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Divigel with IVF

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All processes in the female body associated with the menstrual cycle, conception and pregnancy are controlled by the endocrine system. With a shortage, excess or incorrect ratio of hormones in the blood, various complications and diseases are observed. Most often, due to failures in the activity of the endocrine system, a woman has difficulty conceiving and carrying a pregnancy.

Divigel when planning pregnancy prescribed for the treatment of certain types of infertility associated with estrogen deficiency - female sex hormones. Also, the drug is used after conception to maintain the carrying of a child. The drug has a high efficacy, so it is actively used among expectant mothers.

Drug properties

The active ingredient of Divigel is a synthesized analogue of female estrogen - Estradiol. It has a multifactorial effect on the genitals. Estradiol causes timely rejection of the inner layer of the uterus - the endometrium, which manifests itself in the form of menstrual bleeding.

Also, the active substance stimulates the process of ovulation - the exit of the female sex cell from the ovary. Due to the described effects, the drug regulates the menstrual cycle, relieves the patient from amenorrhea (absence of menstruation) and infertility.

Estrogens contribute to the growth of the inner layer of the uterus in the first phase of the menstrual cycle. With a thin endometrium, the ovum cannot undergo the implantation process necessary for the development of pregnancy. The use of Divegel stimulates the growth of the internal epithelium of the uterus, which saves a woman from infertility.

Estradiol is one of the factors for the maintenance of gestation. With its lack of spontaneous abortion. Divigel during pregnancy contributes to the constant normal concentration of female hormones in the blood.

A hormonal drug has a therapeutic effect not only on the genitals, but also on other human systems. Estrogens are natural factors of protection of the vascular wall, they prevent the development of atherosclerosis. The drug increases the amount of copper, iron and thyroxine in the blood (thyroid hormone).

However, Estradiol also has negative effects on the female body. It causes blood clots due to the activation of coagulation factors. Also, the drug promotes the transfer of fluid from the vascular bed to the interstitial space, which leads to the development of edema.

Release form and shelf life

Divegel is sold only in gel form. It contains 1 milligram of Estradiol, carbomers, propylene glycol, ethanol and distilled water.

The gel is applied to the skin, from where it is absorbed into the systemic circulation. The active substance of the drug enters the liver, where it turns into metabolites. The maximum concentration of estrogen in the blood is observed 1.5 hours after the application of the gel. Most of the drug is excreted through the urinary system.

The drug can be purchased at pharmacies only with a prescription form. The shelf life of the drug is 36 months, at its expiration the use of Divigel is strictly prohibited. The drug should be stored in a dark and cool place away from children.

Indications for use

The use of the drug before conception should occur in the following indications:

  • endometrial thickness is less than 0.5 cm;
  • amenorrhea,
  • irregular menstrual cycle
  • estrogen deficiency
  • lack of ovulation
  • as part of complex therapy for infertility.

During pregnancy, Divigel stimulation is indicated only after IVF. Also, the drug can be used to treat a lack of estrogen after menopause, for the treatment of vaginitis, urogenital disorders.

The effect of the drug on the fetus

The drug belongs to class X according to the FDA classification - taking the drug causes congenital deformities in the fetus. These include heart defects, aplasia of the kidney, microcephaly and other anomalies. Therefore, it is possible to take Divigel during pregnancy only if there is a lack of estrogen after in vitro fertilization, when the absence of therapy causes an interruption of gestation.

Treatment with Divigel during pregnancy planning with timely cancellation does not cause developmental defects in the future child. Estrogens affect generic activity, their intake induces the onset of labor.

Instructions for use

According to the instructions for use, treatment with Divigel is chosen by the doctor, it can be permanent or cyclic. The average dose of the drug is 1 gram per day, but it can be increased or decreased depending on the patient's well-being and the effect of the therapy.

The medicine is recommended to be applied once a day at the same time. Divigel can process the skin of the abdomen, waist, shoulders, buttocks. Places of application of the gel should be changed every day, their volume should be equal to one or two palms. After treatment, the skin can not touch it until the drug is completely dry and wet for one hour.

If the patient has forgotten to apply the gel according to her schedule, it should be done within 12 hours. If this was not possible, the next use of the drug should coincide with the usual time of use. Due to Divigel's irregular application, bloody discharge from the vagina between menstruation is possible.

The technique of applying the drug Divigel:


Contraindications

The drug has a long list of contraindications, including the following diseases:

  • chronic liver disease,
  • congenital abnormalities of red blood cells,
  • herpetic eruptions
  • vascular diseases of the auditory and visual analyzer,
  • obstructive jaundice
  • cholelithiasis,
  • not diagnosed bleeding from the uterus in history,
  • pathology of blood coagulation,
  • high blood calcium,
  • inflammation of the uterus and its appendages.

With extreme caution, Divigel should be used for disorders of glucose metabolism. The drug is not recommended for patients with cardiovascular diseases such as coronary disease, chronic heart failure, high blood pressure. Estrogens are not indicated for women with a history of bronchial asthma.

Side effects

Estrogens are drugs that often cause side effects. With Divigel intake, patients may be disturbed by pain in the head, static and coordination disorders. The drug helps to increase blood pressure, activity of the blood coagulation system.

Divigel can provoke disorders of the menstrual cycle, bleeding between periods, the development of sclerosis of the ovaries, urination disorders. In rare cases, taking the medication causes skin rashes, muscle cramps, obstructive jaundice, and hepatitis.

Divigel's Analogs

Klostilbegit is an anti-estrogen agent, in small doses it stimulates the production of its own hormones. The main indication for the drug is infertility due to the lack of ovulation. Also, the drug is used to treat an irregular menstrual cycle.

Utrogestan and Duphaston - Divigel analogues, containing progesterone. Drugs are used to treat hormonal sterility, lack of ovulation. They can also be used to maintain gestation with a lack of progesterone.

What is the drug prescribed for IVF

Divigel includes estradiol. This hormone is produced during natural pregnancy in large quantities.

With the IVF program, a high level of this female hormone is provided artificially with the help of drugs.

For this purpose, prescribed medication tablets for oral administration, means for external use. But, if the means for internal use are possible side effects, then topical preparations - ointments, gels, creams, do not have a negative effect on the internal organs, as they are absorbed into the skin without penetrating into the systemic circulation.

With natural pregnancy, estradiol levels are very high, this is necessary, as estradiol:

  • prepares the endometrium for implantation of the embryo,
  • controls uterine growth
  • maintains the state of the vagina, fallopian tubes, mammary glands during pregnancy,
  • responsible for the state of the circulatory system
  • required to maintain a high level of iron, copper, thyroid hormone thyroxine,
  • provides a high level of lipoproteins with high density, lowers cholesterol.

The appointment of Divigel in the period of hyperstimulation during IVF has the effect of creating an endometrium that can receive embryos after replanting. The success of the stage of implantation of embryos into the wall of the uterus depends on the thickness of the endometrium.

