Уровень применения современных методов контрацепции в России остается крайне низким. При назначении комбинированных оральных контрацептивов (КОК) главным вопросом как для пациентов, так и для врачей, является допустимый срок для непрерывного приема контрацепции. Многие женщины прекращают прием оральных контрацептивов преждевременно. В настоящее время нет никаких научно обоснованных данных, указывающих на необходимость прерывания приема КОК каждые несколько лет. При правильном назначении КОК – эффективный и безопасный метод контрацепции.
Use of modern contraceptive methods in Russia remains very low. The main issue in the COCs use for both patients and doctors is the valid period of continuous use of contraception. Many women prematurely stop taking oral contraceptives. There is no scientific evidence pointing to the need to take breaks in using of COCs every few years. COC is an effective and safe method of contraception when properly administered.
1. Кулаков В.И., Прилепская В.Н. Практическая гинекология. М.: МЕДпресс-информ, 2002.
2. Прилепская В.Н., Назарова Н.М. Планирование семьи, 1997; 3: 61–3.
3. Серов В.Н., Прилепская В.Н., Овсянникова Т.В. Гинекологическая эндокринология. М., 2006; с. 252–84.
4. Фролова О.Г., Гусева Е.В. и др. Региональные аспекты материнской смертности в Российской Федерации (2010 г.). Методическое письмо. М., 2011.
5. Шмидт Ф.Т. и др. Планирование семьи. 1993; 2: 1–3.
6. Assurance on safety of contraceptive pill: Weighed in the balances? And found beneficial. Family Planning News 1996; 21 (2).
7. Baird DT, Glasier AF. Hormonal contraception. N Eng J Med 1993; 328: 1543–9.
8. Barnhart K et al. Return to fertility after cessation of a continuous oral contraceptive. Fertil Steril 2009; 91 (5): 1654–6.
9. Beral V et al. Ovarian cancer and oral contraceptives: collaborative reanalysis of data from 45 epidemiological studies including 23,257 women with ovarian cancer and 87,303 controls. Lancet 2008; 371 (9609): 303–14.
10. Bosetti C et al. Oral contraceptives and colorectal cancer risk: a systematic review and meta-analysis. Hum Reprod Update 2009; 15 (5): 489–98.
11. Burkman R, Collins J et al. Current perspectives on oral contraceptive use. Am J Obstet Gynecol 2001; 185: S4–12.
12. Burkman R et al. Safety concerns and health benefits associated with oral contraception. Am J Obstet Gynecol 2004; 190 (Suppl. 4): s5–22.
13. Cronin M et al. Rate of pregnancy after using drospirenone and other progestincontaining oral contraceptives. Obstet Gynecol 2009; 114 (3): 616–22.
14. Dinger JC et al. The safety of a drospirenonecontaining oral contraceptive: final results from the European Active Surveillance Study on oral contraceptives based on 142,475 women-years of observation. Contraception 2007; 75 (5): 344–54.
15. Dinger J et al. The risk of venous thromboembolism in OC users: time patterns after initiation of treatment. Pharmacoepidemiol Drug Saf 2010; 19 (S1): S214–5.
16. Farrow A, Hull MGR et al. Prolonged use of oral contraception before a planned pregnancy is associated with a decreased risk of delayed conception. Hum Reprod 2002; 17 (10): 2754–61.
17. Fernandez E et al. Oral contraceptives and colorectal cancer risk: a meta-analysis. Br J Cancer 2001; 84 (5): 722–7.
18. Ford JH et al. Pregnancy and lifestyle study: the long-term use of the contraceptive pill and the risk of age-related miscarriage. Hum Reprod 1995; 10 (6): 1397–402.
19. Gallo MF, Lopez LM, Grimes DA et al. Cochrane Database Syst Rev 2006; 1.
20. Glasier A et al. Can we improve contraceptive use? Contraseption 2006; 73 (Issue 1): 1–3.
21. Halbreich U, Borenstein J et al. The prevalence, impairment, impact, and burden of premenstrual dysphoric disorder (PMS/PMDD). Psychoneuroendocrinology 2003; Suppl. 3: 1–23.
22. Hannaford PC et al. Cancer risk among users of oral contraceptives: cohort data from the Royal College of General Practitioner’s oral contraception study. BMJ 2007; 335 (7621): 651.
23. Harlap et al. Family planning from Encyclopedia of Sociology, 1991.
24. Jensen JT et al. Effective treatment of heavy menstrual bleeding with estradiol valerate and dienogest: a randomized controlled trial. Obstet Gynecol 2011; 117 (4): 777–87.
25. Kuohung W, Borgatta L, Stubblefield Ph. Low-dose oral contraceptives and bone mineral density: an evidence-based analysis. Contraception 2000; 61 (2): 77–82.
