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Современный взгляд на пролонгированный режим использования комбинированных оральных контрацептивов (обзор литературы)
Современный взгляд на пролонгированный режим использования комбинированных оральных контрацептивов (обзор литературы)
Пестрикова Т.Ю., Юрасова Е.А., Юрасов И.В. и др. Современный взгляд на пролонгированный режим использования комбинированных оральных контрацептивов (обзор литературы). Consilium Medicum. 2018; 20 (6): 70–74. DOI: 10.26442/2075-1753_2018.6.70-74
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Аннотация
В обзорной статье представлены данные о преимуществе использования пролонгированного режима микродозированного комбинированного орального левоноргестрелсодержащего контрацептива (91 сут) по сравнению с традиционными схемами приема оральной контрацепции (21+7). Показана эффективность приема комбинированного орального контрацептива в пролонгированном режиме у пациенток, имеющих головные боли, возникающие во время перерыва в приеме контрацептивов по стандартной схеме (21+7). Кроме этого, пролонгированный режим приема контрацептива обоснован при обильных менструациях, эпилепсии, сахарном диабете, эндометриозе, миоме матки, синдроме поликистозных яичников, анемии, дисменорее. В данной статье сделан акцент на необходимости консультирования пациенток с целью объяснения преимущества стандартного и пролонгированного режимов. Обязательной задачей консультирования является необходимость предоставления пациентке свободы выбора. В случае лечебных показаний к пролонгированному приему гормональной контрацепции режим выбирает врач, но этот выбор должен быть аргументирован перед пациенткой, за которой сохраняется право отказа от предложенного метода и предпочтения обычной схемы.
Ключевые слова: микродозированный комбинированный оральный левоноргестрелсодержащий контрацептив, пролонгированный режим.
Ключевые слова: микродозированный комбинированный оральный левоноргестрелсодержащий контрацептив, пролонгированный режим.
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The review article presents data about the benefit of prolonged mode using micro-dosed combined oral levonorgestrel-containing contraceptive (91 days), as compared to traditional oral contraceptive mode (21+7). The performance of taking a combined oral contraceptive in a continuous duty in patients with headaches that occur during a break in taking contraceptives according to the standard pattern (21+7) has been demonstrated. In addition, the prolonged regimen of contraceptive use is justified in case of heavy menstruation, epilepsy, diabetes, endometriosis, uterine myoma, polycystic ovary syndrome, anemia, dysmenorrhea. This article focuses on the need to consult patients, in order to explain to her the advantages of standard and prolonged mode. The obligatory task of consulting is the need to provide the patient with freedom of choice. In the case of medical indications for prolonged administration of hormonal contraception, the regime is chosen by the doctor, but this choice should be reasoned ahead of every patient, for which the right to refuse the proposed method and the preference of usual scheme is preserved.
Key words: micro-dose combined oral levonorgestrel-containing contraceptive, extended mode.
Key words: micro-dose combined oral levonorgestrel-containing contraceptive, extended mode.
Полный текст
Список литературы
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18. Sulak P, Scow RD, Precce C et al. Hormone with drawal symptoms in oral contraceptives users. Obstet Gynecol 2000; 95: 261–6.
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20. http://www.lsgeotar.ru/modell-libera-16284.html
21. FDA Advisory Committee for Reproductive Health Drugs. Final summary minutes. January 23–24, 2007. http://www.fda.gov/ohrms/dockets/ac/07/transcripts/2007-4274t1-part1.pdf
22. Kroll R, Reape KZ, Margolis M. The efficacy and safety of a low-dose, 91-day, extended-regimen oral contraceptive with continuous ethinyl estradiol. Contraception 2010; 81: 41–8.
23. Bonnema RA, Spencer AL. The New Extended-Cycle Levonorgestrel-Ethinyl Estradiol Oral Contraceptives. Clin Med Insights Reprod Health 2011; 5: 49–54.
24. Thomas SL, Ellertson C. Nuisance or natural and healthy: should monthly menstruation be optional for women? Lancet 2000; 355: 922–4.
25. Карахалис Л.Ю. Пролонгированный режим: контрацептивные и неконтрацептивные преимущества. Consilium Medicum. 2017; 19 (6): 54–6. / Karakhalis L.Yu. The prolonged regime: contraceptive and non-contraceptive benefits. Consilium Medicum. 2017; 19 (6): 54–6. [in Russian]
26. Jick SS, Hernandez RK. Risk of non-fatal venous thromboembolism in women using oral contraceptives containing drospirenone compared with women using oral contraceptives containing levonorgestrel: case-control study using United States claims data. BMJ 2011; 342: d2151.
