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Пролонгированные режимы приема комбинированных оральных контрацептивов
Пролонгированные режимы приема комбинированных оральных контрацептивов
Кузнецова И.В. Пролонгированные режимы приема комбинированных оральных контрацептивов. Гинекология. 2017; 19 (1): 31–36.
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Аннотация
Одним из способов совершенствования комбинированной оральной контрацепции является оптимизация режимов ее приема. Стандартный режим использования комбинированных оральных контрацептивов (КОК) не всегда оправдывает ожидания женщин, особенно в ситуациях, когда к их применению существуют дополнительные лечебные показания. Пролонгированные режимы применения КОК в большей степени соответствуют как задачам контрацепции, так и терапевтическим целям использования прогестаген-эстрогенных препаратов. Распространение пролонгированных режимов тормозится рядом предубеждений, связанных с недостаточной информированностью врачей и пациентов, а также малым числом лекарственных средств, аннотированных для применения без межгормональных интервалов. Недавно зарегистрированный на территории России низкодозированный КОК, содержащий левоноргестрел и этинилэстрадиол, предоставляет возможность выбора пролонгированной контрацепции в режиме 84+7. На примере данного препарата в обзоре рассматриваются вопросы контрацептивной и неконтрацептивной эффективности, приемлемости и перспектив применения фиксированных пролонгированных режимов контрацепции.
Ключевые слова: комбинированные оральные контрацептивы, лечебные эффекты контрацепции, пролонгированный режим контрацепции, Модэлль® Либера.
Key words: combined oral contraceptives, curative effects of contraception, prolonged mode of contraception, ModellE® Libera.
Ключевые слова: комбинированные оральные контрацептивы, лечебные эффекты контрацепции, пролонгированный режим контрацепции, Модэлль® Либера.
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Key words: combined oral contraceptives, curative effects of contraception, prolonged mode of contraception, ModellE® Libera.
Полный текст
Список литературы
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19. Rad M, Kluft C, Kam M et al. Metabolic profile of a continuous versus a cyclic low-dose combined oral contraceptive after one year of use. Eur J Contracept Reprod Health Care 2011; 16 (2): 85–94.
20. Jensen JT, Garie SG, Trummer D, Elliesen J. Bleeding profile of a flexible extended regimen of ethinylestradiol/drospirenone in US women: an open-label, three-arm, active-controlled, multicenter study. Contraception 2012; 86 (2): 110–8.
21. Stephenson J, Shawe J, Panicker S et al. Randomized trial of the effect of tailored versus standard use of the combined oral contraceptive pill on continuation rates at 1 year. Contraception 2013; 88 (4): 523–31.
22. Kaneshiro B, Edelman A, Carlson N et al. Unscheduled bleeding with continuous oral contraceptive pills: a comparison of progestin dose. Contraception 2012; 86 (1): 22–7.
23. Kaneshiro B, Edelman A, Carlson N et al. A randomized controlled trial of doxycycline to prevent unscheduled bleeding with continuous oral contraceptive pill use. Contraception 2012; 85: 351–8.
24. Kaneshiro B, Edelman A, Carlson N et al. Treatment of unscheduled bleeding in continuous oral contraceptive users with doxycycline. Obstet Gynecol 2010; 115: 1141–9.
25. 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 (1): 41–8.
26. Trego L, Jordan P. Military women’s attitudes towards menstruation and menstrual suppression in relation to the deployed environment: development and testing of the MWATMS-9 (short form). Women’s Health Issues 2010; 20 (4): 287–93.
27. Powell-Dunford N, Cuda A, Moore J et al. Menstrual suppression for combat operations; advantages of oral contraceptive pills. Women’s Health Issues 2011; 21 (1): 86–91.
28. Read CM. New regimens with combined oral contraceptive pills – moving away from traditional 21/7 cycles. Eur J Contracept Reprod Health Care 2010; 15 (Suppl. 2): S32–41.
