infections; getting rid of an unplanned pregnancy. As a result of this, in both cases, healthy cells begin to divide abnormally, growing and causing a lot of trouble.
Endometriosis mainly occurs in women of reproductive age and is very rare after menopause. This is the main factor that causes pelvic pain. Studies show that a significant number of women undergoing infertility treatment actually suffer from this disease. Risk factors for the development of pathology include the presence of a mother or sister with this disorder, the absence of children, the onset of menstruation at an early age, as well as disruptions in the cycle.
Symptoms and stages
Most women suffering from this disease, in fact, do not feel any discomfort and do not even realize that there is some kind of anomaly inside them. The most common symptoms of endometriosis are:
- pain (usually pelvic) that occurs immediately before menstruation and decreases after it;
- painful intercourse and convulsions after intercourse;
- cramping and pain during bowel movements or urination.
The disease is classified into four stages (I-minimal, II-mild, III-moderate and IV-severe). Most cases are considered minimal or weak. Complications contribute to the formation of cysts or scars in the last two degrees.
Endometriosis may also be associated with fertility problems. From 30% to 40% of women with this diagnosis have problems conceiving. The reason is not entirely clear, but it is believed that scarring in the reproductive tract or malfunction of the gonads and hypothalamus may be involved. Patients with this disease have revealed an imbalance of sex hormones in the body, for example, the permissible norm of luteinizing and follicle-stimulating hormones, estrogen and prolactin is exceeded. What hormones are not enough for endometriosis? Accordingly, male, namely progesterone, which decreases significantly. Therefore, during treatment, doctors use various means that can normalize these violations.
Diagnostics
It can be complicated due to many diseases with similar symptoms and long studies. Unfortunately, several years may elapse from the onset of the disease to an accurate diagnosis.
Research begins with a thorough medical history, including patient complaints, collection of information about hereditary factors, and the initial examination of the doctor.
Further, a transvaginal ultrasound may follow, where the image of the reproductive organs is created using sound waves created by a probe placed in the vagina. It is considered one of the best ways to diagnose endometriosis.
Unfortunately, symptoms and physical examination cannot be used to make a final diagnosis. These methods are used to exclude other diseases of the pelvic organs.
Often blood tests are used to detect endometriosis. What hormones you need to pass for endometriosis, your doctor decides. These hormones are the main way to find out if a woman is susceptible to the disease. Tests for: LH, FSH, testosterone, progesterone, prolactin and estradiol and others may be needed.
Since the level of substances is constantly changing, depending on the monthly cycle and other factors, only a professional has the right to decipher the test results and prescribe treatment.
The only final way to diagnose endometriosis is to take a sample of endometrial tissue from the found formation. For this, a special method called laparoscopy is used. During its implementation, the patient is given general or local anesthesia, and then the operating doctor makes a small incision in the lower abdomen and introduces a special device (laparoscope) inside. With its help, specialists can directly examine the interesting parts of the organs and notice mutations and tissue changes. In the event that they are found, a biopsy is performed (a piece of material is plucked off) for the final stage of the study.
Treatment options
When the doctor confirms the diagnosis based on the results of hormone studies for endometriosis, he will discuss with you possible options for the development of events.
Treatment is necessarily carried out taking into account the individual case, the severity of symptoms and the presence of any complications. Women with the first stage of the disease may not need special medications.
For more serious conditions, there are medical and surgical solutions to the problem. The first involves taking one or more drugs that will help not only relieve pain, but also reduce the growth of pathology. Surgical intervention is used in case of treatment failure or severe options.
NSAID use
Since endometriosis is finally detected only after a biopsy, anti-inflammatory drugs are prescribed for the period of time until an accurate diagnosis is made or as an auxiliary component in the treatment of endometriosis. What hormones need to be taken and how long the course will last, the gynecologist will explain everything.
This group of drugs is used for mild symptoms of the disease, that is, at the mild stage. As a rule, drugs such as Ibuprofen or Nimesil are offered, which can not only reduce pain and cramps, but also affect the inflammatory process.
Unfortunately, this method has no effect on the mutated tissues themselves.
Hormone therapy
This type of treatment may be a good choice if painkillers do not help. Of course, this method is very popular and really brings good results, but it can lead to side effects and is not used during attempts to conceive or become pregnant.
Hormone treatment of endometriosis can cause side effects, such as:
- weight gain;
- depression;
- acne
- increased hair growth on the body and face;
- irregular periods.
You should talk with your doctor about the risks and benefits of this method. In addition, if a woman stops taking such medications, all symptoms may return.
The simplest drugs prescribed by gynecologists for endometriosis include: birth control pills, patches and vaginal rings containing sex hormones in different proportions.
Most often, gestagens are used in the treatment, and after the course it is suggested to take birth control pills.
Combined Oral Contraceptives (COCs)
In most cases, these hormones are used for endometriosis. The list of funds is:
- "Dienogest";
- Levonorgestrel;
- Marvelon
- "Jess" ";
- "Dicyclylene".
The last drug is prescribed by gynecologists most often.
When taking hormones of this group (the duration is 6-9 months), the production of gonadotropes is blocked, which directly affect the production of estrogen in the ovaries. Thanks to such changes, the size of the pathology begins to decrease, as a result of which the synthesis of estrogen and tissue proliferation slows down.
Continuous medication artificially stops menstruation, causing malfunctions in the cycle, headaches and discomfort in the mammary glands.
