How does the menstrual cycle under the action of dexamethasone


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In the modern world it is impossible to imagine the treatment of many diseases without the use of hormonal drugs. In particular, glucocorticosteroids - analogues of substances that normally secrete adrenal cortex cells - have a wide range of indications. For many people, these drugs save lives, protect them from disability. But besides the achieved therapeutic effect, this group of drugs has many side effects. And in many situations one has to choose the lesser of two evils. Do these drugs affect a woman's menstrual cycle and her ability to become pregnant? How are dexamethasone and menstruation delay related?

Why prescribe a drug

Dexamethasone is a synthetic analogue of adrenal hormones. It is used in almost all areas of medicine. The drug has an impact on all types of metabolism: protein, carbohydrate and fat, which is very clearly seen with its prolonged use. The main properties of the drug:

  • anti-inflammatory,
  • desensitizing (reduces the production of antibodies in response to an antigen in the body),
  • antiallergic,
  • immunosuppressive.

As a rule, attention is rarely paid to how dexamethasone affects the period until the woman decides to become pregnant. And long-term use of even small doses is detrimental to the reproductive system.

What is the use of the tool?

The use of anti-inflammatory properties

This is the most frequent use of the tool. All eye drops, skin ointments contain a medicinal substance for this very purpose. The effect of the drug is to reduce the local anti-inflammatory response. Dexamethasone and its analogues are widely used in case of edema, for example, during exacerbation of hemorrhoids or candidal colpitis (thrush). Immediately after laying the candle, the pain is relieved, itching, it becomes much easier.

Brief instructions for use

Dose and method of administration depends on the disease in which the agent is used. This can be either a single intramuscular injection at the rate of 10 µg / kg body weight, or a long-term systematic intake of 10-15 mg / day to 5-10 mg / day. The following forms of medication are common:

It becomes clear that almost every woman at least once in her life is faced with these dosage forms. Sometimes when using the drug, the question arises, can dexamethasone cause a delay in menstruation, which happened exactly in the cycle of taking this medication?

We recommend to read the article about what to do when you delay the monthly. From it, you will learn about the timing of menstruation, the risks and consequences of cycle disruption, folk methods for calling monthly, effective herbal remedies and medicines.

Impact on cycle

Topical administration of dexamethasone does not affect sexual and reproductive function. That is why doctors calmly prescribe ointments and drops, especially courses.

Systemic exposure begins after long-term use of even small doses, regardless of the mode in which the medication is used: pulse therapy, a constant dose, etc.

Dexamethasone and menses - how are they interrelated? The fact is that this medication during long-term and systematic intake disrupts the process of maturation of follicles, thereby causing various dysmenorrhea, up to the appearance of menstruation only 1-2 times a year. Also, taking medication affects the level of TSH - a substance that regulates the function of the thyroid gland. The developing clinic of hypothyroidism contributes to the appearance of multiple small cysts on the ovaries, and disrupts the process of maturation of the follicles. As a result, ovulation occurs only a few times a year.

But if the drug is taken at the clinic hyperandrogenism - increasing the level of male sex hormones, and the dosage is chosen correctly, then the menstrual cycle should only be normalized, and fertility should increase. In some women, conception occurs only after the correction of hormones by prescribing a drug.

Dexamethasone is a serious drug with a multi-faceted effect. Saving many people from the terrible, sometimes deadly consequences and complications of diseases, it has a number of side effects. Studying the properties of the drug, it becomes clear why menstruation began after taking dexamethasone, or, conversely, the cycle was extended to 60 - 90 days. The tool can only be used as prescribed by a doctor, named according to the chosen scheme and dose.

Symptoms and treatment of chickenpox on the labia

Chickenpox (chickenpox) is traditionally considered a child's "adversity." But occasionally the disease affects adults too. A person who has had chickenpox develops immunity, which means there is a reason to hope that the illness will no longer bother. However, for those who suffered an infection in the first years of life, there is a danger of having shingles at the moment of weakening of immunity (this happens against the background of stress, heart problems). The infection, albeit in a “sleepy”, almost innocuous form, remained in the nerve cells. Her awakening is one of the possible scenarios.

Everyone who has encountered chickenpox is associated with the appearance of a huge number of lesions on the body of the patient. At first, the rash looks like small red spots. In their place, bubbles swell, which subsequently burst. And if itchy pimples on the head or stomach can be smeared with green paint, then the chicken pox that occurs on the genital lips in girls is alarming. Moms of patients are looking for harmless ways to reduce the discomfort of their children. And some medicine tricks become salvation.

"First steps" of the disease

Why do children easily get chickenpox? The fact is that the virus has an extremely high degree of volatility: you can become infected just by walking past the patient (close contact is not necessary). The period when the child has already become a carrier of the infection, but the disease has not yet manifested itself, lasts from two to three weeks.

