Using contraceptive pills to treat endometriosis is an excellent alternative to surgery or hormonal injections. The drug Siluet, consisting of 2 components, provides a good therapeutic effect for endometriosis and protects a woman from unwanted pregnancy. The doctor will prescribe a specific regimen for taking the pills in order to create the maximum therapeutic effect and remove the unpleasant symptoms associated with endometrioid disease. The side effects of hormonal pills are minimal, and a significant advantage of the drug is the preservation of a woman’s ability to bear children. Reviews from women taking Siluet for long courses convincingly prove that if you take the pills correctly, you can forget about the pain and irregular periods that occur due to genital endometriosis.
Composition and release form
The drug contains dienogest weighing 2 mg . It is a substance derived from natural progesterone; according to its mechanism of action, it contributes to the provision of antiandrogenic activity; in addition, dienogest affects progesterone receptors.
Ethinyl estradiol weighing 0.03 mg . Synthetic analogue of estrogens.
These substances act as the main active components of the drug; they provide all the effects.
Small amounts of starch, lactose, and talc should be isolated as excipients.
The package consists of 21 tablets , the dosage of the drug in each of them is the same. The tablet has a film shell, white or almost white color, round or biconvex shape. On one side you can find the engraving G53.
Price
The average price for Silhouette is from 1200 to 1400 rubles.
pharmachologic effect
Pharmacodynamics
The silhouette manifests its effect due to its influence on several links. Prevention of pregnancy occurs after influencing hormonal levels, stabilizing it.
The follicles in the organ stop developing and maturing. Ovulation does not occur and the eggs do not come out. In many ways, a similar effect helps to eliminate cystic formations on the ovaries within a short time or maintain the ovarian reserve. This way you can delay the onset of menopause for some time.
Due to changes in the composition of mucus in the cervix, it thickens. As a result, a mechanical obstacle to the passage of sperm is created in the cervical canal.
Due to its composition, Silhouette interferes with processes aimed at transforming the endometrium. As a result, the endometrial tissue does not reach a large thickness, which reduces the amount of blood lost during menstruation.
This is especially important for women with hyperpolymenorrhea and anemic syndrome.
The silhouette also has a low antiandrogenic effect. Due to this, the work of the ovaries is normalized, transforming androgens into estrogens. Signs of excess hair growth are eliminated. The silhouette helps to cope with such manifestations of hyperandrogenism as clinical hirsutism.
Pharmacokinetics
It should be noted that the drug is a combination drug, so the pharmacokinetics of each component should be taken into account separately. Among the main points are:
- Absorption of ethinyl estradiol occurs quite quickly . The drug reaches its maximum concentration in the blood serum on average from 1.5 to 4 hours. The absorption process occurs in the intestinal cavity. The percentage of bioavailability is high and can reach 45%. Binding of the main active substance occurs with blood plasma albumin. It reaches its equilibrium concentration during the second half of the cycle. Metabolism occurs in liver cells. The average half-life is about an hour. Complete elimination takes up to a day. Metabolites are excreted through the urinary system and kidneys.
- Absorption of dienogest is also rapid . It reaches its maximum concentration around 2-3 hours. The bioavailability of dienogest reaches about 100%. Achieving equilibrium concentration appears in about 4 days. Binding occurs with albumin in the blood. Metabolism is carried out by hydroxylation. Inactive metabolites achieve rapid elimination. The half-life of the average concentration of the substance occurs after 9 hours. Excretion is carried out through the kidneys in maximum quantities.
Pharmacological effects
"Silhouette" is a combination drug with a pronounced antiandrogenic effect. Here, ethinyl estradiol acts as an estrogen, and dienogest functions as a progestogen.
The drug inhibits ovulation, affects the peristalsis of the fallopian tubes and endometrium, and increases the viscosity of cervical mucus. The antiandrogenic effect is achieved through the close interaction of ethinyl estradiol and dienogest, which reduces the concentration of androgens in plasma.
It has been proven that the drug, thanks to the active interaction of its components, eliminates acne of varying severity and treats seborrhea.
The “Silhouette” contraceptive (reviews from some women say that the drug was not suitable and has many side effects) should be taken in an amount of 1 mg/day to prevent ovulation.
Indications for use of Silhouette
The main purpose of prescribing the drug is to prevent unwanted pregnancy, especially in cases where alternative methods are contraindicated.
In addition, this may be the restoration of hormonal levels and its stabilization, with manifestations of its disturbance in the form of an irregular menstrual cycle or functional cysts.
