Marvelon endometriosis


Marvelon contraceptive pills are based on the hormones desogestrel and ethinyl estradiol.

The combined effect of these two active components cope with the inhibition of the ovulatory process and the increase in the amount of mucus produced by the cervix, as well as the thickening of its consistency.

Contraceptive mechanism

Desogestrel is responsible for reducing the release of pituitary lutein and follicle-stimulating hormone. Due to this, the process of maturation of the follicles and ovulation itself become impossible.

The action of ethinyl estradiol is also aimed at providing contraceptive effects.

Composition and release form

The drug Marvelon is produced in tablets. They go on sale on 21, 63 or 126 pieces in packing.

The main active ingredients are desogestrel at a concentration of 0.15 mg and ethinyl estradiol in an amount of 0.03 mg.

In the role of additional components for the production of birth control pills are used:

  1. Potato starch,
  2. Povidone,
  3. Stearic acid,
  4. Colloidal anhydrous silica,
  5. Alpha tocopherol,
  6. Lactose monohydrate.

Indications for use

The main purpose of Marvelon contraceptive pills is to prevent unwanted pregnancy.

In addition, the drug is also used:

  • With diagnosed endometriosis,
  • For the regulation of menstrual bleeding, if they are too frequent or rare,
  • As a prevention of cystic-type lesions, as well as for treatment in ovarian cyst,
  • For the prevention of the appearance of fibrocystic, inflammatory, oncological diseases of the genital organs,
  • To avoid pregnancy ectopic type.


Ovarian cyst

Ectopic pregnancy

Menstruation regulation

Prevention of genital ailments


Marvelon contraceptive pills are not recommended for use in the presence of:

  1. Thrombosis
  2. Angina pectoris,
  3. Ischemia
  4. Diabetes mellitus with a lesion of the vascular system,
  5. Risks for the development of arterial / venous thrombosis,
  6. Tumors of any location benign / malignant,
  7. Severe hepatic diseases,
  8. Vaginal bleeding of unknown nature
  9. Pregnancy
  10. Lactation,
  11. Migraine headaches,
  12. Triglyceridemia,
  13. Intolerance to the components of the tool.

Side effects

Marvelon contraceptive pills can cause the development of unpleasant adverse reactions of different locations.

Some women note that there is no menstruation during the 7-day break. This problem is worth contacting your gynecologist.

But one should not forget that while taking the drug Marvelon, the menstrual flow often becomes scarce, but still there must be. Their onset usually falls 2-4 days after the course, which is normal.

Drug interactions

The effectiveness of Marvelon contraceptive pills can decrease due to the simultaneous use of:

  • Rifampicin
  • Hydantoins,
  • Carbamazepine
  • Griseofulvina,
  • Isoniazid
  • Topiramata,
  • Primidone
  • Oxcarbazepine,
  • Felbamate,
  • Barbiturates
  • Penicillins,
  • Tetracyclines,
  • Neomycin,
  • Chloramphenicol,
  • Activated carbon and its analogues.

Photos of medicines:














Activated carbon

The drug inhibits the effects of:

  1. Oral coagulants,
  2. Theophylline,
  3. Glucocorticosteroids,
  4. Anxiolytics,
  5. Clofibrate
  6. Caffeine,
  7. Sugar-reducing agents.

special instructions

Women over 40 who take the drug Marvelon are at high risk of serious diseases of the vascular system. This also applies to smoking patients.

Women who are prone to the formation of age spots on the skin should avoid direct sunlight during Marvelon pill therapy.

Analogues substitutes

You can replace these birth control pills with other drugs. Some Marvelon analogues are cheaper, and some are more expensive.

  • Novinet is made in tablets based on desogestrel and ethinyl estradiol. Producer: Gideon Richter (Hungary).
  • Three-Merci is produced in the form of three-phase tablets based on desogestrel and ethinyl estradiol. Manufacturer: "Organon" (Netherlands).
  • Regulon is available on the basis of ethinyl estradiol and desogestrel in tablet form. Producer: Gideon Richter (Hungary).
  • Mersilon is made with desogestrel and ethinyl estradiols tablets. Manufacturer: "Organon" (Netherlands).


Three mercy



Reviews of gynecologists

Chibar Diana Gordeevna, gynecologist:

“I prescribe any hormonal contraceptives only after a thorough examination and weighing all the pros and cons. Regarding my opinion on the drug Marvelon, it is one of the highest quality, since it rarely causes side reactions and almost never, when properly administered, does not completely block menstruation. ”

Bobrova Vladislava Maksimovna, gynecologist:

“Marvelon contraceptive pills are less conducive to always gaining unwanted weight than other COCs. But, if they arise, the drug should be canceled, for whatever purpose it was used. ”

Registration number:

P № 014867 / 01-2003 from 01.04.2003

The composition of the drug
Active ingredients
desogestrel 0.15 mg and ethinyl estradiol 0.03 mg
Auxiliary ingredients: potato starch, povidone, stearic acid, silicon colloidal oxide, anhydrous, α-tocopherol, lactose monohydrate.

White, round, biconvex tablets labeled "TR 5" on one side and the inscription "ORGANON" on the opposite.

Pharmacological properties
Pharmacotherapeutic group
contraceptive (estrogen + progestogen), Code ATX G03AA09
Marvelon is a combined oral contraceptive. Each tablet contains a small amount of two different female hormones - desogestrel (progestogen) and ethinyl estradiol (estrogen). Due to small amounts of hormones, Marvelone is referred to as low-dose oral contraceptives. Since all the pills in a pack contain the same amount of the same hormones, Marvelon refers to monophasic combined oral contraceptives.
The drug also has an additional non-contraceptive pharmacological effect:

  • while taking the drug, menstruation becomes less plentiful and painful,
  • women taking birth control pills are less likely to have anemia, certain diseases of the uterus, ovaries, mammary glands,
  • It has a beneficial effect on the skin, especially improving its condition in acne vulgaris.
    After discontinuation of the drug, the ability to conceive is quickly restored.

    Indications for use
    Contraception (pregnancy prevention).

    Do not take Marvelon if you have at least one of those diseases or conditions that are listed below. This should be reported to the doctor before making a decision about taking the drug Marvelon:

  • Thrombosis (venous or arterial) at present or in history (including deep vein thrombosis, pulmonary embolism, myocardial infarction, stroke),
  • the presence currently or in the history of possible clinical manifestations of thrombosis (including ischemic disease or angina),
  • diabetes with vascular disease,
  • the presence of severe or multiple risk factors for venous or arterial thrombosis (see “Side Effects”),
  • the presence at present or in the history of severe liver disease (if the indicators of liver function have not returned to normal),
  • the presence or history of liver tumors (benign and malignant),
  • an established or suspected hormone-dependent malignant tumor of the genitals or mammary glands,
  • vaginal bleeding of unknown etiology,
  • established or suspected pregnancy, lactation,
  • hypersensitivity to any of the components of the drug,
  • migraine with focal neurological symptoms,
  • hypertriglyceridemia.
    If the drug is used against the background of one of the following conditions, you may need to be monitored regularly by a doctor. Before you start taking the drug, be sure to tell your doctor about the following conditions / diseases:
  • Do you smoke,
  • You suffer from migraine
  • You have epilepsy,
  • you have diabetes,
  • you are overweight
  • you have high blood pressure,
  • you have a heart valve disease or heart rhythm disorder,
  • you have inflammation of the veins (superficial thrombophlebitis),
  • you have varicose veins,
  • The next of kin had a thrombosis, myocardial infarction or stroke,
  • you or your next-of-kin have high or high cholesterol or triglycerides in the blood,
  • one of the closest relatives had breast cancer,
  • you have liver or gall bladder disease,
  • you have Crohn's disease or ulcerative colitis (chronic inflammatory bowel disease),
  • you have systemic lupus erythematosus,
  • you have hemolytic uremic syndrome (a bleeding disorder that causes renal failure),
  • you have sickle cell anemia,
  • you have or had chloasma (yellow-brown patches of skin pigmentation, mainly on the face). In this case, avoid prolonged exposure to sunlight or ultraviolet radiation.

    Dosage and administration
    The package contains 21 tablets. Each tablet indicates on which day of the week it should be taken.
    Tablets are taken orally, every day, at about the same time, washed down with a small amount of water.
    Follow the direction indicated by the arrows until all tablets are taken. Do not take pills for the next 7 days. During this period, menstruation should begin (bleeding after discontinuation of the drug). Typically, menstruation begins 2-3 days after taking the last pill. On the 8th day, even if your period continues, start taking the pills from the next pack.