29. Benagiano G, Carrara S, Filippi V. Safety, efficacy and patient satisfaction with continuous daily administration of levonorgestrel/ethinylestradiol oral contraceptives. Patient Prefer Adherence 2009; 3: 131–43.
30. Szarewski A, von Stenglin A, Rybowski S. Women’s attitudes towards monthly bleeding: results of a global population-based survey. Eur J Contracept Reprod Health Care 2012; 17 (4): 270–83.
31. Szarewski A, Moeller C. Women’s perceptions about reducing the frequency of monthly bleeding results from a multinational survey. Open Access J Contracept 2013; 4: 29–37.
32. Nappi RE, Kaunitz AM, Bitzer J. Extended regimen combined oral contraception: A review of evolving concepts and acceptance by women and clinicians. Eur J Contracept Reprod Health Care 2016; 21 (2): 106–15.
33. Edelman A, Micks E, Gallo MF et al. Continuous or extended cycle vs. cyclic use of combined hormonal contraceptives for contraception. Cochrane Database Syst Rev 2014; 7 (7).
34. Первый препарат на Российском рынке, который содержит 84 таблетки с 20 мкг этинилэстрадиола и 100 мкг левоноргестрела и 7 таблеток с 10 мкг этинилэстрадиола для непрерывного режима приема в течение 91 дня. http://grls.rosminzdrav.ru/ 22.03.2017
35. Инструкция по применению препарата МОДЭЛЛЬ® ЛИБЕРА. / Instruktsiia po primeneniiu preparata MODELL''® LIBERA. [in Russian]
36. Thomas SL, Ellertson C. Nuisance or natural and healthy: should monthly menstruation be optional for women? Lancet 2000; 355 (9207): 922–4.
2. Cheewadhanaraks S, Choksuchat C, Dhanaworavibul K, Liabsuetrakult T. Postoperative depot medroxyprogesterone acetate versus continuous oral contraceptive pills in the treatment of endometriosis-associated pain; a randomized comparative trial. Gynecol Obstet Invest 2012; 74 (2): 151–6.
3. Dmitrovic R, Kunselman A, Legro R. Continuous compared with cyclic oral contraceptives for the treatment of primary dysmenorrhea: a randomized controlled trial. Obstet Gynecol 2012; 119: 1143–50.
4. Vandever M, Kuehl T, Sulak P et al. Evaluation of pituitary-ovarian axis suppression with three oral contraceptive regimens. Contraception 2008; 77 (3): 162–70.
5. Kuznetsova I.V., Konovalov V.A. Prolongirovannyi priem kombinirovannogo oralnogo kontratseptiva, soderzhashchego drospirenon, v lechenii predmenstrualnogo sindroma. Problemy reproduktsii. 2008; 4: 28–31. [in Russian]
6. Machado R, de Melo N, Maia H. Bleeding patterns and menstrual-related symptoms with the continuous use of a contraceptive combination of ethinylestradiol and drospirenone: a randomized study. Contraception 2010; 81: 215–22.
7. Falcone T, Lebovic DI. Clinical management of endometriosis. Obstet Gynecol 2011; 118 (3): 691–705.
8. Hirota Y, Osuga Y, Nose E et al. The presence of midkine and its possible implication in human ovarian follicles. Am J Reprod Immunol 2007; 58: 367–73.
9. ACOG Practice Bulletin № 114. Management of endometriosis. Obstet Gynecol 2010; 116: 223–36.
10. Chapron C, Souza C, Borghese B et al. Oral contraceptives and endometriosis: the past use of oral contraceptives for treating severe primary dysmenorrhea is associated with endometriosis, especially deep infiltrating endometriosis. Hum Reprod 2011; 26 (8): 2028–35.
11. Seracchioli R, Mabrouk M, Manuzzi L et al. Post-operative use of oral contraceptive pills for prevention of anatomical relapse or symptom-recurrence after conservative surgery for endometriosis. Hum Reprod 2009; 24: 2729–35.
