Pathology of menopause
Endocrinology / / May 22, 2016
estrogen Androgens inferior in strength of its impact on the autonomic nervous symptoms menopausal neurosis.However, in some cases, if you can not treat estrogen for fear cause proliferative changes in the genitals and mammary glands, in the presence of certain comorbidities genitals treatment of climacteric neurosis can be carried out by androgens.
indication for patients with androgen climacteric neurosis are any clinical manifestations hyperestrogenism, the presence of uterine fibroids, adenomyosis, malignant diseases of the genital organs or the breasts in the present or in the past, uterine bleeding.androgen treatment is also shown patients climacteric neurosis, suffering from mastopathy and breast fibroadenomatosis.Androgens are appointed in cases where hormone therapy is required patients climacteric neurosis when stored menstrual cycle or when it breaches.Androgens are indicated for neurovegetative and trophic disorders of the bladder and urethral sphincter, causing dysuria and urinary incontin
mechanism of therapeutic action of androgens on the clinical climacteric symptoms neurosis, apparently, is the decelerating and normalizing action on hypothalamic centers that are in a state of increased excitability.Experimental data indicate the ability to inhibit androgen gonadotropic pituitary function.Under the action of androgens on sexual organs considered "anti-estrogenic" effect - the ability of androgens cause atrophy of the endometrium and vaginal mucosa.However, the effect of androgens on the genitals of the dose administered depends preparations.Small doses of androgens (5-10 mg testosterone propionate in a day intramuscularly) at the initial state of atrophic mucosa of the uterus and vagina causing their proliferation.Average dose progresteronopodobnoe exert influence, high doses (50 mg testosterone propionate intramuscularly per day) inhibit endometrial proliferative processes and cause atrophic changes in the vaginal mucosa at initial high proliferative state.
first reports of good action of androgens at the climacteric neurosis belong Mocquot and Moricard.
For the treatment of androgen-climacteric neurosis used drugs: testosterone propionate, produced in oil solution at 10, 25 and 50 mg per 1 mL, and methyltestosterone tablets to 0,005 g
initial dose of testosterone propionate is defined as a feature of current climacteric neurosisand character related diseases or genital mammary glands.To eliminate the symptoms of menopausal neurosis assigned 10 mg testosterone propionate or 25 mg daily (1 ampoule 2.5% solution) intramuscularly every second day.After the onset of the clinical effect of the dose is reduced by increasing the intervals between injections.Autonomic nervous symptoms menopausal neurosis, and in particular hot flashes disappear somewhat later than in the treatment of estrogen on the 4-5th week of treatment.As a maintenance treatment may be recommended dose of 10 mg testosterone-propionate 1-2 times a week intramuscularly.Maintenance therapy should be done at least 3-4 months, and in some cases even 1 year.Usually, long-term treatment of androgenic drugs is determined not so much by the presence of climacteric symptoms of neurosis as concomitant diseases (uterine fibroids, breast mastitis and others.).In a number of related diseases of the genital organs should start treatment with large doses of testosterone propionate.For example, if patients climacteric neurosis uterine bleeding or uterine fibroids treatment is progressing it is advisable to start with 50 mg testosterone propionate every day or every other day, with a gradual reduction in dose to 50 mg 2 times a week intramuscularly, with a gradual transition to the above maintenance doses.The course of treatment - 3-4 months.In some cases, the presence of strong uterine bleeding, testosterone propionate is assigned to 50 mg daily until complete hemostasis.In such cases, due to a brief high doses, virilizing side effects of the drug is weak.
the presence of patients with climacteric neurosis expressed trophic disorders genital atrophy of the vaginal mucosa should use a property of low doses of androgens cause proliferative changes in the genital organs.In such cases it is advisable to assign long-term 5-10 mg testosterone propionate intramuscularly every other day.Small doses of androgenic drugs are effective in the trophic granulosa vulvitis, obesity.They increase the tone of the bladder and thus reduce dizuricheskie disorder.
methyltestosterone in the early treatment of climacteric neurosis (especially when related genital diseases) are efficient testosterone propionate, and its full therapeutic dose (40 to 50 mg) of patients do not tolerate.methyltestosterone treatment should begin with 30 mg per day (2 tablets 3 times a day sublingually).After the elimination of the symptoms of menopause neurosis methyltestosterone dose gradually reduced to 5-10 mg per day.
