Estrogen uses in gynecology

2021-03-18 12:00 AM

Develops vaginal epithelium, helps cells understand glycogen containing vaginal tissue and enables Dolerlein bacilli to turn this glycogen into lactic acid.

General perception

Using hormones in gynecology as well as using hormones in other specialties, to replace the missing hormones, stimulate the endocrine glands when they need them to work better or inhibit the endocrine glands when needed to reduce or deactivate them. For example, the use of gonadotropins to stimulate ovulation is to replace the pituitary gland while also stimulating the ovaries. Using an artificial menstrual cycle is to replace the ovaries while stimulating the uterus and uterine lining. Using progesterone in the treatment of menorrhagia due to overproduction of the uterine lining is both stimulating and inhibiting the development of the uterine lining on a case-by-case basis.

Estrogen works

Cows muscle growth by increasing the number, length, and strength of muscle fibers. Use for treatment in the underdeveloped uterus.

Making the uterine muscle more sensitive to oxytocin causes the uterus to contract. Apply therapy in stimulating uterine contractions, causing stillbirth.

Development of the uterine lining by increasing uterine mucosal cell proliferation, applying treatment to induce menstrual cycles or rapid regeneration of the uterine lining.

Stimulates the cervical glands to secrete more mucus, make it clear and thin, applied in the treatment of infertility, helping the sperm easily penetrate into the woman's upper genital tract.

Developing vaginal epithelium, helping cells understand glycogen containing vaginal tissue and enabling Dolerlein bacilli to turn this glycogcn into lactic acid. Use for treatment of atrophy of the vagina or vaginitis due to lack of estrogen.

Enlarges the large lips and small lips of the vulva. Treatment application in cases of atrophic vulvitis caused by lack of estrogen in the elderly or those who have had two ovaries removed.

Development of breast milk glands. Treatment of underdeveloped breasts caused by a lack of estrogen (eg Tumerian syndrome).

Increases the retention of water and Na in cells causing edema.

Helps keep calcium in bones during bone formation, and prevents osteoporosis. Use in the prevention and treatment of osteoporosis in the elderly and those whose ovaries have been removed.

Together with the estrogen makes sex (libido).

In the pharmaceutical market there may be natural estrogens such as estradiol usually in the form of estradiol benzoate such as Bert7.ogynocstryl, estron, oil-soluble estriol, or complex estrogcn such as Premarin, which is water soluble. Many times, people use semi-synthetic estrogens such as ethinylestradiol, which is commonly known in Vietnam as Mikrotollin. The stilbene nucleus, such as diethylstilbestrol, which is known especially as Oestrasid is no longer of interest in gynecology.

Treatment for the vulva, vagina

Estrogen treats itching of the vulva, vagina caused by oligospermia in the elderly or the two ovaries have been removed. Elderly people should take Ovestin (containing estriol) 0.25mg per day 2- 4 tablets for 15 days or use Trophicreme ointment containing estriol at a concentration of 100mg in 30g of ointment for the vulva once a day, after symptoms evidence has decreased, then apply once a day. Colpotrophine ointment contained in promestri√®ne can be used at the rate of 1%, as well as above on the vulva and injected into the vagina 1g of ointment per day.

Estriol has no effect on the uterine lining, so it is not afraid to cause cancer of the uterine lining. Promestriene only has a local estrogenic effect, has no far-reaching effects, does not affect the uterine lining, breast and pituitary gland. Both of these are safe for use by the elderly.

For young women who have their two ovaries removed, if they do not have a menstrual need, they can treat the same approach as the elderly. If there is a need for menstruation, it is possible to use artificial menstrual rings, which also have a local therapeutic effect on the vulva. But to regularly monitor the adverse effects on the breast and uterine lining.

Treatment for vaginitis and vulvitis caused by lack of estrogen can be combined with vaginal suppositories and vulvitis for all ages. Vaginal suppositories may be Trophigil eggs with estriol content of 0.2 mg in each tablet, placed twice daily, morning and night, 1 tablet each time, lasting for 2-3 weeks. Physiogine eggs can be used in 0.5mg estriol or colpotrophine tablets containing promestriene 10mg.

Usage and booking time is the same.

For the cervix

Estrogen increases mucus secretion in the cervix, can be used in the treatment of female infertility, especially in the case of using cultural clomifene to decrease mucus secretion. Mikrofollin (ethinylestradiol) can be used with 0.05mg 1-2 tablets/day for 4-5 days, starting from day 10-11 of the menstrual cycle. Should not be used more, fear of suppression of ovule. Also should not last longer, afraid of affecting the nesting of the eggs. Premarin (complex estrogen) can be used 1.25mg, 1-2 capsules per day from the 6th to the 14th day of the menstrual cycle. Can be used

Ovestin 1- 2mg / day at the same time as above. It has been found that there are cases that require as little as 0.25mg of Ovestin per day and vice versa, there are cases requiring up to 8mg per day. Therefore, it is necessary to probe the appropriate dose from low to high in each case.

For the uterine body

Develops uterine muscles in case of an underdeveloped uterus. Because vi has to be used for many months, it is best to use the artificial menstrual cycle, that is, in the first half with estrogcn and the second half combining estrogen with progestin.

Development of the uterine lining in case of long-term amenorrhea due to hormonal insufficiency, helping eggs to nest well when treating infertility later. At best, also the artificial cycle.

There are many ways to induce menstrual cycle, using the following regimen: Mikrofollin 0.05 mg x 1 tablet x 14 days, followed by: Rigevidon 1 tablet x 12 days. So, for a total of 26 days. Stop taking the drug for about 2 days, the patient will menstruate, we get a 28-day period.

There is an author using natural hormones such as Benzo-Gynoestryl 5mg per week, injecting 1 ampoule into the muscle, injection for 4 weeks. From week 3 to inject a combination daily 1 ampoule of progesterone 10mg into muscle until stopping Benzo-Gynoestryl injection. This method is more effective in preparing the uterine lining to treat infertility than the oral method above, but it is more complicated, especially with injections.

Helping the uterine lining to develop rapidly after uterine curettage, especially in cases of postpartum uterine curettage, to avoid uterine stickiness. Mikrofollin can be given by mouth with a 0.05mg tablet daily for 10 days or by injection of Benzo-Gynoestryl 5mg twice, 5 days apart.

Helps metabolize calcium

Estrogen helps to keep calcium, increase the effects of calcitonin, reduce bone resorption, prevent osteoporosis after menopause or postmenopausal resection. Can use Benzo- Gynoestryl 5mg weekly intramuscularly. But perhaps the most convenient is to take Mikrofollin 0.05mg per day for 20-25 days per month. The dose can then be reduced by half, taking 1 tablet every 2 days. Should in the last 10 days of each cycle add progestin, lips 10 mg daily.

Anti-hot flash and vegetative neurological disorders

For people who are menopausal or cut two ovaries who may experience hot flashes and have neurological disorders such as palpitations, heart palpitations, or sweating, cold head limbs can apply the same plan as to preventing osteoporosis as outlined above. Alternatively, estriol 4-8mg per day can be used for a few weeks, then gradually reduce the dose. Stop using when there are signs of breast stiffness.

Contraindications to the use of estrogens

Estrogen is not allowed in cases of breast cancer, uterine lining, cardiovascular disease, hypertension, edematous kidney disease, coronary artery disease, embolism, pregnancy, breast-feeding.