Approximately two weeks after infection, the patient begins to complain of weakness, chills, lack of appetite. Along with the deterioration of overall health, there are external signs of the disease. It becomes easy to learn that chicken pox has invaded a child’s body when a reddish rash develops in a baby or preschooler. The first spots may appear on the cheeks, stomach. And then the rash spreads at an incredible rate. The whole process is accompanied by severe itching, so the kids and strive to comb the hated bubbles.

Annoying manifestations of infection

Chickenpox for girls is often prepared for non-child trials. It becomes unbearable when the red rash occurs in babies in intimate places. The situation is aggravated by the fact that acne on the genitals quickly turn into sores with fluid inside. Until these pock marks are crusted, the discomfort will be enormous. We need to remember this pattern: the more rashes on the patient's body, the more chickenpox exhausts the body. The children who have up to fifty "marks" of the infection have the best feel.

In any case, it is much easier for children to tolerate chicken pox than it is for adults. Young women, finding acne on their genitals, become confused and do not know what ailment to attribute this phenomenon. After all, allergy and some infections transmitted through sexual contact manifest themselves with similar symptoms. The fact that the girl picked up chickenpox, it becomes clear when the temperature rises strongly and the patient begins to torment cough, headaches, runny nose and fever. You may need treatment in an infectious diseases hospital.

If a girl has a rash on the inner and outer lips of the genital lips (it is possible that they appear near the clitoris), these bubbles will cause her a lot of inconvenience. Much depends on the number of such formations. In a situation where a girl has many rashes in the “delicate zone”, every urination will be a problem.

The main task of the mother is to prevent the little sufferer from combing the chicken pox rash. Otherwise, bacterial infection of the wounds cannot be avoided. It is known that combed acne with watery content turns into deep sores that heal for a very long time and leave scars behind.

How to cope with bubbles?

It would be a mistake to think that an adult woman who has got chickenpox can “get off” a slight indisposition. Anyone older than fifteen years, chickenpox causes maximum suffering, and even threatens with complications. Women after this infection often develop kidney inflammation, cystitis, vulvitis. Therefore, the appearance of two - three acne in the "indecent place" in an adult lady should be a reason to call a therapist at home. It is better not to go to the clinic itself (if you really get sick with chickenpox, then you can easily infect others). It is important to monitor your well-being - damage to the nervous system is considered especially dangerous in case of chickenpox. Confusion of consciousness often causes hospitalization of patients.

As for girls who get chickenpox, their weakness is lack of self-control. Baby can comb bubbles, adding to her trouble. It is important for mothers of such children to calm frightened girls and explain that it is absolutely impossible to touch itchy pussies. And, of course, you should avoid extremes in the treatment of chickenpox. Catching all the known means in the hope of eliminating the blisters in the baby is not the way.

What can be done if the disease got to the intimate areas?

  1. Pay due attention to cleanliness. Every day you need to change the bedding, on which the patient sleeps. Of course, the girl’s clothes should also be clean.
  2. Once or twice a day the patient needs to take a shower without using soap. From the washcloth at the time of the disease should stay away (it only contributes to the spread of rash)
  3. It is recommended to refuse to wear tight pants (with regard to the material of children's underwear - pure cotton is preferable). Remember that wearing synthetics can increase itching in places of rashes.
  4. The girl’s fingernails should be cut short.
  5. A small patient, it is important every day to take a bath with a decoction of chamomile, succession.
  6. There is no consensus among doctors about the use of green leaf. But in order to avoid burns it is better not to smear the acne on the genitals with a solution of brilliant green.
  7. Good results are obtained with the use of ointment Acyclovir.
  8. It is forbidden to give aspirin to young children with chickenpox. If you want to bring down the temperature - use paracetamol in the form of candles, suspensions.
  9. Sometimes the doctor prescribes suprastin tablets (this drug eliminates itching).
  10. The problem of acne on the genital lips can solve propolis tincture: it is applied to a clean fleece, which is then smeared on the affected areas. This method is contraindicated in all those who are allergic to honey.
  11. Zinc-containing ointments help reduce blisters and relieve inflammation.
  12. Acne can be treated with Miramistin.
  13. Ointments, including mummy, favor the disappearance of acne in both women and girls.

By the appearance of the rash, you will determine how effective this or that remedy turned out to be. If the medication has reduced inflammation, the blisters will turn pale and the degree of itching will decrease. When these formations dry up and crust over - you can assume that you were able to overcome the main problems.

Who should be afraid of repeated "attack" disease

Often the infection affects women of retirement age, weakened by protracted ailments. And those who are already worried about chickenpox in childhood are ill. Secondary infection manifests itself in the form of shingles. This disease does not provoke rash in intimate places - the back becomes a lesion area.

There is a vaccine against chickenpox that can protect an adult from infection. Her help is resorted to by those who have contacted an infected child. The only caveat: the vaccine will help, if no more than three days pass from the moment of the “problem” meeting to the medical procedure.