12. Seracchioli R, Mabrouk M, Frasca C et al. Long-term oral contraceptive pills and postoperative pain management after laparoscopic excision of ovarian endometrioma: a randomized controlled trial. Fertil Steril 2010; 94 (2): 464–71.
13. Vercellini P, Eskenazi B, Consonni D et al. Oral contraceptives and risk of endometriosis: a systematic review and meta-analysis. Hum Reprod Update 2011; 17 (2): 159–70.
14. Legro R, Pauli J, Kunselman A et al. Effects of continuous versus cyclic oral contraception: a randomized controlled trial. J Clin Endocrinol Metab 2008; 93 (2): 420–9.
15. Seracchioli R, Mabrouk M, Frasca C. Long-term cyclic and continuous oral contraceptive therapy and endometrioma recurrence: a randomized, controlled trial. Fertil Steril 2010; 93: 52–6.
16. Podzolkova N.M., Kuznetsova I.V. Primenenie marvelona v prolongirovannom rezhime v kachestve protivoretsidivnoi terapii giperplasticheskikh protsessov endometriia. Akusherstvo i ginekologiia. 2007; 1: 53–7. [in Russian]
17. Lete I, Doval JL, Pérez-Campos E et al. Self-described impact of noncompliance among users of a combined hormonal contraceptive method. Contraception 2008; 77 (4): 276–82.
18. Hou MY, Hurwitz S, Kavanagh E et al. Using daily text-message reminders to improve adherence with oral contraceptives: a randomized controlled trial. Obstet Gynecol 2010; 116 (3): 633–40.
19. Rad M, Kluft C, Kam M et al. Metabolic profile of a continuous versus a cyclic low-dose combined oral contraceptive after one year of use. Eur J Contracept Reprod Health Care 2011; 16 (2): 85–94.
20. Jensen JT, Garie SG, Trummer D, Elliesen J. Bleeding profile of a flexible extended regimen of ethinylestradiol/drospirenone in US women: an open-label, three-arm, active-controlled, multicenter study. Contraception 2012; 86 (2): 110–8.
21. Stephenson J, Shawe J, Panicker S et al. Randomized trial of the effect of tailored versus standard use of the combined oral contraceptive pill on continuation rates at 1 year. Contraception 2013; 88 (4): 523–31.
22. Kaneshiro B, Edelman A, Carlson N et al. Unscheduled bleeding with continuous oral contraceptive pills: a comparison of progestin dose. Contraception 2012; 86 (1): 22–7.
23. Kaneshiro B, Edelman A, Carlson N et al. A randomized controlled trial of doxycycline to prevent unscheduled bleeding with continuous oral contraceptive pill use. Contraception 2012; 85: 351–8.
24. Kaneshiro B, Edelman A, Carlson N et al. Treatment of unscheduled bleeding in continuous oral contraceptive users with doxycycline. Obstet Gynecol 2010; 115: 1141–9.
25. 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 (1): 41–8.
26. Trego L, Jordan P. Military women’s attitudes towards menstruation and menstrual suppression in relation to the deployed environment: development and testing of the MWATMS-9 (short form). Women’s Health Issues 2010; 20 (4): 287–93.
27. Powell-Dunford N, Cuda A, Moore J et al. Menstrual suppression for combat operations; advantages of oral contraceptive pills. Women’s Health Issues 2011; 21 (1): 86–91.
28. Read CM. New regimens with combined oral contraceptive pills – moving away from traditional 21/7 cycles. Eur J Contracept Reprod Health Care 2010; 15 (Suppl. 2): S32–41.
29. Benagiano G, Carrara S, Filippi V. Safety, efficacy and patient satisfaction with continuous daily administration of levonorgestrel/ethinylestradiol oral contraceptives. Patient Prefer Adherence 2009; 3: 131–43.
30. Szarewski A, von Stenglin A, Rybowski S. Women’s attitudes towards monthly bleeding: results of a global population-based survey. Eur J Contracept Reprod Health Care 2012; 17 (4): 270–83.