27. Benson LS, Micks EA. Why Stop Now? Extended and Continuous Regimens of Combined Hormonal Contraceptive Methods. Obstet Gynecol Clin North Am 2015; 42 (4): 669–81.
3. Yureneva S.V., Ilyina L.M. Gibkiy regim priema: «vtoraya revolyuciya» v ispolyzovanii kombinirovannyeh oralynyeh kontraceptifov. RMZh. 2016; 6: 298–303. [in Russian]
4. Klipping C et al. Contraceptive efficacy and tolerability of ethinylestradiol 20 µg/drospirenone 3 mg in a flexible extended regimen: an open-label, multicentre, randomised, controlled study. J Fam Plann Reprod Health Care 2012; 38: 73–83.
5. Ginekologiia: natsional'noe rukovodstvo. Pod red. G.M.Savel'evoi, G.T.Sukhikh, V.N.Serova i dr. 2-e izd., pererab i dop. M.: GEOTAR-Media, 2017. [in Russian]
6. Prilepskaya V.N., Khlebkova Yu.S. Prolonged contraception. Modern possibilities, efficiency and prospects (literature review). Gynecology. 2016; 18 (1): 88–91. [in Russian]
7. Vandever MA, Kuehl TJ, Sulak PJ et al. Evaluation of pituitary – ovarian axis suppression with three oral contraceptive regimens. Contraception 2008; 77 (3): 162–70.
8. Shrader SP, Dickerson LM. Extended- and Continuous-Cycle Oral Contraceptives. Pharmacotherapy 2008; 28 (8): 1033–40.
9. ARHP/NPWH. Obstacles to using exstended contraceptive regimens. Clin Proc 2003; April: 1–2.
10. Association of Reproductive Health Professionals. Cboosing when to menstruate: the role of exstended contraception. 2004. http://arhphoru healthcareprovidcrs/visitiimfacultvprograms/exstended national surver.dm: 2002.
11. Munro MG, Critchley HO, Broder MS et al. FIGO classification system (PALM COEIN) for causes of abnormal uterine bleeding in nongravid women of reproductive age. Int J Gynaecol Obstet 2011; 113: 3–13.
12. Krishnan S, Kiley J. The lowest-dose, extended-cycle combined oral contraceptive pill with continuous ethinyl estradiol in the United States: a review of the literature on ethinyl estradiol 20 mg/levonorgestrel 100 mg + ethinyl estradiol 10 mg. Int J Women’s Health 2010; 2: 235–9.
13. Wiegratz L, Hummel HH, Zimmermann T et al. Attitudes of German women and gynecologists towards long-cycle treatment with oral contraceptives. Contraception 2004; 69: 37–42.
14. Rukovodstvo po reproduktivnoi meditsine. Pod red. B.Karra, R.Blekuella, R.Aziza. Per. s angl. M.: Praktika, 2015. [in Russian]
15. Anderson FD, Feldman R, Reape KZ. Endometrial effects of a 91-day extended regimen oral contraceptive with low-dose estrogen in place of placebo. Contraception 2008; 77: 91–6.
16. Pestrikova T.Iu., Sukhonosova E.L., Iurasova E.A. Effektivnost' ispol'zovaniia kontratseptiva estradiola valerita v kombinatsii s dienogestom u patsientok s sindromom polikistoznykh iaichnikov. Problemy reproduktsii. 2016; 3: 115–23. [in Russian]
17. Mammologiia: natsional'noe rukovodstvo. Pod red. A.D.Kaprina, N.I.Rozhkovoi. 2-e izd., pererab. i dop. M.: GEOTAR-Media, 2016. [in Russian]
18. Sulak P, Scow RD, Precce C et al. Hormone with drawal symptoms in oral contraceptives users. Obstet Gynecol 2000; 95: 261–6.
19. Blanchard K. Life without menstruation. Obstet Gynecol 2003; 5: 34–7.
20. http://www.lsgeotar.ru/modell-libera-16284.html
21. FDA Advisory Committee for Reproductive Health Drugs. Final summary minutes. January 23–24, 2007. http://www.fda.gov/ohrms/dockets/ac/07/transcripts/2007-4274t1-part1.pdf
22. Kroll R, Reape KZ, Margolis M. The efficacy and safety of a low-dose, 91-day, extended-regimen oral contraceptive with continuous ethinyl estradiol. Contraception 2010; 81: 41–8.