High levels of estradiol can harm neither the fetus nor the mother's body. But with a shortage of estradiol, the threat of pregnancy is created, the risk of sudden interruption increases.

When conducting pregnancy under the IVF protocol, the level of estradiol is provided with hormonal preparations and amounts to 5,000 - 10,000 pmol / l.

To maintain this level of estradiol, prescribe a drug in the IVF protocol in the case of:

  • thin endometrium (less than 5 mm),
  • estradiol deficiency in women.

Divigel is started 2 weeks before embryo transfer is strictly in the dosage indicated by the reproductologist. Canceled drug after embryo transfer according to the results of monitoring. Usually cancellation occurs at the 12th week of pregnancy in the IVF protocol.

You can not cancel the gel on their own just because you do not like the smell or there is redness on the skin. The onset of pregnancy with IVF needs support, without which the body can not provide the necessary level of female hormones on its own.

Side effects

Side effects from the use of Divigel are reversible, and after discontinuation of the drug they disappear, women may have:

  • swelling,
  • stomachache,
  • high pressure,
  • blurred vision
  • swelling of the mammary glands,
  • melasma,
  • bleeding,
  • depression,
  • anorexia,
  • nausea.

In case of any changes in the body during pregnancy, especially if it occurred within the framework of the IVF protocol, it is impossible to cancel the drugs or replace them with others. Only the attending doctor can recommend a scheme for phasing out Divigel in case of side effects.

How Divigel Works

The drug is available in the form of a gel-like substance intended for external application. Having bought a pack of Divigel in a pharmacy, you can find there 500 or 1000 mg portion bags. The active substance is estradiol - a female hormone produced by a healthy body in the first phase of the menstrual cycle.

Divigel is prescribed when planning pregnancy, when the state of the endometrium is unsatisfactory. The main indicator that encourages a doctor to prescribe a hormonal drug, is ultrasound. A woman who turns to a gynecologist for a prolonged absence of pregnancy undergoes a detailed examination.

If a thin endometrium is diagnosed on ultrasound for several cycles, then the cause of the failure may be in it. Hormonal insufficiency is confirmed by laboratory diagnosis. The egg cannot attach to the uterus, when the nutrient medium for the subsequent development of the embryo is hypoplastic. Even if the pregnancy takes place, then with a thin endometrium, it will be interrupted in the first few days. To prevent these circumstances, the patient is prescribed Divigel.

The drug is absorbed through the skin and increases estradiol levels. Due to the hormonal means, occurs:

  • active build-up of endometrial thickness,
  • stimulation of the development of the uterus,
  • beneficial effect on the function of the fallopian tubes and ovaries,
  • regulation of the menstrual cycle
  • increase in blood volume of thyroxine, copper and iron,
  • anti-atherosclerotic effect,
  • the formation of the correct body response to the production of progesterone.

Divigel is prescribed for the growth of the endometrium first. Also, the drug is used to treat menopausal syndrome and other conditions caused by estradiol deficiency.

The analogue of this drug is Estrogel gel.

How to take Divigel when planning pregnancy

A hormonal agent is prescribed by a doctor based on individual health indicators of the patient. The standard scheme is to apply Divigel once a day on the region of the lower abdomen, lower back, buttocks or forearm. The average dosage is 1 gram of gel. If necessary, the doctor regulates it to 500 mg up or down.

In order to increase the endometrium as efficiently as possible, it is not necessary to wet the treated place within 1-2 hours. Coverage area - 1-2 palms. The period of use is determined individually. Usually, when planning a pregnancy, Divigel (provided that no other drugs are used) begin to be used a day after the completion of the menstrual bleeding.

Sometimes patients complain that their endometrium does not grow on Divigel. However, for a full assessment of the result of treatment, it is necessary to use the gel for several cycles. If after a specified time the doctor does not see a positive trend, then an alternative treatment is selected and a thorough search for the cause of the failure is carried out.

Divigel with IVF

Divigel with IVF is used with the same purpose as with conventional conception - to increase the endometrium and thereby increase the chances of a positive outcome. The drug begins to apply no later than two weeks before the procedure. The doctor may prescribe a hormone treatment in the natural cycle to predict the reaction of the patient’s body.

The procedure of in vitro fertilization is quite complex and includes many nuances, so you should calculate the possible steps in advance. If the endometrium grew well in response to the use of Divigel in the natural cycle, it is used in the IVF protocol.

In support of the IVF protocol, the drug is taken daily. It is unacceptable to skip the application of the hormone. After embryo transfer, the drug continues to be used by connecting additional support agents. Divigel contributes to a better effect of progesterone on smooth muscles, which reduces the likelihood of rejection of embryos.

Divigel cancellation after IVF is carried out according to the scheme prescribed by the doctor. If the procedure is successful, the use of the medicine should not be interrupted sharply. The dose of the drug is reduced gradually. Divigel should be canceled during pregnancy after IVF at 6-7 weeks.

Interaction with other drugs

Divigel is a hormonal agent that regulates the level of substances produced in the first phase of the menstrual cycle. The use of the drug after ovulation is theoretically not necessary. However, the medication can be used for a long time as prescribed by the doctor

When planning a pregnancy, other medications that form the correct functioning of the reproductive system are also recommended. Among them, the most common follicle growth stimulants, drugs to maintain the second phase, as well as means that cause the immediate release of the egg from the ovary. It is important to choose a suitable application scheme and at the same time consider possible problems of the combination. This proves once again that without the appointment of a doctor, Divigel cannot be used.

Divigel and Duphaston when planning pregnancy can be used in one cycle. These drugs are responsible for the production of various hormones. Divigel increases the endometrium, and Duphaston maintains it in a condition favorable for implantation. Drugs are well combined and do not suppress the action of each other. The same can be said about Utrozhestane, the action of Duphaston and Utrogestan is similar.

It is important to take Duphaston only in the second half of the cycle. To determine the output of the egg can be using ultrasound or home tests for ovulation. In the IVF protocol, Duphaston begins to take after puncture of the eggs, while continuing to use Divigel.

Thyroid Hormones

Drugs that compensate for the lack of thyroid hormones are taken by women, who often need to increase the endometrium. The question of the simultaneous administration of Divigel and levothyroxine-based products is decided by the doctor individually. Estrogen-containing medications contribute to increased levels of thyroxin-binding globulin, with the result that in some patients the need for a dose of thyroid gland hormones may increase.

The use of the gel in women with diseases of the thyroid gland is carried out under the supervision of a physician.

Klostilbegit

Patients with ovulation problems are prescribed Klostilbegit and Divigel in one cycle. They should not be used at the same time, as together the drugs have a lower therapeutic effect than individually. During stimulation, divigel usually starts to be taken at the moment when Klostilbegit is canceled. This technique allows you to get the maximum positive properties of both hormones.

Stimulation of ovulation begins in the first days of the menstrual cycle.For example, on the fifth day, Klostilbegit is taken. The last dose of the drug is taken on the tenth day of the last menstrual period. At the same time, the scheme provides Divigel, which is used in case of pregnancy for several weeks. Klostilbegitom suppresses the growth of the endometrium, therefore, during its use estrogen-containing remedies are recommended even to those patients in whom the endometrium grows well in the natural cycle.