    How to start taking the drug Marvelon

  • If you have not used oral contraceptives during the last month: start taking Marvelon on the first day of the menstrual cycle (on the first day of your period). Take a pill that indicates this day of the week, then continue to take one pill per day in order. You can also start taking Marvelon for 2-5 days after the start of the menstrual cycle, but in this case, you must use additional non-hormonal methods of contraception during the first 7 days of taking the pills in the first cycle.
  • When switching from other combination pills: You can start taking Marvelon the next day after taking the last tablet of the drug you are using, without any interruption. If the contraceptive package also contains inactive pills (without hormones), you can start taking Marvelon the next day after taking the last pill with hormones. You can start taking Marvelon tablets and later, but no later than the next day after a break in taking the pills (or the next day after taking the last inactive tablet).
  • When switching from progestogen-only pills (mini-pills): You can stop taking mini-pills on any given day and start taking Marvelon the next day at the same time. However, during the first seven days of taking Marvelon tablets, additional contraceptive methods should be used.
  • When switching from an injection or implant: start using Marvelon on the day when there should be the next injection or on the day the implant is removed. During the first seven days of taking Marvelon tablets, you must use additional methods of contraception.
  • After childbirth: it is recommended to wait for the onset of the first normal menstruation, before starting to take Marvelon. If you are breastfeeding, you should consult a doctor.
  • After miscarriage or abortion: follow the doctor's recommendations.

    If you want to stop taking Marvelon
    You can do this anytime you want. If you stop taking the drug because you want to get pregnant, then before you try to conceive a child, it is usually recommended to wait until the first natural menstruation occurs. This will allow you to predict the date of birth of the child.

    What to do if you miss the next drug intake
    If you are late with taking the next pill in less than 12 hours, the effectiveness of the drug is preserved.
    Take the missed pill as soon as you remember, and take the next pill at the usual time.
    If you are late with taking a regular pill for more than 12 hours, then the effectiveness of the drug may be reduced. The more pills you missed, the higher the risk of reducing contraceptive efficacy.
    Especially high risk of pregnancy if you miss the pills at the beginning or at the end of the pack.
    Therefore, you must follow the rules below.
    More than one missed pill in a pack - consult a doctor.
    1 missed tablet in 1st week
    Take the missed pills as soon as you remember (even if you have to take two pills at the same time) and take the following pills at the usual time. Use additional contraceptive methods for the next seven days. If you had sexual intercourse during the week before skipping the pill, then pregnancy may occur. Notify your doctor immediately.
    1 missed tablet in the 2nd week
    Take the missed pills as soon as you remember (even if you have to take two pills at the same time) and take the following pills at the usual time.
    The effectiveness of the drug is maintained, so additional methods of contraception are not required.
    1 missed tablet in 3rd week
    You can choose one of the following schemes, without resorting to additional contraceptive measures.
    1. Take the missed pills as soon as you remember (even if you have to take two pills at the same time) and take the following pills at the usual time. Start the next package as soon as the current one ends, without taking a break in taking the drug. Bleeding with the cancellation may not be until the end of the second pack of the drug, but there may be spotting or unexpectedly abundant bleeding on the days of taking the pills.
    2. Stop taking the pills from the currently used package, take a break of 7 days or less (given the day you missed the pill) and start taking the pills from the next pack. In this case, you can always start taking pills from the next pack on the same day of the week, as usual.

    Recommendations in case of vomiting or diarrhea
    If vomiting or diarrhea occurs within 3-4 hours after taking the drug, absorption may be incomplete. In this case, you should use the recommendations regarding the admission of the next drug intake.

    If you want to delay the onset of menstruation
    You can delay your period if you start taking the pills from the next pack as soon as the previous one has finished (without a break).
    You can take the pills from the next pack until they run out. If you want your period to start, stop taking the pills. When you take pills from the second pack, you may experience unexpectedly heavy bleeding or spotting. Taking the pills from the next pack should begin after a 7-day break.

    If you want to change the day you start your period
    When using the drug in accordance with the recommendations, menstruation begins on the same day every 4 weeks. If you want to change the day you start menstruating, take a shorter next break in the pill.
    For example, if menstruation usually begins on Friday, and you want it to start on Tuesday (three days earlier), you should start taking pills from the next pack 3 days earlier than usual.
    If you take a too short break in taking the pill (for example, 3 days or less), then you may not have any bleeding during the break. While taking the pills from the next pack, there may be spotting or unusually heavy bleeding.

    If you have unexpected bleeding
    As with other oral contraceptives, irregular vaginal bleeding (spotting or sudden vaginal bleeding) between menses may occur during the first few months. The drug in this case should be continued as usual.
    The appearance of intermenstrual bleeding during the first three months of administration does not mean that the contraceptive effect is reduced or that the drug does not suit you.
    Irregular vaginal bleeding usually stops after your body adapts to the drug (usually after three cycles of pills). If bleeding continues, become abundant, consult a doctor.

    If you have no menstruation
    If you took all the pills in a timely manner, you did not have vomiting or diarrhea, you did not take other medicines, then it is unlikely that you are pregnant. Keep taking marvelon as usual.
    If you did not have menstruation twice in a row, you may be pregnant. Do not start a new package until the doctor excludes pregnancy.

    Side effect
    The following adverse reactions have been reported in persons taking Marvelon. They may occur in the first few months of use of the drug and usually decrease with time.
    Headache, gastralgia, nausea, vomiting, soreness and engorgement of the mammary glands, weight gain, impaired glucose tolerance, fluid retention in the body, changes in libido, decreased mood, eyelid edema, skin rash, nodular erythema, conjunctivitis, unpleasant sensations when worn contact lenses, thrombophlebitis, thromboembolism (may manifest as impaired perception: impaired vision, hearing loss), generalized itching, cholestatic jaundice, cholelithiasis, increased blood pressure, intermenstrual bleeding, change put seeking secretion may develop candida vagina.
    With prolonged use (extremely rare) - chloasma, hepatocellular adenoma.

    The serious effects of taking a large number of Marvelon tablets have not been reported. If you take several pills at once, you may experience nausea, vomiting, and vaginal bleeding. If you find that a child has swallowed a pill, consult a doctor.

    Interaction with other drugs and other forms of interactions
    Interaction with certain medications can lead to heavy bleeding and ineffectiveness of oral contraceptives. Such cases were observed when taking hydantoins, barbiturates, primidone, carbamazepine, rifampicin, isoniazid, they are possible with the appointment of oxcarbamazepine, topiramate, felbamate and griseofulvin. A decrease in the effectiveness of oral contraceptives was also observed when taking certain antibiotics, such as ampicillin, tetracycline, neomycin, penicillins, chloramphenicol, as well as activated carbon, laxatives.
    Marvelone reduces the effectiveness of oral anticoagulants, anxiolytics (diazepam), tricyclic antidepressants, theophylline, caffeine, hypoglycemic drugs, clofibrate, glucocorticosteroids.
    Always tell the doctor who prescribes birth control pills which medicines you already use. If a doctor prescribes other medications for you, let him know that you are taking Marvelon.

    When should you see a doctor?

    For regular inspection
    If you are taking birth control pills, you need to undergo regular annual checkups.

    Contact your doctor immediately if:

  • Have you noticed any changes in health status (see “Contraindications”, “Side Effects”),
  • you have a breast lump
  • going to take other medicines
  • You are forced to comply with bed rest (during illness, after injury) or you will have surgery,
  • you have very intense or prolonged vaginal bleeding,
  • You missed a pill in the first week, and you had sexual intercourse seven days before,
  • You suspect you're pregnant.

    Stop taking the drug and consult a doctor immediately if you notice possible signs of thrombosis:

  • unusual cough
  • severe pain behind the sternum, which can give to the left hand,
  • shortness of breath
  • unusual, severe pain or prolonged headache or a migraine attack,
  • partial or complete loss of vision or double vision,
  • speech impairment or loss of speech
  • sudden change in hearing, smell, or taste,
  • dizziness or fainting,
  • weakness or loss of sensation in any part of the body,
  • severe abdominal pain
  • severe pain or swelling of the leg.

    Influence on ability to steer the car and other mechanisms
    The effect of the drug Marvelon on the ability to drive, and work with mechanisms is not marked.

    Release form
    On 21 tablets in the blister from PVC / Al placed in a bag from aluminum foil. Bags of aluminum foil on the 1st, 3 or 6 together with the instructions for use are placed in a cardboard box.

    Storage conditions
    At a temperature of 2-30 ° C. Protect from light and moisture. Keep out of the reach of children. List B.

    Shelf life
    3 years. Do not use after the expiration date printed on the package.

    Pharmacy sales terms
    By prescription.

    N.V. Organon (Netherlands) 5349 AB Oss, Kloosterstraat 6 (Kloosterstraat 6, 5349 AB Oss)

    Representative office in Russia
    125445, Moscow, st. Smolnaya, 24 D. "Meridian", Organon Agencies B.V.

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    Analogs and combined with INN (active ingredient) *

    ethinyl estradiol
    Analogs on the farm. group *

    Combined oral contraceptives
    * Analogs are not equivalent to each other.

    Pharmacological properties

    Marvelon incorporates two main components - desogestrel and ethinyl estradiol, the overall effect of which prevents unwanted pregnancy. It refers to hormonal contraceptives.

    Additionally, Marvelon tablets have the following positive effects on the female body:

    • inhibit the development of cancer cells in the reproductive system,
    • many times reduce the possibility of progression of various inflammatory processes in the pelvic organs,
    • act as a prophylactic agent for cystic forms of tumors, as well as ectopic pregnancy,
    • with regular contraceptive use, the likelihood of fibrocystic ailments is less than 10%,
    • due to the large amount of iron in the composition, the drug does not allow the development of anemia,
    • menstrual bleeding will not be so abundant
    • regularity and discharge during menstruation will return to normal, and lower abdominal pain will disappear.