23. Bonnema RA, Spencer AL. The New Extended-Cycle Levonorgestrel-Ethinyl Estradiol Oral Contraceptives. Clin Med Insights Reprod Health 2011; 5: 49–54.
24. Thomas SL, Ellertson C. Nuisance or natural and healthy: should monthly menstruation be optional for women? Lancet 2000; 355: 922–4.
25. Karakhalis L.Yu. The prolonged regime: contraceptive and non-contraceptive benefits. Consilium Medicum. 2017; 19 (6): 54–6. [in Russian]
26. Jick SS, Hernandez RK. Risk of non-fatal venous thromboembolism in women using oral contraceptives containing drospirenone compared with women using oral contraceptives containing levonorgestrel: case-control study using United States claims data. BMJ 2011; 342: d2151.
27. Benson LS, Micks EA. Why Stop Now? Extended and Continuous Regimens of Combined Hormonal Contraceptive Methods. Obstet Gynecol Clin North Am 2015; 42 (4): 669–81.
2. Хамошина М.Б., Лебедева М.Г., Артикова Н.Л., Добрецова Т.А. Управление менструальным циклом: новые возможности. Инновации в контрацепции – гибкий пролонгированный режим и цифровые технологии дозирования: информационный бюллетень. Под ред. В.Е.Радзинского. М.: StatusPraesens, 2016. / Khamoshina M.B., Lebedeva M.G., Artikova N.L., Dobretsova T.A. Upravlenie menstrual'nym tsiklom: novye vozmozhnosti. Innovatsii v kontratseptsii – gibkii prolongirovannyi rezhim i tsifrovye tekhnologii dozirovaniia: informatsionnyi biulleten'. Pod red. V.E.Radzinskogo. M.: StatusPraesens, 2016. [in Russian]
3. Юренева С.В., Ильина Л.М. Гибкий режим приема: «вторая революция» в использовании комбинированных оральных контрацептивов. РМЖ. 2016; 6: 298–303. / Yureneva S.V., Ilyina L.M. Gibkiy regim priema: «vtoraya revolyuciya» v ispolyzovanii kombinirovannyeh oralynyeh kontraceptifov. RMZh. 2016; 6: 298–303. [in Russian]
4. Klipping C et al. Contraceptive efficacy and tolerability of ethinylestradiol 20 µg/drospirenone 3 mg in a flexible extended regimen: an open-label, multicentre, randomised, controlled study. J Fam Plann Reprod Health Care 2012; 38: 73–83.
5. Гинекология: национальное руководство. Под ред. Г.М.Савельевой, Г.Т.Сухих, В.Н.Серова и др. 2-е изд., перераб и доп. М.: ГЭОТАР-Медиа, 2017. / Ginekologiia: natsional'noe rukovodstvo. Pod red. G.M.Savel'evoi, G.T.Sukhikh, V.N.Serova i dr. 2-e izd., pererab i dop. M.: GEOTAR-Media, 2017. [in Russian]
6. Прилепская В.Н., Хлебкова Ю.С. Пролонгированная контрацепция. Современные возможности, эффективность, перспективы (обзор литературы). Гинекология. 2016; 18 (1): 88–91. / Prilepskaya V.N., Khlebkova Yu.S. Prolonged contraception. Modern possibilities, efficiency and prospects (literature review). Gynecology. 2016; 18 (1): 88–91. [in Russian]
7. Vandever MA, Kuehl TJ, Sulak PJ et al. Evaluation of pituitary – ovarian axis suppression with three oral contraceptive regimens. Contraception 2008; 77 (3): 162–70.
8. Shrader SP, Dickerson LM. Extended- and Continuous-Cycle Oral Contraceptives. Pharmacotherapy 2008; 28 (8): 1033–40.
9. ARHP/NPWH. Obstacles to using exstended contraceptive regimens. Clin Proc 2003; April: 1–2.
10. Association of Reproductive Health Professionals. Cboosing when to menstruate: the role of exstended contraception. 2004. http://arhpho.ru healthcareprovidcrs/visitiimfacultvprograms/exstended national surver.dm: 2002.
11. Munro MG, Critchley HO, Broder MS et al. FIGO classification system (PALM COEIN) for causes of abnormal uterine bleeding in nongravid women of reproductive age. Int J Gynaecol Obstet 2011; 113: 3–13.