Related and Recommended Questions

First of all, for a correct assessment of the results of analyzes, I need to know the norms of all the above-mentioned tests in your laboratory (they differ depending on the laboratory and the reagents used in it, are indicated on the sheet with the results of analyzes).
What worries you, why did you decide to get tested?
Do you take any medications now?

Sincerely, Nadezhda Sergeevna.

Currently, the function of your thyroid gland is completely normal and cannot lead to the development of the symptoms that you describe. Reception of Dexamethasone on the function of the thyroid gland has no effect.

An increased level of AT-TPO suggests that you have autoimmune thyroiditis. This means that damaging antibodies (actually AT-TPO) to your own thyroid gland are formed in your body. Over time, this can lead to a decrease in thyroid function and a lack of its hormones. With an increase in AT-TPO, we do not conduct special treatment, the only thing that in such a case is necessary at least once a year to prophylactically monitor TSH and T4 is free.
It is possible that the hormones of the thyroid gland will be still very long time to remain normal despite the presence of antibodies. The level of AT-TPO in the future can not be controlled, because the presence or absence of antibodies, and not their number, is of diagnostic importance; once formed, they no longer disappear from the body.

Sincerely, Nadezhda Sergeevna.

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5 causes of menstrual disorders

1. The most common (and most banal) cause of failure - infection of the pelvic organs. Therefore, it is first necessary to be examined for the causative agent (this could be, for example, chlamydia, uroplasma, mycoplasma) and anti-inflammatory treatment. If the problem was reduced to infection, as a rule, violations of the cycle no longer recur.

2. Much more difficult is the situation when behind the irregularity of the cycle lies hormonal disorders. They can occur at different levels of the formation of hormones, so there is a certain list of them, which must be checked.

The overall survey plan includes thyroid research, - and violations here can be associated with its hyperfunction, and, conversely, with a decrease in activity. Sometimes the problem is associated with a change in the function of the adrenal glands.

3. Hormonal disruptions can occur in the ovaries themselves. However, not necessarily because of inflammation at the moment. Alas, The cause may be, for example, a high infection index in childhood: that is, frequent colds in a girl under 12 years old.

4. Transferred rubella and chicken pox can also affect the laying of follicles in the ovary and sometimes violations occur literally from the very first cycle. The difficulty here is that adolescents themselves rarely pay attention to this, so the problem is diagnosed much later.

It happens that cycle violations reflect a whole complex of causes, including hormonal ones.

Is hormonal correction required?

5 causes of menstrual disorders

This question is solved individually. If a patient has minor hormonal changes in the form of small delays for 5-10 days and there is already some structural pathology in the ovaries, it is often possible to adjust the cycle with homeopathic preparations in combination with cyclic vitamin therapy.

Широко используются и другие немедикаментозные средства (например, физиотерапия). Чтобы добиться успеха, здесь исключительно важен комплексный подход.

Consultation of a medical psychologist may also be very useful, because hormonal changes are manifested not only in violations of the cycle: acne on the skin, male-type hair growth easily become occasions for complexes.

At the same time, there is no need to expect an immediate effect from the treatment, since it is carried out for 9-10 months.

What else could be causing a cycle violation?

Pros and cons of hormone treatment

5 causes of menstrual disorders

If a woman has pronounced hormonal changes, as evidenced by delays of 2-3, or even 6 months, there is no way to cope here without hormonal correction.

Often, such patients have delays in the development of the uterus. Fortunately, it is quite possible to help her with modern methods.

5. It happens that the follicular apparatus is genetically so laid down that a woman will have a cycle violation throughout her life - so-called polycystic ovary. Typically, these patients are at the dispensary.

If necessary, long-term treatment between courses of hormonal preparations, the body of a woman is given a break from the intensive influence of medicines, using the methods mentioned above.

When deciding on hormone treatment, any woman will ask herself the question: "How will the use of these drugs affect her appearance?". The fact is that a comprehensive examination of patients with irregular menstrual cycles includes an insulin test.

If the patient has insulin resistance, there is a risk of getting better on the background of hormones. Fortunately, this question is quite solvable by a “detour”, because from taking the pill is not growing weight, and appetite. Given this factor, the patient is assigned, for example, hypocaloric diet. The woman herself notices an increase in appetite.

And if she is ready to take care of herself, she will be taught how to calculate her energy in order not to gain weight. Some also want to lose weight.

Sidelnikova V.M. Diseases of the female reproductive system. (Continued). Hyperandrogenism

This pathological condition is caused by changes in the secretion and metabolism of androgens. To one degree or another they caused 46-77% of menstrual disorders, 60-74% of cases of endocrine infertility and 21-32% of miscarriage.

Hyperandrogenism of adrenal genesis

This is the leading factor in miscarriage in 30% of women with hyperandrogenism.

The diagnosis, in addition to the visible manifestations of masculinization, is made on the basis of an elevated level of 17 a-hydroxyprogesterone and dehydroepiandrosterone.