    Dosing and Administration

    The drug Marvelone is administered only orally, and, preferably, at the same time of day (+/- half an hour). One full period of use of tablets lasts 21 days, then a break for one week. If you take a break in reception, you should refrain from using any drugs with a similar effect, since it is during this period that menstruation must pass.

    If bleeding in the pass does not occur, it may indicate a pregnancy. Before a new course, you need to make sure that it is not available, and only then continue to take pills.

    How to take Marvelon for the first time? If a girl is just starting treatment with this contraceptive, she should drink the 1st pill on the first day of her period.

    It happens that women forget to take a pill at the appointed time. Nothing catastrophic about it. If the difference is no more than 12 hours, the safety of contraception from the previous dose is still "held" by the body. In the case of a pass, you must take a pill as soon as it is remembered. The next time you can drink medicine at regular times.

    More detailed recommendations on the use and dosage of Marvelon are contained in the instructions for use.


    Marvelon is a low toxic drug, no overdose has been observed. But if a girl has taken a dose of medication for treatment that exceeds the therapeutic norm several times, unpleasant symptoms can still occur. These include dizziness, nausea and vomiting. Young girls can observe bloody discharge, similar to menstruation, only much less.

    If such symptoms are present, measures must be taken to suppress them. This contraceptive can also affect the mood of women.

    Instructions for use of the drug Marvelon

    Marvelon is a combination hormone. drug. which contains in its composition ethinyl estradiol in the amount of 30 mg and desogestrel in the amount of 150 mg. Due to the fact that the drug contains not only estrogen, but also a gestagen, Marvelone can be used both as a contraceptive and for the regulation of the menstrual cycle.

    In turn, desogestrel reduces the production of lutein-stimulating and folic-stimulating hormones. Thereby follicle maturation and ovulation are blocked not happening.

    Exploring pharmacokinetics of marvelon. we can say that with a single dose of the drug reaches its maximum concentration in the blood after 1.5 hours, and its bioavailability varies from 62 to 81%.

    With coursework concentration etonogestrel increases in blood threefold and remains at a constant level throughout the course.

    In general, the combined composition of the drug beneficial effect on blood lipid composition by improving HDL and LDL. Due to this, the overall condition of the skin is improved, the menstrual cycle is normalized. The drug helps to prevent the development of a number of gynecological pathologies, including tumoral nature.

    How to take marvelon for endometriosis

    ApplicationMarvelon for the treatment of endometriosis nothing is significantly different from taking it as a hormonal contraceptive.

    If hormonal preparations were not prescribed before taking Marvelon, they begin taking on the first day of the menstrual cycle. The drug is taken at the same time. to keep the drug concentration at the required level.

    If there was a violation of the reception, the drug must be taken on an emergency basis.

    If the delay wasless than 12 hours skipping the dose will not affect the hormonal and contraceptive activity of the drug. If more - you need to use additional methods of contraception.

    In addition, it should be noted that any intake of oral contraceptives is associated with a risk, therefore, before the start of the intake it is necessary to undergo a comprehensive medical examination in order to exclude the presence of pathologies that can be promoted by hormones.

    Reviews of doctors and patients about the drug Marvelon

    Opinion of doctors about Marvelone in case of endometriosis is very clear. The drug has excellent ability to inhibit the growth of endometrial tissue. and relieve inflammation. In addition, it is often prescribed for polycystic ovaries. This suggests that Marvelon is definitely one of the most effective means in the treatment of gynecological diseases.

    As for patients, in 80% of cases with course treatment with Marvelon, treatment endometriosis was successful. However, most women report frequent headaches and nagging pains in the lower abdomen.

    Despite the fact that Marvelon has established itself from a positive point, before taking it consultation of the gynecologist is necessary .

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    How to cure endometriosis?

    Can endometriosis be completely cured?

    Yes, and even more so, about a third of women who do not receive any treatment have endometriosis on their own. This is due to the work of the immune system, which can recognize the “unwanted” endometrium and destroy it.

    How is endometriosis treated?

    Based on the foregoing, endometriosis is not always necessary to treat. There are three types of management of endometriosis in the world gynecology:

    Observation without treatment: this tactic is not for everyone, and only if endometriosis was discovered by chance (for example, during an ultrasound scan or an operation for another reason), the foci of endometriosis are small and do not cause any inconvenience.

    Drug treatment: the most common treatment strategy. We will talk about it in more detail below.

    Surgical treatment (surgery): usually prescribed, if the drug treatment did not help or endometriosis led to serious disruption of the internal organs. Also, surgery may be required if infertility has developed as a result of endometriosis. More information on how to get pregnant with endometriosis "

    What drugs are used in the treatment of endometriosis?

    The main drugs for endometriosis, which are prescribed by gynecologists, are hormones and affect the level of the body's own hormones. We will talk about 4 groups of drugs that are used in the treatment of endometriosis most often:

    Contraceptive pills (oral contraceptives, OK): Janine, Yarin

    Medicines containing progesterone and its analogues: Utrozhestan, Duphaston

    Analogs of gonadotropins: Buserelin, Zoladex

    Each of these groups of drugs affects the body differently.

    Contraceptive pills (Janine, Yarin) and endometriosis

    Your gynecologist may prescribe birth control pills (OC) for the treatment of endometriosis: Janine, Yarina. Marvelon, Regulon and others. These drugs contain different doses of hormones, so be sure to consult with the gynecologist before taking the medicine.

    Contraceptive pills help reduce pain in endometriosis shortly before and during menstruation. For successful treatment of endometriosis, it is necessary to take OK for at least 6 months. If the effect is noticeable (the pain disappears), then your gynecologist may advise you to take OK for another 3-6 months. As a result of this treatment, areas of endometriosis can noticeably decrease in size.

    Utrotestan, Duphaston and Endometriosis

    Preparations containing progesterone (female hormone) or its analogues, such as Utrotestan, Duphaston, Depo-Provera and some others give a good effect in the treatment of endometriosis. These drugs reduce the production of estrogen in the body, which inhibits the growth of endometrium (both in the uterus and in the foci of endometriosis). It is better to prepare in advance for long-term treatment, since the course of taking these drugs can be delayed for 6-9 months.

    Danazol and endometriosis

    Danazol is a synthetic hormone that at the time of administration suppresses the production of female sex hormones, helping to reduce the foci of endometriosis. For the emergence of therapeutic effect Danazola you must take it at least 3-6 months.

    This drug has previously been widely used in the treatment of endometriosis, but in some countries, doctors are starting to abandon Danazol for several reasons. First of all, it is side effects Danazol, which include high blood pressure, irregular menstruation, weight gain, swelling and chest pain, excessive hair growth on the face and body, acne, hair loss and others. Secondly, in the arsenal of gynecologists, new drugs have appeared that are also effective as Danazol, but at the same time are devoid of its side effects.

    Buserelin, Goserelin (Zoladex) and endometriosis

    Analogues of gonadotropin-releasing hormones, which include Buserelin, Goserelin (Zoladex), Sinarel and others, suppress ovarian function and reduce the level of female sex hormones in the blood. At the time of treatment, you will not have menstrual periods, and you may also experience menopause symptoms (feeling hot flashes, mood swings), but this can be corrected by taking small doses of hormones.

    The course of treatment of endometriosis with these drugs is not more than 6 months. After the end of the medication, the ovaries again begin their work, so you should not worry that they will never “start” again.

    Material from gynecologist consultation

    Composition and release form.

    1 tablet contains desogestrel 0.15 mg and ethinyl estradiol 0.03 mg, in a box of 1, 3 or 100 blisters of 21 pcs.

    Suppresses the function of the pituitary gland, inhibits ovulation.

    It causes regular cyclic menstrual bleeding, resembling normal menstruation in terms of volume and duration, and, as a rule, starting 2-3 days after stopping, has a low androgenic activity.

    Thrombophlebitis, thromboembolic processes (including history), hypertension (severe), liver disease (including history), if not normalized functional parameters, jaundice (cholestatic, during pregnancy, caused by the use of steroids ), Rotor's and Dubin-Johnson syndromes, estrogen-dependent tumor (including suspicion), endometrial hyperplasia, vaginal bleeding of unknown etiology, porphyria, hyperlipoproteinemia, severe itching or herpes caused during pregnancy or steroid treatment s pregnancy.

    Headache, migraine, frequent mood changes, the appearance of unpleasant sensations in the cornea when wearing contact lenses, thrombosis, increased blood pressure, nausea, vomiting, cholelithiasis, cholestatic jaundice, engorgement, soreness, breast enlargement (milk may appear), intermenstrual bloody discharge, amenorrhea (after withdrawal), changes in cervical secretion, an increase in the size of uterine fibroids, exacerbation of manifestations of endometriosis, vaginal microbial diseases (including candidiasis), fluid retention, reduction of tolerability glucose, change in body weight, chloasma, erythema nodosum, rash.

    Dosage and administration.

    Inside Daily 1 tab. at the same time for 21 days, then a break for 7 days.The first tablet from the first package is taken on the first day of the menstrual cycle. Taking the tablets from the subsequent packaging begins after a seven-day break. After childbirth - from the first day of independent menstruation, after an abortion or miscarriage - immediately.

