Norkolut with endometrial hyperplasia

Treatment of endometrial hyperplasia include hormonal and surgical unit, with the prescriptions carried solely depending on the type of this disease, and is primarily aimed at ending the excessive growth of domestic layer of the uterus.

Norkolut endometrial hyperplasia is the drug of choice among hormonal agents from the group of progestogens. Norkolut hormone analogue is 2 female cycle phase.

Application due Norkoluta its direct impact on the main link in the pathogenesis of endometrial hyperplasia - reduced production of progesterone.

The inner layer of the uterus of the structure is highly sensitive to the female reproductive system hormones produced by the hypothalamus-pituitary system, ovaries. A normal menstrual cycle is completely subservient to the system and the result of her work is the presence of regular menses and ovulation, with the gradual fading functions premenopausal. Various pathologies that lead to failure of hormone production, leading to disruption of the cycle, in particular to endometrial pathology.

Healthy woman rejected the endometrium each month causing menstruation. Starting from 1 day ovaries produce estrogen cycle actively controlled by the pituitary gland and the hypothalamus. Basal lining endometrium proliferates rapidly and ensures the growth of the functional layer, which contains the glands. The first phase - proliferative - reflects exactly this process of increase. In the middle of the menstrual cycle, ovulation occurs - release of an egg from the ovarian follicle. In place of the follicle forms the corpus luteum - this temporary intensively iron produces the hormone progesterone, a which influence the proliferative phase of the endometrium enters the secretory phase, and then rejected in the absence of conception.

Norkolut in the treatment of endometrial hyperplasia replaces the corpus luteum and progesterone, that a woman is not synthesized or is produced in small quantities. The pathogenesis of endometrial hyperplasia is considered to decrease progesterone production against the background of excessive formation of estrogen. As a result, the inner layer of the uterus incessantly growing, but at some stage vessels cease to feed it, and hemorrhage occurs.

Acyclic uterine bleeding nature - this is the main symptom of endometrial hyperplasia. Such bleeding occur sporadically, usually at 20 - 40 day cycle. Independently suspected pathology is almost impossible, as the woman considers these metrorragii as irregular periods. endometrial hyperplasia often in girls occurs in a complex with mastopathy.

Patients in menopause tend to come to the hospital with uterine bleeding during amenorrhea.

Signs of the disease may include:

• menstrual irregularities - 60% of cases;
• delay of 1 to 3 months with the introduction of long uterine bleeding;
• regular but heavy menstruation (7 days or more);
• lack of ovulation.

Almost 80% of women with this disorder are obese. In addition, for the disease is characterized by miscarriage, the presence of foci of adenomyosis and fibroids.

The mechanism of action Norkoluta

Norkolut is a synthetic analogue of the corpus luteum. This drug is used for substitution treatment when diagnosed with endometrial hyperplasia.

Seeking the appointment Norkoluta with endometrial hyperplasia considered to decrease the amount of estrogen, and the normalization of the inner layer of the uterus growth.

Excess estrogen in women may be direct or indirect. This opens his pathology in young women, and at the stage of menopause.

Reasons for increasing the production of estrogen:

• anovulatory cycles with follicle atresia, which is typical of adolescence and formation cycle;
• lack of ovulation in polycystic ovary syndrome;
• prolonged estrogen therapy;
• obesity;
• type 2 diabetes;
• early onset of menstruation;
• late menopause.

The direct reasons hyperestrogenia include early menarche and late menopause, follicle atresia (anovulatory cycles), when hormone production is increased. A circumstantial reasons include obesity and diseases accompanied by high levels of hormone in the blood. It is known that excess fat tissue - is a provider of estradiol in a woman's body. It is the patient's excess weight during menopause are hyperplasia.

There are rare form of endometrial hyperplasia when these factors are absent, but directly in the uterus has too much estrogen receptor. Detect such pathology is possible only after immunohistochemical study of the endometrium.

As a result of estrogen production Norkoluta reduced by suppressing artificial progesterone in women who are at a low level. Endometrium from proliferation phase passes into stage secretion and rejected during menstruation. In young women recovering ovulatory function in patients receiving Norkoluta.

Indications Norkoluta

Norkolut in the treatment of endometrial hyperplasia are not prescribed for all types of pathology. As a rule, a woman is diagnosed with hyperplasia urgent hospitalization due to uterine bleeding. But in some cases, the patient refers to the gynecologist with complaints about the lack of success in trying to get pregnant and a violation of menstrual cycles. In any of these situations require a biopsy for histological evaluation material. Fence tissues was carried out as under the scraping, or by aspiration biopsy or aspiration vacuum endometrium.

Norkolut in the treatment of endometrial hyperplasia is prescribed in the case of the following types of the disease:

• simple endometrial hyperplasia without atypia;
• Easy relapsing form without atypia.

It should be noted that these species often are diagnosed in young women, so the scope of the Norkoluta - patients 20 to 35 years.