Does it affect ovulation

The drug Divigel is used to get a "lush" endometrium, in which a fertilized egg is easily implanted. The drug has no effect on follicle growth and ovulation. If the drug is used alone, without additional stimulants, then its use begins from the first days of the cycle. By the time the follicle opens, the thickness of the uterine mucous layer reaches the desired level. The use of the drug with stimulants involves alternate use, as a result of which the patient requires an increase in the dose of an estrogen-containing agent.

About the composition of Divigel

As stated above, the main substance of the gel is estradiol - the female hormone contained in a single dose of the gel in the amount of half a gram. This substance does not dissolve in water, therefore, the additional composition of the gel consists of the following components:

  • propylene glycol,
  • Carbopol 974P,
  • methylcarbinol,
  • trolamine,
  • distilled water.

The gel was packaged in metallized sachets, in doses of 500 mg, 1 g. One pack includes 28 disposable sachets. Different doses at the discretion of the attending physician.

About the way of Divigel

The gel should be applied once a day, at the selected hour, without changing the time of application, on the skin below the abdomen, possibly in turn on one of the buttocks or the lumbar spine.

Divigel is applied with an area of ​​no more than two palms, the dosage of the gel should not be higher than that prescribed by the gynecologist, since an excessive amount of a hormonal drug is unacceptable and unhealthy. If the dose of the gel is distributed over a wider area, it will interfere with the absorption of hormones, and, as a result, the treatment. The amount of gel per day is from 500 mg to 1.5 g. The dose prescribed by the doctor takes into account how large the female hormone deficiency is in women and the severity of the manifestations of menopause.

How long does it take to absorb the substance into the skin? After spreading, you need to wait for the medicine to absorb; a few minutes is enough for the substance to completely penetrate. Do not wash, do not wipe the place of application of the gel for one hour.

It is forbidden to apply a medicine to the region of the mammary glands and the epithelium of the vagina and external genital organs.

Effect of Divigel on the body

After absorption, the hormones penetrate through the blood into the necessary organs and carry out the following work:

  • stimulation of the normal functioning of the genitals, mammary glands,
  • protection against bone destruction,
  • increase in the presence of serotonin hormones in the body, as they are needed to eliminate such signs of menopause as depression, emotional instability, anger,
  • elimination of insomnia
  • tide neutralization
  • stop salt deposits on the joints,
  • normalization of blood clotting,
  • blood fortification with minerals
  • the fight against atherosclerosis,
  • lowering blood sugar
  • establishment of monthly cycles,
  • correct endometrial cyclic transformation
  • cleaning vessels from cholesterol deposits,
  • removal of uterine spasms, leading to lower abdominal pain.

The question may arise: how many months to smear the skin with this potent gel? Instructions for use says that the duration of treatment with Divigel in menopause is three months. In case of surgical menopause, there is a need in addition to gel treatment to add progestin hormones used in each three-month treatment cycle for ten to twelve days in a row.

Interesting! Scientists have found that taking low-dose estrogen drugs (among them Divigel) in the amount of one mg per day is just as effective for lowering bad cholesterol as statins, which have many negative effects after they are treated.

If you start using estradiol massively for women since the onset of perimenopause, the death rate from cardiovascular problems will decrease by almost a third.

Preparation for treatment with Divigel

Before the appointment of estrogen therapy, the patient is examined:

  1. ultrasound examination of female and nearby organs,
  2. oncocytological examination of a smear of the female organ,
  3. mammography,
  4. hormone and sugar tests,
  5. coagulograms,
  6. biochemical analysis of blood, bilirubin.

Who should not appoint Divigel?

Since Divigel is an estrogen drug, it can only be used after determining the state of the hormonal background.

It is forbidden to treat hormonal gel in the presence of the following diseases:

  • lipid metabolism disorders
  • anemia,
  • angiopathy, retinopathy, decompensated diabetes,
  • hemangiomas,
  • congenital hyperbilirubinemia,
  • thrombophlebitis, venous thrombosis, pulmonary embolism, vein blockage,
  • hormone-dependent pituitary neoplasms,
  • diffuse diseases
  • hemorrhagic, ischemic cerebral stroke, cerebral atherosclerosis,
  • increased estrogen level during menopause,
  • endometritis, salpingoophoritis, cervicitis,
  • hyperplasia of the uterine lining,
  • uterine bleeding of unknown etiology,
  • tumors of the mammary glands: benign, malignant, diagnosed or transferred,
  • otosclerosis
  • tumors of the female organs, benign, malignant (oncology of the ovaries, vagina, cervix and the uterus itself, myomas, fibroids),
  • cholestatic jaundice,
  • intolerance to estradiol and other components of the gel.

Attention! There are rules that must be strictly followed during hormonal therapy during menopause:

  1. Since treatment with Divigel is included in the category of hormone replacement therapy, before the patient begins to use it or reappoint it, the woman should provide the doctor with reliable information about the diseases she and her family have had.
  2. A complete examination of the patient is necessarily assigned to eliminate contraindications and be safely treated with this drug.
  3. During treatment with Divigel during menopause, for safety reasons, regular repeated examinations are important, which are completely individual for each woman according to her medical history.
  4. You should not avoid prescribed examinations, which can protect the woman from the undesirable effects of the drug.
  5. Doctors are required to exercise continuous monitoring of the patient's condition: if she had previously described the diseases described below, had exacerbations during pregnancies or possible hormone therapies earlier.

With strict control of doctors, treatment of severe manifestations of menopause with Divigel is possible with caution if the woman and her immediate family have the following diseases:

  • migraine,
  • heart failure
  • liver failure, kidney,
  • epilepsy,
  • liver adenomas,
  • thromboembolism
  • inflammation of blood vessels,
  • diabetes mellitus
  • bronchial asthma,
  • hypertension,
  • swelling,
  • stones in the liver and kidneys, gall bladder,
  • endometriosis,
  • previously treated hyperplasia of the uterine lining,
  • otosclerosis of the ears,
  • porphyrias,
  • fibrocystic mastopathy,
  • the presence of immediate relatives of estrogen-dependent breast tumors (to eliminate the risk of the patient becoming ill with them),
  • women over sixty-five.

Despite the obligatory control in the course of gel treatment, sometimes, although rarely, relapses and exacerbations of the above diseases occur.

In this case, you need to stop using the gel.

How does the doctor control Divigel?

Since Divigel is a hormonal remedy, the patient is obliged to come to the gynecologist once a year during the treatment in order to verify the positive effect of the hormonal drug. It is also necessary to carry out:

  1. colposcopy
  2. ultrasound examination of female organs
  3. mammography screening
  4. blood tests (biochemistry, sugar, liver enzymes, AST, blood clotting).

All of these analyzes may seem annoying, but are essential for the safety of a woman’s condition.

