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.
