OC in therapy of dysfunctional uterine bleeding in adolescent girls

OC in therapy of dysfunctional uterine bleeding in adolescent girls

N.M. Pasman, E.A. Snisarenko, A.V. Dudareva, A.V. Tepliskaiya

Novosibirsk Government University, Russia

Introduction: The menstrual cycle disorders consist one of the mane

places in structure of gynecological diseases in adolescents. One of the main

reasons of dysfunctional uterine bleeding is unmaturity of central nervous and

ovary regulation in adolescent girls. Hormonal changes occur in parallel in

central nervous system and in the ovary as a result of the maturation of the

reproductive organs and their regulatory mechanisms (Spence J.E., 1997; Gurkin

U.A, 2000). During the first years after menarche menstrual cycles are often

irregulare and in high percentage menstrual cycles are anovulatory. The

reproductive system is carefully controlled from hypothalamic centers. The

normal regulation can violate as a result of influence of somathic illness,nutritional

insufficiency, negative emotions and sexual transmission infections. Timely

correction of this disorders and its reasons permit of following problems of

reproductive health.

Materials and methods: 109 girls aged of 13–19 suffering of

dysfunctional bleeding were investigated. Hormonal level (FSH, LH, Estradiol,

Progesterone, Kortizole, DEAS,17OH-progesterone, Prolactin), Ultrasound

researches, bleeding analysis (trombocytes, Hb, Er, fibrinogen, AT111) were

examined. 58 girls were included in 1-th group. This patient’s don’t

suffered of endometrial hyperplasia and received therapy of low dose oral

contraception during 6 month’s after hormonal hemosthasis. The patients of the

2-th group with revealed endometrial hyperplasia (n=32) were treated by

didrogesteroni in dose of 20 mg per day during 6 monthe. Before treatment by

gestagens to 26 patients (with endometrii 12–14 mm) provided Pipel-diagnostic,

bleeding in 19 patients were required of surgical hemostasis Clinical and

laboratory control were provided before and after treatment. In control group

were included 15 girls with traditional therapy without hormones.

Results: In all patients of 1-th and 2-th groups were achieved stable

normalization of menstrual cycle and hormonal homeostasis after 6 months of

therapy. Positive effect were reached in treatmentof endometrial hyperplasia by

didrogesteroni in all 32 patients.

Conclusion: Adolescents with dysfunctional bleeding with endometrial

hyperplasia are needed in treatment of progesterone; girls without hyperplasia

can treating by low dose OC.

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