About excess doses and duration of estrogen therapy

Both the lack and excess of estrogen in the body causes negative consequences:

  1. Women who have been taking hormone therapy for a long time may develop hyperplasia of the uterine mucosa, due to excessive estrogen background, or a malignant lesion of the mucous membranes of various organs. To guarantee protection against this risk, a combination therapy of estrogens and progesterone hormones is needed for twelve days of the therapeutic process of hormone therapy, in case the woman has non-surgical menopause.
  2. There are cases when patients who have taken Divigel therapy for menopause for several months, breakthrough bleeding or minor bleeding occurs. This makes it necessary to search for the causes of such processes, using the biopsy of the mucous membranes of the female organ, to prevent the onset of the transformation of healthy or atypical cells into oncological ones.
  3. Long-term hormone replacement estrogen therapy increases the risk of breast oncology. More subtle women (slim) are exposed to such danger, because obese women have the availability of estrogen, which the body can receive by transforming the cells of the subcutaneous tissue of fat. By stopping hormone therapy, we can expect a return to the formerly low level of estrogen presence in the body after five years, then the danger of breast cancer goes away.
  4. With combined estrogen-progesterone therapy, the risk of breast cancer is identical to the treatment of only female hormones, and sometimes higher than the second.
  5. Women who have treated menopause ZGT, two to three times more often get diseases of the veins in the legs, blockages of blood vessels, especially in the 1st year after therapy with hormones.
  6. Hormone treatment should be stopped four to six weeks before planned surgical interventions in the pelvic organs, orthopedic operations of the legs.
  7. Female hormones can cause water retention in the body. If a woman has kidney disease, the doctor is obliged to strictly monitor the patient's condition during treatment with estrogen.
  8. Patients with diabetes mellitus from the beginning of HRT need to measure the state of sugar in the blood, since estradiol removes glucose from the body.
  9. In some cases, the administration of Divigel increases the lipid level in the vessels, which can cause pancreatitis.
  10. Estrogen treatment can cause a rise in the presence of a globulin, hormonal background thyroid.

How does estrogen affect other medications?

Estrogen therapy often coincides with the treatment of other diseases that occur during and after menopause.

In a young age, women rarely maintain absolute health, and in the treatment of ailments, it is necessary to take into account the effect of estradiol on the following drugs:

  • enhances the positive effect of drugs to reduce the lipid presence in the blood,
  • reduces the therapeutic effect of the progesterone drug, antidiabetic, diuretic, pressure reducing, anti-thrombotic therapeutic agents.

How do other medicines affect divigel?

Since Divigel is a female hormone that is necessary for menopausal estrogen hormone deficiency, it is necessary to take into account during treatment, which reduces its therapeutic effect by taking the following drugs:

  • barbiturates
  • tranquilizers,
  • Oppioid analgesics,
  • anesthetics
  • antiepileptic - carbamazepine, phenytoin,
  • liver inducers zixorin, phenobarbital,
  • drugs with St. John's wort.

A drug such as Phenylbutazone, while taking it with Ampicillin, Rifampicin, Rifabutin, antiviral Nevirapine, Efavirenz, reduces the presence of estradiol in the blood, so you should discuss all the details of treatment with your doctor before therapy.

Folic acid, drugs for the treatment of thyroid, on the contrary, increase the effectiveness of estradiol.

Surgical Menopause and Divigel

The concept of a surgical pause refers to the operational cessation of the functions of the uterus and ovaries after their removal. With surgical menopause, there is no smooth transition to a lack of female hormones: menopause occurs abruptly, the body is unable to adapt to the new conditions of the hormonal background. Usually, after the removal of the genitals or part of them, very quickly, within a month, severe signs of menopause begin to appear, sometimes leading to disability.

Treatment of surgical menopause is performed by a gynecologist, a mammologist and an endocrinologist - all together. Moreover, HRT is prescribed for a period of two years, after a month and a half or two months, there is a noticeable relief of the condition, although some women in the forum claim that Divigel was weak for them, some symptoms persisted. With different removal of organs, the therapy is different:

  1. Remote appendages while preserving the uterus in patients up to the age of fifty require cyclic use of estrogen for two mg per day and one mg of cipraterone or estrogen, one mg each with ten mg of didrogesterone.
  2. For patients after fifty-one years and after the removal of the uterus and appendages - the constant intake of estradiol in the amount of one mg with five mg of didrogesterone.
  3. After removal of the endometrium of the uterus with endometriotic lesion, one-time treatment with estrogen in the amount of one mg with five mg of didrogesterone is practiced.

Estradiol in the form of Divigel involves a more careful treatment, saving the liver, stomach and intestines.

Utrozhestan and Divigel: combined application

This Belgian drug is unique in its kind, contains the substance of micronized natural progesterone. Utrogestan is a suitable drug for HRT in menopause and perimenopause for complex therapy with Divigel. Pros Utrozhestan:

  • lack of swelling of the body,
  • does not cause obesity,
  • can be used in combination with various medications.

This drug is produced in capsules of one hundred and two hundred mg and candles. The agent in capsules consists of the following substances:

  • progesterone isolated from the yam plant
  • peanut butter,
  • lecetin,
  • glycerol,
  • gelatin,
  • titanium dioxide.

In premenopausal women, hormones are drunk in the evenings to two hundred mg, and, if necessary, as it is, in the morning one hundred mg, from the seventeenth to the twenty-sixth day of the menstrual cycle.

When prescribed hormone therapy in menopause, the drug is drunk from the eighth day from the beginning of each three-month treatment cycle for 14 days. Do not be afraid if with complex treatment at first there will be withdrawal bleeding. The postmenapausal period includes the administration of one hundred to two hundred mg of Utrozhestan daily with estrogens. The exact amount of the drug prescribed by doctors individually for each patient.

Progesterone drug is also produced in the form of vaginal suppositories for use in the following cases:

  • in combination with estrogens after remote appendages,
  • with early perimenopause, after it, also with estrogen,
  • if gestagenic insufficiency occurs,
  • for the prevention of fibroids,
  • with endometriosis.

Candles have a less negative effect on the body, and therefore are more often recommended for treatment.

Before the appointment of Utrozhestan, the doctor should conduct the necessary examination of the patient. Like any hormonal remedy, suppositories and capsules of this drug must be applied daily, without interruption of treatment, then during menopause every day there will be a normal amount of progesterone, which will help smooth out the negative manifestations of menopause.

Progesterone requires precise quantitative and temporary use to avoid overdose and adverse events, such as:

  • bleeding during menopause, similar to menses,
  • osteoporotic bone thinning,
  • allergic reactions to the constituent substances of the drug.

With persistent damage to the health of a woman from various diseases, the use of a progesterone can aggravate some chronic diseases, but in the history of use this has happened extremely rarely. It is better for women with liver disease to use Divigel than tablets, with simultaneous treatment with utrozestan vaginal suppositories.