In the diagnosis of this disorder, occurring in erased form, there is a need for functional tests. If the level of 17 a-hydroxyprogesterone is above 500 ng / dl, no further testing is performed, since the diagnosis is clear. If it is below 500 ng / dl, but above 200 ng / dl, conduct a test with ACTH (0.25 ml of ACTH is administered IV). If after that the level of 17 a-hydroxyprogesterone is more than 1000 ng / dl, the non-classical form of hyperandrogenism of the adrenal genesis is confirmed.

Preparation for pregnancy of patients with adrenal hyperandrogenism

Woman gets dexamethasone from 0.125 mg to 0.5 mg per day under the control of 17-ketosteroids (17-KS) in the urine or 17-hydroxyprogesterone (17-OP) and dehydroepiandrosterone sulfate (DEA-C) in the blood. In most patients after the start of dexamethasone, the menstrual cycle is normalized, ovulation and pregnancy occurs.

Simultaneously with dexamethasone, metabolic therapy complexes are prescribed or vitaminsincluding folic acid.

If the pregnancy does not occur within 2-3 cycles, you can stimulate ovulation clomiphene on 50 mg per day from the 5th to the 9th day of the cycle while receiving dexamethasone or to prescribe a drug containing ethinyl estradiol + cyproterone (Diane-35), and from the 1st day of the cycle, when pregnancy is planned, -dexamethasone.

According to the study, in 55% of patients with adrenal hyperandrogenism, pregnancy occurred only during treatment with dexamethasone. The duration of rehabilitation therapy is on average from 2 to 4 cycles.

Tactics of pregnancy

Given the congenital defect of pathology, treatment should be carried out throughout pregnancy. If you stop taking dexamethasone, it may not be interrupted - the fetus will take over the body's supply of glucocorticoids. But in this case, the probability of intrauterine hyperfunction of the adrenal cortex of the fetus will appear, and at the time of stress (birth process) the child may die.

If, under the influence of treatment with this drug, the level of 17-KS in the urine decreases more than the permissible lower norm, the dose of dexamethasone can be reduced to 1/4 tablet every other day, but it is not advisable to stop taking it.

Particular attention should be paid to pregnancy 13, 24 and 28 weeks. At this time, the endocrine organs of the fetus can actively produce androgens.

If their level in the pregnant woman's body is increased, the dose of dexamethasone should be increased very carefully. On the 3-4th day after birth, it is gradually reduced and therapy is stopped on the 7-8th day after birth.

With adrenogenital syndrome (AGS) with a normal level of 17-KS or 17-OP, but with increased DEA-C, dexamethasone therapy can be performed only up to 16 weeks of gestation (counting from ovulation). At this point, the placenta is completing its development, and already steroidogenesis provides a sufficient amount of estrogen, therefore, the participation of the adrenal glands in their products is not so significant.

It is not necessary to prescribe progesterone drugs, since such patients usually have hyperprogesteronemia. It is necessary to monitor the cervix, because 2/3 of pregnant women with AHS, including when it is worn out, there is ICN.

In the process of pregnancy from the first trimester, monitoring of the state of the fetus and prevention of placental insufficiency are obligatory. In the development of tactics of labor should pay attention to the structural features of the pelvis. In patients with hyperandrogenism, his output is usually narrowed, which may complicate the course of labor. In the case of an extremely burdened history, pelvic presentation of the fetus and the anatomical features of the pelvis, it is advisable to give birth by cesarean section.

After the baby is born, it is necessary to inform the neonatalog about the doses and duration of dexamethasone intake by the mother, since the infant may develop a withdrawal syndrome of glucocorticoids. Considering that patients with AHS can pass the gene of AHS to a fetus, prenatal diagnosis is required, which should be carried out simultaneously with the diagnosis of a Down's fetus.

At 17-18 weeks gestation, it is necessary to determine the level of α -fetoprotein (a FP), CG, estradiol (E2) and 17-OP in the blood of a woman. At elevated levels of 17-OD, amniocentesis is indicated to establish the level of 17-OP in the amniotic fluid. If it is high, AHS is diagnosed in the fetus.

According to modern tests, it is possible to make a diagnosis, but it is very difficult to determine the severity of AHS, which varies from a non-classical mild form to a heavy, losing condition.

The question of whether to continue the pregnancy or interrupt it in connection with the AHS of the fetus, the parents decide.

Ovarian hyperandrogenism

Polycystic ovary syndrome (PCOS) was detected in only 12.1% of women who complain about miscarriage due to interruption of a history of pregnancy.

Characteristic features of this form of hyperandrogenism are infertility, irregular menstruation up to amenorrhea, hirsutism. The main source of androgen overproduction in such patients is the ovaries. The dysregulation of cytochrome p450 with the 17-androgen-forming enzyme in the ovaries and adrenal glands is apparently the central pathogenetic mechanism of PCOS development. The reasons for its formation are not clear. About half of women with ovarian hyperandrogenism are obese.

