New approaches to prophylaxis of endometrium hyperplasia relaps in premenopausal women

Abstract

Research aim: to evaluate the effectiveness of therapy aimed at preventing endometrial hyperplasia recurrence in premenopausal women.Materials and methods. Clinical and paraclinical examinations of 76 premenopausal women were carried out. Transvaginal ultrasound was performed, levels of estradiol, progesterone, homocysteine, folic acid, serum HOMA index evaluated, body mass index and blood pressure assessed. Women were divided into two groups after histological results obtained: the main group included 40 women who received oral progestins (dydrogesterone 10 mg) twice a day in combination with Depapilin® 395 mg twice a day; the comparison group included 36 women who received only oral progestins (dydrogesterone 10 mg) twice a day. Comparison of the therapy effectiveness was performed 6 and 9 months after the start of treatment.Results. Endometrial thickness stabilized within 9 months in women of the main group, and was within the physiological norm (before treatment – 22 ± 3.1 mm, 6 months after the start of treatment – 8,3 ± 0.46 mm, after 9 months – 9,7 ± 0.31 mm, p <0.05). The positive treatment effect consisted in a significant decrease in the frequency of endometrial hyperplasia recurrence, which was 17 (17.5%) cases in the main group and 16 (44.4%) cases in the comparison group (p <0.05). Women of the main group also showed stable normalization of the level of estrogen and progesterone, a steady decrease in the level of homocysteine and a synergistic increase in the level of folic acid, normalization of blood pressure and reduction of body mass index.Conclusions. Depapilin® inclusion in the basic therapy of endometrial hyperplasia in premenopausal aged women is pathogenetically justified due to the complex effect of the drug components on the extragonadal estrogens synthesis and the antiproliferative effect on the endometrium.