Contents
Endometriosis is a disease that is characterized by the growth of endometrioid heterotopias in the tissues of the uterus and beyond. The drugs of choice in the treatment of this pathology are COCs (combined oral contraceptives). Pills Silhouette belong to this group.
Silhouette is an oral hormonal contraceptive that provides an antiandrogenic effect. It is produced by the Romanian pharmaceutical company Gedeon Richter. Silhouette can be called a structural analogue of the drug Jeanine, these tablets have similar properties. However, the advantage of the Silhouette is its more affordable price.
Mechanism of action of Silhouette in endometriosis
The composition of one Silhouette tablet is represented by low doses of hormones:
Dienogest – 2 mg.
Ethinylestradiol – 0,03 mg.
The mechanism of action of the drug is due to the active substances that make up its composition. Dienogest has a progestogenic effect, but does not have a pronounced androgenic, mineralocorticoid and glucocorticoid effect on the body. In other words, this substance contributes to the regulation of excessive estrogen activity, which is the cause of the development of endometriosis, but does not depress the woman’s immunity. Dienogest does not interfere with the metabolic processes of the body, so Silhouette can be taken for a long time (even several years).
As for ethinyl estradiol, this substance has a high oral bioavailability, allows cellular enzymes to transform into less active forms of estrogen and accelerates their breakdown.
The main effect of the Silhouette on the body, which is important for the treatment of endometriosis:
Regression, degeneration and subsequent atrophy of endometriosis foci in the uterus and beyond.
Blocking the proliferation (possibility of germination) of new endometrioid heterotopias in tissues.
Creating the effect of “pseudo-pregnancy”, which leads to the achievement of amenorrhea, and in the future – to the cessation of hormonal activity in endometrioid foci. Against the background of such a condition, the ectopic endometrium undergoes regression, and new foci are unable to form.
Cessation of the local inflammatory response by blocking prostaglandins such as PG E2 and estrogen-like substances.
Acceleration of local processes of breakdown of female hormones. Estradiol is converted to inactive estrone. This, in turn, prevents the germination of new endometriosis lesions.
Inhibition of angiogenesis processes, which prevents new blood vessels from forming around endometriosis foci and nourishing them.
Suppression of ovulation and the formation of follicles, a change in the structure of the endometrium in the uterine cavity, a decrease in peristalsis of the fallopian tubes, thickening of mucus in the cervical canal – all these effects are related to the contraceptive properties of the drug. However, they were the basis for the treatment of endometriosis.
Who should be treated with Silhouette for endometriosis?
Gynecologists prescribe Silhouette for women at an early stage in the development of endometriosis. It is possible to carry out therapy when a second stage of the disease is detected. However, in this case, treatment should be considered as a preparatory stage before surgery (laparoscopy).
Silhouette is recommended for women who have undergone surgery to remove endometriotic adhesions and cysts. This greatly reduces the risk of recurrence of the disease.
Independent use of a hormonal drug is not possible, the duration of therapy must be determined by the doctor.
Possible treatment regimens
Silhouette treatment can have different variations. If a woman turned to a gynecologist about the impossibility of conceiving a child, and she was diagnosed with endometriosis at an early stage, then she is recommended the classic treatment option. To do this, she will have to take the drug for 21 days, then take a break for 7 days. During this week’s break, she will have her menstrual bleeding. This scheme of admission will need to be followed for 3 months. It is possible to extend therapy up to six months if the foci of endometriosis have a slow tendency to regress. Upon completion of the course, a comprehensive diagnostic examination is carried out and the issue of further pregnancy planning is resolved.
When a woman is not going to give birth in the near future, and the goal of treatment is to get rid of foci of endometriosis or prevent its recurrence after an intervention, gynecologists recommend a prolonged therapeutic course.
Tablets can be prescribed according to the scheme:
42 days of admission and 7 days off;
63 days of admission and 7 days off;
84 days on and 7 days off.