Elimination of acne or excess hair growth, which is based on the primary mechanism of hyperandrogenism.
Silhouette can also be taken against endometriosis.
General information about the drug “Silhouette”
"Silhouette" is an effective medicine of a new generation, which belongs to the group of monophasic low-dose contraceptives. It is produced by a Romanian pharmaceutical company and is a structural analogue of a COC called “Janine”, which has the same medicinal properties. Unlike the latter, “Silhouette” is more accessible to women in our region due to its affordable price.
The definition of “Monophasic” means that the concentration of the two active ingredients remains constant in each tablet, regardless of the day of the menstrual cycle. “Low-dose” means that the dosage of dienogest in it is higher than in other related pharmacological subgroups (“microdose” drugs).
"Silhouette" is an effective medicine of a new generation, which belongs to the group of monophasic low-dose contraceptives
Instructions for use
The silhouette provides for regular use of the drug. The dosage regimen is 1 tablet. in a day. You should drink Silhouette regularly, preferably at the same time.
The duration of the course is 21 days, after which there is a 7-day break, and then the course is resumed again from a new package.
Treatment should begin on the first day of menstruation. After the end of 21 days of taking Silhouette, a menstrual-like reaction appears.
If Silhouette is prescribed to women after childbirth, then use begins no earlier than 21 days after birth. The course conducted will be no different from the recommended basic course.
Instructions for use for endometriosis stipulate that treatment is carried out without interruption.
Silhouette, prescribed after diagnostic curettage of the uterine cavity or termination of pregnancy, is recommended to be taken from the first day after the procedure. The first tablet is taken on the day of the procedure.
If you miss taking a Silhouette tablet for more than 12 hours, no additional measures are taken. If the break was more than 12 hours, you should also take the missed pill and resume taking the next ones according to the usual regimen, but you must use protective equipment for 7 days.
Dosage and method of administration
Silhouette should be taken daily for 21 days. You should take one tablet every day. Dragees are consumed according to the days of the week indicated on the blister. A new package is started after a week's break, during which menstruation usually arrives. The bleeding may not stop before taking pills from a new pack, but despite this, you should continue to take the pills.
The transition to this contraceptive from drugs containing only progesterone can be carried out at any time. In the case of the first hormonal contraception, the drug “Silhouette” (tablets) is prescribed on the day of the start of menstruation. When switching from other combined contraceptives, Silhouette is taken on the first day after a seven-day break. You can take the drug the next day after taking the last pill from the old package.
The transition from implants to an oral contraceptive occurs on the day of implant removal, and from injections - on the next day after the last contraceptive injection.
After an abortion during the period from the first to the twelfth week of pregnancy, the drug should be taken immediately, especially if there are no other methods of protection. After delivery or abortion in the second trimester, a contraceptive is prescribed on days 21-28. A later period of contraceptive use necessitates the need for additional methods of protection over the next seven days. If sexual intercourse took place at an “unprotected” moment, then before using the pills you need to completely exclude pregnancy and wait until the first menstrual cycle.
Contraindications
The drug has absolute and relative contraindications that should be taken into account before taking the drug. Among them are:
- revealed hypersensitivity to the components included in the composition, as well as the development of allergic reactions that occur in the anamnesis;
- a history of thrombosis, thrombophlebitis or other acute pathologies of the venous system. Revealed hypercoagulation or a tendency to develop thrombosis, unsatisfactory coagulogram results;
- acute diseases of the cardiovascular system, a history of angina attacks and ischemic attacks. The presence of high risk factors for the development of myocardial infarction or cerebral stroke;
- arterial hypertension with high rates;
- diagnosed diabetes mellitus with high levels of glucose in the blood and complications diagnosed with it, especially in the vascular area. These include diabetic microangiopathy, retinopathy, nephropathy, etc.;
- acute inflammatory diseases in the pancreas;
- acute inflammatory and chronic pathologies of the liver, gallbladder and biliary system;
- identified by biochemical research and clinically defined dyslipoproteinemia;
- epilepsy or other neurological pathologies accompanied by convulsive syndrome;
- a history of uterine bleeding with an unknown cause;
- pregnancy at any gestational stage;
- lactation.
For which patients is Silhouette contraindicated?
