Hormonal drugs for endometriosis. Medications for endometriosis Medications for endometriosis

The site provides reference information for informational purposes only. Diagnosis and treatment of diseases should be carried out under the supervision of a specialist. All drugs have contraindications. Expert advice is required!

Svetlana Viktorovna asks:

What birth control should I take for endometriosis?

Also, with endometriosis, a woman may experience the following symptoms:

bleeding during menstruation becomes longer and more abundant;
pain during intercourse;
pain during bowel movements;
infertility.

Hormonal contraceptives.

Hormonal contraceptives contain analogues of female sex hormones - estrogen and progesterone. Data contraceptives provide not only a reliable contraceptive effect, but also have therapeutic effect on the body. Hormonal contraceptives are used in the treatment of diseases such as endometriosis, uterine fibroids, endometrial polyps, etc.

The mechanism of action of these hormonal contraceptives is as follows:

inhibit ovulation;
thicken cervical mucus in the cervical area;
block the growth of the uterine mucosa;
block endometrial metastasis in endometriosis.

In addition, hormonal contraceptives are used as a prophylaxis for endometriosis, and also reduce the likelihood of recurrence ( repetition) diseases.

1. Combined oral contraceptives. These drugs contain a combination of two hormones - estrogen and progestin. Produced in the form of tablets ( the package contains 21 or 28 tablets), which should be taken daily, starting from the first day of menstruation. With endometriosis, a woman is recommended to take monophasic oral contraceptives ( Yarina, Janine, Marvelon, etc.). In the packaging of these drugs, all tablets have the same dose of hormones, unlike biphasic and triphasic drugs.

2. Non-combined oral contraceptives (mini-pill). These drugs contain only one hormone - progestin. Each mini-pill pack contains 28 tablets to be taken daily at the same time and without interruption ( at the end of one package, the reception of another immediately begins). These contraceptives micronor, microlute, etc.) is also recommended for use in endometriosis.

3. Depo-Provera Injections. This contraceptive also contains the hormone progestin. A hormonal injection is administered intramuscularly by a gynecologist. The validity of this remedy is 12 weeks, after which, if desired, the injection is repeated. Depo-Provera injections are quite effective in the treatment of endometriosis.

4. Hormonal intrauterine device Mirena. This contraceptive contains in its composition a synthetic analogue of the female sex hormone progesterone - levonorgestrel. The intrauterine device is a plastic device that is inserted into the uterine cavity by a gynecologist. The spiral acts locally on the uterus, thereby providing both a therapeutic and contraceptive effect.

Hormonal contraceptives for endometriosis are accepted:

at the age of a woman up to 35 years;
with the first or second degree of the spread of endometriosis.

There are the following contraindications for the use of hormonal contraceptives for endometriosis:

breast cancer;
genital cancer;

Not all women are unequivocal about the fact that the doctor prescribes them hormones for endometriosis as the main drug of the treatment regimen.

Myths and prejudices around the consequences of taking hormones have existed for a long time, since the first oral contraceptives appeared, which were accompanied by a loss of libido, weight gain, and an increased risk of cancer.

Since then, more effective drugs with minimal side effects have appeared, solving many problems at the same time.

Since endometriosis is a hormone-dependent disease, which is often based on hypersecretion of estrogen, hormone therapy for endometriosis allows you to establish the full functioning of the ovaries, reduce the spread of endometrioid lesions.

The essence of therapy is the artificial suppression of menstruation - the physiological process of rejection of the endometrium. Periods completely stop, or they are replaced by bleeding, similar to menstruation. As a result, heterotopias do not bleed, they undergo destruction, and the body gets the opportunity to recover.

Pros and cons of hormonal treatment

To hormonal treatment internal or external endometriosis was effective, it should be carried out on early stages pathological process. In the later stages of the disease, such drugs are used as preoperative preparation, as well as to stabilize the state of the female body after the intervention.

