- Conventional stimulation and regulation therapy: its efficiency in adolescent girls with hypomenstrual syndrome
Conventional stimulation and regulation therapy: its efficiency in adolescent girls with hypomenstrual syndrome
HEALTH OF WOMAN. 2017.3(119):37–40; doi 10.15574/HW.2017.119.37
Levenets S. A., Nachotova T. A., Verkhoshanova O. H., Udovikova N. A., Kashkalda D. A.
SI «Institute of Child Health and teenagers NAMS of Ukraine», Kharkiv
The objective: to determine near and distant effectiveness of the non-hormonal conventional stimulation therapy in girls with oligomenorrhea and secondary amenorrhea (hypomenstrual syndrome-HMS).
Patients and methods. 86 girls aged 13-18 years with HMS were examined in our study. The study involved immunoenzymatic (LH, FSH, PRL, E2, testosterone-T, and insulin-In) and photometric methods (blood serum vitamin E) and pelvic ultrasonography. Therapeutic measures included biostimulants, adaptogens, vitamin and mineral complexes, as well as biguanides and cyproheptadine according to the treatment indications.
Results. The immediate treatment efficiency deteriorates significantly in the presence of uterus hypoplasia (36.7% vs. 60.8% without hypoplasia), in cases with blood FSH and LH increase, hypoestrogenemia and in girls with uterine hypoplasia together with a rise in the testosterone level.
The remote efficiency of the treatment (1-3 years after the beginning) depends on the duration of the disease (HMS), deteriorating during its existence without treatment for 2 years or more (43.3% vs. 55.9% when duration of the disease is shorter). Hormonal findings demonstrate a negative effect of the initial hypoestrogenemia on the treatment remote efficiency, which has been recorded in 80% of girls with uterine hypoplasia and two times less frequent in cases with good results. Initial hypoestrogenemia has been observed in 11.1% of patients with positive effect and uterine volume appropriate to the age. Three times more frequent this disorder has been recorded in patients with negative results.
Conclusion. Further improvement of non-hormonal methods with extensive involvement of non-medicamentous means and verification of the indications for the hormonal drugs prescription is essential to improve the treatment effectiveness of adolescent girls with HMS.
Key words: аdolescent girls, oligomenorrhea, secondary amenorrhea, the effectiveness of non-hormonal treatment.
1. Zybina LYu. 2008. Pubertal pathology as an unfavorable background for a complicated course of pregnancy in the future. Reproductive health of the youth – health of the following generations. Rep. Abstr. XI European Congress of Children and Adolescent Gynecologists. St. Petersburg:21.
2. Shilova OYu, Krulikovskaya TN. 2007. Differential diagnostic and therapeutic approaches to the management of adolescents with oligomenorrhea. Reproductive health of children and adolescents 6:22-29.
3. Andriets OA, Shkrobanets ID, Bodnaryuk OI, Koriyakova A. 2009. Problems of reproductive health in the girls of Bukovina. Collection of Scientific works, Association of obstetricians and gynecologists of Ukraine: 11-13.
4. Chebotareva YuYu. 2011. Polycystic ovary syndrome in the period of puberty: mechanisms of the formation, clinical course, prevention and treatment Endocrine gynecology. 6:105-114.
5. Levenets SА, Kashkalda DA, Nachetova ТА et al. 2011. Blood leptin and insulin content in adolescent girls with menstrual dysfunction on the background of different body weight. Achievements and prospects of experimental and clinical endocrinology (10th Danilevsky reading): materials of scientific and practical. Conf. with intern. Participation: 75-76.