31. Szarewski A, Moeller C. Women’s perceptions about reducing the frequency of monthly bleeding results from a multinational survey. Open Access J Contracept 2013; 4: 29–37.
32. Nappi RE, Kaunitz AM, Bitzer J. Extended regimen combined oral contraception: A review of evolving concepts and acceptance by women and clinicians. Eur J Contracept Reprod Health Care 2016; 21 (2): 106–15.
33. Edelman A, Micks E, Gallo MF et al. Continuous or extended cycle vs. cyclic use of combined hormonal contraceptives for contraception. Cochrane Database Syst Rev 2014; 7 (7).
34. Первый препарат на Российском рынке, который содержит 84 таблетки с 20 мкг этинилэстрадиола и 100 мкг левоноргестрела и 7 таблеток с 10 мкг этинилэстрадиола для непрерывного режима приема в течение 91 дня. http://grls.rosminzdrav.ru/ 22.03.2017
35. Instruktsiia po primeneniiu preparata MODELL''® LIBERA. [in Russian]
36. Thomas SL, Ellertson C. Nuisance or natural and healthy: should monthly menstruation be optional for women? Lancet 2000; 355 (9207): 922–4.
2. Cheewadhanaraks S, Choksuchat C, Dhanaworavibul K, Liabsuetrakult T. Postoperative depot medroxyprogesterone acetate versus continuous oral contraceptive pills in the treatment of endometriosis-associated pain; a randomized comparative trial. Gynecol Obstet Invest 2012; 74 (2): 151–6.
3. Dmitrovic R, Kunselman A, Legro R. Continuous compared with cyclic oral contraceptives for the treatment of primary dysmenorrhea: a randomized controlled trial. Obstet Gynecol 2012; 119: 1143–50.
4. Vandever M, Kuehl T, Sulak P et al. Evaluation of pituitary-ovarian axis suppression with three oral contraceptive regimens. Contraception 2008; 77 (3): 162–70.
5. Кузнецова И.В., Коновалов В.А. Пролонгированный прием комбинированного орального контрацептива, содержащего дроспиренон, в лечении предменструального синдрома. Проблемы репродукции. 2008; 4: 28–31. / Kuznetsova I.V., Konovalov V.A. Prolongirovannyi priem kombinirovannogo oralnogo kontratseptiva, soderzhashchego drospirenon, v lechenii predmenstrualnogo sindroma. Problemy reproduktsii. 2008; 4: 28–31. [in Russian]
6. Machado R, de Melo N, Maia H. Bleeding patterns and menstrual-related symptoms with the continuous use of a contraceptive combination of ethinylestradiol and drospirenone: a randomized study. Contraception 2010; 81: 215–22.
7. Falcone T, Lebovic DI. Clinical management of endometriosis. Obstet Gynecol 2011; 118 (3): 691–705.
8. Hirota Y, Osuga Y, Nose E et al. The presence of midkine and its possible implication in human ovarian follicles. Am J Reprod Immunol 2007; 58: 367–73.
9. ACOG Practice Bulletin № 114. Management of endometriosis. Obstet Gynecol 2010; 116: 223–36.
10. Chapron C, Souza C, Borghese B et al. Oral contraceptives and endometriosis: the past use of oral contraceptives for treating severe primary dysmenorrhea is associated with endometriosis, especially deep infiltrating endometriosis. Hum Reprod 2011; 26 (8): 2028–35.
11. Seracchioli R, Mabrouk M, Manuzzi L et al. Post-operative use of oral contraceptive pills for prevention of anatomical relapse or symptom-recurrence after conservative surgery for endometriosis. Hum Reprod 2009; 24: 2729–35.
12. Seracchioli R, Mabrouk M, Frasca C et al. Long-term oral contraceptive pills and postoperative pain management after laparoscopic excision of ovarian endometrioma: a randomized controlled trial. Fertil Steril 2010; 94 (2): 464–71.
13. Vercellini P, Eskenazi B, Consonni D et al. Oral contraceptives and risk of endometriosis: a systematic review and meta-analysis. Hum Reprod Update 2011; 17 (2): 159–70.