Oral contraceptive pills are generally well tolerated by patients with abnormal endometrial growth. Their use helps to get rid of pain, inhibits the growth of formations and prevents them from bleeding.
Progestogens (progesterone analogues)
These include pills, injections and an intrauterine device. Gestogens reduce pain and, at the same time, delay menstruation at the time of administration.
Progestins (drugs containing the corpus luteum hormone) are more effective than previous drugs and are prescribed for more severe symptoms, severe pain. These include:
- "Provera";
- Dufaston;
- Norethisterone;
- Linestrenol;
- Norkolut
- "Organometril";
- Lactinet
- "Vizana".
These drugs are prescribed for those who cannot use oral contraceptives in the treatment of endometriosis with hormones (for medical reasons). However, they have limitations. Side effects include:
- constant mood swings;
- nausea
- swelling
- headaches and dizziness;
- bowel problems.
Also, drugs of the gestagen series are contraindicated for those who in the near future want to acquire offspring, because during the intake and for a long time after them there is no menstruation, and, accordingly, conception becomes impossible.
"Vizana", according to many women, is recognized as the most effective means. However, the decision about which hormones to take with endometriosis should be agreed only with the attending physician, since the gestagen in their composition has a huge number of contraindications.
Gonadoliberin agonists (GnRH)
Doctors usually recommend limiting their use to six months due to the many problems that drugs can bring to your body.
Analogs of the gonadotropin-releasing hormone of the hypothalamus (GnRH) - for example, Buserelin, Diferelin, Leiprorelin, very well help relieve pain, spasms and have a beneficial effect on reducing the size of overgrown tissues.
Medicines belonging to this group. able to stop the production of LH in the pituitary gland, which leads to a gradual decrease in estradiol in the blood, a decrease in the tissues of the mucous membrane (including in the uterus) and inhibition of follicular maturation in endometriosis. What hormones are elevated in the disease, we found out - the balance between progesterone and estrogens is upset. The absence of a female hormone in the body leads to a situation identical to that which occurs during menopause, which lasts while taking GnRH. Side effects due to a lack of sex hormones include metabolic disorders, sexual disorders, hot flashes, headaches, psychoses, and joint pains.
The use of a combination of progesterone and GnRH in treatment is considered quite successful. Their combined use avoids undesirable side effects of single therapy.
According to women, Zoldex is considered one of the best hormones for endometriosis in its category. It is used by introducing a depot capsule subcutaneously into the navel. The number of injections depends on the severity of the condition, but more than six months is not recommended. Of the minuses - a fairly high price (from 9,700 per syringe 3.6 mg) and many side effects. According to patients, not every doctor will agree to inject this injection because of the complexity of this procedure.
Danazol
A synthetic drug that suppresses the production of gonadotropins in the body, that is, the secretion of hormones in the genitals, and increases the level of androgen, thereby lowering the level of estrogen.
The negative side is considered to be a huge number of side effects that begin to appear as they are taken. A woman can dramatically recover from edema throughout her body. The amount of hair on the face increases, the skin becomes oily and becomes covered with an unpleasant rash, the voice becomes coarse. Symptoms that appear with menopause (lack of sex drive, hot flashes and hysteria) may also begin to bother.
Of course, after the course of treatment ends, the body recovers and all unpleasant moments disappear, but gynecologists still try not to prescribe the drug due to many restrictions on its use.
Aromatase inhibitor and reviews
Another type of hormone for endometriosis. Reviews of doctors say that these are quite promising remedies that can significantly alleviate symptoms and prevent mutating cells from developing further. Such drugs as Anastrazole or Letrozole have the ability to interrupt the production of a particular enzyme, which, according to scientists, is one of the culprits of the appearance of endometriosis. Due to this, the level of estrogen in the body drops, which makes it possible for male hormones to increase naturally.
Like all other similar drugs, aromatase inhibitors are not recommended for too long because of leaching of calcium. Doctors rarely use the medicine for this diagnosis, but if they do, then in combination with other methods of therapy.
Surgical intervention
If after the treatment with hormones with endometriosis, the improvement did not come, you have to do the operation. After it, the gynecologists again prescribe a course of medications to prevent the remaining mutated cells from growing again.
Also, the surgical method is offered to the patient in the case when the formation begins to compress the organs, leading to their deformation, or when, with an internal arrangement, it contributes to obstruction.
The types of operations are divided into conservative, in which the reproductive organs are left, or final, with the removal of one uterus or together with the ovaries. After such manipulations, drugs are also used to secure.
Food effect
Since a decrease in the level of sex hormones with endometriosis in the body directly affects the well-being and symptoms of the disease, you can use a special diet along with medications that can enhance their effect. Naturally, you should limit the consumption of foods and drinks that contain natural estrogens (such as coffee, beer, legumes), and red meat.
Extensive studies have shown that a diet that includes a large number of vegetables such as cucumbers, pumpkin, zucchini, peppers, tomatoes, eggplant, as well as melons and watermelons has a beneficial effect on the health of patients.
We found out what stages and methods of examination exist for endometriosis, which hormones are elevated, and also learned about the most different options for controlling the disease.
Unfortunately, modern medicine has not yet learned to completely cure the disease, but timely diagnosis and correctly prescribed treatment can significantly improve the quality of your life, and also help to give birth to a healthy baby.