26. La Vecchia C. Drug Saf 1996; 14: 260–72.
27. Lech MM, Ostrowska L. Risk of cancer development in relation to oral contraception. Eur J Contrasept Reprod Health Care 2006; 11 (3): 162–8.
28. Lidegaard O et al. Hormonal contraception and risk of venous thromboembolism: national follow-up study. BMJ 2009; 339: b2890.
29. Ness RB et al. Hormonal and barrier contraception and risk of upper genital tract disease in the PID Evaluation and Clinical Health (PEACH) study. Am J Obstet Gynecol 2001; 185 (1): 121–7.
30. Oelkers W. Antimineralocorticoid activity of a novel oral contraceptive containing drospirenone, a unique progestogen resembling natural progesterone. Eur J Contrasept Reprod Health Care 2002; Suppl. 3: 19–26.
31. Parsey KS et al. An open-label, multicenter study to evaluate Yasmin, a low-dose combination oral contraceptive containing drospirenone, a new progestogen. Conraception 2000; 61 (2): 105–11.
32. Petitti DB et al. Contraseption. Oral contracept myocard infarct 1998; 57 (3): 143–55.
33. Pymar HC, Creinin MD. The risks of oral contraceptive pills. Semin Reprod Med 2001; 19 (4): 305–12.
34. Rohan TE, Miller AB. A cohort study of oral contraceptive use and risk of benign breast disease. Int J Cancer 1999; 82 (2): 191–6.
35. Rosenberg MJ et al. Oral contraceptive discontinuation: A prospective evaluation of frequency and reasons. Am J Obstet Gynecol 1998; 179 (Issue 3): 577–82.
36. Shulman L et al. Return to fertility after use of reversible contraception. Dialogues Contracept 2006; 10: 1–3.
37. Ursin G, Peters RK et al. Oral contraceptive use and adenocarcinoma of cervix. Lancet 1994; 344: 1390–4.
38. Vessey M et al. Oral contraceptive use and cancer. Findings in a large cohort study, 1968–2004. Br J Cancer 2006; 95 (3): 385–9.
39. Vogt C et al. Disparities in knowledge and interest about benefits and risks of combined oral contraceptives. Eur J Contracept Reprod Health Care; 16 (3): 183–93.
40. WHO Collaborative Study of Cardiovascular Disease and Steroid Hormone Contraception, Acute myocardial infarction and combined oral contraceptives: results of an international, multicentre, case-control study. Lancet 1997; 349: 1202–9.
41. Wolner-Hanssen P et al. Decreased risk of symptomatic chlamydial pelvic inflammatory disease associated with oral contraceptive use. JAMA 1990; 263 (1): 54–9.
________________________________________________
1. Кулаков В.И., Прилепская В.Н. Практическая гинекология. М.: МЕДпресс-информ, 2002.
2. Прилепская В.Н., Назарова Н.М. Планирование семьи, 1997; 3: 61–3.
3. Серов В.Н., Прилепская В.Н., Овсянникова Т.В. Гинекологическая эндокринология. М., 2006; с. 252–84.
4. Фролова О.Г., Гусева Е.В. и др. Региональные аспекты материнской смертности в Российской Федерации (2010 г.). Методическое письмо. М., 2011.
5. Шмидт Ф.Т. и др. Планирование семьи. 1993; 2: 1–3.
6. Assurance on safety of contraceptive pill: Weighed in the balances? And found beneficial. Family Planning News 1996; 21 (2).
7. Baird DT, Glasier AF. Hormonal contraception. N Eng J Med 1993; 328: 1543–9.
8. Barnhart K et al. Return to fertility after cessation of a continuous oral contraceptive. Fertil Steril 2009; 91 (5): 1654–6.
9. Beral V et al. Ovarian cancer and oral contraceptives: collaborative reanalysis of data from 45 epidemiological studies including 23,257 women with ovarian cancer and 87,303 controls. Lancet 2008; 371 (9609): 303–14.
10. Bosetti C et al. Oral contraceptives and colorectal cancer risk: a systematic review and meta-analysis. Hum Reprod Update 2009; 15 (5): 489–98.
11. Burkman R, Collins J et al. Current perspectives on oral contraceptive use. Am J Obstet Gynecol 2001; 185: S4–12.
12. Burkman R et al. Safety concerns and health benefits associated with oral contraception. Am J Obstet Gynecol 2004; 190 (Suppl. 4): s5–22.
13. Cronin M et al. Rate of pregnancy after using drospirenone and other progestincontaining oral contraceptives. Obstet Gynecol 2009; 114 (3): 616–22.
14. Dinger JC et al. The safety of a drospirenonecontaining oral contraceptive: final results from the European Active Surveillance Study on oral contraceptives based on 142,475 women-years of observation. Contraception 2007; 75 (5): 344–54.