Advantages of hormonal drugs for the treatment of endometriosis:

Eliminate the main symptoms of the disease - pain, bleeding, the spread of endometrioid foci;
Suppress estrogen hypersecretion by affecting the functioning of the ovaries or the pituitary gland;
Gently restore the ability to bear children, allowing you to avoid surgery in the early stages;
Drugs prescribed for the treatment of endometriosis are contraceptives at the same time;
After the abolition of hormonal pills, the female body quickly recovers, maintaining its fertility, the menstrual cycle remains natural.

Ideal drugs do not yet exist, the method of hormone therapy also has disadvantages:

If endometriosis is based on causes other than hyperestrogenism, this treatment regimen will be ineffective;
The course of hormone treatment is quite long, it takes up to 6-12 months, sometimes several years;
There may be addiction to the drug, develop drug dependence;
When taking contraceptives, it is better not to miss a single day, otherwise breakthrough uterine bleeding will occur;
In some patients, the main cause of endometriosis is not eliminated, there is a risk of relapse after discontinuation of drugs.

When taking hormonal drugs for endometriosis, you must strictly follow the doctor's recommendations, dosage and frequency of administration.

There are different treatment regimens, the selection of which depends on many factors - the desire of a woman to have a child in the future, the individual characteristics of the body, the presence of contraindications. These include allergies, liver failure, diabetes, disorders in the circulatory system, the presence of diseases of the heart and blood vessels.

With prolonged use of hormones, side effects may occur, which also refers to the disadvantages of such therapy.

Possible side effects:

Nausea;
puffiness;
Breast engorgement;
Violation of the functioning of the gastrointestinal tract;
Weight gain;
Headache;
Nausea;
Development of atrophic vaginitis;
Depressive mental state.

Most side effects disappear after 1-2 months of treatment.

Are there analogues of hormone therapy in the treatment of endometriosis?

In the presence of serious contraindications to hormone treatment, women are looking for alternative methods. non-hormonal therapy. They use balneotherapy, homeopathy, the use of leeches, physiotherapy methods, computer reflexology.

Patients place their greatest hopes on prescriptions. traditional medicine using medicinal herbs with phytohormones (upland uterus, lovage, celery, red brush, goose cinquefoil and other plants).

Unfortunately, the therapeutic effect of such methods is difficult to calculate in advance, and therefore there is always a risk of further development of the disease, the appearance of relapses. These funds can be used as an additional remedy, but they cannot be a complete alternative to hormonal drugs.

Types of hormonal drugs, their features and a list of names

In hormonal therapy, hormonal preparations of several medicinal groups. All of them perform different functions, they are based on a different active substance.

Hormonal drugs used for endometriosis - names and main groups:

Gestagens.

Reduce the activity of cells in endometriotic foci, inhibit the synthesis of estrogens without suppressing the functioning of the ovaries ( Dufaston, Byzanne, Orgametril, Norkolut, Utrozhestan, Femoston). The drug with progestin Depo-Provera is administered by injection.

Antigonadotropins.

Reduce the level of estrogen and progesterone by blocking their receptors in the endometrioid tissue, inhibit the action of gonadotropin, which inhibits ovulation and leads to endometrial atrophy ( Gestrinone, Danazol).

Gonadotropic releasing hormone agonists.

Stimulate artificial menopause by blocking luteinizing hormone receptors, create hormonal changes in the body ( Buserelin, Zoladex).

Combined contraceptive drugs.

Stop preovulatory growth of the endometrium ( Janine, Clayra, Femodene, Silhouette, Diecyclene), contain a combination of estrogen with progestin, COCs are undesirable for use after 35 years in order to avoid the formation of blood clots. The drug Diane 35 is used for endometriosis, combined with hyperandrogenism.

Non-combined oral contraceptives.

monophasic contraceptives.

All tablets contain an equal dose of the hormone that does not change throughout the cycle ( Yarina, Marvelon, Rigevidon). The drug Jess from this group is not indicated for women over 40 years of age.

If the doctor selects hormonal therapy, taking into account all the features of the disease, the symptoms of endometriosis will disturb the woman much less often, or disappear completely.

Endometriosis of the uterus is a serious disease. It occurs in many women of childbearing age, is dangerous to health, can cause infertility and other pathologies. Treat this disease different ways but most often by surgery. Is this disease curable? medicines? The fact is that at the moment, no cure for endometriosis is able to completely cure this disease. Despite this, medications significantly slow down the development of pathology, alleviate the symptoms of the disease.