    In the event of thromboembolic complications and abnormal liver function, the intake is stopped. With caution used in the postoperative period, while maintaining prolonged bed rest, with severe varicose veins. Patients over the age of 35 should stop smoking at the time of admission. Patients with heart failure, impaired renal function, hypertension, epilepsy, migraine (including a history), sickle cell anemia, and estrogen-dependent diseases (uterine myoma) should be under continuous medical supervision. A decrease in the contraceptive effect and the onset of pregnancy is possible with an irregular intake, diarrhea or vomiting during the first 4 hours after administration, the simultaneous use of anticonvulsants, barbiturates, tetracyclines, rifampicin, activated carbon, and laxatives. Women with a tendency to chloasma should avoid direct sunlight. With the development of depression, supplementation with vitamin B is recommended.6 .

    Patients with diabetes may decrease glucose tolerance and increase insulin requirements. It affects the quality and reduces the amount of breast milk.


    Endometriosis is the proliferation of the endometrium lining the inner surface of the uterus, outside of it. Endometriosis is the most mysterious and relevant disease in modern gynecology - the incidence of endometriosis is about 10% of all other gynecological diseases.

    The most famous and common causes of endometriosis are as follows:

    - menstruation. Overwhelmingly endometriosis occurs in women of reproductive age. The peak incidence occurs at the age of 30-50 years. It is believed that during menstruation, blood is thrown from the endometrial cells into the abdominal cavity. Subsequently, the endometrium is transported to the surrounding tissues and peritoneum,

    - hormonal disorders. It is noted that almost all patients with endometriosis there are changes in the ratio of steroid hormones: there is a high release of FSH (follicle-stimulating hormone) and LH (luteinizing hormone). At the same time, the level of progesterone decreases, prolactin increases and the androgenic function of the adrenal cortex is disturbed.

    - genetic predisposition - emit even family forms of endometriosis. There are cases of endometriosis in eight daughters born from the same mother. Identified specific genetic markers that determine the woman's disposition to the incidence of endometriosis,

    - impaired immunity - with a normal level of immunity, endometrial cells cannot survive outside the uterus. The protective functions of the body destroy endometrial cells outside the inner layer of the uterus and prevent them from implanting beyond its limits. And in women with endometriosis, a different picture is observed - due to impaired immune systems, the endometrial tissue calmly continues its growth outside the uterus or grows into the body of the uterus.

    - endometrial metaplasia - that is, the transformation of one tissue into another. There is a theory that the endometrium, falling outside the uterus, can turn into another tissue. However, the cause of metaplasia is still not clear and causes controversy among researchers.

    Prices MARVELON

    Birth control pillsMarvelon - oral (oral) contraceptive.

    Indications for use:

    Marvelon starting from the 1st day of the menstrual cycle for 21 days, 1 tablet per day at the same time. After this course, a 7-day break is necessary, during which bleeding of the menstruation type appears. The next 21-day course of taking the drug begins immediately after the 7-day break (even if there was no bleeding during the break), preferably on the same day of the week.

    The risk of cardiovascular complications increases with smoking (especially after 35 years). Before starting taking the drug, and regularly on the background of its use, gynecologist consultations are necessary. The drug is immediately stopped if the following symptoms appear: early signs of phlebitis (inflammation of the vein walls) , thrombosis (vascular occlusion with a blood clot), embolism (vascular impairment) - swollen veins, unusual leg pain, chest pain when breathing or coughing, chest tightness, for the first time ivshiesya migraine-like headaches, sudden hearing and visual impairment, motor narusheniya.Priem Marvelon stops 6 weeks before the planned surgery. The risk of thrombosis increases with high blood pressure. The drug is canceled with hepatitis, jaundice, itching, cholestasis (bile stasis in the bile ducts), an increase in epilepsy attacks, primary or secondary appearance of porphyria (a disease associated with violation of the exchange of porphyrins / pigments /). When used simultaneously with barbiturates, rifampicin, ampicillin, griseofulvin, butadiene, antiepileptic drugs, the effectiveness of the drug with It is possible to change glucose tolerance (glucose tolerance) when taking the drug against the background of antidiabetic therapy.

    Vomiting or diarrhea can lead to the removal of the drug taken from the body, therefore, in cases where these symptoms disappear within 1 day, the pill must be reapplied. If the symptoms persist for a longer time, other methods of preventing pregnancy should be temporarily used.

    Weight gain, swelling of the mammary glands.

    Liver dysfunction, cholecystitis (inflammation of the gallbladder), tendency to thrombosis (clotting of blood in the vessel), malignant tumors.

    Tablets of 0.1 g.

    List B. In the dark spot.

    Janine and Endometriosis

    It is not a secret for anyone that sooner or later almost every woman will have a desire to become a mother. After all, children are the most beautiful thing that can be in the life of every person. Well, she got married, thought about everything, discussed with her husband, emotionally tuned - we want a child. But what to do? - does not work. These situations occur quite often. There are also many reasons for this. One of them is endometriosis. Endometriosis is a fairly widespread gynecological disease that can be found in every third woman with primary and secondary infertility.

    What is endometriosis?

    This gynecological disease is characterized by the formation of nodes that are similar in structure to the internal mucosa of the uterus, and which are located both inside the uterus and beyond. Every month, in case of non-fertilization of the egg tissue of the uterus, which were prepared for the attachment of the fetus, are rejected. There are cases when, together with the blood flow, the endometrium enters the fallopian tubes and begins to grow. As a result, a disease such as endometriosis develops. In most cases, women of childbearing age, who are very often exposed to various kinds of stress, suffer from endometriosis.

    Also provoke the development of endometriosis can hormonal disorders, diseases of the thyroid gland. complicated childbirth or abortion. overweight, abuse of alcohol, caffeine or tobacco. Sometimes women have a genetic predisposition to the disease. If we talk about the symptoms of endometriosis, they may be the following: pain before menstruation, pain during stool and urination, pain during sexual acts, menstrual disorders, blood discharge between menstruation, as well as infertility.

    Immediately it is worth noting that getting rid of endometriosis is quite difficult. The fact is that until now specialists in gynecology cannot reach a consensus regarding the rational treatment of endometriosis and the preparation of a woman for pregnancy. To date, there are two main methods of treatment of this disease. This is a surgical and medical methods. The medical college of ( will talk with you about the medical treatment of endometriosis, and more specifically about the treatment of this gynecological disease with the help of Zhanin.

    Janin - hormonal drug, which has found its wide application in the fight against endometriosis. There is a dienogest in this medicine. This is the first progestogen that has a strong inhibitory effect on the proliferation of endometrial heterotopies. Scientific studies have proven that Janine causes almost complete regression of endometriosis foci. It should also be noted that this drug has a fairly high bioavailability. That is why its small doses are enough for effective treatment of this disease.

    Estradiol is also a part of Zhanin. which along with dienogest provides a complete menstrual cycle for a young woman. The effectiveness of each drug is judged by the results of research conducted with its use. Janine was also subjected to research. Well, now, studies have shown that the use of this drug significantly reduces the severity of endometrioid heterotopias. Plus, the use of this contraceptive hormone often does not lead to such side effects as: increased blood pressure. abnormalities in the functionality of the liver. changes in blood lipid spectrum and body weight.

    If a woman who suffers from endometriosis wants to become pregnant, she is prescribed to take Janine in continuous mode for more than sixty or eighty days.

    Before use, you should consult with a specialist.

    Author: Pashkov M.K.Content Coordinator.

    Drug treatment of endometriosis is the main place in the treatment of this pathological condition. However, in some cases, the operation can not do. The choice of a particular tactic is determined by the general condition of the patient, comorbidities, age, desire to preserve reproductive function, and many other factors discussed in this article.

    Hormone therapy

    Hormonal drugs that are prescribed for endometriosis are necessary for the normalization of the work of the hypothalamic-pituitary system, as well as for acting on the receptors located in the endometriotic foci. All this contributes to reducing the size of endometrioid heterotopias and reducing the severity of the pathological manifestations of endometriosis.

    The main hormonal drugs that are indicated for the treatment of endometriotic disease are as follows:

  • combined oral contraceptives are hormones that contain both an estrogen and gestagen component,
  • progestins - hormones that have in their composition only the gestagen component (Duphaston with endometriosis),
  • drugs with anti-progestogenic effects, such as Gestrinone,
  • antigonadotropic agents (Danazol),
  • Gonadoliberin agonists (Buserelin, Nafarelin),
  • drugs exhibiting anti-estrogenic activity (Tamoxifen, Leuprorelin),
  • androgens (methyltestosterone),
  • anabolic steroid.

    All these means are produced mainly in the form of tablets, injections for administration, nasal sprays, suppositories as a convenient dosage form among them are absent.

    Selection of the optimal hormonal drug

    The choice of a drug is determined by the following factors:

  • the age of the patient
  • the desire to preserve reproductive function (Duphaston in this case is a necessary drug),
  • location of endometrioid heterotopias,
  • severity of endometriosis,
  • drug tolerance,
  • the presence of concomitant diseases of the body, in the first place should be taken into account the pathology of the mammary glands (endometriosis is often combined with mastopathy),
  • clinical manifestations of the disease (uterine bleeding, pain),
  • dosing regimen of a hormonal drug (constant or cyclic),
  • possible contraindications to a particular drug,
  • the presence of infectious and inflammatory complications (in this case, antibiotics are prescribed).