The use of this drug in some patients can lead to unpredictable consequences. For women there are the following contraindications:
- thromboembolic diseases that are currently observed or present in the anamnesis;
- hormonally dependent malignant formations of the reproductive organs and mammary glands;
- jaundice of any etiology, as well as severe damage to the liver and its tumors;
- significant dyslipoproteinemia and coagulation disorders;
- migraine;
- epilepsy;
- uncontrolled essential hypertension;
- smoking over 35 years of age.
Side effects
When taking Silhouette, as well as many other drugs from the group of combined oral contraceptives, all side effects have a similar manifestation, and they are divided into two main groups, these are the most common:
- development of headache, which is spasmodic in nature;
- attacks of nausea or vomiting that occur regardless of food intake;
- the appearance of loading in the mammary glands, simultaneously with an increase in size and the development of pain. The pain may be dull in nature, occurring 7-10 days after administration;
- pain in the spinal region like lumbodynia;
- convulsive syndrome in the calf muscles;
- the development of menstrual-like bleeding, regardless of the amount of the drug previously taken;
- development of venous thromboembolism, worsening of varicose veins and the appearance of telangiectasias;
- weight gain associated with increased appetite and the development of fluid retention in soft tissues;
- the emergence of a tendency to depressive disorders due to decreased mood.
Less commonly, the following conditions can be identified, which should also be attributed to side effects. These are conditions such as:
- development of abdominal pain. It proceeds differently, in some cases simulating the clinical picture of gastritis or colitis;
- interruptions in the functioning of the heart with symptoms of tachycardia and angina-type pain;
- manifestation of increased excitability, frequent mood swings, irritability;
- impaired visual acuity or constant dryness of the mucous membranes, including the vagina;
- anemic syndrome;
- skin reactions in the form of the appearance of inflammatory elements or acne;
- flu-like condition with constant weakness, exercise intolerance, etc.;
- allergic reaction to the components of the drug;
- sleep disturbance with insomnia;
- the appearance of myalgia and arthralgia;
- the development of vaginitis and the addition of a fungal infection.
When treating with Silhouette, you should carefully monitor your health; if any pathologies are detected, you should consult a specialist.
Indications for use
Contraceptive pills Siluet can be taken in the following cases:
- protection against unwanted conception;
- long-term therapy of endometrioid disease;
- correction of menstrual cycle disorders with restoration of hormonal balance;
- treatment of skin diseases associated with an increase in androgen hormones in the blood (acne, seborrhea).
Often, a woman has several problems at once that can be solved with long-term use of highly effective medications. Siluet will help protect against unplanned pregnancy and will have a therapeutic effect on endometriosis and acne. But the doctor will decide on the possibility of using the drug, because it is necessary to take into account contraindications and side effects.
Drug interactions
You should be careful when taking Silhouette with other drugs. Before using drugs, you should consult a specialist to see if it is possible to simultaneously combine the drugs and possible contraception for the duration of use.
Thus, the effectiveness of the silhouette decreases when taking ampicillin, rifampicin, tetracycline . Barrier contraception should be used for the entire duration of administration and half-life .
Rifampicin enhances the drug effect on the body for an average period of about 28 days.
The simultaneous use of phenobarbital, rifampicin, carbamazepine, griseofulvin and other potent drugs that affect the nervous system, as well as St. John's wort can cause breakthrough bleeding.
Analogues of Silhouette for the treatment of endometriosis
Currently, the silhouette is recommended for use by women with signs of endometriosis. In addition, there are a fairly large number of drugs that can replace it, showing a similar effect. The most popular include:
- Visanne
The drug has a similar mechanism of action against endometriosis and is currently one of the most popular. It contains only dienogest in a volume of 2 mg. Due to it, a progestogenic and antiandrogenic effect is achieved. During a course of treatment, it promotes the decidualization of endometrial foci, as a result of which the ectopically located endometrium, which is the main cause of the development of endometriosis, is rejected.
The duration of its use should not be less than six months. An incomplete course may provoke a relapse. Can be used for prophylactic purposes after surgery to remove endometriotic lesions. Visanne should be taken without interruptions.
- Janine, Yarina
Drugs related to combined oral contraceptives. The composition contains several main components, it includes gestagen and estrogen. After taking it, the production of your own hormones is replaced and the hormonal balance is adjusted.
Reception should be carried out for a long time, the minimum course is use for 6 months. Regular use should be considered a special point. For endometriosis, a continuous course of treatment is prescribed. At this time, menstruation will be absent, only in some cases breakthrough bleeding will develop. In this case, this will be considered acceptable, but for some women it may be necessary to change the treatment with the choice of a higher dosage of the drug when treating endometriosis.