Before the end of the publication, I want to cite one of the reviews of women who use Divigel:

A woman named Elena writes:

“I think Divigel is the best remedy for menopause. I don’t trust the pills, even though there are many of them, a sick stomach and intestines. The terrible manifestations of menopause made me think of being treated with hormones. Gel treatment was very pleasant, gradual, can be taken in small portions, the effect - as with healthy appendages. I have been smearing for five years now, periodically, for two months continuously, with a break for a month. I believe that it will soon be possible to stop using the gel: the tides are gone, the vagina is moisturized, and other symptoms of menopause do not bother. "

If you follow a number of rules and recommendations of doctors, we can say that Divigel can be your assistant in the fight against manifestations of menopause without much difficulty. Be healthy!

Important and useful video on this topic:

The role of the endometrium in the process of conception

The healthy state of the uterus is an important condition for conceiving and carrying a child. During pregnancy, the body is incredibly changing to provide the fetus with everything necessary for full growth and development. The uterus is a hollow muscular organ. Its internal mucosa, including the basal and functional layers, is called the endometrium.

Endometrium is a hormone-sensitive tissue, therefore, when a hormonal failure occurs, a woman is often diagnosed with infertility. If for some reason the endometrium does not reach the normal width, the egg cell does not attach or very soon rejects. The condition can be diagnosed during an ultrasound.

In the normal state, endometrial functionality is regulated by estrogens. The uterine lining can only thicken under their influence. They are produced by follicles at the end of the follicular phase of the cycle. If the process of maturation of the dominant follicle is disrupted, hypoplasia may develop, since endometrium has no place to come from.

During each menstrual cycle, the endometrium changes to be ready at any moment to accept a fertilized egg. When fertilization does not occur, the functional layer is rejected and removed from the body. During fertilization, the embryo attaches to the mucosa. From the endometrium, the fetal membrane and placenta are subsequently formed.

The rate of endometrial thickness is different for each phase of the cycle. To determine this figure, you can use ultrasound. At the beginning of the cycle, the thickness of the endometrium is 1–4 mm, gradually increasing to 14–20 mm. For the onset of pregnancy requires more than 7 mm.

After the onset of pregnancy, the endometrium continues to develop. The number of vessels and glandular cells, which will form the placenta in the future, is growing rapidly. In the first trimester, the endometrium is a source of oxygen and nutrients for the fetus. With insufficient performance, even after successful conception, miscarriage can occur, so it is important to keep hormones normal.

Divigel with endometrial hypoplasia

Abnormalities include hyperplasia and hypoplasia. Hypoplasia is characterized by constant endometrial fineness throughout the entire cycle. This is observed in chronic endometritis, circulatory disorders and a decrease in the sensitivity of the receptors to the hormones estrogen. Hyperplasia is the reverse state when the endometrium is hypertrophied. The disease is diagnosed with a strong hormonal disorder, increased estrogen concentration and reduced progesterone levels.

Divigel when planning pregnancy is most often prescribed in the event that there is endometrial insufficiency. When a woman is diagnosed with hypoplasia, fertilization occurs, but there is no possibility for the embryo to consolidate in the uterus and begin to fully develop. If the thickness of the endometrium is less than 5 mm, the chances of getting pregnant are reduced to 1%.

Hypoplasia can be cured with hormone therapy. If the estrogen deficiency is replenished, the endometrial thickness is normalized. Divigel - gel with estradiol on a spirit basis. Getting on the skin, the alcohol evaporates, and estradiol penetrates into the circulatory system. The optimum area of ​​application is 200-400 cm 2. When the gel spreads over a large area, the degree of absorption decreases.

Divigel therapy does not cause fluctuations in the concentration of estrogen in the blood plasma, which differs from treatment with oral hormones. This is due to the ability of estradiol to linger in the subcutaneous tissue and bypass the first stage of hepatic metabolism.

In the treatment with Divigel, the ratio of estradiol and estrone is kept at a level of 0.4-0.7, while when taking oral estrogen it decreases to 0.2. Features of metabolism and excretion of Divigel correspond to natural estrogens.

Features of Divigel

Since the main component of Divigel is identical biologically and chemically to the natural hormone, it performs similar functions. Estradiol Valerite is a synthetic 17β-estradiol, which is an analogue of human endogenous estradiol. The substance is able to compensate for the lack of hormones in women at the stage of menopause (and thereby reduce the severity of symptoms), as well as eliminate the signs of endometrial hypoplasia in young women.

As monotherapy or additional effects on the body, the drug is prescribed for polycystic ovaries, genital underdevelopment, estrogen deficiency, and also before IVF. Estrogens can prevent bone loss that occurs during menopause and after oophorectomy.

Penetration of estradiol and medroxyprogesterone acetate through the skin contributes to lowering cholesterol, but does not change the HDL cholesterol. Divigel during menopause acts similarly to oral estrogen preparations.

Composition Divigel:

  • gel 0.1% (0.5 g): estradiol 0.5 mg, carbomer 974P, ethanol 96%, triethanolamine, propylene glycol, water,
  • gel 0.1% (1 g): estradiol 1 ml, carbomer 974P, ethanol 96%, triethanolamine, propylene glycol, water.

After absorption, the components are associated with carrier proteins and act on the uterus, ovaries and mammary glands. Divigel is preferred because it does not overload the liver and does not cause fluctuations in the level of estrogen in the blood. This has a positive effect on the effectiveness of therapy. It is noteworthy that estradiol is well absorbed only when using a normal dose, and with decreasing or increasing portions of the gel, this process slows down.

Instructions for use

Divigel prescribed for estrogen deficiency caused by menopause (natural or artificial), receptor disorders and endometriosis. Also, the drug is prescribed for the prevention of osteoporosis in the postmenopausal period, when the risk of fracture increases, and other drugs are contraindicated.

Divigel is intended for long-term treatment. The doctor chooses the dates and doses individually for each patient. The therapeutic effect is achieved with transdermal application. Usually, 1 g (1 mg of estradiol) is prescribed per day at the start of therapy. Dose can be adjusted after 2-3 cycles. Permissible dose of 0.5-1.5 g per day. To eliminate the symptoms of postmenopause, prescribe a minimum dose for a short course.

In patients with an intact uterus, the drug must be combined with progestogen therapy (with an interval of 20 days). For these purposes, norethindrone, didgrogesterone, medroxyprogesterone acetate or norethindrone acetate are prescribed for 2 weeks. It must be remembered that progestogens are contraindicated after hysterectomy, unless endometriosis has been identified.

You must always choose one time. The gel is applied to clean and dry skin. The drug can be applied to the lower part of the peritoneum, shoulder, forearm, lower back and buttocks. It is important to regularly change the place of application. You can not apply the gel on the genitals, mammary glands, face and irritated skin. Avoid eye contact. Wash hands immediately after application.

The optimum area of ​​application is 1-2 palms. After using Divigel, you need to wait several minutes before drying. The site can not be washed for an hour. It is best to apply Divigel before bedtime. This eliminates the possibility of moisture on the area of ​​application. When irritation or a rash occurs after applying the gel, you should stop using the drug and consult a doctor.

