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Прогестеронсодержащие контрацептивы: место в практической гинекологии (в помощь практикующему врачу)
Прогестеронсодержащие контрацептивы: место в практической гинекологии (в помощь практикующему врачу)
Доброхотова Ю.Э., Боровкова Е.И., Залесская С.А. Прогестеронсодержащие контрацептивы: место в практической гинекологии (в помощь практикующему врачу). Гинекология. 2018; 20 (3): 48–51.
DOI: 10.26442/2079-5696_2018.3.48-51
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Аннотация
Прогестеронсодержащие контрацептивы не оказывают существенного влияния на обменные процессы и могут назначаться пациенткам с системными (сахарный диабет, ожирение) и другими заболеваниями. Дезогестрел входит в состав пероральных препаратов в дозе 75 мкг. Основным механизмом его контрацептивного действия является подавление овуляции (в 97% случаев). Частота наступления беременности составляет 0,17 на 100 женщин-лет. Прогестеронсодержащие контрацептивы не должны расцениваться как препараты 2-го выбора при решении вопроса о планировании семьи. По рекомендациям Центра по контролю и профилактике заболеваний и Всемирной организации здравоохранения дезогестрел является приемлемым вариантом контрацепции для женщин с соматическими заболеваниями, определенной опухолевой патологией и тромботическими состояниями в анамнезе.
Ключевые слова: оральная контрацепция, прогестерон, дезогестрел, прогестиновые оральные контрацептивы, лактация.
Key words: oral contraception, progesterone, desogestrel, progestin oral contraceptives, lactation.
Ключевые слова: оральная контрацепция, прогестерон, дезогестрел, прогестиновые оральные контрацептивы, лактация.
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Key words: oral contraception, progesterone, desogestrel, progestin oral contraceptives, lactation.
Полный текст
Список литературы
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2. World Health Organization. Medical Eligibility Criteria for Contraceptive Use, 5th Edition, World Health Organization, 2015.
3. Benagiano G, Primiero FM. Seventy-five microgram desogestrel minipill, a new perspective in estrogen-free contraception. Ann NY Acad Sci 2003; 997: 163.
4. Milsom I, Korver T. Ovulation incidence with oral contraceptives: a literature review. J Fam Plann Reprod Health Care 2008; 34: 237.
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6. Lebech PE, Svendsen PA, Ostergaard E, Koch F. The effects of small doses of megestrol acetate on the cervical mucus. Acta Obstet Gynecol Scand 1969; 48 (Suppl. 3): 22.
7. Wright SW, Fotherby K, Fairweather F. Effect of daily small doses of Norgestrel on ovarian function. J Obstet Gynaecol Br Commonw 1970; 77: 65.
8. Trussell J. Contraceptive failure in the United States. Contraception 2011; 83: 397.
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10. Curtis KM, Jatlaoui TC, Tepper NK et al. U.S. Selected Practice Recommendations for Contraceptive Use, 2016. MMWR Recomm Rep 2016; 65: 1.
11. Lopez LM, Edelman A, Chen M et al. Progestin-only contraceptives: effects on weight. Cochrane Database Syst Rev 2013: CD008815.
12. MacGregor EA. Contraception and headache. Headache 2013; 53: 247.
13. Belsey EM. Vaginal bleeding patterns among women using one natural and eight hormonal methods of contraception. Contraception 1988; 38: 181.
14. Hussain SF. Progestogen-only pills and high blood pressure: is there an association? A literature review. Contraception 2004; 69: 89.
15. Godsland IF, Crook D, Simpson R et al. The effects of different formulations of oral contraceptive agents on lipid and carbohydrate metabolism. N Engl J Med 1990; 323: 1375.
16. Winkler UH. Blood coagulation and oral contraceptives. A critical review. Contraception 1998; 57: 203.
17. Cardiovascular disease and use of oral and injectable progestogen-only contraceptives and combined injectable contraceptives. Results of an international, multicenter, case-control study. World Health Organization Collaborative Study of Cardiovascular Disease and Steroid Hormone Contraception. Contraception 1998; 57: 315.