What is endometriosis?

Endometriosis is a purely female disease that can occur in the uterus and ovaries. Associated with excessive growth of the endometrium, covering the surface of the uterus. This is a special layer that helps the egg to catch on during fertilization. Usually, after the egg is firmly fixed in the endometrium, the formation of vessels responsible for the development of the fetus occurs. If the pregnancy is interrupted, then the layer of the uterine mucosa exfoliates and comes out with the blood. The woman is having her period.

Endometriosis is of two types:

Endometriosis genital. With this pathology, the uterus and its neck, vagina, ovaries are affected. This type of disease can be found in 85% of cases.
Extra-genital endometriosis. With this type of disease, the internal organs, bladder, intestines and postoperative scars. This is a rare form of the disease. It occurs due to the ingress of blood clots into the abdominal cavity. This type of pathology is treated by the surgical method.

Endometriosis provokes inflammation in the peritoneum. Violates the work of internal organs. It affects the walls of the uterus. Causes the formation of adhesions and knots. This disease is the cause of infertility.

The most common causes of this disease include:

hormonal disorders;
immune failures;
heredity;
stress;
various neuropsychological disorders.

Symptoms of the disease do not appear immediately, but only at a late stage of development:

The uterus increases in size up to six weeks of pregnancy. Takes on a round shape.
There is heaviness in the lower abdomen.
Disturbed pain in a stomach. They are felt both during menstruation and during urination, defecation, and also during sexual intercourse.
There is infertility.
Violation occurs menstrual cycle.

The disease in all women proceeds differently. An experienced gynecologist, based on the results of the tests, can easily make an accurate diagnosis and prescribe the appropriate treatment, prescribe a medicine for endometriosis, which will prevent relapses.

Ways to treat pathology

What medicines treat endometriosis? This question is difficult to answer. Most doctors agree that the treatment of pathology should be comprehensive. It is necessary to treat not one single organ, but the whole body as a whole.

Before prescribing a cure for endometriosis, the doctor takes into account the neglect of the disease, the patient's immunity, the characteristics of the disease, complications, localization and spread of the process.

Endometriosis is treated in three main ways:

combination therapy;
surgical intervention;
conservative method of treatment.

Endometriosis can be cured without surgery only in rare cases. To conservative therapy come in only when:

infertility;
asymptomatic course of the disease;
women's reproductive age;
adenomyosis.

In all other cases, gynecologists advise surgical method treatment. Depending on the severity of the disease, the uterus will be preserved or completely removed.

With the conservative-surgical method, the damaged areas are removed surgically, and non-pigmented, hard-to-reach and microscopic foci are treated with a medical method. After treatment of endometriosis, patients safely become pregnant, bear a child and give birth.

Medicines used in the treatment of pathology

The gynecologist selects the medicine for endometriosis based on the severity of the disease. The drugs used are:

to reduce the production of sex hormones;
from uterine bleeding;
to eliminate the pain symptom and other negative manifestations;
before surgery;
during the rehabilitation period, after surgery.

Medicines for endometriosis should be taken only according to the regimen prescribed by the doctor. You should strictly adhere to the recommended duration of the course, since many drugs, with longer use, can cause many side effects.

What medicines treat endometriosis? This question is often asked by women who have discovered this pathology. As a rule, drugs of several groups are used in the treatment of this disease, these are:

Gonadotropin-releasing hormone agonists. Medicines are hormonal. Reduce the amount of estrogen production. They can be used both in the form of tablets and in the form of injections. Enter the body into artificial menopause. Periods stop coming due to lack of estrogen. Against this background, the endometrium also stops growing. The lesions are regressing. These drugs should be treated for about six months. Longer therapy can lead the body to early menopause. The best medicines for endometriosis in this group are the drugs Zoladex, Diferelin, Buserelin.
Antigestagens, inhibitors of the production of gonadotropic hormones. Drugs in this category inhibit the production of luteinizing, follicle-stimulating hormones. Suppress the production of progesterone. The drugs are available in the form of tablets and capsules. Medicines have severe side effects. The most popular medicines are Mifepristone and Danazol.
Gestagens. Another group of medicines used in the treatment of endometriosis. Progesterone tablets stabilize the menstrual cycle by lengthening the second phase. To the most effective medicines this category includes "Norkolut", "Dufaston", "Utrozhestan". Medicines can be prescribed not only in the form of tablets, but also in the form of injections.
Combined oral contraceptives. They contain estrogens and gestagens. Stimulate the production of female sex hormones. Stabilize the development and prevent the growth of the endometrium. Drugs in this category are drunk for about six months. Popular: "Janine", "Klayra", "Diana-35", "Jess" and "Yarina".

For the treatment of the disease can be used The most popular is Mirena. Sometimes medicines containing male hormones, androgens, are used. One of these drugs is Methyltestosterone. In addition to these drugs, non-hormonal drugs can also be used in the treatment of endometriosis.

Treatment of endometriosis is complex and long-term, at least six months. To achieve a good result, you must follow all the doctor's instructions. Do not violate the treatment regimen. The disease is very serious and can progress, so self-medication in this situation should be excluded.

Combined oral contraceptives

In the treatment of endometriosis in young women, low-dose oral contraceptives are widely used. They minimize the effects of male hormones. At the time of taking the pills, the greasiness of the skin and hair decreases in women, and the amount of acne is noticeably reduced. This therapy is often carried out in combination with surgery. If the operation is not done, then the medicine for endometriosis of the uterus is drunk for 6-9 months.

The following medicines are considered the most effective:

"Silhouette". These are hormonal pills. combined type. They have anti-androgenic and anti-inflammatory properties. Active substance ethinylestradiol. The medicine "Silhouette" for endometriosis is taken daily, one tablet per day. The therapeutic course is at least three weeks. The cost of the drug is about 700 rubles.
Norkolut. The drug is very quickly absorbed into the gastrointestinal tract. Effective two hours after ingestion. Contains the active ingredient - norethisterone. The drug is taken from the fifth to the fifteenth day of the menstrual cycle. Daily rate 5 ml. The duration of the course is six months. The price is 350 rubles.
"Yarina". The drug has antiandrogenic properties. Reduces the activity of the sebaceous glands. Reduces acne. The medicine for endometriosis is drunk every day for three weeks. Duration of reception is regulated by the doctor. The drug costs about 500 rubles.
"Regulon". It is a contraceptive multi-phase drug. It contains two active ingredients, these are ethinylestradiol and desogestrel. Tablets activate the secretion of sex hormones. They are drunk daily. The course is 21 days. The price of the medicine is about 300 rubles.
"Klaira". Combination contraceptive. Its action is based on the properties of two active substances: dienogest and estradiol valerate. The medicine changes the quality of the cervical fluid, due to which the processes of ovulation are suppressed. Course - 28 days. The drug costs around one thousand rubles.
"Novaring". The drug is presented in the form of a special ring for the vagina. Contains two active ingredients - etonogestrel and ethinyl estradiol. The medication is inserted into the vagina for 21 days. The price is 380 rubles.
"Jess". It is characterized by antiandrogenic properties. Active substances: drospirenone and ethinylestradiol. It is taken orally. Duration of treatment - 28 days. There are tablets in the region of 1000 rubles.
"News". Suppresses ovulation. Stabilizes the quality of cervical mucus. Contains ethinylestradiol with desogestrel. The medicine is taken for three weeks, then a 7-day break is taken. After that, the course of treatment is continued. The price is 600 rubles.
"Logest". Contains ethinyl estradiol in combination with gestodene. Suppresses the processes of ovulation. Normalizes cervical mucus. Tablets are taken orally for 21 days. Then they take a break for a week. If necessary, the treatment is continued.

These drugs should be taken at the same time. If the drug is prescribed without a seven-day break, then menstruation does not come.

"Janine" with endometriosis

"Janine" is the most popular cure for uterine endometriosis. In patients who took this medication, the disease regressed for a long time. Significantly improved health.

