Experience with Tri-Merci used for combined therapy of cervical
intraepithelial neoplasia in patients with hyperandrogenia
A.A. Sukhanova
Department of Obstetrics and Gynecology, Medical Academy of Postgraduate
Education, Kiev, Ukraine
Objective: to study Tri-Merci efficacy in the combined therapy in
women with cervical intraepithelial neoplasia (CIN) and evaluated testosterone
level.
Design & Methods: The study group included 32 women (mean age 25+3)
with CIN, elevated testosterone level and menstrual disorders. The degree of
gravity of CIN was specified cytological and morphologically. Combined therapy
of CIN I-II included Tri-Merci (Organon, the Netherlands) administration (6
months minimum) for normalization of the menstrual cycle and cryolysis as local
therapy of CIN later on after the normalization of cycle. Testosterone level was
estimated at a baseline, after 3 and 6 cycles of Tri-Merci treatment.
Results: Were evaluated in 1, 2 and 6 months after cryolysis based on
the colposcopy and cytology. The complete adhesion was observed at 26 patients
(81,3%) in 1 month after cryolysis. After 2 and 6 months in all patients the
laminated flat epithelium was found at a colposcopy, and the type 1 of Pap-smear
test was defined at a cytology. Complication after cryolysis and relapses of
disease were not observed. In all patients (100%) against a background of
Tri-Merci intake the cycle became regular. After 3 months of Tri-Merci
administration the normal level of testosterone was noted in 22 patients
(68,75%), after 6 months – in 30 (93,75%). In two patients (6,25%)
testosterone level decreased, but did not reach the normal level. All patients
experienced positive effect on skin during Tri-Merci treatment.
Conclusions: The low dose oral contraceptive Tri-Merci is recommended
to be used in combined therapy of cervical intraepithelial neoplasia (CIN) in
patients with hyperandrogenia to correct cycle disorders and differentiation,
maturation of basal layer cells in order to form a highly-differential laminated
flat cervical epithelium, and also to prevent relapses of disease.