18. Heinemann LA, Assmann A, DoMinh T, Garbe E. Oral progestogen-only contraceptives and cardiovascular risk: results from the Transnational Study on Oral Contraceptives and the Health of Young Women. Eur J Contracept Reprod Health Care 1999; 4: 67.
19. Gomes MP, Deitcher SR. Risk of venous thromboembolic disease associated with hormonal contraceptives and hormone replacement therapy: a clinical review. Arch Intern Med 2004; 164: 1965.
20. Lidegaard Ø, Løkkegaard E, Jensen A et al. Thrombotic stroke and myocardial infarction with hormonal contraception. N Engl J Med 2012; 366: 2257.
21. Bergendal A, Persson I, Odeberg J et al. Association of venous thromboembolism with hormonal contraception and thrombophilic genotypes. Obstet Gynecol 2014; 124: 600.
22. Tepper NK, Whiteman MK, Marchbanks PA et al. Progestin-only contraception and thromboembolism: A systematic review. Contraception 2016; 94: 678.
23. ACOG Committee on Practice Bulletins-Gynecology. ACOG practice bulletin. No. 73: Use of hormonal contraception in women with coexisting medical conditions. Obstet Gynecol 2006; 107: 1453.
24. Curtis KM, Tepper NK, Jatlaoui TC et al. U.S. Medical Eligibility Criteria for Contraceptive Use, 2016. MMWR Recomm Rep 2016; 65: 1.
25. Dunson TR, McLaurin VL, Grubb GS, Rosman AW. A multicenter clinical trial of a progestin-only oral contraceptive in lactating women. Contraception 1993; 47: 23.
26. Kjos SL, Peters RK, Xiang A et al. Contraception and the risk of type 2 diabetes mellitus in Latina women with prior gestational diabetes mellitus. JAMA 1998; 280: 533.
2. World Health Organization. Medical Eligibility Criteria for Contraceptive Use, 5th Edition, World Health Organization, 2015.
3. Benagiano G, Primiero FM. Seventy-five microgram desogestrel minipill, a new perspective in estrogen-free contraception. Ann NY Acad Sci 2003; 997: 163.
4. Milsom I, Korver T. Ovulation incidence with oral contraceptives: a literature review. J Fam Plann Reprod Health Care 2008; 34: 237.
5. Speroff L, Darney P. A Clinical Guide for Contraception, 4th ed, Williams and Wilkins, Baltimore 2005.
6. Lebech PE, Svendsen PA, Ostergaard E, Koch F. The effects of small doses of megestrol acetate on the cervical mucus. Acta Obstet Gynecol Scand 1969; 48 (Suppl. 3): 22.
7. Wright SW, Fotherby K, Fairweather F. Effect of daily small doses of Norgestrel on ovarian function. J Obstet Gynaecol Br Commonw 1970; 77: 65.
8. Trussell J. Contraceptive failure in the United States. Contraception 2011; 83: 397.
9. Vessey MP, Lawless M, Yeates F et al. Progestogen-only oral contraception. Findings in a large prospective study with special reference to effectiveness. Br J Fam Plann 1985; 10: 117.
10. Curtis KM, Jatlaoui TC, Tepper NK et al. U.S. Selected Practice Recommendations for Contraceptive Use, 2016. MMWR Recomm Rep 2016; 65: 1.
11. Lopez LM, Edelman A, Chen M et al. Progestin-only contraceptives: effects on weight. Cochrane Database Syst Rev 2013: CD008815.
12. MacGregor EA. Contraception and headache. Headache 2013; 53: 247.
13. Belsey EM. Vaginal bleeding patterns among women using one natural and eight hormonal methods of contraception. Contraception 1988; 38: 181.
14. Hussain SF. Progestogen-only pills and high blood pressure: is there an association? A literature review. Contraception 2004; 69: 89.