In practice came highly effective synthetic drug metilandrostendiol having anabolic effect and mild androgenic properties.Metilandrostendiol climacteric neurosis given to patients for the same indications as the androgens.The almost complete absence of side virilizing allows to recommend metilandrostendiol for long-term therapy.In addition, due to pronounced anabolic metilandrostendiol indicated for osteoporosis is observed in menopausal and postmenopausal women.Metilandrostendiol available in tablets of 10 and 25 mg for sublingual use.Early treatment assigned metilandrostendiol 25-50 mg daily until clinical effect, and then the dose is reduced to 25 mg per day and then to 10 mg daily or every other day.The total duration of treatment - 3-4 months.
androgenic drugs are beneficial to a number of neurovegetative symptoms: hot flashes, dizziness, palpitations, etc. They are much more effective than estrogen in the presence of pain in the heart..Apparently, this is due to the ability of androgens to improve coronary circulation.In addition, androgenic drugs are effective in a number of psychoneurotic manifestations of climacteric neurosis.For example, in the treatment of androgen increases efficiency, reduces irritability and tearfulness and mood changes in people who are prone to depression.In some cases, increased libido women perceive as a good effect, indicative of the restoration of sexual life.
- Menopause (Menopause) and diseases of menopause in women
- Pathology of menopause (menopause).Climacteric neurosis
- menstrual cycle
- diagnosis and treatment of climacteric neurosis
- The use of estrogen for the treatment of climacteric neurosis
- Hormonal disorders of the menstrual cycle
- granulosa tumor.Follikuloma
- Violation monthly rate.Amenorrhea
- Violation of the menstrual cycle with monthly rhythm disorder.Polimenoreya
- principles of hormone therapy violations
- menstrual Principles of hormonal treatment of dysfunctional uterine bleeding
- Prevention of recurrence of dysfunctional uterine bleeding
- Tumor cells Leydigovyh hilyusa ovaries.
treatment of androgenic (testosterone propionate and methyltestosterone) favorably affects the course of concomitant gynecological diseases: when appropriate doses of drugs in most patients with delayed uterine fibroids growing, stop uterine bleeding and decrease the phenomenamastitis in mammary glands.
Among the side effects of androgens should include virilization symptoms: brutalization vote, the appearance of hair growth on the face, acnae vulgaris.Furthermore, the treatment can occur excessive androgens erotization and fluid retention.The latter circumstance makes it necessary to use a combined treatment of androgen with diuretics (eg hydrochlorothiazide).All adverse events occurring during treatment with androgens, rapidly disappear after cessation of treatment.The sensitivity of women to the side effects of androgens is different.Sometimes the presence of a number of concomitant diseases of the genital organs (uterine fibroids) patients tolerate well very large doses.Of the drugs androgenic effect adverse events are most pronounced in methyltestosterone, less - in the application of testostronpropionata and mild - in the application of metilandrostendiola.
Thus, androgenic preparations when appropriate indications are effective in the treatment of climacteric neurosis.Of the drugs with androgenic properties most advantageous metilandrostendiol which has weak virilizing properties and suitable for use (applied sublingually).However, testosterone propionate and methyltestosterone specifically indicated for a number of related diseases of the genital organs, where methyl androstenediol, due to the weak androgenic properties that may not have adequate influence (uterine bleeding, uterine fibroids, breast fibroadenomatosis).
main methods of hormonal treatment of menopausal neurosis
The use of estrogen for the treatment of climacteric neurosis
The use of androgens in the treatment of climacteric neurosis
combined use of estrogen and androgen