Simple endometrial hyperplasia is the most secure form of pathology, since only 3% of cases, it can degenerate into cancer. This is not true of atypical hyperplasia, are transformed into endometrial cancer in 80%.

The basis for the purpose Norkoluta Only a histological diagnosis, confirming the simple form of endometrial hyperplasia. Acceptance of the drug is possible after the blood analysis on hormones.

It is obvious that the treatment of endometrial hyperplasia Norkolutom should be done only after a detailed diagnosis. Sometimes doctors perform scraping against the backdrop of uterine bleeding and do not prescribe hormonal drug, committing a blunder. In such cases, relapse is inevitable.

Histological examination of material characterized by a simple variety of large amounts of iron, many of which cystic expanded. A complex or adenomatous form described restructuring of the gland, they are numerous and are highly branched. The most dangerous kind - atypical (simple and complex) - is characterized by changes in the cell nucleus and cytoplasm, multiple rows of gland cells, their bizarre shape.

Isolated use Norkoluta with atypical variants are not allowed. For the treatment of hazardous forms hyperplasia and gestagens used in particular Norkolut as well as GnRH agonists and antigonadotropiny - Buserelin, Danazol, Gestrinone and others. Such agents inhibit the synthesis of female hormones, but only reduces their Norkolut.

The composition, the form of release and dosage

Norkolut produced famous Hungarian pharmaceutical company "Gedeon Richter". The active substance is Norkoluta norethisterone, which belongs to the group of progestogens - preparations second phase. Available drug in tablets of 5 mg, a total of 20 pieces per pack.

Drug therapy is prolonged. Norkolut for the treatment of endometrial hyperplasia in the standard dosage of drink with 16 day menstrual cycle (or on day 16 from the start of uterine bleeding) over 10 days for 6 months. In some situations, the doctor prescribes a dose of 10 mg (2 tablets) per day. The medicine should be taken at the same time. If a woman has forgotten to take a pill, it is necessary to carry out the reception as soon as possible, but can not use a double dose.

If the result of the therapy Norkolutom was positive, further actions of doctors will be aimed at the restoration of a normal menstrual cycle and the prevention of rebleeding. To this end, women are prescribed combined contraceptives for a long time (perhaps several years).

To evaluate the effectiveness of treatment Norkolutom, ultrasound is conducted in the dynamics and yearly endometrial biopsy or aspiration vacuum aspiration. The final decision is made after obtaining endometrial histology results obtained with the diagnostic curettage.

When applying Norkoluta 5 day ovulatory cycle function is disabled. The drug is prescribed only after a blood test for hormones. Determine the level of estradiol, FSH, LH, Progesterone, free and bound testosterone, DHEA-sulfate, 17-OH-progesterone. When increased synthesis of estrogen appointment confirmation Norkoluta deemed to be justified.

Contraindications and particularly when used

Norkolut not apply in the following situations and diseases:

• puberty in girls;
• suspicion or the presence of breast cancer;
• cancer of the reproductive system;
• pregnancy;
• acute hepatitis;
• expressed human liver and kidney function;
• elevated serum total and conjugated bilirubin;
• presence of venous thrombosis or tendency thereto;
• obesity;
• bleeding from the genital tract with unclear reasons;
• herpes infection in the acute phase.

An important consideration when appointing Norkoluta is the differential diagnosis of hyperplasia and some diseases with a similar clinical picture:

• endometrial polyps;
• cancer of the inner layer of the uterus;
• submucosal uterine fibroids;
• chronic endometritis;
• internal endometriosis.

Hyperplasia often occurs in combination with the above mentioned pathologies, in such cases, the treatment is carried out on other circuits that do not include Norkolut. To confirm or refute comorbidity perform ultrasound, hysterosalpingography.

During the application of hormonal agents may cause nausea, vomiting, migraine, engorgement breasts, spontaneous bleeding from the vagina, exacerbation of varicose veins, thrombophlebitis, allergies.

Norkolut shows the anabolic effect - This means that in patients receiving the drug may increase body weight. In addition, there may be signs of virilization: hirsutism, acne.

It should be noted that the treatment of endometrial hyperplasia includes adhering to the principles of a balanced diet, because adipose tissue is a source of estrogen. Recommended calorie counting, tracking weight, active walking, light exercise. Will be useful foods rich in phytoestrogens: beans, soybeans, cereals, red clover, celery, vegetable oil, vegetables. Phytoestrogens have a similar structure to the natural female hormone, so they are on the principle of competition associated with the estrogen receptor, located in the uterus and mammary glands. As a result, the hormone ceases binding to its receptors and pathological action stops.

Endometrial hyperplasia is one of the leading causes of female infertility, so timely hormonal correction and treatment at an early age allows time to conceive and give birth to a child. In the absence of adequate therapy of the disease can lead to endometrial cancer.