15. Godsland IF, Crook D, Simpson R et al. The effects of different formulations of oral contraceptive agents on lipid and carbohydrate metabolism. N Engl J Med 1990; 323: 1375.
16. Winkler UH. Blood coagulation and oral contraceptives. A critical review. Contraception 1998; 57: 203.
17. Cardiovascular disease and use of oral and injectable progestogen-only contraceptives and combined injectable contraceptives. Results of an international, multicenter, case-control study. World Health Organization Collaborative Study of Cardiovascular Disease and Steroid Hormone Contraception. Contraception 1998; 57: 315.
18. Heinemann LA, Assmann A, DoMinh T, Garbe E. Oral progestogen-only contraceptives and cardiovascular risk: results from the Transnational Study on Oral Contraceptives and the Health of Young Women. Eur J Contracept Reprod Health Care 1999; 4: 67.
19. Gomes MP, Deitcher SR. Risk of venous thromboembolic disease associated with hormonal contraceptives and hormone replacement therapy: a clinical review. Arch Intern Med 2004; 164: 1965.
20. Lidegaard Ø, Løkkegaard E, Jensen A et al. Thrombotic stroke and myocardial infarction with hormonal contraception. N Engl J Med 2012; 366: 2257.
21. Bergendal A, Persson I, Odeberg J et al. Association of venous thromboembolism with hormonal contraception and thrombophilic genotypes. Obstet Gynecol 2014; 124: 600.
22. Tepper NK, Whiteman MK, Marchbanks PA et al. Progestin-only contraception and thromboembolism: A systematic review. Contraception 2016; 94: 678.
23. ACOG Committee on Practice Bulletins-Gynecology. ACOG practice bulletin. No. 73: Use of hormonal contraception in women with coexisting medical conditions. Obstet Gynecol 2006; 107: 1453.
24. Curtis KM, Tepper NK, Jatlaoui TC et al. U.S. Medical Eligibility Criteria for Contraceptive Use, 2016. MMWR Recomm Rep 2016; 65: 1.
25. Dunson TR, McLaurin VL, Grubb GS, Rosman AW. A multicenter clinical trial of a progestin-only oral contraceptive in lactating women. Contraception 1993; 47: 23.
26. Kjos SL, Peters RK, Xiang A et al. Contraception and the risk of type 2 diabetes mellitus in Latina women with prior gestational diabetes mellitus. JAMA 1998; 280: 533.
2. World Health Organization. Medical Eligibility Criteria for Contraceptive Use, 5th Edition, World Health Organization, 2015.
3. Benagiano G, Primiero FM. Seventy-five microgram desogestrel minipill, a new perspective in estrogen-free contraception. Ann NY Acad Sci 2003; 997: 163.
4. Milsom I, Korver T. Ovulation incidence with oral contraceptives: a literature review. J Fam Plann Reprod Health Care 2008; 34: 237.
5. Speroff L, Darney P. A Clinical Guide for Contraception, 4th ed, Williams and Wilkins, Baltimore 2005.
6. Lebech PE, Svendsen PA, Ostergaard E, Koch F. The effects of small doses of megestrol acetate on the cervical mucus. Acta Obstet Gynecol Scand 1969; 48 (Suppl. 3): 22.
7. Wright SW, Fotherby K, Fairweather F. Effect of daily small doses of Norgestrel on ovarian function. J Obstet Gynaecol Br Commonw 1970; 77: 65.
8. Trussell J. Contraceptive failure in the United States. Contraception 2011; 83: 397.
9. Vessey MP, Lawless M, Yeates F et al. Progestogen-only oral contraception. Findings in a large prospective study with special reference to effectiveness. Br J Fam Plann 1985; 10: 117.
10. Curtis KM, Jatlaoui TC, Tepper NK et al. U.S. Selected Practice Recommendations for Contraceptive Use, 2016. MMWR Recomm Rep 2016; 65: 1.
11. Lopez LM, Edelman A, Chen M et al. Progestin-only contraceptives: effects on weight. Cochrane Database Syst Rev 2013: CD008815.