If the patient has not previously undergone hormone replacement therapy or goes to Divigel after combination therapy, treatment can begin on any day. After continuous hormone replacement therapy, Divigel is started after the last treatment cycle. Divigel's irregular use can provoke uterine bleeding, similar to menstruation.

If one session of applying the gel has been missed, the treatment is continued the next day. Divigel is used according to a specific scheme, so it is advisable not to skip the procedure. Ignoring therapy for four consecutive days can cause uterine bleeding. For this reason, hormonal therapy is not abruptly canceled (only in the case of pronounced side effects). Abrupt cessation of therapy can cause miscarriage.

What to look for

Breakthrough bleeding and bleeding may occur in the first months of treatment. If they arise shortly after starting treatment or continue after Divigel is canceled, it is necessary to establish the cause. Endometrial biopsy will provide an opportunity to exclude malignant disease.

Some patients note an increase and tenderness of the mammary glands. Usually these phenomena are short-lived, they disappear even with continued treatment. Side effects of varying intensity are observed in 76% of patients.

Possible side effects

  1. Benign and malignant neoplasms, cysts, polyps, fibroids.
  2. Exacerbation of angioedema (hereditary).
  3. Swelling, weight gain, increased appetite.
  4. Depression, drowsiness, anxiety, apathy, insomnia, agitation.
  5. Headaches, dizziness, migraine.
  6. Dryness of the membranes of the eyeball, visual disturbances (rare).
  7. Hot flashes, heart palpitations, high blood pressure.
  8. Nausea and vomiting, colic, flatulence, constipation, diarrhea, abdominal pain.
  9. Acne, dry skin, rash, dermatitis.
  10. Increased frequency of urination, cystitis.
  11. Vaginal discharge, menstrual disorder, endometrial hyperplasia.
  12. Itching, irritation, discomfort.

When Divigel was combined with estrogen-progestogens, there were cases of estrogen-dependent tumors, venous thromboembolism, heart attack and a sudden stroke. In some cases, there are violations of the functionality of the gallbladder, chloasma, erythema, hemorrhagic rash. Patients over 65 can develop dementia.

Risks of hormone therapy Divigel

Long-term therapy with estrogens and progestogens (more than 5 years) increases the risk of developing breast cancer. Women who have been treated with estrogen monotherapy are less susceptible to cancer.

In patients with an intact uterus who did not use hormone replacement therapy at the stage of menopause, the risk of endometrial cancer increases (5: 1000). Hormone monotherapy is not recommended. The risk of oncology depends on the duration of treatment and the dosage of hormones. The risk is reduced by adding progestogens for at least 12 days into the therapy cycle.

Studies show that five-year replacement therapy does not contribute to endometrial cancer, as does ovarian cancer. During 5 years of observation, one additional case of oncology of ovaries per 2500 women with HRT was recorded.

After cessation of replacement therapy, the risk of cancer persists for 10 years. Erogen-free progestogen monotherapy can increase the risk of precancerous and malignant changes in endometriosis. The doctor may add progestogen to therapy for patients who have treated endometriosis through hysterectomy.

The risk of malignant breast disease is increased in those who are undergoing estrogen monotherapy, as well as in those patients who receive estrogen and gestagen. Combined estrogen-progestogen therapy increases the risk of breast cancer (manifested after 3 years).

Hormone monotherapy in women with a history of hysterectomy does not increase the risk of breast cancer. The increased risk of cancer pathologies with long-term estrogen monotherapy is obvious, but the risks are reduced to baseline several years after discontinuation of therapy.

Hormone replacement therapy doubles the risk of venous thromboembolism. Typically, violations are diagnosed in the first year of treatment. Somewhat increases the risk of coronary disease in patients over 60 years. The risk of ischemic stroke increases one and a half times (as with estrogen monotherapy, and when combined). Chances of hemorrhagic stroke do not increase.

Treatment Directions for Divigel

Hormone replacement therapy is prescribed only when the symptoms of disorders extremely negatively affect the quality of life. The physician should evaluate the benefits and risks of treatment. Divigel can only be used until the benefit exceeds the harm.

Divigel can be prescribed only after examination. The doctor must collect a personal and family history and diagnose (carefully examine the pelvic organs and mammary glands). This is necessary in order to determine the contraindications and adjust the dose.

What conditions require control in treating Divigel:

  • uterine leiomyoma,
  • endometriosis,
  • thromboembolic pathologies,
  • estrogen-dependent tumors
  • arterial hypertension,
  • bronchial asthma,
  • liver disease,
  • epilepsy,
  • diabetes,
  • otosclerosis
  • cholelithiasis
  • severe headaches or migraines,
  • systemic lupus erythematosus,
  • endometrial hyperplasia,
  • Quincke's edema (hereditary).

When the gel should stop taking

Divigel hormone therapy is immediately stopped if jaundice occurs, poor liver function is observed, blood pressure is pronounced, severe headaches appear, or pregnancy occurs. If you experience chest pain, painful swelling of the lower extremities and shortness of breath, you should immediately consult a doctor. These may be symptoms of thromboembolism.

It must be remembered that estrogen-progestogen therapy increases the density of the mammary gland, and this may impede the radiological diagnosis of cancer. With long-term use of anticoagulants, the question of the appointment of Divigel is considered separately.

Estrogens are able to trap fluid. Patients with pathologies of the heart and kidney should regularly visit the doctor. It is important to observe patients with hypertriglyceridemia. During hormone therapy, they may experience a sharp increase in plasma triglyceride levels and develop pancreatitis. Estrogens increase the level of thyroid binding hormone and increase the concentration of thyroid hormones. The concentration of binding proteins increases in the blood.

Sometimes during replacement therapy, chloasma occurs, especially in patients who have skin problems during pregnancy. Such women need to minimize the influence of the sun and ultraviolet radiation during hormonal therapy.

The use of Divigel during pregnancy and lactation is not recommended. If conception occurred during hormonal treatment, it is necessary to stop using the gel. Accidental use of the product during childbirth has no significant effect on the embryo.

Divigel has no contraceptive effect. The drug is not prescribed to children. Divigel does not affect the reaction rate and attentiveness. Allowed to drive vehicles and potentially dangerous equipment.

Interaction with other drugs Divigel

Estradiol metabolism can be accelerated when Divigel is combined with hepatic enzyme inducers. Ritonavir and Nelfinavir have an inducing effect. Divigel's effect is enhanced when combined with folic acid and thyroid hormones, as well as barbiturates and analgesics. Phenylbutazone and some antibiotics reduce the effectiveness of Divigel.

Preparations with herb St. John's wort can increase the exchange of estrogen and progestogen. Since during transdermal use, the components of Divigel do not undergo primary processing by the liver, estrogens and progestogens are less affected by enzyme inducers, unlike oral hormones.

Divigel before IVF

In vitro fertilization has now become a salvation for many couples who dream of children. The technique allows you to achieve pregnancy even in severe cases of female and male infertility. However, it is impossible to simply conduct IVF, because the woman's body must be ready for fertilization. To prepare the endometrium of the uterus, doctors may prescribe Divigel.