14. Legro R, Pauli J, Kunselman A et al. Effects of continuous versus cyclic oral contraception: a randomized controlled trial. J Clin Endocrinol Metab 2008; 93 (2): 420–9.
15. Seracchioli R, Mabrouk M, Frasca C. Long-term cyclic and continuous oral contraceptive therapy and endometrioma recurrence: a randomized, controlled trial. Fertil Steril 2010; 93: 52–6.
16. Подзолкова Н.М., Кузнецова И.В. Применение марвелона в пролонгированном режиме в качестве противорецидивной терапии гиперпластических процессов эндометрия. Акушерство и гинекология. 2007; 1: 53–7. / Podzolkova N.M., Kuznetsova I.V. Primenenie marvelona v prolongirovannom rezhime v kachestve protivoretsidivnoi terapii giperplasticheskikh protsessov endometriia. Akusherstvo i ginekologiia. 2007; 1: 53–7. [in Russian]
17. Lete I, Doval JL, Pérez-Campos E et al. Self-described impact of noncompliance among users of a combined hormonal contraceptive method. Contraception 2008; 77 (4): 276–82.
18. Hou MY, Hurwitz S, Kavanagh E et al. Using daily text-message reminders to improve adherence with oral contraceptives: a randomized controlled trial. Obstet Gynecol 2010; 116 (3): 633–40.
19. Rad M, Kluft C, Kam M et al. Metabolic profile of a continuous versus a cyclic low-dose combined oral contraceptive after one year of use. Eur J Contracept Reprod Health Care 2011; 16 (2): 85–94.
20. Jensen JT, Garie SG, Trummer D, Elliesen J. Bleeding profile of a flexible extended regimen of ethinylestradiol/drospirenone in US women: an open-label, three-arm, active-controlled, multicenter study. Contraception 2012; 86 (2): 110–8.
21. Stephenson J, Shawe J, Panicker S et al. Randomized trial of the effect of tailored versus standard use of the combined oral contraceptive pill on continuation rates at 1 year. Contraception 2013; 88 (4): 523–31.
22. Kaneshiro B, Edelman A, Carlson N et al. Unscheduled bleeding with continuous oral contraceptive pills: a comparison of progestin dose. Contraception 2012; 86 (1): 22–7.
23. Kaneshiro B, Edelman A, Carlson N et al. A randomized controlled trial of doxycycline to prevent unscheduled bleeding with continuous oral contraceptive pill use. Contraception 2012; 85: 351–8.
24. Kaneshiro B, Edelman A, Carlson N et al. Treatment of unscheduled bleeding in continuous oral contraceptive users with doxycycline. Obstet Gynecol 2010; 115: 1141–9.
25. 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 (1): 41–8.
26. Trego L, Jordan P. Military women’s attitudes towards menstruation and menstrual suppression in relation to the deployed environment: development and testing of the MWATMS-9 (short form). Women’s Health Issues 2010; 20 (4): 287–93.
27. Powell-Dunford N, Cuda A, Moore J et al. Menstrual suppression for combat operations; advantages of oral contraceptive pills. Women’s Health Issues 2011; 21 (1): 86–91.
28. Read CM. New regimens with combined oral contraceptive pills – moving away from traditional 21/7 cycles. Eur J Contracept Reprod Health Care 2010; 15 (Suppl. 2): S32–41.
29. Benagiano G, Carrara S, Filippi V. Safety, efficacy and patient satisfaction with continuous daily administration of levonorgestrel/ethinylestradiol oral contraceptives. Patient Prefer Adherence 2009; 3: 131–43.
30. Szarewski A, von Stenglin A, Rybowski S. Women’s attitudes towards monthly bleeding: results of a global population-based survey. Eur J Contracept Reprod Health Care 2012; 17 (4): 270–83.
31. Szarewski A, Moeller C. Women’s perceptions about reducing the frequency of monthly bleeding results from a multinational survey. Open Access J Contracept 2013; 4: 29–37.