12. MacGregor EA. Contraception and headache. Headache 2013; 53: 247.
13. Belsey EM. Vaginal bleeding patterns among women using one natural and eight hormonal methods of contraception. Contraception 1988; 38: 181.
14. Hussain SF. Progestogen-only pills and high blood pressure: is there an association? A literature review. Contraception 2004; 69: 89.
15. Godsland IF, Crook D, Simpson R et al. The effects of different formulations of oral contraceptive agents on lipid and carbohydrate metabolism. N Engl J Med 1990; 323: 1375.
16. Winkler UH. Blood coagulation and oral contraceptives. A critical review. Contraception 1998; 57: 203.
17. Cardiovascular disease and use of oral and injectable progestogen-only contraceptives and combined injectable contraceptives. Results of an international, multicenter, case-control study. World Health Organization Collaborative Study of Cardiovascular Disease and Steroid Hormone Contraception. Contraception 1998; 57: 315.
18. Heinemann LA, Assmann A, DoMinh T, Garbe E. Oral progestogen-only contraceptives and cardiovascular risk: results from the Transnational Study on Oral Contraceptives and the Health of Young Women. Eur J Contracept Reprod Health Care 1999; 4: 67.
19. Gomes MP, Deitcher SR. Risk of venous thromboembolic disease associated with hormonal contraceptives and hormone replacement therapy: a clinical review. Arch Intern Med 2004; 164: 1965.
20. Lidegaard Ø, Løkkegaard E, Jensen A et al. Thrombotic stroke and myocardial infarction with hormonal contraception. N Engl J Med 2012; 366: 2257.
21. Bergendal A, Persson I, Odeberg J et al. Association of venous thromboembolism with hormonal contraception and thrombophilic genotypes. Obstet Gynecol 2014; 124: 600.
22. Tepper NK, Whiteman MK, Marchbanks PA et al. Progestin-only contraception and thromboembolism: A systematic review. Contraception 2016; 94: 678.
23. ACOG Committee on Practice Bulletins-Gynecology. ACOG practice bulletin. No. 73: Use of hormonal contraception in women with coexisting medical conditions. Obstet Gynecol 2006; 107: 1453.
24. Curtis KM, Tepper NK, Jatlaoui TC et al. U.S. Medical Eligibility Criteria for Contraceptive Use, 2016. MMWR Recomm Rep 2016; 65: 1.
25. Dunson TR, McLaurin VL, Grubb GS, Rosman AW. A multicenter clinical trial of a progestin-only oral contraceptive in lactating women. Contraception 1993; 47: 23.
26. Kjos SL, Peters RK, Xiang A et al. Contraception and the risk of type 2 diabetes mellitus in Latina women with prior gestational diabetes mellitus. JAMA 1998; 280: 533.
________________________________________________
2. World Health Organization. Medical Eligibility Criteria for Contraceptive Use, 5th Edition, World Health Organization, 2015.
3. Benagiano G, Primiero FM. Seventy-five microgram desogestrel minipill, a new perspective in estrogen-free contraception. Ann NY Acad Sci 2003; 997: 163.
4. Milsom I, Korver T. Ovulation incidence with oral contraceptives: a literature review. J Fam Plann Reprod Health Care 2008; 34: 237.
5. Speroff L, Darney P. A Clinical Guide for Contraception, 4th ed, Williams and Wilkins, Baltimore 2005.
6. Lebech PE, Svendsen PA, Ostergaard E, Koch F. The effects of small doses of megestrol acetate on the cervical mucus. Acta Obstet Gynecol Scand 1969; 48 (Suppl. 3): 22.
7. Wright SW, Fotherby K, Fairweather F. Effect of daily small doses of Norgestrel on ovarian function. J Obstet Gynaecol Br Commonw 1970; 77: 65.
8. Trussell J. Contraceptive failure in the United States. Contraception 2011; 83: 397.
9. Vessey MP, Lawless M, Yeates F et al. Progestogen-only oral contraception. Findings in a large prospective study with special reference to effectiveness. Br J Fam Plann 1985; 10: 117.