Before the procedure, partners are examined, a woman is subjected to hormone therapy to prepare her body for pregnancy. Without this, the fetus will not be able to remain in the uterus and fully develop. Doctors do not conduct IVF without preparation, because all chances are reduced to nothing.

In order to prevent the rejection of the embryo, the patient is prescribed estrogen drugs that stimulate mucosal growth. Only in such conditions will the fetus provide vital activity. This helps the synthetic estrogen contained in Divigel.

Divigel is prescribed before fertilization in order to eliminate hypoplasia and prepare the uterus for pregnancy, as well as after IVF to compensate for the lack of estrogen. Divigel is also prescribed in the absence of ovulation, which affects the state of the endometrium. In addition to increasing the endometrium, Divigel helps to improve the functionality of the entire reproductive system of a woman and create ideal conditions for pregnancy.

Divigel increases the level of estrogen, which contributes to the thickening of the endometrium. In addition, the drug stimulates the development of genital organs and tubular bones. It is impossible to exceed the dosage of Divigel. With proper use of the drug has an effective effect and solves the problem of hormonal infertility. However, non-compliance with instructions and dosages can harm the body of a woman.

What is this drug and what is its effect?

«Дивигель» являет собой спиртосодержащий гель, и является синтетическим эстрадиолом, похожим на естественный гормон, производимый яичниками у женщин. Этот gel promotes development:

  • the reproductive system (uterus),
  • fallopian tubes,
  • vagina,
  • ducts of the mammary glands.

In addition, it stimulates the transition in the tissue of intravascular fluid, an increase in the blood of copper, iron and thyroxin.

Indications, contraindications, side effects

Divigel is also prescribed for the treatment of menopausal syndrome associated with menopause (natural or artificial), which appeared after surgery. But, like most drugs, Divigel has contraindications, and can cause side effects.

The drug is prohibited for use in the presence of the following diseases:

  • special sensitivity to the ingredients of the gel,

  • suspected breast cancer or its presence,
  • tumors of the uterus, ovaries or endometrium,
  • vaginal bleeding,
  • venous thrombosis,
  • otosclerosis
  • epilepsy,
  • heart diseases,
  • pulmonary embolism
  • thrombophlebitis,
  • congenital hyperbilirubinemia,
  • liver diseases (cancer, hemangioma),
  • stroke,
  • diabetes,
  • impaired fat metabolism,
  • bronchial asthma.

If the gel is applied improperly or when a higher dose is used than recommended, adverse effects may occur. Namely:

  • slight puffiness
  • headaches,
  • irritability and depression
  • lack of sexual desire
  • poor appetite
  • diarrhea,
  • nausea,
  • appearance of atypical vaginal discharge,
  • itching of the skin,
  • hives,
  • cramps and cramps in the stomach,
  • high blood pressure.

Why is it prescribed for in vitro fertilization?

In order for the IVF procedure (in vitro fertilization) to be successful, prospective parents need a long and careful preparation for it. At all stages of examinations and therapies, the female body needs special support.

For this, doctors prescribe to use "Divigel." It helps to prepare the endometrium for the introduction of the embryo, to control the development of the uterus, to maintain the state of the mammary glands and the genital tract during pregnancy. And also regulates the state of the circulatory system, and reduces cholesterol levels.

The use of “Divigel” helps to achieve the desired effect to create an endometrium that accepts the embryo after implantation. The drug is used to increase the thickness of the uterine mucosathat will further help the fetus to gain a foothold, and thereby prevent miscarriage.

Recommendations and schemes of application

Do not forget that "Divigel", like any drug, should be used only after consulting and diagnosing a doctor. And only for its intended purpose.

The gel is used by rubbing into clean skin.:

And strictly at the same time once a day. As a rule, the drug is applied at bedtime to avoid contact of water with the areas of gel application. They can not wet two to three hours after the procedure. But the hands after applying the gel must be thoroughly washed. With soap.

It is worth noting that the gel is taken according to the scheme, and if it was not possible to apply “Divigel” at the right time, but less than 12 hours have passed, it should be applied immediately. If more than 12 hours - then use the gel is not necessary. In this case, the next procedure should be started at the right time according to the schedule. Highly It is important to avoid frequent omissions of remedial measures, otherwise uterine bleeding may occur..

When and how after fertilization cancel the reception?

Discontinuing the use of Divigel plays an important role, as in its appointment. The refusal of the prescribed funds occurs only after consultation with the doctor and under strict control.

Usually, a child’s drug is withdrawn 12 weeks after the beginning of the child’s birth. But for each woman, the timing of the cancellation of the gel is individual, and is calculated on the basis of medical indications after a special diagnosis.

The dosage of the drug should be reduced gradually, without abruptly abandoning it., as this can lead to miscarriage.

Years of experience with the use of "Divigel" proved the effectiveness of the drug. What is evidenced by clinical trials and positive reviews of women who have resorted to in vitro fertilization. But do not forget that when planning pregnancy, the use of the gel is possible only after a thorough examination, and on the recommendation of specialists.

The composition of the drug

"Divigel" is produced by manufacturers in the form of a transdermal gel, which serves to eliminate signs of a lack of estrogen. It is a homogeneous composition and is packaged in aluminum bags.

In its composition, the gel has:

  • Estradiol in the amount of 500 mg or 1 g.
  • Carbomer 974R.
  • Triethanolamine.
  • Propylene glycol.
  • 96% ethyl alcohol.
  • Purified water.

Pharmacological action of the drug

"Divigel" refers to a group of medicines that are used to correct disorders caused by menopause in a woman’s life. It has estrogenic effects.

The therapeutic effect after application is achieved as a result of the activity of estradiol. This estrogenic agent, which contains “Divigel” for endometrial growth, is identical in its biological, chemical and pharmacological properties to endogenous estradiol synthesized by the ovaries in the female body.

If you look at the classification of drugs, estradiol belongs to several pharmacological groups:

  1. Estrogens, gestagens, their antagonists and homologs.
  2. Antineoplastic hormones and hormone antagonists.

The active ingredient of the drug compensates for the lack of female hormones and stimulates the activity of estrogen receptors located in target cells.

Pharmacokinetics

Estradiol contained in the gel, through diffusion freely penetrates into target cells, where it is transported into the nucleus and forms a bond with estrogen receptors. Such receptors are found in different tissues. But most of them are found in the uterus, liver, ovaries, bones and breasts.

The active component of the gel - 17 beta estradiol - has the following effects:

  • Stimulates the development of the female reproductive system.
  • It causes pigmentation in the nipple area.
  • Provides rejection of the endometrium that lines the uterus.

  • Provides a regular menstrual cycle.
  • Stops the production of breast milk.
  • It has a procoagulant effect.
  • It has a positive effect on the recovery of leukocyte counts after radiation injury.