They often have hyperinsulinemia and insulin resistance, which is most likely due to obesity, rather than hyperandrogenism. Insulin alters steroidogenesis, regardless of the secretion of gonadotropins. Insulin and insulin-like growth factor I are present in ovarian stromal cells, and a specific defect (decrease in autophosphorylation) in binding insulin receptors is observed in 50% of patients with PCOS.

Such patients often develop diabetes, so during pregnancy, glucose tolerance monitoring is necessary. Normalization of carbohydrate metabolism is achieved by reducing body weight, and the level of androgens also decreases.

Diagnosis of PCOS is based on clinical, hormonal screening, and ultrasound results. In patients suffering from this pathology, the manifestations of androgenization are more pronounced: the hirsute number is 15.2 ± 0.6, the body mass index (BMI) is increased - 26.3 ± 0.8. All patients have oligomenorrhea, anovulation, a significant reduction in generative function: in the history of primary infertility, and after a terminated pregnancy - 64.7% secondary.

The results of hormonal examinations reveal a high concentration of luteinizing hormone (LH), testosterone (T), and an increase in the level of follicle stimulating hormone (FSH). Ultrasound reveals in 78.6% of women an increase in the volume of the ovaries, hyperplasia of the stroma, more than 10 atretic follicles of 5 to 10 mm in size, located along the periphery under the thickened capsule.

Preparation for pregnancy

To clarify the genesis of hyperandrogenism, a combined functional test with dexamethasone and hCG is carried out, based on direct stimulation of the hCG of ovarian-producing ovaries, while simultaneously dexamethasone acting on the pituitary-adrenal system.

Dexamethasone appoint 0.5 mg 4 times a day for three days from the 6th day of the menstrual cycle. Then in the next 3 days simultaneously with the reception of the same dose of the drug injected in / m HCG -1500-3000 ME per day. The content of androgens is determined on the 5th day of the cycle, on the 8th after the use of dexamethasone and on the 11th day after administration of hCG. In the ovarian form of hyperandrogenism, the level of androgens increases.

Preparing for pregnancy in patients with polycystic ovary syndrome before hormonal therapy should begin with weight loss for those who have it, with diet and exercise, which leads to a decrease in the level of androgens, insulin and LH, and also improves the lipid profile of the blood.

During this stage of treatment, the patient is recommended to use oral contraception with antiandrogenic effects - ethinyl estradiol + ziproterone, and spirono-lactone 100 mg per day in the 1st phase of the cycle for 10 days to reduce the degree of hirsutism and testosterone levels.

Then in the 2nd phase of the cycle, gestagens begin to be applied. Due to the fact that didrogesterone and progesterone do not suppress a woman’s own ovulation, their use is preferable to other gestagens.

Didrogesterone appoint 10 mg 2 times a day from the 16th day of the 10-day cycle of the cycle for 2-3 consecutive cycles under the control of basal temperature graphs. Then apply dexamethasone at 0.5 mg per day until the level of 17-CU is normalized. The content of testosterone in the appointment of dexamethasone is not changed. The drug reduces the level of adrenal androgens, reducing their total effect.

In the next cycle, if there is no pregnancy, they stimulate ovulation. clomiphene 50 mg per day from the 5th to the 9th day of the cycle. If the pregnancy does not come again, in the next cycle the dose of clomiphene can be increased to 100 mg and repeat the stimulation for another 2 cycles. At the same time, derivatives of progesterone are reappointed in its second phase. If treatment with clomiphene is performed, folliculogenesis control is necessary:

  • with ultrasound - on the 13-15th day of the cycle, the dominant follicle is marked at least 18 mm, the thickness of the endometrium is at least 10 mm
  • according to the schedule of rectal temperature - a two-phase cycle and the 2nd phase of the cycle for at least 12-14 days
  • in the blood test - the level of progesterone in the middle of the 2nd phase is more than 15 ng / ml

If such parameters are found, hCG is not used to stimulate ovulation, since this often contributes to hyperstimulation. In addition, it is difficult to determine the exact time for its introduction: too early can cause premature luteinization of the immature follicle.

In the absence of the effect of stimulating ovulation for 3 cycles, it is better to refrain from further attempts and reappoint gestagens during the 2nd phase of the 2-3rd cycle, and then repeat it with stimulation with clomiphene.

If there is no effect again, it is necessary to use direct ovulation stimulants or refer the patient to surgical treatment.

According to the study, after combination therapy in women with ovarian genesis of hyperandrogenism, pregnancy occurred in 64.7%. The duration of rehabilitation therapy is 4-5 cycles.

Mixed form of hyperandrogenism

This group of patients is the most heterogeneous both in hormone content and in clinical parameters, and among women with hyperandrogenism, it is the most numerous (57.9%). Characteristic signs are an increase in the level of dehydroepiandrosterone (DEA) and moderate hyperprolactinemia, the lack of a significant increase in 17-OD and the excretion level of 17-C, a moderate increase in PH at normal FSH values, and in 1/3 of women its content is reduced.