10. Curtis KM, Jatlaoui TC, Tepper NK et al. U.S. Selected Practice Recommendations for Contraceptive Use, 2016. MMWR Recomm Rep 2016; 65: 1.
11. Lopez LM, Edelman A, Chen M et al. Progestin-only contraceptives: effects on weight. Cochrane Database Syst Rev 2013: CD008815.
12. MacGregor EA. Contraception and headache. Headache 2013; 53: 247.
13. Belsey EM. Vaginal bleeding patterns among women using one natural and eight hormonal methods of contraception. Contraception 1988; 38: 181.
14. Hussain SF. Progestogen-only pills and high blood pressure: is there an association? A literature review. Contraception 2004; 69: 89.
15. Godsland IF, Crook D, Simpson R et al. The effects of different formulations of oral contraceptive agents on lipid and carbohydrate metabolism. N Engl J Med 1990; 323: 1375.
16. Winkler UH. Blood coagulation and oral contraceptives. A critical review. Contraception 1998; 57: 203.
17. Cardiovascular disease and use of oral and injectable progestogen-only contraceptives and combined injectable contraceptives. Results of an international, multicenter, case-control study. World Health Organization Collaborative Study of Cardiovascular Disease and Steroid Hormone Contraception. Contraception 1998; 57: 315.
18. Heinemann LA, Assmann A, DoMinh T, Garbe E. Oral progestogen-only contraceptives and cardiovascular risk: results from the Transnational Study on Oral Contraceptives and the Health of Young Women. Eur J Contracept Reprod Health Care 1999; 4: 67.
19. Gomes MP, Deitcher SR. Risk of venous thromboembolic disease associated with hormonal contraceptives and hormone replacement therapy: a clinical review. Arch Intern Med 2004; 164: 1965.
20. Lidegaard Ø, Løkkegaard E, Jensen A et al. Thrombotic stroke and myocardial infarction with hormonal contraception. N Engl J Med 2012; 366: 2257.
21. Bergendal A, Persson I, Odeberg J et al. Association of venous thromboembolism with hormonal contraception and thrombophilic genotypes. Obstet Gynecol 2014; 124: 600.
22. Tepper NK, Whiteman MK, Marchbanks PA et al. Progestin-only contraception and thromboembolism: A systematic review. Contraception 2016; 94: 678.
23. ACOG Committee on Practice Bulletins-Gynecology. ACOG practice bulletin. No. 73: Use of hormonal contraception in women with coexisting medical conditions. Obstet Gynecol 2006; 107: 1453.
24. Curtis KM, Tepper NK, Jatlaoui TC et al. U.S. Medical Eligibility Criteria for Contraceptive Use, 2016. MMWR Recomm Rep 2016; 65: 1.
25. Dunson TR, McLaurin VL, Grubb GS, Rosman AW. A multicenter clinical trial of a progestin-only oral contraceptive in lactating women. Contraception 1993; 47: 23.
26. Kjos SL, Peters RK, Xiang A et al. Contraception and the risk of type 2 diabetes mellitus in Latina women with prior gestational diabetes mellitus. JAMA 1998; 280: 533.
Авторы
Ю.Э.Доброхотова, Е.И.Боровкова*, С.А.Залесская
ФГБОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И.Пирогова» Минздрава России. 117997, Россия, Москва, ул. Островитянова, д. 1
*katyanikitina@mail.ru
N.I.Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation. 117997, Russian Federation, Moscow,
ul. Ostrovitianova, d. 1
*katyanikitina@mail.ru
ФГБОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И.Пирогова» Минздрава России. 117997, Россия, Москва, ул. Островитянова, д. 1
*katyanikitina@mail.ru
________________________________________________
N.I.Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation. 117997, Russian Federation, Moscow,
ul. Ostrovitianova, d. 1
*katyanikitina@mail.ru
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