"Janine" refers to the drugs of the latest generation. It is a low-dose hormonal drug. Contains dienogest in combination with ethinyl estradiol. It is quickly absorbed and immediately begins to act. It inhibits the production of hormones, resulting in a decrease in the amount of estrogen. Tablets prevent the onset of ovulation. When using them, you can not get pregnant. Another drug reduces the contractility of the fallopian tubes. It makes it difficult for the egg to move.

Gynecologists prescribe "Janine" to prevent the growth and development of the focus of the disease. To suppress pain and inflammation.

This medicine for endometriosis has only positive reviews. Ladies note that while taking this remedy, their pain syndrome disappeared, the condition of nails and hair improved, the skin became cleaner. The drug also helped women with hirsutism. Representatives of the weaker sex recommend these pills to those who have an overestimated amount of androgens in the body.

"Janine", like other similar contraceptives, is indicated for endometriosis on initial stage development. The drug can be prescribed before and after surgery surgical intervention to prevent recurrences.

To achieve the result, you should drink "Janine" for at least nine months, continuously. The drug is prescribed strictly according to the indications and after a detailed examination of the woman. The medicine has contraindications and can cause side effects, so you should not take it without a doctor's prescription. The cost of "Zhanina" varies within 800 rubles.

In order to reduce the negative impact of hormonal drugs in endometriosis, hepatoprotectors, such as Karsil or Essentiale, are additionally prescribed. Enzymes ("Pancreatin", "Creon") may be prescribed. Recommended to protect the stomach sea buckthorn oil, "Gastal", "Methyluracil" and others.

Gestagens

What medications are prescribed for endometriosis? In the treatment of this disease, the most different drugs including gestagens. We have already mentioned these drugs, but it is worth considering this group of drugs in more detail. These drugs are substitutes for progesterone, a female hormone produced by the corpus luteum of the ovary. This substance is synthesized at the site of the ruptured follicle, after the process of ovulation. It positively affects the hormonal background and improves the structure of the endometrium.

To the best medicines from endometriosis of this group include the following drugs:

"Duphaston". The drug is prescribed to drink from 5 to 25 days of the menstrual cycle. Then they take a week break and take medicinal product resume. Daily dose 10-20 mg.
Norethisterone. The treatment regimen is similar to Duphaston. The maximum allowable daily allowance is 5 mg.
"Mirena". Intrauterine device. The active substance is levonorgestrel.
"Utrozhestan". The drug is prescribed from 16 to 25 days of the menstrual cycle. The treatment course can last up to 9 months. Judging by the reviews, it helps to cope with pathology.

Of particular note is the cure for endometriosis "Visanna". It is used most often. The drug showed just an excellent result in the treatment of this disease. The medication is drunk one tablet a day, for about a year.

The drug reduces lesions and reduces the number of vessels that provoke the appearance of endometriosis, which significantly reduces the trophism of the disease. Side effects when taking "Visanne" are rare. This is usually a work disorder. gastrointestinal tract, pain in the abdomen, headache, skin rashes and depression.

Medicines for fibroids and endometriosis are the same. With a nodular form of fibroids, gynecologists usually prescribe Duphaston. "Visanna" is prescribed in the advanced stage of the development of the disease.

Spiral "Mirena"

What medications treat endometriosis effectively? These are the drugs that were described above. Among them, not the last place is occupied by the Mirena intrauterine device.

The therapeutic system inhibits the growth of the endometrium. Contains levonorgestrel, a substance that is an analogue of the female hormone - progesterone.

The spiral affects the woman's body locally, as a result of which fewer hormones enter the body than with the use of tablet preparations.

Mirena normalizes the menstrual cycle, reduces the duration of menstruation and the amount of bleeding. Removes pain.

Endometriosis in a mild stage of development can be easily cured with this medication. At the beginning of the use of the spiral, spotting may be observed. But, after some time, the situation changes dramatically. The cycle is straightening out. And the periods become less long and not so plentiful. For some ladies, after installing the spiral, menstruation stops altogether. With endometriosis, this is a positive thing.

Antigonadotropic agents

About what medicines to drink with endometriosis says a gynecologist. As a rule, if the disease is not running, then medications are prescribed for its treatment that stop the production of pituitary hormones. After all, they actively stimulate the work of the ovaries. They inhibit the synthesis of LH and FSH.

