Post-menopausal symptoms of estrogen deficiency (dyspareunia, dryness, pruritus, recurrent urinary tract infections). Pre-and postoperative in post-menopausal women undergoing vaginal surgery. Infertility in the course of hostility of cervical mucus. Diagnosis of cervical pathology.
Composition:
1 tabl contains 2 mg of estriol.
Action:
Preparation of natural estriol for oral use. It is particularly effective in the treatment of local emergencies during pre- and menopausal periods. It normalizes the epithelium of the disappearing vaginal mucosa, restores its normal flora and physiological pH, eliminates the feeling of so-called dry vagina, increases the resistance of vaginal epithelial cells to infection. It also reduces the symptoms of the urinary tract, accompanying the period of menopause. After oral administration, estriol is absorbed from the gastrointestinal tract quickly and almost completely, metabolized mainly in the liver. Maximum concentration of unconjugated estriol in blood serum occurs within 1 h after administration. Excreted mainly in the urine.
Contraindications:
Hypersensitivity to the components of the drug. Present or present breast cancer (or its suspicion), current or suspected malignancy (eg endometrial cancer). Bleeding from the genital tract of unknown origin. Untreated endometrial hyperplasia. An earlier or current venous thromboembolism (deep venous thrombosis, pulmonary embolism). A confirmed coagulation disorder (eg C, S or antithrombin protein deficiency). Occurrence of occlusal thromboembolic events (eg angina pectoris, myocardial infarction). acute or past liver disease until the liver parameters return to normal. Porphyria. Rare hereditary diseases of galactose intolerance, Lapp lactase deficiency or malabsorption of glucose-galactose.
Precautions:
In the treatment of menopausal symptoms, HRT should be used only when they negatively affect the quality of life. At least once a year, the risk and benefits of HRT should be assessed and a check-up performed. Caution in patients with the following conditions (present or past): leiomyomas (myoma) or endometriosis, risk factors for thromboembolic events and estrogen-dependent cancers (eg breast cancer in first-degree relatives), hypertension, liver disease (e.g. liver adenoma), diabetes with or without vascular changes, cholelithiasis, migraine or severe headache, systemic lupus erythematosus, endometrial hyperplasia, epilepsy, asthma, otosclerosis. Treatment should be discontinued if jaundice or hepatic dysfunction, marked increase in blood pressure, occurde novo migraine headache, pregnancy. The drug may increase the risk of endometrial cancer, especially with long-term use. The causes of possible vaginal bleeding should be carefully examined, and the annual andometrium tests should be performed, alternatively, the progestogen should be used for at least 12-14 days each month. The drug affects the risk of venous thromboembolism and should be discontinued if there are potential symptoms (painful swelling of the limbs, sudden chest pain, shortness of breath). Estrogens can cause fluid retention, so patients with heart or kidney failure should remain under close medical supervision.
Pregnancy and lactation:
The preparation is contraindicated in pregnant women. If the patient becomes pregnant while taking the preparation, the treatment should be stopped immediately. The results of epidemiological studies related to inadvertent exposure of the fetus to estrogen do not show teratogenic or toxic effects. The preparation is not indicated in women during lactation. Estriol is excreted with human food and may reduce its quantity.
Side effects:
Nausea, discomfort and pain in the breast, spotting from the genital tract, secretion from the cervix, fluid retention. These symptoms usually go away, but may also indicate too much of the medicine.Other side effects observed: estrogen-dependent benign and malignant tumors (eg endometrial carcinoma), cholecystitis, subcutaneous and cutaneous melasma syndromes, erythema multiforme, erythema nodosum, vascular purpura, probable dementia in patients 65 years of age Increased risk of breast cancer (depending on the duration of therapy), low risk of ovarian cancer, risk of venous thromboembolism (especially in the first year of therapy), risk of coronary heart disease (in women taking estrogen-progastegene HRT at the age of 60), and the risk of ischemic stroke.
Dosage:
In the treatment of symptoms of estrogen deficiency after menopause: initially 4-8 mg per day, as the symptoms disappear, the dose is gradually reduced. During long-term treatment in women with a preserved uterus, it is recommended to observe the endometrium or, alternatively, simultaneous use of progestogen. As preparation for surgery: 4-8 mg / day for 2 weeks before and 1-2 mg / day for 2 weeks after surgery. In the diagnosis of the cervix: 2-4 mg / day for 1 week. In the treatment of infertility: usually 1-2 mg / day (in exceptional cases up to 8 mg / day) in the period of 6-15 days of the Next menstrual cycle, until the optimal condition of cervical mucus. Diagnostic help for doubtful images of cervical smears: 2-4 mg / day for 7 days before swabbing. If you forget to take a dose, take it as soon as possible if the break is not longer than 12 hours. In the case of a longer break, skip the forgotten dose and take the next tablets according to the prescribed schedule. The tablets should be taken at the same time of the day. Women who do not use HRT or women who want to change a continuous complex HRT can start taking the medicine at any time. Women who change from sequential HTZ products should start drug therapy one week after the end of the cycle.