At the end of treatment, a diagnosis is made, after which the issue of prolonging therapy is considered. It is possible that the Silhouette may be appointed for several years.
As for the first dose of the drug, doctors recommend starting the course on day 1 of the menstrual cycle.
Pros
Thanks to the use of the Silhouette, you can refuse surgical intervention and get rid of endometriosis 1 and 2 degrees.
While taking the drug, a woman is reliably protected from unwanted pregnancy.
With proper management of the disease and individual selection of the course, the drug has a minimum of side effects on the body.
After discontinuation of the drug, the woman retains the function of childbearing. Moreover, the chances of getting pregnant are significantly increased, since endometriosis is cured, which means that nothing interferes with the normal passage of the egg through the fallopian tubes, its fertilization and fixation in the uterus.
Therapy with the drug contributes to the fact that the skin becomes healthier, in particular, acne disappears in women. Moreover, it is possible to get rid of acne, not only mild, but also moderate.
The positive effect of the Silhouette in patients with seborrhea has been proven.
Women get rid of severe pain in the pelvis, which, against the background of endometriosis, is often chronic and of high intensity.
Disappear signs of dysmenorrhea – an unstable menstrual cycle.
Menstrual bleeding becomes less heavy.
Due to the normalization of blood loss, it is possible to get rid of the signs and symptoms of anemia.
It has been established that taking the drug prevents malignancy of ectopic foci. This reduces the risk of developing cancer.
Contraindications and side effects
The drug is safe and usually well tolerated, however, there are contraindications to its appointment:
Thromboembolic disease in history.
Hepatitis A, Gilbert’s syndrome, Rotor syndrome, Dubin-Johnson syndrome.
Pancreatitis.
Sickle cell anemia.
Diabetes mellitus complicated by vascular diseases.
Disorders of the lipoprotein balance of the blood.
Smoking (for patients older than 35 years).
Severe liver pathology.
Hypertension, uncontrollable.
Vaginal bleeding, the cause of which is unknown.
Migraine.
The presence of tumors (malignant and benign), or suspicion of tumor processes.
Breastfeeding, childbearing.
Epilepsy.
Lactose intolerance, its deficiency in the body.
To minimize the risk of side effects, a woman should undergo a qualitative examination before starting the treatment of endometriosis with Silhouette.
During therapy, there is a risk of developing thromboembolic complications, disorders of the central nervous system, intolerance to contact lenses. At the beginning of the course, acyclic vaginal bleeding, swelling and soreness of the mammary glands are often observed. However, as practice shows, after 2-3 months these undesirable phenomena disappear. Since the drug is taken orally, digestive disorders may occur, for example, exacerbation of gastritis, the development of cholecystitis, the addition of symptoms of enteritis. The most common side effects are nausea, constipation, bloating, and vomiting.
If any pathological phenomena occur on the part of the body, it is necessary to consult a doctor. Moreover, in some cases they can be quite serious and life-threatening (for example, myocardial infarction or cerebral stroke). This requires prompt withdrawal of the drug and correction of the woman’s condition.
Important tips and tricks
Doctors strongly recommend that a woman quit smoking if a decision has been made to treat endometriosis with Silhouette. The fact is that with regular intake of nicotine in the body, the risk of such a side effect as thromboembolism of the veins and arteries increases many times over.
It should be remembered that Silhouette is a contraceptive, so it will not be possible to get pregnant during treatment. However, the drug does not protect a woman from the risk of contracting sexually transmitted infections.
If treatment was started not from the first day of the menstrual cycle, but later, then the effect of contraception is reduced. Therefore, additional barrier methods of protection against unwanted pregnancy should be used.
So, if the doctor, after a comprehensive examination, recommends that a woman begin treatment of endometriosis with Silhouette, then the prescribed course should be taken. Moreover, in most cases, the drug is well tolerated and gives excellent results in terms of getting rid of the disease.