    When conducting hormone therapy, it is necessary to conduct recommended studies with a frequency of once a quarter. This will help avoid the development of serious complications and damage to internal organs.

    Note that after the cancellation of the hormonal drug, the return of the clinical manifestations of endometriosis is gradually observed, despite the regress achieved. This determines the need for repeated courses of treatment, that is, endometriosis in the reproductive age is an incurable disease. After menopause, due to the loss of hormonal influences, there is a complete regression of pathological changes in endometriosis.

    Progestins in the treatment of endometriosis

    The treatment of endometriosis by Duphaston for a long time was the only way to restore the reproductive function of a woman. Therefore, this type of treatment is still very popular, demonstrating relatively high efficiency.

    Duphaston as an active ingredient contains Didrogesteron, which is derived from progestron. In this regard, the risk of side effects while taking this hormonal drug is minimized, especially with regard to virilization and virilization. The course of treatment Duphaston long. It usually ranges from six months to one and a half years. The daily dosage of the drug is 10-20 mg, that is, one or two tablets are prescribed.

    Clinical improvement is noted by almost all patients (90-96%). However, there is a huge variation in statistics regarding the occurrence of pregnancy if the patient is taking Duphaston. The minimum frequency is 5%, and the maximum - 90%. Also, to assess the effectiveness of therapy with Duphaston, it is necessary to take into account the frequency of relapses. In this case, it is equal to 9-40%. To increase the effectiveness of such therapy, it is imperative to include Wobenzym, rectal suppositories Indomethacin in the treatment program. Antibiotics in this situation are not shown.

    Thus, Duphaston is an effective drug that should be prescribed if the patient wants to have children, since endometriosis is accompanied by the development of multifactorial infertility.

    Adjuvant therapy

    The goal of adjunctive therapy is to enhance the positive therapeutic effects of hormone therapy. To achieve this goal, it is recommended to use the following methods:

  • physiotherapy,
  • balneological therapy
  • the appointment of pharmacological drugs that are not hormonal.

    Adjuvant drug therapy consists of using the following medications:

  • immunocorrective, which either increase the immune activity or decrease it depending on the initial status,
  • drugs that prevent oxidative stress in the body,
  • nonsteroidal anti-inflammatory drugs that reduce pain (mainly appointed candles)
  • absorbables (Wobenzym, which has a complex effect),
  • hemostatic agents that reduce bleeding,
  • desensitizing agents that reduce the severity of the body's allergic mood,
  • psychotropic drugs, if there are violations in the mental sphere,
  • antibiotics are shown only with concomitant infectious-inflammatory process.

    Let us consider in more detail each of these therapeutic areas. Immunocorrective treatment involves the prescription of Levamisole, Dekaris, Splenin, Timalin, Taktivin, etc. The stimulating physiotherapeutic effect on the thymus gland can increase the effectiveness of the flow of immune responses. With the concomitant infectious-inflammatory process, which changes the body's immune reactivity, antibiotics are used.

    Antioxidant direction in the complex program of endometriosis treatment involves the use of the following drugs:

  • vitamin E,
  • Unithiol,
  • Pycnogenol,
  • Vitamin C,
  • Wobenzym

    The use of sodium thiosulfate allows to achieve a complex effect on the foci of endometriosis. It consists in the following:

  • anti-inflammatory effect
  • reducing the body's allergic mood,
  • resorption of connective tissue and the prevention of its formation.

    Of the nonsteroidal anti-inflammatory drugs that are most effective in endometriosis, Indomethacin is generally accepted. You should give preference to such dosage form as rectal suppositories. This drug reduces the severity of the inflammatory response, normalizes the balance of prostaglandins, and also reduces pain. С целью уменьшения боли помимо Индометацина могут быть использованы и другие нестероидные свечи (Артрокол, Диклофенак), а также спазмолитические препараты, и целенаправленные анальгетики (Анальгин, Баралгин, Этимизол и другие).

    Very often, endometriosis is manifested by specific neurological and mental disorders that require a certain correction. It is carried out in conjunction with a specialist (neurologist, psychiatrist). Usually prescribe tranquilizers and sedatives.

    Place Wobenzym in adjuvant therapy for endometriotic disease

    Wobenzym is an enzyme preparation. Appointed as part of complex therapy for diseases such as endometriosis. Wobenzym does not possess hormonal activity, in contrast to such drugs as Duphaston, Marvelon, Regulon, etc.

    Wobenzym tablets contain the following ingredients:

  • pancreatin,
  • rutoside,
  • papain,
  • bromelain (pineapple extract),
  • amylase,
  • trypsin
  • lipase
  • chymotrypsin.

    Wobenzym belongs to the group of anti-inflammatory and immunomodulatory agents. Therefore, it is good to use it in uterine myoma, especially if there is endometriosis, that is, a combination of these diseases.

    The main therapeutic effects that can be achieved if the use of Wobenzym tablets in the complex therapy of endometrial disease are the following:

  • local correction of immune disorders (Duphaston has a similar effect),
  • a decrease in the severity of a local inflammatory reaction, as in the case if antibiotics are prescribed for infectious and inflammatory processes,
  • reduces the increased blood clotting, which accelerates the resorption process,
  • It has an additional analgesic effect, especially in uterine myoma and endometriosis, which can manifest as a pronounced pain syndrome.

    In conclusion, it should be noted that endometriosis is a polyetiological disease, the development of which is associated with various pathogenetic mechanisms. All these circumstances must be considered in the treatment process. That is why hormonal therapy is indicated (hormones are prescribed according to accepted principles), immunostimulating and symptomatic therapy. It should also be time to determine the indications for surgical treatment of the disease endometriosis. Such a complex approach can significantly improve the quality of life of the patient, if necessary, to restore reproductive function, while Duphaston is central to such treatment. It is also shown to include complex therapy and Wobenzym.

    Marvelon and menses - action, features of discharge

    Marvelon and menstruation are directly related as hormonal pills reorganize the reproductive system. The drug is monophasic, in its composition 30 μg of ethinyl estrogenol, 150 μg of desogestrel. Equal doses of estrogen, progesterone enter the body. In the body there are significant changes that affect the duration of the cycle, the nature of the discharge.

    Marvelon action

    The drug, first of all, is a contraceptive. All his efforts are aimed at preventing ovulation. Because only in the event of the release of the egg from the follicle is possible conception.

  • Marvelon controls the amount of estrogen, increasing the level of progesterones. In such conditions, the egg ceases to develop or goes to defective. Conception can not happen.
  • Changes in hormonal balance affect the formation of the endometrial layer on the walls of the uterus. It loses its natural structure, becomes loose, its thickness decreases. Such transformations do not give a fertilized egg, in the case of conception, to attach to the walls of the uterus. After a while she dies.
  • Controlled hormones change the composition and nature of cervical mucus. It becomes extremely thick, it prevents the sperm from moving to the uterus.
  • Marvelon forces the body to work according to a certain scheme; in the process of adaptation, it is possible that the menstrual cycle is disturbed, the appearance of bleeding in the middle, the absence of menstruation, rarely bleeding.

    Transition from another contraceptive

    Tablets begin to take from 1 day of menstruation, at most, at 4. If 5 days have passed, you will have to wait until the next menstruation. The transition from another contraceptive occurs without interruption. Critical days begin, you can take a new pill. In this case, "dummy" of the past drug can not drink.

  • Individual intolerance,
  • Spotting of unspecified etymology,
  • Liver diseases,
  • Renal, heart failure,
  • Migraine, severe headache,
  • Chronic colitis
  • Hormone-dependent neoplasms,
  • Problems with blood coagulation,
  • Genetic predisposition to serious illnesses,
  • Mental disorders.

    Common side effects include headache, problems in the gastrointestinal tract, nausea, weight gain, breast augmentation. Marvelone is often prescribed to women on the background of a sufficient amount of its own estrogen. Recommended after abortion, miscarriages.

    Features of the monthly admission

    The tool regulates the duration of the cycle, reduce the number of menstrual flow. Usually menstruation appears within 7 days after drinking the 21st pill. Since the endometrial layer is formed inferior, it is rejected faster, with less blood. The uterus is restored in 3 days, while without pills it took 5 days. Given this feature of contraceptives, they are often prescribed to women with heavy bleeding. Manifestations of premenstrual syndrome are reduced. A woman does not feel pain in the abdomen, mood swings, does not lose the ability to work. Menstruation is transferred much easier.

    However, in such an ideal scenario, the body does not always act. First of all, it all depends on the regularity of the cycle before taking the pills. If there were errors, adaptation to new conditions occurs within 3 months. Loose brown discharge is possible on any day of the cycle, especially in the middle. Menstruation is very scanty or does not appear at all. The situation requires the abolition of the drug, if the monthly against the background of Marvelon does not come within 3 months.

    Bleeding is extremely rare. This is due to the premature discontinuation of contraceptive use or the wrong dosage. If a drug with a higher dosage was taken before Marvelon, against the background of its reduction, the menstrual cycle fails. Other side effects are enhanced.

    The drug is often prescribed to women after 40 years to regulate the monthly cycle at the onset of menopause. The drug reduces the appearance of menopause, allows you to go through a difficult stage without serious consequences. Marvelon is taken under the strict control of specialists, periodically check the level of hormonal levels.

