A practical approach to treating diffuse benign endometrial hyperplasias


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Resumo

Endometrial hyperplastic processes are the most common indications for intrauterine interventions and often for hysterectomy. It has been previously proven that a therapeutic approach to treating endometrial hyperplasia (EH) is in fact anti-recurrent after histological evaluation of a removed substrate. EH therapy using a GnRH agonist has been pathogenetically substantiated by the proven multiple mechanisms of action: from desensitization of the pituitary gland to interaction with specific receptors in endometrial cells. The offensive potential of currently available combined oral contraceptives in the prevention of recurrent EH in reproductive-aged patients who are not planning to become pregnant after a therapy cycle with a GnRH is determined primarily by the tropism of the gestagen included in the drug for the endometrium.

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Sobre autores

Alexander Tikhomirov

A.I. Evdokimov Moscow State University of Medicine and Dentistry, Ministry of Health of the Russian Federation

Email: paciflcofT@mail.ru
MD, professor of the Department of Obstetrics and Gynecology, Medical Faculty

Bibliografia

  1. Ellsworth В S., Burns A.T, Escudero K. WS, Duval D.L., NelsonS.E., Clay C.M. The gonadotropin releasing hormone (GnRH) receptor activating sequence (GRAS) is a composite regulatory element that intenacts with multiple classes of transcription factors including Smads, AP-1 and a forkhead DNA binding protein. Mol. (Cell. Endocrinol. 2003; 206(1-2): 93-111
  2. Доброхотова Ю.Э. Гиперплазия эндометрия. М.: ГЭОТАР-Медиа; 2016. 87 с
  3. Тихомиров А.Л. Лечение больных миомой матки с использованием суперагониста гонадотропин-рилизинг-гормона. Российский вестник акушера-гинеколога. 2017; 17(5В: ,8-90
  4. Bono k, Kyo S., Kiyono T., Mizumoto Y, Nakamura M ., Maida Y. et al. Coccurrnnt estrogen action was essential for maximal prngestin effect in oral contraceptives. Fertil. Steril. 2C14; 101(5): 1337-43. https://dx.doi. org/10.1016/j.fertnstert.2014.02.005

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