Yarina and Zhanin also have an antiandrogenic effect in combination with a contraceptive effect.
The choice of such remedies should be made for endometriosis at the initial stage of development, as well as in limited areas.
- Jess and Jess plus
The drugs, like Silhouette, are classified as combined oral contraceptives. Their composition contains a gestagen and estrogen component, but their dosage is slightly lower, which allows them to be taken by female representatives with unrealized reproductive function. This ensures better tolerability and fewer side effects.
Reception should be carried out according to the specified scheme. It will show its maximum effectiveness with long-term continuous use over several years; in addition, the prescription can be carried out for prophylactic purposes. It shows its effect only at the first stage of internal endometriosis; it is almost impossible to improve the condition with a more pronounced process or the presence of ectopic foci.
- Novinet
A microdosed product that belongs to combined oral contraceptives. Due to the content of ethinyl estradiol, it has a positive effect on the female genital organs, endometrium, and lipid spectrum.
Desogestrel, which is included in the composition, acts similarly to levonorgestrel. The main effect is on the condition of the endometrium. It has a slight effect on androgen levels, helping to cope with hyperandrogenism. Can be used for endometriosis. It prevents the growth of endometrioid lesions, but a significant effect appears only at the initial stage of the pathological process.
Pharmacodynamics of “Silhouette”: general contraceptive and specific therapeutic effect
How the combined oral contraceptive “Silhouette” affects the hypothalamic-pituitary-ovarian axis and reliably prevents conception. This drug solves this problem comprehensively:
- suppresses ovulation and folliculogenesis in the ovaries;
- changes the structure of the endometrium in the uterine cavity in this way and due to this makes it impossible for the implantation of the embryo in it;
- reduces the intensity of contractions of muscle fibers in the fallopian tubes, as a result of which their peristalsis slows down and obstacles are created for the movement of the egg if ovulation does occur;
- changes the properties of mucus in the cervical canal, making it thicker and more viscous, which negatively affects the movement of sperm through the female genital tract.
The therapeutic effect of the drug for endometriosis is based on the medicinal properties of the pharmacological group to which it belongs. Let's consider its main pharmacodynamic effects and trace the ways of its influence on the female body.
“Silhouette” ensures degeneration, regression and further atrophy of endometrioid lesions, regardless of their location. By reducing the intensity of estrogen synthesis and suppressing ovulation, it blocks proliferative cyclic changes to which the endometrium is susceptible in and outside the uterine cavity. Dienogest in its composition eliminates local hyperestrogenism, affecting the mechanisms of intracellular communication. Thanks to this, the stroma of ectopic formations is differentiated and histological changes similar to those that occur during pregnancy can be observed in it. Therefore, this state is called “pseudodecidualization.” The epithelium also transforms and acquires secretory features, significantly slowing down its growth in the future. This is how the striking antiproliferative effect of “Silhouette” manifests itself.
How the combined oral contraceptive “Silhouette” affects the hypothalamic-pituitary-ovarian axis and reliably prevents conception
The second important property that this drug has is anti-inflammatory. It stops the local inflammatory response because it inhibits the prostaglandin cascade and selectively blocks the formation of prostaglandins such as PG E2, as well as estrogen-like substances.
“Silhouette” significantly reduces the activity of enzymes such as cyclooxygenase-2 and prostaglandin synthetase in ectopic epithelial cells. Patients get rid of intense pain in the pelvic area, which often becomes chronic.
There is a positive dynamics of the disease, signs of dysmenorrhea and polymenorrhea (heavy menstrual bleeding, accompanied by painful attacks) disappear, the severity of dyspareunia (pain during sexual intercourse) decreases.
This drug accelerates and intensifies the local processes of breakdown of female hormones to low and inactive components (conversion of estradiol to estrone), which is another mechanism for normalizing the local estrogen background. The drug acts on a natural intracellular catalyst called 17-beta-hydroxysteroid dehydrogenase type 2, which is responsible for the aromatization and degradation of these substances.
“Silhouette” inhibits angiogenesis, that is, it prevents the formation of new blood vessels around the focus of endometriosis, as it reduces the level of endothelial vascular growth factor in the blood . The production of other growth factors stops, and the immune response is stimulated due to a decrease in the concentration of tumor necrosis factor-alpha (TNF-alpha). The amount of midkine factor in the follicular and peritoneal fluids, which plays a major role in the complex mechanism of endometriosis development, sharply decreases. The drug stops the implantation of endometrial cells outside the uterus, and also inhibits the metaplasia of the peritoneal mesothelium into endometroid tissue.