    Features of menstruation when canceling

    How quickly the body recovers after drug withdrawal depends on the duration of its administration.

    1. Up to 1 year. Ovulation appears as early as next month. On the background of hormonal pills, the probability of conception increases several times. If a woman is not planning a pregnancy, you need to worry about reliable contraception. Menstruation comes on time or with a slight delay. Subsequently, its duration, the nature of the discharge will be the same as it was before Marvelon.
    2. More than a year. With good tolerability of the drug can take pills up to 5 years. Then it is recommended to take a break. However, after the drug is discontinued, the body needs some time to get used to the new conditions again. For a long time the work of the ovaries was inhibited, hormones came in from the outside. To improve the functions of the reproductive system, it takes some time - from 1 to 6 months. Most often there is a delay of menstruation, scanty discharge. It is recommended to visit a gynecologist, be examined. The problem is solved faster under the guidance of experienced professionals.

    How quickly a cycle without Marvelon is adjusted depends on the individual characteristics.

    average price

    The drug is produced in the Netherlands, Ireland. The cost depends on the manufacturer, the location of the pharmacy, pricing policies institutions. You can purchase tablets at an online pharmacy.

    The average price for Marvelon Irish production is 1400 p. Packing is calculated on 1 month of reception.

    The cost of Marvelon Netherlands made an average of 1450 p. Packing with 3 blisters costs about 3440 rubles.

    The shelf life of 5 years from the date of manufacture.

    Analogues in composition

    The main similar drug is Regulon. He completely repeats the composition of Marvelon in the identical ratio of hormones. Regulon has been produced in Hungary for over 50 years, in Russia under license. Gynecologists prescribe it more often than other drugs. The main advantage is the price of packaging. 400 rub. for a blister with tablets in the amount of 21 pcs. 1100 per pack with 3 blisters. The drug has the same advantages, disadvantages, contraindications, side effects as Marvelon.

    With a similar composition of active components Marcelon, Novinet. They have a reduced estrogen concentration of up to 20 micrograms, progesterones remain at 150 micrograms.

    Doctor's review

    Irina Kalinina, gynecologist: “Marvelon is a reliable contraceptive drug. Its main advantage is a mild effect on the woman’s body. Synthetic hormones are as close to natural as possible, thereby reducing the number of side effects. According to women, there is nausea, headache, bitter taste in the mouth in the first month of taking the pills. On the second blister, everything comes back to normal. Problems with menstruation occur in rare cases. I recommend taking the pills for a year, then take a break for 6 months. Such a scheme helps to avoid trouble with the menstrual cycle and health in general. "

    Reviews of women after 40 years

    You can leave your feedback about the drug Marvelon, other users will be interested:

    “There is an experience of using Marvelon in young years and already past 40. There is something to compare with. In the manual, no one writes that it is a drug for women in age, it is not recommended for a young healthy body. So, I did not know all this. In the 90s, I was prescribed Triquilar as a contraceptive. She lost a lot of weight on her, relatives began to worry, and then she simply did not find it in pharmacies. Friends advised good contraceptives - Marvelon. Began to drink. The weight was greatly increased, which really annoyed me. All attempts to lose weight turned out to be a failure. Then she turned for help to the gynecologist. She's swearing at me. She said no pills for half a year, only condoms. And there will appoint, but certainly not Marvelon. Years have passed and I am over 40. Already at the consultation I was appointed to him. What I want to say. Well regulates hormones, there are no problems with manifestations of menopause, the state of health does not deteriorate. But overweight worries me again. "

    “The first acquaintance with Marvelon happened at the age of 35. Appointed because of the lack of their own hormones. Saw 8 years. Weight is fine. Side effects were only in the first month. Severe headache, nausea. Monthly came on time, but after 8 years the problems started. Had to cancel. After 40 years you need to be careful in choosing hormonal drugs. Do not just start drinking on the recommendation of a gynecologist. Need to insist on the initial examination of hormonal levels. Otherwise, there is bleeding, delay, gynecological diseases and other troubles develop. ”


    There is an effective treatment for endometriosis, cysts, fibroids, unstable menstrual cycle and other gynecological diseases.. Follow the link and find out what the chief gynecologist of Russia recommends.

    Classification of internal endometriosis

    There are 4 degrees of internal endometriosis (adenomyosis):

  • internal endometriosis of the first degree, in which all parts of the mucous membrane to the myometrium are affected, there is only one center of endometriosis,
  • internal endometriosis 2 degree, in which the defeat is observed until the middle of the myometrium, there are several small lesions,
  • internal endometriosis 3 degrees, in which the endometrium is affected to the serous layer,
  • internal endometriosis 4 degrees, in which there is a lesion of all the walls of the uterus, including the parietal peritoneum.

    Until the end of the causes of endometriosis is not installed. But any surgical intervention on the uterus (abortion, cesarean section, curettage of the uterus, surgery on the uterus) can provoke the penetration of the endometrium deep into the tissues of the uterus and cause intrauterine endometriosis. Other possible causes are heredity, immune or hormonal disorders in women (for example, an excess of estrogen with progesterone deficiency).

    Internal endometriosis - symptoms

    One of the main symptoms of endometriosis is abdominal pain of varying intensity, which is often associated with the onset of menstruation. Pains are possible during sexual intercourse, but they can be symptoms of other diseases in the pelvis, including inflammatory ones.

    There may be brown discharge before or after menstruation, dysfunctional uterine bleeding (possible bleeding in the middle of the menstrual cycle). Infertility remains one of the main symptoms of endometriosis, although more often external but not internal endometriosis of the uterus precludes pregnancy. But the onset of pregnancy can cause a reverse development of internal endometriosis, up to its complete cure.

    It is rare to suspect endometriosis only in a gynecological examination - the round shape of the uterus and its increase in size do not yet establish the diagnosis. But with a dynamic ultrasound examination, especially with a vaginal sensor, it is possible to detect foci of adenomyosis or to detect internal diffuse endometriosis with a uniform lesion of the uterus process. A focal form of internal endometriosis is less common than a diffuse form and should be differentiated from fresh foci of fibroids. For a more accurate diagnosis using a blood test for a marker of endometriosis CA-125.

    Internal endometriosis - treatment

    There are many views on how and what to treat internal endometriosis, but the methods of treatment are divided into conservative, surgical (surgical treatment) and combined. If a woman has internal grade 1 endometriosis, then his treatment is conservative and consists of long-term hormone therapy. Use hormonal contraceptives - combined estrogen-progestin drugs (Marvelon, Non-ovlon, suppress ovulation), progestin drugs (Norcolut, Duphaston, Utrogestan, including often use IUDs with Mirena gestagens).

    For the treatment of endometriosis, antigonadotropic drugs, such as Danol, Danazol or Danogen, are prescribed, which suppress the secretion of sex hormones and reduce the sensitivity of the receptors to them. Another group of drugs - antagonists of gonadotropic releasing hormone (Buserelin or Zoladex), firmly suppress ovulation, they are used 1 time per month, the course of treatment of endometriosis - at least 6 months.

    If internal endometriosis of grade 2 is diagnosed, its treatment does not differ from grade 1 endometriosis. And with endometriosis 3 and 4 degrees, as well as with diffuse endometriosis, surgery can be used for treatment.

    Treatment of internal endometriosis with folk remedies is the use of herbal medicine in combination with the main means of herbal medicine - plantain infusions, nettle, St. John's wort, but they cannot become a substitute for medicines.

    In addition to these substances, the composition of the tablets contains lactose in the form of monohydrate, potato starch, magnesium stearate, talc, gelatin. The shell is made using sucrose, dextrose, macrogol 35000, calcium carbonate . polyvidone, titanium dioxide, carnauba wax.

    Pharmacodynamics and pharmacokinetics

    Dragee action is aimed at suppressing secretion gonadotropic pituitary hormones, inhibition of maturation follicles and suppression ovulation. With the use of the drug increases the viscosity of the mucus filling the cervical canal, which creates obstacles to penetration sperm into the uterine cavity.

    Reception dragee Janine accompanied by normalization menstrual cycle. a decrease in the pain of menstruation and intensity of discharge, which significantly reduces the risk of development associated with iron deficiency anemia .

    Dienogest - progestin component of the drug is a derivative nortestosterone. Clinical studies of the use of this substance in patients with acne disease allowed to establish its pronounced anti-androgenic activity. Besides, dienogest characterized by the ability to increase the concentration of high-density drug in the blood.

    After p / os taking 1 dragee dienogest quickly and completely absorbed from GIT. Plasma concentration peaks after 2 hours and 30 minutes. The absolute bioavailability index is at the level of 96% (and this value is preserved in combination with the estrogen component of the Janine tablets).

    About 1/10 of the dose taken dienogesta is stored in plasma in free form, the remaining 90% is non-specifically associated with albumin . The substance does not bind to specific transport proteins. And this is precisely the reason that it does not force out cortisol and testosterone from links with KSG and SHBG, respectively.

    The effect of the first passage is negligible. The resulting metabolic products are inactive.

    Half life dienogesta with a single dose - about 9 hours, with multiple - about 10. After oral administration, a little more than 85% of the dose is eliminated in 6 days (about half - during the first day).