The clinical picture in patients with a mixed form of hyperandrogenism includes symptoms characteristic of patients with adrenal and ovarian hyperandrogenism.

Samples with dexamethasone and hCG make it possible to determine a mixed source of excess androgen content: a tendency for an increase in the level of 17-CU, an increase in the content of testosterone and 17-OP after stimulation of CG with dexamethasone.

  • Hormonal research in the mixed form of hyperandrogenism allows to identify:
    • elevated DEA level
    • moderate hyperprolactinemia
    • no significant increase in 17-OP
    • an increase in the level of 17-COP in 51.3% of patients (they have hirsutism, an excess of body weight)
    • increased levels of LH and decreased levels of FSH
  • With ultrasound, 46.1% of women show a typical picture of polycystic ovaries, 69.2% have small cystic changes
  • The dexamethasone probe with hCG reveals a mixed source of hyperandrogenism, a tendency to an increase in 17-CU, a significant increase in testosterone and 17-OP after stimulation of CG in the background of suppression with dexamethasone.

In patients with a mixed form of hyperandrogenism in a history of stressful situations, head injuries, on the encephalograms changes in the bioelectrical brain activity are often detected.

These patients are characterized by insulin resistance, which often leads to the development of type 2 diabetes, lipid metabolism disorders, increased blood pressure.

Preparation for pregnancy

First of all, weight loss, normalization of lipid, carbohydrate metabolism through diet, fasting days, exercise are necessary. Various sedatives, acupuncture sessions are useful. At this time, it is advisable to use a combined drug containing ethinyl estradiol and cyproterone.

In the 2nd phase of the cycle is prescribed dexamethasone 0.5 mg per day, then you can stimulate ovulation clomiphene. At elevated levels of prolactin in the scheme should be included bromocriptine from the 10th to the 14th day of the cycle, 2.5 mg 2 times a day.

Such therapy is carried out for no more than 3 cycles, and if the pregnancy has not come, it is reasonable to recommend surgical treatment of polycystic ovaries.

During preparation of a woman for pregnancy, regardless of the form of hyperandrogenism, she is prescribed metabolic therapy complexes. This is necessary due to the fact that glucocorticoids, even in small doses, have an immunosuppressive effect, and the majority of patients with habitual miscarriage, regardless of its genesis, are carriers of a wide variety of viruses.

For the prevention of exacerbation of viral infection in patients receiving dexamethasone, it is advisable to use metabolic therapy complexes, which, by removing tissue hypoxia, interfere with viral replication.

Tactics of pregnancy management in patients with ovarian and mixed hyperandrogenism

After the onset of pregnancy, careful monitoring of the patient is necessary, since the threat of termination of pregnancy occurs in 36% of these patients. Determining the level and dynamics of CG, DEA-C, 17-KS, estradiol (E2) and progesterone (P) is necessary for the selection of hormonal treatment.

Dexamethasone therapy is prescribed to reduce the combined effect of androgens on the embryo. Hyperandrogenism to a much greater extent impairs its development than the dose of glucocorticoids, which is recommended to use - no more than 0.5 mg dexamethasone in a day.

Given the history of NLF-14 stimulation of ovulation, it is advisable to appoint Duphaston (Didrogesteron) in normal doses. It is shown at relative hyperestrogenia, when the ratio of E2 and P> 1.5.

If it is normal, treatment with gestagens can be omitted. Hormone therapy they stop at 16 weeks of pregnancy, when the formation of the placenta is completed.

At low levels of chronic hepatitis, these drugs can be administered in maintenance doses. Their appointment should be carried out under the control of the level of 17-KS.

Patients with the ovarian form of hyperandrogenism stop dexamethasone treatment after 16 weeks, and with the mixed form continue almost until the end of pregnancy, but no later than 35-36 weeks. Often, in these periods, the second half of toxemia develops (this complication occurs in 34.2% of patients in these groups), because of which treatment with dexamethasone after 35-36 weeks is not indicated. Однако во всех случаях угрозы преждевременного прерывания беременности лечение глюкокортикоидами должно быть продолжено.

Во II триместре беременности важно следить за состоянием шейки матки, причем не только с помощью УЗИ, но и при влагалищном исследовании, поскольку у 30,8% женщин не исключена возможность ИЦН.

From the first weeks of pregnancy, prevention of placental insufficiency and activation of a viral-bacterial infection is necessary.

Dexamethasone is one of the most effective glucocorticosteroids.

Dexamethasone acts as a surgical scalpel - quickly and very effectively. But at the same time it is dangerous not less than a surgical operation, as it gives numerous side effects, which manifest themselves mainly during its long-term use. Under no circumstances should this drug be taken without a prescription.

The beneficial effect of dexamethasone

Human adrenal glands produce glucocorticosteroid hormones - GCS, which have a multilateral effect on all organs and systems of the body. Dexamethasone is a synthetic fluorine-containing analogue of GCS.