We have already mentioned the list of the most popular drugs in this group, but it is worth dwelling on them in more detail. When using these drugs, the patient experiences an artificial menopause and the production of estrogen is reduced to a minimum level.

The best drugs in this group include:

Buserelin. Available in the form of a spray. It is used for about 4-6 months. Three instillations are administered daily into each nasal passage.
Buserelin Depot. Available in ampoules. It is applied in the form of injections. The drug is administered once a month, intramuscularly.
"Zoladex". The medicine is produced in the form of subcutaneous capsules. Injected under the skin every 28 days.
Danazol. Produced in capsules for oral administration. Refers to antigonadotropins. It is characterized by a slight anabolic effect. Slows down the growth of the endometrium. Prevents ovulation. Blocks the synthesis of sex hormones. Daily dose 400 mg. Judging by the reviews, this is a fairly effective drug.

This group of drugs is prescribed before and after the operation, to prevent the growth of lesions. The drugs are difficult to tolerate by patients and can cause a number of negative effects. The duration of their reception is 6-9 months.

The attending physician will tell you about which medications to take for endometriosis. It will be based on the symptoms of the disease and the severity of the pathology.

Cure for endometriosis, non-hormonal

In addition to hormonal drugs, non-hormonal drugs can also be used in the treatment of endometriosis, these are:

Immunomodulators. Such as: "Levamisole", "Polyoxidonium", "T-activin", "Likopid", preparations with interferon and others.
Non-steroidal anti-inflammatory drugs. They relieve inflammation and relieve pain. The most effective are Diclofenac, Naproxen, Ibuprofen, Indomethacin. They are used five days before the onset of menstruation.
Natural herbal remedies. These drugs for ovarian endometriosis cause fewer side effects than hormonal drugs, but they work less effectively. It takes much longer to achieve the desired effect. Despite their naturalness, they should not be used without a doctor's prescription. Most often, with endometriosis, "Cyclodinone" and "Gynekol" are used.
dietary supplements. These agents do not cure endometriosis and have not passed all the necessary clinical trials, but their use may improve the outcome. The most common are Indole Forte and Ovariamin.

If there are certain indications, antibiotics may be prescribed to treat endometriosis. But these medicines are rarely used, as they stimulate the development of the disease and provoke the growth of the endometrium.

Herbs for endometriosis

Medicinal plants are indispensable assistants in the treatment of pathology. Reviews of women say that with constant use, herbs can provide a lasting result. So, the plants that are used for endometriosis include:

boron uterus;
red brush;
nettle;
fees with elderberry, raspberry and blackberry;
celandine.

From herbs, you can prepare decoctions, make alcohol tinctures and douching.

Don't Forget Before Using medicinal plants consult a doctor. And you should not replace the therapy prescribed by the gynecologist with herbs. So you can completely start the disease and provoke the occurrence of complications, serious problems with health.

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.

On 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

Research recent years 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.

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.

Other groups are used to treat endometriosis. hormonal drugs, which do not give a reliable contraceptive effect, so they cannot be called contraceptive:

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 while 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 "Visanne" 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:

Content

Proper Treatment endometriosis by an experienced doctor will allow a woman to get rid of dangerous disease, restore the normal functioning of the uterus and appendages. An unpleasant ailment can cause infertility and develops in 80% of cases in childbearing age in patients who have not reached menopause. Find out if endometriosis can be permanently cured and what therapies are.

What is endometriosis

Before treatment, you need to understand the specifics of a gynecological disease. The human uterus consists of a body, cervix and tubes, inside it is lined with a special layer - the endometrium. Its main function is reproductive. During pregnancy, the tissue grows on the inner surface of the uterus, the egg is introduced into the thickness of the mucous membrane and attached. Vessels appear, which, with the help of the placenta, ensure the vital activity of the fetus. If pregnancy does not occur, the mucous surface of the uterus exfoliates and comes out with blood, that is, the woman begins her period.