15. Dinger J et al. The risk of venous thromboembolism in OC users: time patterns after initiation of treatment. Pharmacoepidemiol Drug Saf 2010; 19 (S1): S214–5.
16. Farrow A, Hull MGR et al. Prolonged use of oral contraception before a planned pregnancy is associated with a decreased risk of delayed conception. Hum Reprod 2002; 17 (10): 2754–61.
17. Fernandez E et al. Oral contraceptives and colorectal cancer risk: a meta-analysis. Br J Cancer 2001; 84 (5): 722–7.
18. Ford JH et al. Pregnancy and lifestyle study: the long-term use of the contraceptive pill and the risk of age-related miscarriage. Hum Reprod 1995; 10 (6): 1397–402.
19. Gallo MF, Lopez LM, Grimes DA et al. Cochrane Database Syst Rev 2006; 1.
20. Glasier A et al. Can we improve contraceptive use? Contraseption 2006; 73 (Issue 1): 1–3.
21. Halbreich U, Borenstein J et al. The prevalence, impairment, impact, and burden of premenstrual dysphoric disorder (PMS/PMDD). Psychoneuroendocrinology 2003; Suppl. 3: 1–23.
22. Hannaford PC et al. Cancer risk among users of oral contraceptives: cohort data from the Royal College of General Practitioner’s oral contraception study. BMJ 2007; 335 (7621): 651.
23. Harlap et al. Family planning from Encyclopedia of Sociology, 1991.
24. Jensen JT et al. Effective treatment of heavy menstrual bleeding with estradiol valerate and dienogest: a randomized controlled trial. Obstet Gynecol 2011; 117 (4): 777–87.
25. Kuohung W, Borgatta L, Stubblefield Ph. Low-dose oral contraceptives and bone mineral density: an evidence-based analysis. Contraception 2000; 61 (2): 77–82.
26. La Vecchia C. Drug Saf 1996; 14: 260–72.
27. Lech MM, Ostrowska L. Risk of cancer development in relation to oral contraception. Eur J Contrasept Reprod Health Care 2006; 11 (3): 162–8.
28. Lidegaard O et al. Hormonal contraception and risk of venous thromboembolism: national follow-up study. BMJ 2009; 339: b2890.
29. Ness RB et al. Hormonal and barrier contraception and risk of upper genital tract disease in the PID Evaluation and Clinical Health (PEACH) study. Am J Obstet Gynecol 2001; 185 (1): 121–7.
30. Oelkers W. Antimineralocorticoid activity of a novel oral contraceptive containing drospirenone, a unique progestogen resembling natural progesterone. Eur J Contrasept Reprod Health Care 2002; Suppl. 3: 19–26.
31. Parsey KS et al. An open-label, multicenter study to evaluate Yasmin, a low-dose combination oral contraceptive containing drospirenone, a new progestogen. Conraception 2000; 61 (2): 105–11.
32. Petitti DB et al. Contraseption. Oral contracept myocard infarct 1998; 57 (3): 143–55.
33. Pymar HC, Creinin MD. The risks of oral contraceptive pills. Semin Reprod Med 2001; 19 (4): 305–12.
34. Rohan TE, Miller AB. A cohort study of oral contraceptive use and risk of benign breast disease. Int J Cancer 1999; 82 (2): 191–6.
35. Rosenberg MJ et al. Oral contraceptive discontinuation: A prospective evaluation of frequency and reasons. Am J Obstet Gynecol 1998; 179 (Issue 3): 577–82.
36. Shulman L et al. Return to fertility after use of reversible contraception. Dialogues Contracept 2006; 10: 1–3.
37. Ursin G, Peters RK et al. Oral contraceptive use and adenocarcinoma of cervix. Lancet 1994; 344: 1390–4.
38. Vessey M et al. Oral contraceptive use and cancer. Findings in a large cohort study, 1968–2004. Br J Cancer 2006; 95 (3): 385–9.
39. Vogt C et al. Disparities in knowledge and interest about benefits and risks of combined oral contraceptives. Eur J Contracept Reprod Health Care; 16 (3): 183–93.
40. WHO Collaborative Study of Cardiovascular Disease and Steroid Hormone Contraception, Acute myocardial infarction and combined oral contraceptives: results of an international, multicentre, case-control study. Lancet 1997; 349: 1202–9.
41. Wolner-Hanssen P et al. Decreased risk of symptomatic chlamydial pelvic inflammatory disease associated with oral contraceptive use. JAMA 1990; 263 (1): 54–9.
Авторы
Л.Л.Бостанджян, В.Н.Прилепская
ФГБУ Научный центр акушерства гинекологии и перинатологии им. акад. В.И.Кулакова Минздрава РФ, Москва