12. Krishnan S, Kiley J. The lowest-dose, extended-cycle combined oral contraceptive pill with continuous ethinyl estradiol in the United States: a review of the literature on ethinyl estradiol 20 mg/levonorgestrel 100 mg + ethinyl estradiol 10 mg. Int J Women’s Health 2010; 2: 235–9.
13. Wiegratz L, Hummel HH, Zimmermann T et al. Attitudes of German women and gynecologists towards long-cycle treatment with oral contraceptives. Contraception 2004; 69: 37–42.
14. Руководство по репродуктивной медицине. Под ред. Б.Карра, Р.Блекуэлла, Р.Азиза. Пер. с англ. М.: Практика, 2015. / Rukovodstvo po reproduktivnoi meditsine. Pod red. B.Karra, R.Blekuella, R.Aziza. Per. s angl. M.: Praktika, 2015. [in Russian]
15. Anderson FD, Feldman R, Reape KZ. Endometrial effects of a 91-day extended regimen oral contraceptive with low-dose estrogen in place of placebo. Contraception 2008; 77: 91–6.
16. Пестрикова Т.Ю., Сухоносова Е.Л., Юрасова Е.А. Эффективность использования контрацептива эстрадиола валерита в комбинации с диеногестом у пациенток с синдромом поликистозных яичников. Проблемы репродукции. 2016; 3: 115–23. / Pestrikova T.Iu., Sukhonosova E.L., Iurasova E.A. Effektivnost' ispol'zovaniia kontratseptiva estradiola valerita v kombinatsii s dienogestom u patsientok s sindromom polikistoznykh iaichnikov. Problemy reproduktsii. 2016; 3: 115–23. [in Russian]
17. Маммология: национальное руководство. Под ред. А.Д.Каприна, Н.И.Рожковой. 2-е изд., перераб. и доп. М.: ГЭОТАР-Медиа, 2016. / Mammologiia: natsional'noe rukovodstvo. Pod red. A.D.Kaprina, N.I.Rozhkovoi. 2-e izd., pererab. i dop. M.: GEOTAR-Media, 2016. [in Russian]
18. Sulak P, Scow RD, Precce C et al. Hormone with drawal symptoms in oral contraceptives users. Obstet Gynecol 2000; 95: 261–6.
19. Blanchard K. Life without menstruation. Obstet Gynecol 2003; 5: 34–7.
20. http://www.lsgeotar.ru/modell-libera-16284.html
21. FDA Advisory Committee for Reproductive Health Drugs. Final summary minutes. January 23–24, 2007. http://www.fda.gov/ohrms/dockets/ac/07/transcripts/2007-4274t1-part1.pdf
22. Kroll R, Reape KZ, Margolis M. The efficacy and safety of a low-dose, 91-day, extended-regimen oral contraceptive with continuous ethinyl estradiol. Contraception 2010; 81: 41–8.
23. Bonnema RA, Spencer AL. The New Extended-Cycle Levonorgestrel-Ethinyl Estradiol Oral Contraceptives. Clin Med Insights Reprod Health 2011; 5: 49–54.
24. Thomas SL, Ellertson C. Nuisance or natural and healthy: should monthly menstruation be optional for women? Lancet 2000; 355: 922–4.
25. Карахалис Л.Ю. Пролонгированный режим: контрацептивные и неконтрацептивные преимущества. Consilium Medicum. 2017; 19 (6): 54–6. / Karakhalis L.Yu. The prolonged regime: contraceptive and non-contraceptive benefits. Consilium Medicum. 2017; 19 (6): 54–6. [in Russian]
26. Jick SS, Hernandez RK. Risk of non-fatal venous thromboembolism in women using oral contraceptives containing drospirenone compared with women using oral contraceptives containing levonorgestrel: case-control study using United States claims data. BMJ 2011; 342: d2151.
27. Benson LS, Micks EA. Why Stop Now? Extended and Continuous Regimens of Combined Hormonal Contraceptive Methods. Obstet Gynecol Clin North Am 2015; 42 (4): 669–81.