    After p / os taking ethinyl estradiol quickly and completely absorbed from the digestive tract, the maximum plasma concentration is achieved in the next 1.5-4 hours after taking one tablet.

    The substance is subject to the effect of the first passage, which is due to its low bioavailability (this figure usually does not exceed 44%).

    In free form in plasma is about 1.5% ethinyl estradiol. approximately 98.5% of the substance is bound to albumin. Ethinyl Estradiol enhances the biosynthesis of HGS and SHBG, without being associated with these transport proteins .

    After taking one pills half-life ethinyl estradiol is 10 hours. After three cycles of use of the drug, it rises to 15 hours.

    From 30 to 50% of metabolic products are excreted in the urine, about 30-40% - with the contents of the intestine.

    Contraceptive pills Janine, instructions for use (method and dosage)

    Janine tablets are designed to be taken regularly, a violation of the standard regimen provokesintermenstrual bleeding. and also reduces the contraceptive and therapeutic efficacy of the drug.

    According to the instructions for use Zhanin, take daily with water in the order indicated on the package. One cycle consists of 21 days of taking pills and 7 days of a break, during which (usually 2 or 3 days) the woman begins menstrual bleeding. Sometimes the withdrawal bleeding does not stop until the start of taking pills from a new package.

    How to take the first time Janine pills?

    If in the previous month a woman was not protected hormonal drugs. That drops begin to drink from day 1 menstrual cycle (on the first day of bleeding). If taking started from 2 to 5 days of the cycle during the week after taking the first pill, use barrier contraceptives .

    How to take the drug when switching from other contraceptives?

    When switching from othercombined hormonal drugs Pills begin taking the next day after the last tablet is taken with the active substances of the previous drug.

    Reception should be started no later than:

  • the day after the standard week break (if the woman used the drug containing 21 pills),
  • the next day after taking the last dragee - “placebo” (in case package No. 28 is used).
  • When going from progestin drug (implant, mini drank . injectable contraceptives) pills begin to take without a break:

  • any day, if the transition is done with a mini-drank,
  • from the day when the next injection was planned, if the transfer is made from contraceptives in injections,
  • on the day of implant removal.

    In all the above cases, in the first week of taking Janan’s dragees, you should use barrier contraceptives .

    Postpartum or abortion rules

    After termination of pregnancy in its first 13 weeks, the drug can be started immediately. Additional contraception is not needed.

    After the termination of pregnancy for a period of between 14 and 27 weeks, and also, if the pregnancy ends in childbirth, receiving pills begin at 21-28 days. If the first dragee is taken later, in the first week of taking the drug should be used. barrier contraceptives .

    If there was sexual intercourse in the period between taking the drug and giving birth / abortion, you should exclude the possibility of pregnancy or wait for the first menstrual period before taking Zanin.

    How to drink drops when they skip?

    Missed drops should be taken as soon as possible, the following from the package - at the usual time. A delay of less than 12 hours does not reduce the contraceptive effect of the drug.

    The intervals between taking the pills should not be more than 7 days, because it is for 7 days of continuous use of the drug that an adequate suppression of the functional activity of the system is achieved. hypothalamus pituitary ovaries .

    If a delay is more than 12 hours in the first 14 days of taking the drug, the next dragee is taken immediately when it is remembered (even if it involves taking 2 dragees at the same time). The next 7 days should be used barrier contraceptives .

    The greater the number of pills missed and the closer the pass to the standard weekly break, the higher the risk of a woman becoming pregnant.

    If a delay of more than 12 hours occurred from 15 to 21 days of taking the drug, the next dragee must be taken immediately when it is remembered (even if it involves taking 2 dragees at the same time).

    Further reception continues as usual and at the same time. In the following 7 days after skipping, barrier contraceptives should be used. In addition, the reception of drops from the new package will need to start immediately when the previous one ends, i.e. not sustaining a seven-day break.

    Normally, withdrawal bleeding in such a case does not begin before the second package is completed. Nevertheless, the probability of the appearance of spotting bleeding and even breakthrough bleeding is not excluded.

    The absence of withdrawal bleeding after skipping pills in the seven-day free period from Janine is a reason to assume a pregnancy.

    Vomiting ranging from three to four hours after ingestion of dragees reduces the absorption of the active substances of the drug. In this case, you should follow the recommendations when skipping tablets.

    If a woman does not plan to change the usual regimen, if necessary, take additional pills from the next package.

    To delay the onset of cyclic bleeding, the drug continues to be taken continuously, using new packaging. Take pills from a new pack can be as long as a woman wants (up until the pack is over). At this time there may be spotting and breakthrough bleeding.

    Reception from the next pack starts after a week break.

    How long can you take Janine? If the drug is well tolerated, it can be used for as many years as the need for contraception remains.

    What pills prescribed for endometriosis?

    In accordance with the instructions, the effect of the drug Janine is aimed at relieving pain, normalizing the disturbed cycle, reducing the intensity of bleeding, that is, at eliminating the symptoms that are the main (although not the only ones) for endometriosis .

    Blood excretion during menstruation is normal due to the fact that the mucous membrane formed in the second half of the cycle is rejected and the vessels are damaged. Since Janine suppresses ovulation, endometrium not so actively grows, respectively, the tissues around are not inflamed and do not squeeze the nerve trunks.

    In addition, like any hormonal agent. the drug allows you to normalize the cycle, making it strictly periodic.

    How to take with endometriosis?

    Janine is effective as genital and extragenital (non-genital) endometriosis. The components of the drug are highly active in the body, which allows them to be used at the lowest possible dose.

    Developed several schemes for the use of the drug Janine endometriosis. In addition, for each woman, the doctor must select the treatment individually.

    In some cases, it is considered advisable to drink dragees in accordance with the contraceptive scheme: one per day, from the first day of the cycle. After three cycles “21 days of admission + 7 days break ”The patient should be tested for blood clotting, to monitor the condition of the lesions endometriosis. and also to evaluate the functional state of the liver by biochemical blood analysis.

    It is also possible to take the drug for a prolonged regimen, in accordance with which pills should be taken continuously for 63 or 84 consecutive days, and then take a week break.

    In addition to the direct influence of the active components of the drug on tissues and organs, with such a treatment regimen, the drug reduces the amount of menstrual bleeding (instead of 3-4, one usually passes), which also favorably affects the patient's condition.

    Doctors reviews about Zhanin pri endometriosis indicate a high efficacy of the drug. Their statements also confirm the results of numerous studies and practical experience: according to statistics, the use of the drug allows to achieve positive results in about 85% of cases.

    In addition, experts note that Janine is well absorbed in the body (its bioavailability index is 90%) and quite rarely provokes side effects.


    Simultaneous intake of Janine birth control pills with inducing agents microsomal liver cell enzymes (including barbiturates. hydantoins. Rifampicin . Carbamazepine . Primidone and probably Topiramate . Griseofulvin . Felbamate ), provokes an increase in clearance dienogesta and ethinyl estradiol. what can cause a decrease in contraceptive effect.

    As a rule, the maximum activity of liver enzymes occurs after 2-3 weeks after the start of treatment with these agents, however, it can be observed for the next 4 weeks after completion of the course.

    Against the background of the use of Zhanin in combination with drugs ampicillin and tetracycline series reduced concentration ethinyl estradiol .

    It should be remembered that women who take any of the above short course drugs should additionally use barrier contraceptives during the entire period of treatment and within 7 days after its completion.

    If a woman is undergoing treatment Rifampicin. then the need for additional contraceptive measures is maintained for a full 4 weeks after its completion. If concomitant therapy is started at the end of the hormonal pill package, the following should be started without sustaining the usual break.

    Jeanine or Silhouette - which is better?

    Drugs Janine and Silhouette are structural analogues, that is, they contain identical substances in the same dosage as active ingredients, they have the same mechanism of action, indications and contraindications.

    The funds are issued by different companies and have a significant difference in price, Silhouette about half the price of its counterpart.

    Which is better: Kleira or Janine?

    The basis of the drugClaira make up dienogest and estradiol valerate (a substance that is a precursor produced by the human body 17? -Estradiol ). Each package contains 5 types of tablets, which differ in the composition of the active ingredients and their concentration.

    Contained in Janan dragee ethinyl estradiol exhibits greater metabolic stability in contrast to the estrogen component Klyry. however, it has a more pronounced effect on liver .

    Mechanism of action Klyry due to the ability of its active components to suppress ovulation and alter the properties of cervical mucus. In addition, the drug reduces the pain and intensity of bleeding during menstruation. impedes development iron deficiency anemia. reduces the risk of development ovarian cancer and endometrial cancer .

    Which is better: Janine or Diane 35?

    Diane-35 is a combination cyproterone (2 mg) and ethinyl estradiol (35 mcg). If Janine is prescribed primarily to prevent pregnancy in women with endometriosis. then the use of Diane-35 is advisable for contraception in women with pronounced signs androgenization .

    Janine or Byzanna - which is better?

    In the composition of the drug Byzanna 2 mg present as active ingredient micronized dienogest. The drug is intended to treat endometriosis. To achieve a therapeutic effect, tablets are taken within six months.

    The main indication for the use of the drug Janine is contraception (in particular, contraception in women with endometriosis ).