The main beneficial properties of dexamethasone, which are used to treat various diseases, are the ability to suppress allergic and inflammatory processes in the bud, instantly relieve tissue swelling, as well as pain and itching caused by inflammation and pain. Even dexamethasone "can" also instantly increase blood pressure (BP), which is very important for any type of shock when BP drops sharply.

The beneficial effects in the treatment of a number of diseases (for example, associated with allergies to the body’s own tissues) include suppression of immune processes. At the same time, this action of dexamethasone contributes to the development of bacterial, viral and fungal infections.

Dexamethasone actively inhibits proliferation - the ability of tissue cells to reproduce. Tumor tissue multiplies most actively, so dexamethasone is often used in the treatment of cancer patients.

Dexamethasone also inhibits the growth of connective tissue, which is, on the one hand, a beneficial effect, as it can reduce scars and adhesions. Spikes - how to get rid of them? . On the other hand, this property of dexamethasone can be harmful, as it prevents scarring of the heart muscle after myocardial infarction.

Unfortunately, in addition to the beneficial effects of dexamethasone (like all GCS) there are many side effects that are far from always beneficial to the body.

Dexamethasone has a significant effect on all types of metabolism. It stimulates the breakdown of proteins, which leads to impaired growth in children and reduced immunity.

From dexamethasone, proteins and their breakdown products form glucose Glucose: a source of energy that enters the blood in large quantities. At the same time, the pancreas produces the maximum amount of insulin. Principles of insulin action - science saves lives, but it is not enough for all glucose to be absorbed by the tissues. Therefore, steroid diabetes develops.

A large amount of energy material (glucose) stimulates the breakdown and the formation of fat, but the latter process prevails and the patient actively gains weight. At the same time, under the action of hormones, an improper distribution of fat occurs, which changes the shape of the patient's figure: fat accumulates in the upper part of the body.

A feature of dexamethasone is that, unlike other GCS, it has less effect on water-salt metabolism, that is, it retains very little sodium and water salts and removes potassium. However, with prolonged use of the drug may develop potassium deficiency in the body, which primarily affects myocardial contractility - contributes to the development of cardiovascular insufficiency, stagnation of blood in the veins and the formation of thrombosis. With a lack of potassium, the weakness of the entire muscular system also develops.

Calcium, unfortunately, under the influence of dexamethasone is very actively excreted, which contributes to the rapid formation of osteoporosis - thinning and fragility of bones, a tendency to fractures.

Prolonged intake of dexamethasone in large doses inhibits the activity of the main endocrine gland of the pituitary gland, resulting in a decrease in the release of its hormones. Reduced secretion of adrenocorticotropic hormone (ACTH), whose function is to stimulate the adrenal cortex, leads to suppression of secretion of its own (endogenous) GCS. And this in turn causes the development of Itsenko-Cushing syndrome: a moon-shaped face, fat deposition on the back, neck and shoulders, increased hair growth and dysfunction of the sex glands. In women, menstrual irregularity and infertility develop, and in men, impotence. Impotence - the female view of the problem.

Dexamethasone can also affect the central nervous system. Patients develop headaches, dizziness, mood disorders (high or low mood), and insomnia. In some cases, the development of psychosis and seizures.

Atrophy (thinning) of the skin, areas of increased or decreased skin pigmentation, punctate hemorrhages and purulent inflammatory processes may develop at the injection site of dexamethasone.

Dexamethasone is a very effective glucocorticoid drug that has many side effects that only a doctor can consider.

Dexamethasone and its effect on menses

Girls, tell me who faced the drug - dexamethasone! The doctor prescribed for a decrease in testosterone, there are no periods for 34 days now that this could be xs ... side effects. except for this circumstance, no.

Mobile app"Happy Mama"4,7 Communicating in the application is much more convenient!

Saw him for almost 2 years, the cycle did not get off even once, all day-to-day

And why did you drink?

Dexamethasone has nothing to do with it.

Thank you, girls, for being not indifferent. I want to lalechka, I already scare the whole row, like what a change in the body, I have a panic!

Has your health improved? how much time were treated?

And when I do not know when to stop drinking it, the doctor kept this secret secret, and I forgot to ask

How do you drink? and by how much?

Quarter every day at 2 pm, for 30 days.

I drank in quarter and half, and even 1.5 for the night, my progesterone went off scale 5 times, leveled off and I got pregnant, quit drinking already at the end of pregnancy, at 32 weeks

You know, I even leveled these hormones with the help of a boron uterus and a red brush)) although they told me that there was no point, but testosterone didn’t touch the weed at all ... honestly, I was afraid that the lack of m-result of dexamethasone ... you I was really pleased with my pregnancy))) in an amicable way, I think the test should be done, but I'm afraid. if not //, I do not know what I will do.

The effect of dexamethasone on critical days.

Did you stop drinking it on time M?

No, I have been drinking it for almost 4 months. (1/2 in the evening). G said that I even with B needed his reception. (in the first trimester).

