Please, explain a situation with purpose or appointment Veroshpirona

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Masha - - ---Dear doctors, help or assist advice or council. Within several months I drank according to the doctor -35 the diagnosis - giperandrogenija, picture SPKJA is not present. Testosteron-Depotum after a course has decreased. Androgens at me not an adrenal parentage i.e. superfluous. Now to me have registered stimulation of an ovulation klomidom and to drink veroshpiron for maintenance of a normal level of androgens. Having read through the summary to this medicine, I was frightened - I do not have any of the listed indications otdalenno - a hirsutism on a background of a polycystosis. The abundance of side effects has extremely guarded me - there there are also disturbances MTS which I only recently the heap of the others prelestej has eliminated or erased;removed also. Klomid to accept the beginnings, and here veroshpiron to drink I am afraid. A question: 1. Whether it is possible to accept veroshpiron in such situation. 2. What are real consequences and side effects veroshpirona. In advance I thank, Masha

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(Water-melon) - - ---Masha, you have asked very interesting question. Personally to me there was no technique of stimulation of an ovulation with veroshpironom. Not absolutely clearly, why without picture SPKJA you consider or count, that androgens at you jaichnikovogo parentages. Usually happens very much the other way. It would be desirable to see the concrete given US, levels of Testosteron-Depotum and nYa-WITH with norms or rates of laboratory, certainly. To you preparation for stimulation by a preparation to Diana-35 reducing a level jaichnikovyh of androgens was perfectly spent. Usually after that spend stimulation or one Klomidom at a normal level nYa-WITH, or Klomidomdeksametazonom at raised or increased or boundary nYa-WITH. Veroshpiron, basically, reduces a level a 5-alpha- its or his other effects as I here lower or omit the antagonist of Aldosteronum. Therefore he also is applied to treatment girsutizama at which rising activity of this enzyme in hair follicles is observed. On a level of androgens he renders insufficient influence. And it is shown only in case of long reception some months continuously. At reception veroshprirona without other hormonal preparations disturbances of a cycle can be observed. Therefore at treatment it or him simultaneously appoint or nominate gestageny or oral contraceptives. If to you do not appoint or nominate support ljuteinovoj a phase gestagenami the expediency of use veroshpirona seems to me rather doubtful. It or he can be appointed or nominated at a stage of preparation for stimulation, but not during it or her. If someone from experts has other opinions I shall be glad them to hear.

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The STUDENT - - ---Agrees with uv. Dr. Jacob on bill Veroshpirona! From Masha's resulted or brought history, I assume, that at it or her all the same SPKJA which can be and without have withdrawn. On US of ovaries. The adrenal source, probably all taki is excluded by normal levels Digidroepiandrosterona and nYa-WITH, time definition not an adrenal parentage sounded. And depression of a level of free Testosteron-Depotum at treatment -35 and normalization of a cycle Progesteronum has shown balance, that supressija ovaries occurs or happens, as was to be shown and that was the medical purpose! Veroshpiron here, at absence of a hirsutism and at reception of desirable result on Diane in general it is inappropriate. That at us it will turn out... Veroshpiron competes about Testosteron-Depotum-connecting or -binding receptors first of all, already then as Jacob has fairly noticed, prishodit depression of production of Testosteron-Depotum due to the block or trochlea enzimov synthesis of steroids. And at supressii a feedback stimulates the Luteinizing hormone which stimulates development or manufacture of androgens. Organs-targets that are protected Veroshpironom, but all these androgens will turn on periphery to estrogen to which does not have opposition of Progesteronum and we shall have again disturbance of a cycle plus supressirovannyj o??O?-stimulating hormone and as consequence or investigation an anovulation! Vobshchem other opinions uv. Jacob is not present! Machines or Cars Dr. likely has mixed indications to application Veroshpirona, last apply vosnovnom at a hirsutism when other methods do not work, instead of in its or her position. At similar statuses can be still dif. The diagnosis with Hilus cell tumor and Lupoid cell tumor is not present picture SPKJA, giperandrogenemija not an adrenal parentage, but it more likely diagnostic gamble without absence of full history and datas of laboratory. Well and the last. One of dangerous by-effects Veroshpirona, probably will be Gipokalemija, as antogonista Aldosteronum. With uv. The STUDENT

