Hormone therapy for the treatment of uterine fibroids
Hormone therapy - is the foundation of the conservative treatment of fibroids. Conditions for its implementation is the size of the uterus, not exceeding 12 weeks of pregnancy, the diameter of myoma nodules less than 2 cm subserous or intramural their location, the presence of mild clinical symptoms, absence of rapid growth and changes in tumors from adjacent organs. Perhaps the use of hormones in preparation for surgery and / or in the postoperative period.
The aim of hormone therapy
The purpose of conservative treatment of uterine fibroids - a reduction in local gormonemii cancer by reducing the production of hormones by the ovaries until a certain critical level, which does not develop hyperplastic processes in the myometrium. Provide blocking the already functioning of anomalous zones of growth and decreased sensitivity of tumor tissue to estrogens.
Drugs used in hormone replacement therapy
The main drugs in the treatment of uterine fibroids are antigonadotropiny agonists and gonadotropin-releasing hormone.
Antigonadotropinov action is to suppress production of gonadotropic hormone in the pituitary gland by indirect (via the hypothalamus) influence. As derivatives of androgens, these drugs have multidirectional anti-hormonal action and, in addition to inhibition of ovarian activity, have a number of side effects. Therefore, duration of continuous therapy should not be longer than 6 months. The majority of patients during treatment with antigonadotropinov amenorrhea occurs, some - hypomenstrual syndrome.
Hormone therapy for the treatment of uterine fibroids
Today, more than two thousand synthesized synthetic agonists of gonadotropic releasing hormones, mechanism of action is to bind to receptors in the pituitary GnRH and inhibition of gonadotropin secretion, which contributes to the development of the patients temporary pharmacological menopause and uterine regression. With the introduction of these drugs with the pituitary cell surface receptors available disappear and new ones in an amount neobhodimomom for the synthesis of gonadotropins, do not appear. The disadvantages of gonadotropin-releasing hormone therapy is the rapid growth of fibroids in the irregular admission or cancellation of these drugs, the induction of these menopausal symptoms, including reduced bone mineral density.
It is considered a promising application of antiprogestagenov. Their pharmacological action is the competitive blockade of endogenous gonadotropin receptors on the cell membrane of pituitary cells, without a brief phase of stimulation.
The stabilizing effect of the small myoma nodes (up to 2-2.5 cm in diameter) has a hormone-releasing intrauterine system with progestogen levonorgestrel.
In the conservative treatment of uterine fibroids with its size no more than 1.5 cm are used combined oral contraceptives, blocking the main links in the pathogenesis of the disease: eliminate disturbances in the hypothalamic-pituitary system, normalize ovarian function and improve the state of the myometrium.
Hormonal treatment of this pathology is acceptable and it is quite effective in the reproductive period.
