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
investigated.
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.