32. Nappi RE, Kaunitz AM, Bitzer J. Extended regimen combined oral contraception: A review of evolving concepts and acceptance by women and clinicians. Eur J Contracept Reprod Health Care 2016; 21 (2): 106–15.
33. Edelman A, Micks E, Gallo MF et al. Continuous or extended cycle vs. cyclic use of combined hormonal contraceptives for contraception. Cochrane Database Syst Rev 2014; 7 (7).
34. Первый препарат на Российском рынке, который содержит 84 таблетки с 20 мкг этинилэстрадиола и 100 мкг левоноргестрела и 7 таблеток с 10 мкг этинилэстрадиола для непрерывного режима приема в течение 91 дня. http://grls.rosminzdrav.ru/ 22.03.2017
35. Инструкция по применению препарата МОДЭЛЛЬ® ЛИБЕРА. / Instruktsiia po primeneniiu preparata MODELL''® LIBERA. [in Russian]
36. Thomas SL, Ellertson C. Nuisance or natural and healthy: should monthly menstruation be optional for women? Lancet 2000; 355 (9207): 922–4.
________________________________________________
2. Cheewadhanaraks S, Choksuchat C, Dhanaworavibul K, Liabsuetrakult T. Postoperative depot medroxyprogesterone acetate versus continuous oral contraceptive pills in the treatment of endometriosis-associated pain; a randomized comparative trial. Gynecol Obstet Invest 2012; 74 (2): 151–6.
3. Dmitrovic R, Kunselman A, Legro R. Continuous compared with cyclic oral contraceptives for the treatment of primary dysmenorrhea: a randomized controlled trial. Obstet Gynecol 2012; 119: 1143–50.
4. Vandever M, Kuehl T, Sulak P et al. Evaluation of pituitary-ovarian axis suppression with three oral contraceptive regimens. Contraception 2008; 77 (3): 162–70.
5. Kuznetsova I.V., Konovalov V.A. Prolongirovannyi priem kombinirovannogo oralnogo kontratseptiva, soderzhashchego drospirenon, v lechenii predmenstrualnogo sindroma. Problemy reproduktsii. 2008; 4: 28–31. [in Russian]
6. Machado R, de Melo N, Maia H. Bleeding patterns and menstrual-related symptoms with the continuous use of a contraceptive combination of ethinylestradiol and drospirenone: a randomized study. Contraception 2010; 81: 215–22.
7. Falcone T, Lebovic DI. Clinical management of endometriosis. Obstet Gynecol 2011; 118 (3): 691–705.
8. Hirota Y, Osuga Y, Nose E et al. The presence of midkine and its possible implication in human ovarian follicles. Am J Reprod Immunol 2007; 58: 367–73.
9. ACOG Practice Bulletin № 114. Management of endometriosis. Obstet Gynecol 2010; 116: 223–36.
10. Chapron C, Souza C, Borghese B et al. Oral contraceptives and endometriosis: the past use of oral contraceptives for treating severe primary dysmenorrhea is associated with endometriosis, especially deep infiltrating endometriosis. Hum Reprod 2011; 26 (8): 2028–35.
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Авторы
И.В.Кузнецова*
ФГБОУ ВО «Первый Московский государственный медицинский университет им. И.М.Сеченова» Минздрава России. 119991, Россия, Москва, ул. Трубецкая, д. 8, стр. 2
*ms.smith.ivk@gmail.com
I.M.Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation. 119991, Russian Federation, Moscow, ul. Trubetskaia, d. 8, str. 2
*ms.smith.ivk@gmail.com
ФГБОУ ВО «Первый Московский государственный медицинский университет им. И.М.Сеченова» Минздрава России. 119991, Россия, Москва, ул. Трубецкая, д. 8, стр. 2
*ms.smith.ivk@gmail.com
________________________________________________
I.M.Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation. 119991, Russian Federation, Moscow, ul. Trubetskaia, d. 8, str. 2
*ms.smith.ivk@gmail.com
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