The disease can occur when blood from the uterine cavity enters other organs of the small pelvis. Endometriosis is a pathological process of growth of the endometrium. There is a disease in two forms;

Endometriosis genital - affects the uterus, ovaries, vagina, cervix. Occurs in 85% of cases.
Endometriosis extra-genital - affected postoperative scars, intestines, bladder, internal organs. A rare form, occurs due to the fact that blood clots can enter the abdominal cavity. Normally, they should resolve, but it happens that endometrial cells take root outside the uterus and begin to grow. The probability of this form of the disease is 5-15%. Treatment can only be done surgically.

Endometriosis causes an internal inflammatory process in abdominal cavity. A change in the structure of organs leads to violations of their work. Very often this disease is confused with fibroids. Endometriosis leads to damage to the surface of the uterus, the appearance of nodes and adhesions, which is fraught with the impossibility of the embryo to attach, i.e. causes infertility. Modern gynecology has not studied all the causes of a pathological disease. The most likely are immune and hormonal disorders, hereditary factor, nervous disorders, stress.

Symptoms of endometriosis

An insidious disease is fraught with the appearance of signs only at a late stage. The patient may suffer from an illness for a long time, without even knowing about it. Symptoms of endometriosis:

Enlargement of the uterus in size up to 5-6 weeks of pregnancy. It takes on a rounded shape.
Feeling of heaviness in the lower abdomen.
Stomach ache. They can be during menstruation, sex, defecation and urination.
Infertility.
Violation of the menstrual cycle (onset earlier or later than the scheduled date). Allocations become plentiful, change color.

How fast does endometriosis develop?

Depending on environmental factors, genetic predisposition, age - endometriosis develops in every woman in different ways. With good immunity, the cells of the uterine mucosa will not take root in a different environment, or it will take long time. With difficult childbirth hormonal disruptions, endometriosis may take less than 6 months to develop. The gynecologist will be able to diagnose with high accuracy, cure the disease and control the occurrence of relapses. An experienced doctor will prescribe the following methods for diagnosing endometriosis:

Examination and palpation on the gynecological chair. The doctor may notice an enlarged uterus and appendages.
Ultrasound is effective only in the last stages of the disease, when the lesions can be clearly seen. It can be used to identify cysts.
Laparoscopy. A painless procedure will allow you to examine the endometrium, pelvic organs, and pathological formations through a small hole.

How to treat endometriosis

Treatment of endometriosis is selected individually depending on the form of the patient's disease. conservative method used in women of childbearing age. It includes taking medications (hormonal painkillers, anti-inflammatory drugs). If there is no improvement in the patient's condition, a surgical method of treatment is used. The operation is performed with large blood loss, adhesive process, pain syndrome. You can learn more about how to treat endometriosis of the uterus with medication or surgery from your doctor.

Treatment of endometriosis with drugs

For a young woman, it is important to maintain reproductive function, therefore, endometriosis treatment with drugs is used for the age category of 25-45 years. An integrated approach, various schemes make it possible to get a good effect in a short period of time. In addition to hormonal drugs, symptomatic therapy is used. Treatment is to relieve pain, nausea, spasm.

Hormonal drugs

Endometriosis pills make it possible to control the duration of the menstrual cycle, and as a result, the growth of the endometrium. Drugs are prescribed for the treatment of endometriosis after a thorough analysis of the hormonal background. When used correctly, they will not cause negative effects. The doctor selects the duration of admission and dose individually. Hormonal drugs for endometriosis:

Single-phase COCs (combined oral contraceptives). These include Janine, Femoden, Logest, Regulon.
Preparations containing one progestogen component - Progesterone, Duphaston, Utrozhestan. This treatment helps restore fertility.
Intrauterine devices based on levonorgestrel. Mirena is popular, it is placed for a different period (from 3 to 7 years).
Preparations containing male hormones androgens (Methyltestosterone).
Gonadotropic drugs (Danol, Danazol). With this treatment, the body's own production of sex hormones is suppressed.

Treatment regimen for endometriosis

The correct treatment regimen for endometriosis is the one prescribed by your gynecologist after a comprehensive examination. The doctor selects all the means individually, especially for hormones. The scheme includes not only taking pills and injections according to the prescribed course, but also washing, douching, special tampons, compresses, folk methods. These methods can allow a woman to get rid of the problem. On average, treatment will last from 6 to 9 months.

