Menogon

Menogon is a drug with a pronounced follicle-stimulating therapeutic effect.

The active ingredient of the drug is the substance hMG. The composition of the drug contains hormones LH and FSH in a ratio of 1 to 1 - 75 IU of the specified hormones, which are also produced by the human pituitary gland. In this case, the specified active element is obtained from urine, which is taken from women in postmenopause. [ 1 ]

Indications Menogon

It is used for the following conditions and disorders:

• infertility in women caused by a disorder of the follicular maturation process – due to normo- or hypogonadotropic ovarian functional insufficiency;
• induction of the ovulation process (in combination with the drug hCG);
• infertility in men due to a disorder of spermatogenesis associated with normo- or hypogonadotropic hypogonadism (in combination with the substance hCG).

Release form

The medicinal element is released in the form of powder for injection liquid (subcutaneous and intramuscular injections) - 5 or 10 ampoules with powder and 5 or 10 ampoules with a special solvent inside the box.

Pharmacodynamics

The use of Menogon in women causes an increase in blood estrogen levels and also leads to the maturation of the egg; when used in men, spermatogenesis and testosterone production are activated. [ 2 ]

Pharmacokinetics

Plasma values of Cmax FSH are noted after 6-48 hours with intramuscular injection, and after 6-36 hours with subcutaneous injection. Then the blood value of FSH gradually decreases with a half-life of 56 hours (intramuscular administration) and 51 hours (subcutaneous injection).

Dosing and administration

The medication should be administered subcutaneously or intramuscularly, after dissolving the lyophilisate in the solvent included in the kit.

For women, to stimulate follicular growth, the dose is selected individually, taking into account how the ovaries react. The correction is performed in accordance with the data obtained by ultrasound and blood estrogen levels.

In case of using an excessive dosage of hMG, multiple 1- or 2-sided follicular growth occurs.

Therapy often begins with a dose of 75-150 IU (equivalent to 1-2 ampoules of the drug) per day. If the ovaries do not respond to this dosage, it is gradually increased until an increase in the blood estrogen level or follicular growth is registered. This dose is maintained until the preovulatory estrogen level is reached. If a rapid increase in estrogen levels is observed at the beginning of therapy, it is necessary to reduce the dose of hMG.

To induce ovulation, it is necessary to administer 5-10 thousand IU of hCG once, 1-2 days after the last hCG injection.

Men need to use 1-3 thousand IU of hCG, 3 times a week, to stimulate spermatogenesis until the blood testosterone level stabilizes. Then, for several months, 75-150 IU of the drug is used 3 times a week.

Use Menogon during pregnancy

Menogon should not be used during breastfeeding or pregnancy.

Contraindications

Main contraindications:

• severe intolerance to the components of the drug and solvent;
• the presence of cysts or an increase in the size of the ovaries (their cause is not PCOS);
• neoplasm in the hypothalamus-pituitary region;
• hyperprolactinemia;
• diseases affecting the adrenal glands and thyroid gland;
• PCOS;
• any defects in the development of the genitals (in which the normal course of pregnancy is impossible);
• uterine fibroids;
• metrorrhagia of uncertain origin;
• prostate carcinoma;
• tumor neoplasms of an estrogen-dependent nature (carcinoma affecting the uterus, breast or ovaries);
• primary ovarian functional insufficiency;
• androgen-related neoplasms.

Side effects Menogon

Side effects include:

• lesions associated with the gastrointestinal tract: vomiting or nausea often occurs;
• endocrine dysfunction: ovarian hyperstimulation often develops;
• disorders of the mammary glands and genitals: men often experience gynecomastia or pain in the mammary glands;
• immune damage: signs of intolerance (epidermal rashes or increased temperature) are occasionally observed. Formation of antibodies is noted sporadically;
• local symptoms: very often there is pain, swelling or itching in the area of the injection.

The use of hCG substances may provoke ovarian hyperstimulation, which clinically occurs after the use of hCG (it is prescribed to stimulate the ovulation process). As a result, ovarian cysts may form, which are large in size and can rupture and provoke bleeding inside the abdomen. At the same time, intense ovarian hyperstimulation may lead to the appearance of oliguria, ascites, hypotension, hydrothorax and signs of thromboembolism.

Long-term use of drugs can occasionally lead to the formation of antibodies, which makes the treatment course ineffective.

Overdose

In case of intoxication, ovarian hyperstimulation develops:

• in case of the 1st degree of disorder (mild), specific treatment is not carried out; in this case, there is a slight enlargement of the ovaries (maximum 5-7 cm), an increase in the values of sex steroids and the appearance of pain in the abdominal area. It is necessary to notify the patient about this condition, after which constant monitoring of her is established;
• 2nd degree of disorder – hospitalization and symptomatic actions are required, including intravenous infusions – administration of medicinal fluids that maintain the BCC values (if hemoglobin levels increase). With ovarian cysts, the size of which is in the range of 8-10 cm, nausea, manifestations in the abdominal area and vomiting are noted;
• 3rd degree of disorder – the ovaries increase in size to 10+ cm, hydrothorax, dyspnea, ascites develop, pain in the abdominal area and its enlargement appear, the blood hemoglobin index increases, blood viscosity increases, which potentiates platelet adhesion (there is a risk of thromboembolism), and electrolyte retention occurs. In this case, the patient must be hospitalized.

Storage conditions

Menogon should be stored in a place closed to small children. The liquid should not be frozen. Temperature indicators are a maximum of 25 °C.

Shelf life

Menogon is permitted to be used for a period of 3 years from the date of production of the therapeutic substance.

Analogues

Analogues of the drug are Puregon, Ovitrel with Gonal-f, Sustanon with Bravel, Menopur and Formon. In addition, Luveris, Pregnyl, Horagon with Merional, Humog with Pergoveris and Profasi.

Reviews

Menogon receives good reviews regarding its therapeutic effectiveness – it is noted that it helps in the onset of pregnancy. Its high cost is one of its disadvantages.