“Silhouette” tablets have an antianemic effect, normalize the exchange of Fe ions in the body and prevent the progression of iron deficiency anemia. This effect is achieved by eliminating the signs of dys- and polymenorrhea.
“Silhouette” inhibits angiogenesis, that is, it prevents the formation of new blood vessels around the site of endometriosis
Japanese researchers have found that dienogest, which is part of the drug, prevents malignancy (malignant degeneration) of ectopic foci, that is, it protects women who used it from cancer, significantly reducing the risk of their occurrence.
Reviews
Patient reviews
Elena, 31 years old. The drug was prescribed for contraceptive purposes. After using the product, there were no side effects, only a slight headache. After just 2 packs, my breasts increased by 1 full size. I've been drinking it for 2 years now. A positive aspect is the ability to control menstruation. After consulting a specialist, he explained how to take Silhouette to prevent menstruation, I was able to delay their onset during the holidays.
Anna, 28 years old. I encountered the problem of endometriosis after the birth of my child by caesarean section. I was bothered by severe pain and heavy spotting before and after my period. The doctor recommended starting treatment with hormonal drugs, she did not agree for some time, but then she decided to try. After several courses of therapy, I noticed a positive effect, especially since the reviews on Silhouette are predominantly positive. There was a decrease in pain and a decrease in menstruation. Novinet for 3 years now . An undeniable advantage is the contraceptive effect, so you don’t have to worry about contraception.
Natalya, 30 years old. A year ago, adenomyosis was diagnosed, which was confirmed by ultrasound. The doctor recommended starting treatment, as this could subsequently cause infertility. I planned to get pregnant only a few years later. Therefore, it was decided to start taking hormonal medications, of which we chose Silhouette. Continuous treatment was carried out for a year, after which a repeat ultrasound examination was performed. The doctor noted a significant improvement in my condition. It is allowed to use Silhouette before planning pregnancy. I didn't notice any side effects.
Reviews from doctors
Olga, gynecologist. Silhouette is often prescribed to women with clinical signs of endometriosis. A significant positive effect is achieved when treating endometriosis in the early stages. A small number of contraindications for drugs with a similar mechanism of action significantly expands the indications for use. Silhouette is prescribed in a continuous mode, the minimum duration to produce an effect is on average 6 months.
Anna, gynecologist. The silhouette helps delay the development of infertility associated with endometriosis. It is also prescribed to women at risk for endometriosis. The disease is inhibited in its development, which ensures the rapid onset of pregnancy. For endometrioid ovarian cysts, Silhouette helps to avoid surgical intervention, as within several months it completely eliminates the manifestation of the disease. That is why many reviews of the treatment are only positive.
special instructions
Before taking a contraceptive, you need to conduct a full medical examination and completely exclude pregnancy. Hormonal tablets "Silhouette" may not act as effectively in cases of missed doses, gastrointestinal disorders and during concomitant treatment. St. John's wort significantly reduces the effect of the drug.
In the first three months of taking the contraceptive, bleeding from the vagina may be observed, which is associated with the adaptation period. If this happens all the time, you should consult a gynecologist.
There may be a complete absence of menstruation in the interval between taking the medicine from the old and new packaging. If a woman takes pills without skipping doses, then pregnancy must be ruled out. If there are irregularities in taking the drug, then before starting a new pack, you should make sure that there is no pregnancy.
The use of a combined contraceptive increases the likelihood of venous thromboembolism, especially in the first year of using a hormonal contraceptive. This picture is due to the combination of ethinyl estradiol and dienogest. The occurrence of the disease is indicated by pain in the legs and chest with numbness of the left arm, shortness of breath, coughing attacks, prolonged headaches, partial loss of vision, diplopia, blurred and slurred speech, fainting and dizziness, weakness and partial numbness of the limbs, abdominal pain.
Using the drug worsens migraines and increases the risk of developing cervical and breast cancer. Promotes the development of benign and malignant tumors. Increases blood pressure, provokes the development of pancreatitis, acute and chronic liver diseases, diabetes mellitus, chloasma, ulcerative colitis and Crohn's disease.
Taking the drug may distort biochemical analysis, including indicators responsible for the functions of the liver, thyroid gland, and kidneys. As a rule, changes are minor and fluctuate within normal limits.