Tampons for endometriosis

Used in gynecology tampons for endometriosis. They are especially effective when the disease has affected the cervix, vagina. Tampons are factory-made, soaked in herbal extracts, hyaluronic, lactic acid. Their action is aimed at restoring functionality, reducing the pain of sexual intercourse. You can also make your own tampons. To do this, take a cotton wool roller and a sterile bandage, fold it into 6-8 layers. Well soaked in oil or infusion. Leave the tampon in the vagina overnight. The course of treatment is 5-6 weeks.

douching

The use of douches for endometriosis may be prescribed by a doctor to reduce the growth of the endometrium in the uterus and beyond, to reduce inflammatory processes. Treat with an irrigation douche or a conventional soft-tip douche. Used for endometriosis pharmaceutical preparations(powders, ready-made solutions: Tantum Rose, Furacilin) and decoctions of medicinal herbs.

Surgery

The radical treatment is surgery. It is appointed after a thorough examination. To preserve the possibility of reproductive function, laparoscopy is widely used. Surgery endometriosis using this method is minimally invasive, involves the rapid removal of endometrial tissue and has a good cosmetic effect. Surgery passes through small incisions through which the doctor can remove lesions in the uterus and other organs. Or curettage is carried out according to the mechanics of abortion.

How to cure endometriosis folk remedies

Doctors can tell you how to cure endometriosis folk remedies. Women are afraid to use hormonal drugs, fearing side effects, herbs, animal products and beekeeping come to the rescue. Learn how to treat uterine endometriosis at home from your doctor with simple recipes. The combination of different methods gives excellent results and prevents relapses.

Herbal treatment

Proven over the years, the treatment of endometriosis with herbs gives a lasting effect. Many herbal medicines are taken for gynecological disorders. A remedy from a boron uterus, a red brush is taken orally in the form of herbs or alcohol-based drops. Fees with elderberry, raspberry leaves, blackberries help prevent the growth of the endometrium in the uterine cavity.

Nettle

The unique properties of nettle - to cleanse the blood of toxins and restore hormonal disorders - have long been known. The herb can be taken internally and externally (douches, tampons). Nettle with endometriosis relieves pain, reduces the abundance of secretions. They are treated only with freshly prepared decoction. To do this, 2 tablespoons of nettle should be poured with a glass of boiling water and insisted for half an hour.

Celandine

A beautiful celandine plant is a natural bactericidal and fungicidal healer. It can inhibit neoplasms in the human body. Use celandine with endometriosis should be used with caution. If the indicated dosage is exceeded, the patient may develop side effects. Recipes with celandine:

Internal infusion, apply 50 ml 3 times a day for 7-14 days. To prepare it, it is necessary to brew 15 g of celandine grass in a glass of boiling water. Let it brew for about 2 hours in a thermos.
Infusion for douching is used 2 times a day for 45-65 days. To prepare it, take 20 g of grass and pour ¾ cup of boiling water. Strain the resulting liquid to get rid of solid particles.

Propolis treatment

When folk and drug methods do not help, the treatment of endometriosis with propolis gives a good effect. The unique composition of this bee product helps to slow down the growth of the epithelium. Any of its use is effective: tinctures, compresses, candles, tampons. Propolis tincture for alcohol can be bought at a pharmacy and diluted (1 spoon per glass of water) to douche, make compresses.

Prevention

To prevent the development of the disease, it is necessary to regularly visit a gynecologist. Prevention of endometriosis includes the following:

Taking folk remedies and medications that increase immunity.
Abstinence from sex during menstruation.
Timely treatment of gynecological diseases.
Right choice contraception to avoid abortion.

It is necessary to be observed by an experienced doctor who will detect the disease in a timely manner, provide assistance, and prescribe treatment. The disease also manifests itself in women who do not have problems with conception, sometimes, it is found quite by accident. If your menstruation is painful, it goes more than once a month, but more often or less often, it does not have a certain cycle - this is an occasion to consult a doctor.