I also accept dex. I also became poorer than they were.

By the way, during M. I do not stop taking.

I drink it throughout the cycle, and during M too.

And I still have it, does not seem to affect M. Pugh 3 months. every day at night

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Dexamethasone in gynecology with infertility has a wide spectrum of action. It is an anti-inflammatory, anti-allergic hormonal drug, which is used to treat infertility.

The effectiveness of the pills is proven, they are used by doctors to treat various serious diseases, often used in gynecology.

This tool has many side effects, so women often doubt its effectiveness, looking for analogues of Dexamethasone. To avoid worries, all medications, it is important to use after consulting a doctor.

Drug action

If a couple has sex life for a year, having sex at least once a week, without using contraception and other protective equipment, and conception does not occur, you should consult a doctor.

The problem of infertility is very common today. The causes of deviations may be different. More often it is observed with hormonal failure, irregular menstruation.

Dexamethasone, is an analogue of hormones that produces the adrenal cortex, the drug has such an effect on the body:

  • Normalizes the level of adrenal hormones.
  • Helps reduce male hormones.
  • Interfere with hyperandrogenism, which causes infertility.
  • Warns the threat of premature abortion, miscarriage.

Therefore, when a woman cannot conceive a child due to an increased level of male hormones, this tool will help to cope with the problem. To avoid side effects, before using the pills, you need to read the instructions, consult with a specialist. The course of treatment, the dosage and the duration of the appointment is prescribed only by the doctor, individually for each patient.

Often the daily dose of the drug is one-fourth pill, there are cases when a long-awaited pregnancy occurred within a month. After treatment, the patient normalizes hormones, other male signs disappear.

Tolerability and contraindications tablets

When a woman complies with all the recommendations of the doctors, serious side effects can be avoided. After the onset of pregnancy, you can not refuse therapy, it will prevent the threat of miscarriage. The doctor takes into account the risk associated with the use of Dexamethasone and its effectiveness. Therefore, with a minimum dose, the drug does not cause complications in the body, and does not affect the child in the womb.

Major side effects:

  • Increases emotional activity or causes inhibition, affects the functioning of the central nervous system.
  • Anxious, insomnia, increases intracranial pressure.
  • Violations in the cardiovascular system.
  • May cause nausea, vomiting, loss of appetite.
  • Immunity decreases.
  • Allergic reaction appears in some cases. Dexamethasone is antiallergic agent, but individual intolerance to the active substance can be observed.
  • Increases blood glucose levels.
  • Improper use of the drug can provoke atrophic processes of the skin.

If you take pills properly, the chance of side effects is very low. Many girls complain of weight gain, up to five kilograms. Therefore, during the period of treatment it is necessary to monitor nutrition.

In the treatment of infertility, it is important to know the contraindications of the remedy:

  1. Osteoporosis - increased bone fragility, often develops after prolonged use of the glucocorticosteroid drug.
  2. The presence of infectious diseases.
  3. Liver problems with renal failure.
  4. Hypersensitivity to the active substance that is part of Dexamethasone.

If the patient has the above problems, the remedy is prohibited. The doctor will recommend another treatment that does not harm the body. To select the correct dosage, laboratory tests are conducted. Such control depends on pathological abnormalities in the body.

Dexamethasone and pregnancy

After conception, hormonal agents are prescribed if the result of treatment exceeds the risk of not having a favorable effect on the child. Therefore, Dexamethasone is recommended only in special cases when another treatment does not bring results.

In the first trimester, it is attributed to prevent the threat of miscarriage. After all, an increased level of male hormones interferes with the normal course of pregnancy.

Often, hormonal disorders in the body, cause a decrease in the immune system, which provokes premature labor. The body perceives the child in the womb as something foreign, the mother's body, trying to get rid of him. The drug is able to eliminate such a problem.

Therefore, this medicine is very effective both when planning conception and during pregnancy. The main thing is not to self-medicate on the advice of friends; all appointments are made by the doctor.

In order for the remedy to bring only benefit, not to cause serious complications, it is necessary to follow the recommendations of specialists:

  • At the time of use of the drug should be limited to the intake of fatty, fried foods, it is better to follow a diet. After all, the drug causes an increase in fatty acids, increases cholesterol, which contributes to weight gain.
  • For the period of treatment, additionally take potassium, calcium. These trace elements are removed from the body, so it is important to restore them.
  • Dexamethasone reduces the immune system, to avoid infectious diseases, it is necessary to use vitamins, immunomodulators.
  • Drink pills to correct problems with conception, you need regularly, at one fixed time. It is better to do this after breakfast, so as not to disrupt the work of the gastrointestinal tract.

If you follow these tips, do not ignore the recommendations of experts, the drug will bring efficacy and the long-awaited pregnancy will come. Eliminating the cause of infertility, we can hope for a positive result, the main thing is not to self-medicate. This will protect the woman and her child from serious consequences. The effectiveness of the pills has been proven by many patients.