Estradiol still has many important qualities, which include:

  • Prevention of atherosclerosis.
  • Increased blood levels of HDL.
  • Decreased LDL values.
  • Reducing cholesterol.

After the onset of menopause in the body of a woman, the ovaries stop producing estradiol, this function remains in the liver and adipose tissue. The decrease in the level of estrogen leads to the fact that there is vasomotor instability, manifested in flushing of the face, problems with sleep.

Another negative consequence of the lack of estrogen is the development of osteoporosis. This metabolic disease primarily affects the spine.

When taking estradiol orally in the form of tablets, injections, there is a gradual accumulation in the body of this substance, which leads to a significant jump in blood pressure. "Divigel" for the growth of the endometrium in this regard, has positive, the patient during the reception do not mark hypertension.

The gel is made on the basis of alcohol, but after contact with the skin, ethanol quickly disappears, and the active substance penetrates through the integument and is absorbed into the blood. A small amount of estradiol is retained in the skin, and then gradually released into the bloodstream.

During the course of treatment with Divigel, the ratio between estradiol and estrone is from 0.4 to 0.7. The bioavailability of the drug - 82%. The effectiveness of therapy will depend directly on how to use "Divigel" for endometrial growth.

Doctors recommend using this gel as a hormone replacement therapy for women who have a lack of estrogen for various reasons. The drug is often prescribed to eliminate menopausal syndrome.

The gel has proven itself as a preventive measure to prevent the development of osteoporosis. Divigel has positive reviews for endometrial growth in IVF as a drug that supports the normal course of pregnancy.

The drug is prescribed in an individual dosage, which is selected by the attending physician in the clinic, where the fertilization procedure was carried out. It is better to start using it a couple of weeks before fertilization and continue for about a month after it.

After the occurrence of pregnancy, the termination of the application can not be done abruptly, as in this case there is a danger of miscarriage.

If Divigel is prescribed for endometrial growth, the dosage is adjusted on a case-by-case basis. During pregnancy planning, the physician must ensure that there is endometrial hypoplasia; to stimulate ovulation, it is advisable to combine the use of the gel with other hormonal preparations. In each of these cases, the treatment regimen will be different.

Undesirable consequences

Each organism is individual, in its own way perceives the effects of drugs, so even the absence of contraindications to use does not mean that there will be no side effects. In the process of gel treatment they may be as follows:

  1. Nervous system disorders: headache, dizziness, migraine attacks, depression.
  2. From the work of the heart and blood vessels: thrombophlebitis and persistent increase in blood pressure.
  3. The digestive system can cause nausea, vomiting, stomach pain, flatulence.
  4. On the part of the reproductive system can be observed: vaginal bleeding, persistent discharge, proliferation of the endometrium, changes in libido, cancer of the uterus.
  5. The endocrine system may exhibit the following symptoms: the emergence of excess weight, engorgement of the mammary glands.

With prolonged use of the gel can accumulate fluid in the body, which leads to edema. Given that the drug is used externally, allergic rashes and itching may appear on the skin.

Some patients who use Divigel to grow the endometrium, the reviews leave negative because of the frequent manifestations of side effects such as visual impairment and strong vaginal candidiasis.

To avoid all undesirable effects, use the drug must be strictly prescribed by a doctor.

How to take "Divigel" for endometrial growth

The drug with good tolerability and no contraindications can be used for long-term therapy. At the initial stage of treatment, the dosage is 1 g of gel. After several courses, taking into account the change in the patient's pattern, the dosage may be increased or decreased.

It is very important to find out from the doctor not only where to smear “Divigel” for the growth of the endometrium, but also on what day of the monthly cycle this should be started.

According to the instructions, the gel should be applied to clean skin in the lower abdomen, lower back, shoulders, forearm, or buttocks. It is advisable to do this at the same time every day; the areas of application must be alternated.

The most optimal area for application is the size of 1-2 palms. The treatment site can not be washed for an hour after using the gel.

If a woman forgets to apply the gel, then it must be done no later than 12 hours from the time of use of the drug on a schedule. If more time has passed, you should postpone it until the next time.

If the dose is exceeded

Many believe that if you take the drug in a higher dosage, the onset of a positive effect will occur faster, but this is not at all the case. If you violate the recommendations of the doctor on the use of "Divigel" and the dosage is exceeded, the following signs may be observed:

  • Chest tenderness.
  • Bloating.
  • The emergence of anxiety.
  • Irritability.
  • Bouts of nausea.
  • Vomiting.

When these symptoms occur, you should discuss with your doctor and change the dosage or discontinue use of the drug.

"Divigel" in combination with other means

If the doctor prescribes "Divigel", then it is necessary to find out beforehand what medicines the patient is taking. Estradiol may have the following effects:

  • Increase the effectiveness of lipid-lowering drugs.
  • Weaken the effects of drugs, which include male sex hormones.
  • Weaken the effect of drugs used in diabetes.
  • Reduce the effectiveness of drugs against hypertension.
  • Weaken the therapeutic effect of anticoagulants.

Accelerates estradiol metabolism joint reception:

  • Barbiturates.
  • Narcotic analgesics.
  • The means used for anesthesia.
  • Some antiepileptic drugs.

The effectiveness of Divigel will significantly decrease if it is used in conjunction with some antibiotics, as well as with Phenylbutazone. To enhance the effect, it is possible to take folic acid preparations together with it for the thyroid gland.

Special recommendations

"Divigel" for endometrial growth reviews of doctors receives more positive, only experts recommend to appoint it after a thorough examination of the patient and a detailed conversation with her.

To avoid undesirable consequences, a woman should undergo a full examination of the pelvic organs and breasts. It must be regularly and throughout the treatment.

We considered, "Divigel" for the growth of the endometrium where to smear, in what area. It is important to wash your hands with soap and do not touch your eyes.

You can not apply the gel on the region of the mammary glands and sex glands, as well as on the places where there is irritation. Using "Divigel" can disrupt the process of ovulation. Synthesis of hormones directly depends on the concentration of estrogens in the blood, and when they are received from the outside, it can be violated, therefore, it is necessary to take the drug when planning conception.

Use of the drug during pregnancy and lactation

Despite the fact that "Divigel" for the growth of the endometrium during IVF receives good, when a pregnancy occurs, it is worth discussing the tactics of its further use with a doctor. If diagnosing an interesting situation in a woman is beyond doubt, then most likely the doctor will decide to stop using the drug.

Various studies show that one-time and occasional use of the gel during pregnancy does not cause a teratogenic effect, but you should not risk the health of the future baby.

During the period of breastfeeding to apply the gel is prohibited.

A woman's health is a fragile thing, it can falter at the most inappropriate moments of life. No one wants to stuff his body with chemicals, but there are situations when Divigel is just necessary for the growth of the endometrium, the feedback, especially since it gets excellent. Positively, this drug is characterized not only by doctors, but also by patients, especially during menopause.

It will not be superfluous to remind once again that only a competent specialist should prescribe any treatment, you should not take such serious drugs on the advice of a friend or after seeing an advertisement on television. Take care of your health!

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