    According to doctors and patients treated with both drugs, the treatment endometriosis Zhaninom is not always as effective as treatment with Visanna. In addition, the latter is often better tolerated and provokes fewer side effects.

    Asking the question on which drug to stop the choice, it should be remembered that the body of each woman is different, moreover, the indications for use may differ in each specific case. In this regard, an expert must appoint this or that remedy.

    Use with alcohol

    In the instructions for the drug manufacturer does not make any recommendations regarding the possibility of the use of Janine pills with alcohol.

    Recommended Dose of Alcohol for Female Host oral contraceptives. - 20 grams of ethanol (a glass of wine).

    However, it should be remembered that:

  • the reaction of different organisms to the same dose of alcohol may differ,
  • hormonal drugs are an additional burden for the liver. which is responsible for the splitting of ethyl alcohol (i.e., in case of alcohol overdose, the consequences can be quite serious both for the liver and for the organism as a whole),
  • with an increased activity of liver enzymes due to an alcohol overdose, the decomposition and elimination of substances contained in the preparation are significantly accelerated (i.e., the contraceptive effect can be reduced),
  • an overdose of alcohol, accompanied by vomiting, leads to the fact that the active substances of the tablets do not have time to be absorbed from the gastrointestinal tract, as a result - the effectiveness of the drug decreases.

    According to doctors, between taking pills and alcoholic beverages should be kept for at least 3 hours.

    During pregnancy

    In the course of epidemiological studies, it was found that Janine does not increase the risk of teratogenic effects in a child whose mother, prior to pregnancy or — unknowingly — took birth control pills in her first weeks.

    However, during pregnancy, taking the drug is contraindicated.

    Since the combined hormonal agents are characterized by the ability to suppress lactation and influence the composition of breast milk, lactating women are advised to refrain from taking them.

    When planning a child should stop using birth control pills. Doctors try to get pregnant from the beginning of a new cycle. Pregnancy after taking the pills usually comes quickly enough.

    Reviews of Zanine

    Reviews of Zanin on the forums are quite diverse. Most of them are positive, because the drug is well tolerated by a woman, easy to use, and copes well with its main task.

    In addition, patients and doctors in the reviews of Zhanin note that the drug, in addition to the contraceptive, has a number of other positive side effects: helps with acne, normalizes the menstrual cycle, reduces the intensity and pain of bleeding. In women who stop taking Janine pills because of the desire to get pregnant, pregnancy after the withdrawal of funds often occurs in the first 2-3 cycles.

    Due to the ability of the drug to stabilize hormones and suppress foci endometrial abnormal growth. it is often effective at myome and atendometriosis (usually in situations where the disease is not too advanced).

    However, there are negative reviews about the drug, which are associated either with the lack of results in the treatment endometriosis. or with side effects that significantly impair the quality of life of a woman. Experts tend to believe that such phenomena may occur if the tool was chosen without taking into account contraindications to use, or simply does not fit a particular woman.

    Analyzing the reviews of doctors on the contraceptive pills Janine, it can be concluded that experts respond positively to this drug. Such a high score is due to the fact that being a low-dose agent, the latter has a pronounced contraceptive effect, helps to restore hormonal imbalance and has a positive effect on the general condition of the woman.

    Price Zanin, where to buy

    The price of Janine contraceptive pills depends on what pharmacy they are for. The cost of transportation and pricing features of a particular pharmacy network affect the cost of a drug in pharmacies. Given that pills are produced only by one pharmaceutical company, there is no difference between the more expensive and cheaper drugs.

    The price of Zhanin in pharmacies of Ukraine is an average of 215 UAH (per package number 21).

    The cost of packaging, in which there are 21 dragees, in Russian pharmacies is approximately more than 870 rubles. You can buy a package with 63 dragees for approximately 2,200 rubles.

    What is retrocervical endometriosis?

    Endometriosis is the movement of the endometrium from its physiological location (uterus) to other organs and tissues. Retrocervical endometriosis is one of the dangerous types of endometriosis. The disease has a dyshormonal nature with autoimmune and genetic disorders.An ectopic endometrium grows and functions in non-physiological areas, which is manifested mainly by a pronounced pain syndrome and pathological bleeding.

    One of the frequent areas of movement of the endometrium is the retrocervical area - the projection of the posterior surface of the cervix - fatty tissue, the area of ​​the sacro-uterine ligaments.

    Causes of disease

    The specific cause of ectopia of the endometrium is still not clear. Selected several predisposing factors.

  • Long-term unimplemented reproductive function - if a woman postpones her first pregnancy for a long time.
  • In adolescent girls - menstrual disorders.
  • Hereditary predisposition - any kind of endometriosis in the female part of the family.

    Theories explaining the possibility of endometrial ectopia:

    It is important to know! Frequent medical manipulations in the uterus cause trauma to the endometrium and the removal of its particles beyond the uterus - the occurrence of endometriosis. Such manipulations include diagnostic and therapeutic curettage, abortion, manual examination of the uterus, removal of myoma nodes.

    A very dangerous type of endometriosis is retrocervical. The pathological focus is localized behind the cervix.

    Classification of retrocervical endometriosis

    Retrocervical endometriosis proceeds in four stages:

  • Stage 1 - endometriotic foci do not extend beyond the retrocervical fatty tissue without reaching the rectum.
  • Stage 2 - The endometrium grows into the cervix and vaginal wall, forming cysts. The cervix is ​​deformed.
  • Stage 3 - Endometriosis affects the ligaments of the uterus and the outer wall of the rectum.
  • Stage 4 - the endometrium grows into the cavity of the rectum, adhesions form between the intestine and the uterus.

    Clinical picture

    Complaints of a woman will depend on the degree of lesion of the rectum and sacral plexus, on how far the pathological focus has spread. A woman worried about the pain of obscure localization, deep in the pelvis, whining character. The pain can be felt in the vagina and in the rectal area. A few days before menstruation and during it the intensity of pain increases, their character changes - they become pulsating, they can radiate to the rectum, the vaginal area.

    If the endometrium grows in the vagina - during sexual intercourse, bleeding occurs.

    Its germination in the rectal cavity is accompanied by disorders of the act of defecation, the appearance of blood in the feces.

    Complications of the disease

    Endometriosis can lead to serious complications, the treatment of which will require a lot of effort and patience from a woman.

  • The most unpleasant for women of reproductive age is infertility. This is also the most frequent complication - it can occur in 40 cases.
  • Chronic iron deficiency anemia - frequent and heavy bleeding leads to persistent anemia.
  • Adhesions and fistulas in the abdominal cavity or small pelvis. In retrocervical endometriosis, an adhesive process often occurs between the uterus and the rectum, in the region of the sacro-uterine ligaments.
  • Malignancy of the endometriotic focus is a rare but most serious complication.

    Diagnosis of the disease

    For the diagnosis of retrocervical endometriosis, a specialist collects anamnesis, clarifies complaints, conducts examination and prescribes instrumental methods of research. A gynecological examination with a hand behind the cervix reveals a dense elastic formation.

    From instrumental methods, the most informative will be ultrasound - behind the cervix visualized heterogeneous for echogenicity education. Smooth isthmus and a change in the contour of the rectum are also observed.

    To confirm the stage of the disease are used rectoromanoscopy, cystoscopy, computed and magnetic resonance imaging.

    An excision of the site of the pathological focus for histological examination and the exclusion of the malignant process.

    Pathology treatment

    Treatment of retrocervical endometriosis is quite complicated, since the disease violates not only the physical but also the psychological state of the woman.

    First you need to suppress the activity of endometrial foci or remove them. Usually, surgical excision of lesions is used for removal. After that, the therapy of complications and mental disorders.

    The main method in the treatment of genital, in particular, retrocervical endometriosis is the surgical removal of ectopic foci. There are many methods of treatment and the choice will depend on the stage of development of the disease and the damage to neighboring organs.

  • At the first stage, the lesion is excised using laparoscopic access and instruments.
  • The second stage requires excision of the affected part of the vagina.
  • The third and fourth stages are more complex operations, excision of sections of the vagina and rectum, removal of foci from the sacro-uterine ligaments.

    The effect will be more pronounced if hormone therapy was performed as a preparation for surgery.

    Preparations for hormone therapy:

    With existing disorders of the immune system used immunomodulators - "Cycloferon", "Timogen".

    Enzyme therapy. Assigned to prevent the activation of the macrophage system, for the resorption of adhesions and scars. Used for this purpose, "Wobenzym", "Flogenzim."

    Mandatory in the treatment of endometriosis is the appointment of vitamins with antioxidant properties. These include alpha-tocopherol, ascorbic acid, pycnogenol.

    In the presence of pain, use drugs from the group of NSAIDs and antispasmodics - “Nurofen”, “No-shpa”.

    Psychological disturbances are stopped by non-drug methods, and if necessary, tranquilizers and anxiolytics are prescribed.

    Disease prevention

    To prevent the onset or recurrence of retrocervical endometriosis, a few simple recommendations should be followed:

  • Visit the gynecologist at least twice a year.
  • If any gynecological diseases are detected, their adequate and complete treatment.
  • If there are risk factors predisposing to the development of endometriosis, eliminate them if possible.
  • To prevent abortion - adequate hormonal contraception.