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Masha - - ---Thanks you, Dr. Jacob, and to you, Mr. the Student, for a detailed explanation. At me really situation, boundary with SPKJA, namely: lg/o?u = 1, Testosteron-Depotum before treatment diane was twice above the top border of norm or rate, 17- in norm or rate, shchitovidka in norm or rate, =23. According to the analysis after a course diane: T in norm or rate, nYa-WITH it is a little raised or increased all analyses - 7 day of a cycle. The basal curve was always above in the second phase, but skipped from 37 up to 36,6 and back. Subjective sensations of an ovulation were present. Monthly vsegla were irregular from 30 till 47 days, allocation were normal. On US: a uterus without a pathology, ovaries are not increased, thickenings of a capsule is not revealed. However one ovary contains very few follicles, and another is sated or saturated by them. A laparoscopy and GSG did not do or make, since the doctor has told or said, that all over again it is necessary to eliminate or erase;remove the most obvious disturbances. Dexamethazonum to me did not register. If you will have comments to my case, I shall be grateful to you for any information. Yours faithfully, Masha P/S to Me of 27 years.

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The STUDENT - - ---Masha! Was absent in view of employment. On all your history I shall be limited to the general or common conclusion. I think business or affairs go at you well, i.e. there is an ovulation and I predpologaju that basal rate. It is raised or increased within 11 days, there is no failure Ljutealnoj of the Phase. A picture of US good-quality. Even if will find out cysts of 3-5 sm does not follow ostonavlivat stimulation. A laparoscopy and GSG apply in case of failure with Klomidom. I think to you it it is not required. It would be desirable as to notice, that rules of reception Klomida and the subsequent sexual iterkorsov for successful conception are very important. Otherwise at not to the correct scheme or plan all can come to naught. Last setentsija because of appointed or nominated to you Veroshpirona as there is a question, whether correctly you use Klomidom! If want you write which this scheme or plan follow also doses. And that at once a laparoscopy and GSG.. The STUDENT

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Masha - - ---Dear Mr. the Student, is recommended to Me the doctor the following scheme or plan on Klomidu. 1 a cycle - about 5 days of a cycle five days on one tablet, 2 a cycle - the same on one and a half tablet while goes the first cycle. In total doctor has recognized expedient to try or taste during 4 cycles. Then in case of failure - a laparoscopy. It is grateful to you for the response. Masha

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The STUDENT - - ---Hello Masha! Having familiarized with your scheme or plan of treatment, I consider or count it is necessary to add the following! The first: I predpologaju tablet Klomida 50. And it is recommended to you of attempt of conception for 5 day after last tablet, in day at least. On bill one and a half, can usually be accepted 2 100 but if you already have an ovulation it is possible vobshchem to remain and on 50. Usually course of acceptance of 6 months. The second: If not looking at the Ovulation and skipping Basal Temperatu and otsutsvie pregnancy we shall tell or say for 4 mes at treatment, the biopsy endometrija on Adekvatnost Ljutealnoj Phases undertakes and the US search folikuly which do not reach or achieve the mature size and at verification of this neadekvatnosti can be applied GSG. But it is usual already poslednj therapeutic reception Before reception GSG if at you there will not come or step pregnancy during 4 cycles at yours nYa-WITH, I would recommend Dexamethazonum of 0.5 mg within 10 days on one tab for night very important time of reception, for night. If and from this nothing will turn out. I predpologaju, that at you normal Prolactinum many women become pregnant when the aforesaid does not help or assist, at addition of Bromocriptinum!!! Yes yes.. I was not mistaken - at normal Prolactinum! One of the important factors so is your weight! If there are surpluses that having got rid from them you can solve this problem. Vobshchem as you can see up to GSG and laparoscopies are many therapeutic receptions, with much smaller complications. GSG vsetaki causes an extrauterine pregnancy or a salpingocuesis that was to be avoided. As you see, this subject delicate enough as demands experience of appointed or nominated doses of medicines and time. I hope at you the skilled or experienced doctor and you will cope with this illness without GSG and tembolee Laparoscopies!! Success if there are questions at your doctor can to set them here! The STUDENT-PROFESSOR

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Masha - - ---Thanks you for exhaustive information. It is very pleasant, when someone your problems are not indifferent. I hope, that at us the kid without operations and EKO will turn out. Successes, to you, Mr. the Student, in your hard business. With deep respect and gratitude, Masha.