Principles of pathogenetic correction of the hormonal disorders in reproductive women with adenomyosis

Principles of pathogenetic correction of the hormonal disorders in

reproductive women with adenomyosis

I. Vovk, A. Kornatskaya, G. Chubey, V. Kondratyuk, O. Trokhimovich

Institute of Pediatrics, Obstetrics and Gynecology, Turkey

Introduction: The multiple researches have revealed the role of cycle

secretion and the correlation of steroid and gonadotropins in adenomyosis

development. In the past years there is a question under discussion whether the

illness could arise in the result of steroid interaction disorders with the

receptors of endometrium cells.

Objective: Correction of hormonal disorders in women of reproductive

age with adenomyosis depending on endometrium and myometrium receptors condition.

Methods: The profile of gonadotropins and sex hormones as well as the condition

of the endometrium and myometrium receptor in 50 women with adenomyosis was


Results: The basic estradiol level in the tested women was high

(520,29+65,6 pmol/l) and remained on the high level in dynamics during

the menstrual cycle. There was a high level of LH to be observed in the early

follicular phase. The correlation of LH/FSH was equal 0.43–0.47. In this

connection the insufficiency of progesterone in the periovulatory and luteal

phase was ascertained. Adenomyosis in its 1st stage was morphologically revealed

in 30 tested women (invasion of endometrium into the depth of one visual field).

Immunohistological investigation of estrogens and progesterones receptors in the

dynamics during the menstrual cycle showed the conservation of the receptor

apparatus of endo- and myometrium in this contingent of patients. Therefore

these patients were prescribed monophasic combination of dienogest and

ethynilestradiol (dienogest 2 mg + ethynilestradiol 0.03 mg) for the 6–12

months period. The clinical effect of the conducted therapy was confirmed in 29

patients (96.6%). The pregnancy was diagnosed in 12 out of 20 women within 2

years of observation. Normal deliveries have already came in 8 patients.

Conclusions: Modern oral contraceptives are effective for the hormonal

correction in reproductive women with mild adenomyosis.

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