________________________________________________
1. Rukovodstvo po kontratseptsii. Pod red. V.N.Prilepskoi. 4-e izd., dop. M.: MEDpress-inform, 2017. [in Russian]
2. Khamoshina M.B., Lebedeva M.G., Artikova N.L., Dobretsova T.A. Upravlenie menstrual'nym tsiklom: novye vozmozhnosti. Innovatsii v kontratseptsii – gibkii prolongirovannyi rezhim i tsifrovye tekhnologii dozirovaniia: informatsionnyi biulleten'. Pod red. V.E.Radzinskogo. M.: StatusPraesens, 2016. [in Russian]3. Yureneva S.V., Ilyina L.M. Gibkiy regim priema: «vtoraya revolyuciya» v ispolyzovanii kombinirovannyeh oralynyeh kontraceptifov. RMZh. 2016; 6: 298–303. [in Russian]
4. Klipping C et al. Contraceptive efficacy and tolerability of ethinylestradiol 20 µg/drospirenone 3 mg in a flexible extended regimen: an open-label, multicentre, randomised, controlled study. J Fam Plann Reprod Health Care 2012; 38: 73–83.
5. Ginekologiia: natsional'noe rukovodstvo. Pod red. G.M.Savel'evoi, G.T.Sukhikh, V.N.Serova i dr. 2-e izd., pererab i dop. M.: GEOTAR-Media, 2017. [in Russian]
6. Prilepskaya V.N., Khlebkova Yu.S. Prolonged contraception. Modern possibilities, efficiency and prospects (literature review). Gynecology. 2016; 18 (1): 88–91. [in Russian]
7. Vandever MA, Kuehl TJ, Sulak PJ et al. Evaluation of pituitary – ovarian axis suppression with three oral contraceptive regimens. Contraception 2008; 77 (3): 162–70.
8. Shrader SP, Dickerson LM. Extended- and Continuous-Cycle Oral Contraceptives. Pharmacotherapy 2008; 28 (8): 1033–40.
9. ARHP/NPWH. Obstacles to using exstended contraceptive regimens. Clin Proc 2003; April: 1–2.
10. Association of Reproductive Health Professionals. Cboosing when to menstruate: the role of exstended contraception. 2004. http://arhphoru healthcareprovidcrs/visitiimfacultvprograms/exstended national surver.dm: 2002.
11. Munro MG, Critchley HO, Broder MS et al. FIGO classification system (PALM COEIN) for causes of abnormal uterine bleeding in nongravid women of reproductive age. Int J Gynaecol Obstet 2011; 113: 3–13.
12. Krishnan S, Kiley J. The lowest-dose, extended-cycle combined oral contraceptive pill with continuous ethinyl estradiol in the United States: a review of the literature on ethinyl estradiol 20 mg/levonorgestrel 100 mg + ethinyl estradiol 10 mg. Int J Women’s Health 2010; 2: 235–9.
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Авторы
Т.Ю.Пестрикова*1, Е.А.Юрасова1, И.В.Юрасов1, Т.Д.Ковалева1, О.Г.Щербакова2
1 ФГБОУ ВО «Дальневосточный государственный медицинский университет» Минздрава России. 680000, Россия, Хабаровск, ул. Муравьева-Амурского, д. 35;
2 КГБУЗ «Родильный дом №1» Минздрава Хабаровского края. 680030, Россия, Хабаровск, ул. Запарина, д. 8
*typ50@rambler.ru
1 Far Eastern Medical State University Ministry of Health of the Russian Federation. 680000, Russian Federation, Khabarovsk, ul. Murav'eva-Amurskogo, d. 35;
2 Maternity Hospital №1 of the Ministry of Health in the Khabarovsk’s Region. 680030, Russian Federation, Khabarovsk, ul. Zaparina, d. 8
*typ50@rambler.ru
1 ФГБОУ ВО «Дальневосточный государственный медицинский университет» Минздрава России. 680000, Россия, Хабаровск, ул. Муравьева-Амурского, д. 35;
2 КГБУЗ «Родильный дом №1» Минздрава Хабаровского края. 680030, Россия, Хабаровск, ул. Запарина, д. 8
________________________________________________
T.Yu.Pestrikova*1, E.A.Yurasova1, I.V.Yurasov1, T.D.Kovaleva1, O.G.Shcherbakova2
1 Far Eastern Medical State University Ministry of Health of the Russian Federation. 680000, Russian Federation, Khabarovsk, ul. Murav'eva-Amurskogo, d. 35;
2 Maternity Hospital №1 of the Ministry of Health in the Khabarovsk’s Region. 680030, Russian Federation, Khabarovsk, ul. Zaparina, d. 8
*typ50@rambler.ru
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