Комбинированные оральные контрацептивы с натуральным эстрогеном и сексуальная функция: оптимальный метод контрацепции для женщин разного возраста
Комбинированные оральные контрацептивы с натуральным эстрогеном и сексуальная функция: оптимальный метод контрацепции для женщин разного возраста
Юренева С.В., Ильина Л.М. Комбинированные оральные контрацептивы с натуральным эстрогеном и сексуальная функция: оптимальный метод контрацепции для женщин разного возраста. Гинекология. 2019; 21 (1): 33–37. DOI: 10.26442/20795696.2019.1.190184
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Yureneva S.V., Ilina L.M. Combined oral contraceptives with natural estrogen and sexual function: the optimal method of contraception for women of different ages. Gynecology. 2019; 21 (1): 33–37.
DOI: 10.26442/20795696.2019.1.190184
Комбинированные оральные контрацептивы с натуральным эстрогеном и сексуальная функция: оптимальный метод контрацепции для женщин разного возраста
Юренева С.В., Ильина Л.М. Комбинированные оральные контрацептивы с натуральным эстрогеном и сексуальная функция: оптимальный метод контрацепции для женщин разного возраста. Гинекология. 2019; 21 (1): 33–37. DOI: 10.26442/20795696.2019.1.190184
________________________________________________
Yureneva S.V., Ilina L.M. Combined oral contraceptives with natural estrogen and sexual function: the optimal method of contraception for women of different ages. Gynecology. 2019; 21 (1): 33–37.
DOI: 10.26442/20795696.2019.1.190184
Обоснование. Комбинированные оральные контрацептивы (КОК) являются наиболее распространенным методом предупреждения нежелательной беременности у женщин от раннего репродуктивного периода до перименопаузы, поэтому их влияние на качество жизни, сексуальную функцию и общее благополучие остается предметом активного обсуждения. Некоторые исследования выявили различные проявления сексуальной дисфункции на фоне приема КОК, поэтому подобные вопросы, а также преимущества/недостатки отдельных компонентов препаратов представляют интерес для клинициста. Цель. Оценить механизмы влияния КОК на сексуальную функцию женщины. Материалы и методы. Для написания данного обзора был осуществлен поиск отечественных и зарубежных публикаций в российских и международных системах поиска (PubMed, eLibrary и пр.) за последние 2–15 лет. В обзор были включены статьи из рецензируемой литературы. Результаты. Во многих исследованиях доказано благоприятное влияние комбинации эстрогена, идентичного натуральному, – эстрадиола валерата и прогестина IV поколения диеногеста в динамическом режиме дозирования на качество жизни и сексуальную функцию, благодаря сочетанным эффектам обоих компонентов препарата и режима приема. Заключение. Сочетание эстрогена, идентичного натуральному, – эстрадиола валерата и прогестина IV поколения диеногеста может быть оптимальным методом контрацепции для женщин любого возраста, в том числе и молодых, со снижением либидо на фоне приема других КОК.
Background. Combined oral contraceptives (COCs) are the most common method of prevention of unwanted pregnancies in women from the early reproductive period to perimenopause, therefore their impact on quality of life, sexual function and general well-being remains the subject of active discussion. Some studies revealed various manifestations of sexual dysfunction in patients receiving COCs, therefore such questions, as well as the advantages / disadvantages of individual components (their type and dose) of drugs, are of interest to the clinician. Aim. Assess mechanisms of influence of COCs on female sexual function. Materials and methods. In order to write this review domestic and foreign publications were searched in Russian and international search systems (PubMed, elibrary, etc.) for the last 2–15 years. Relevant articles from the peer-reviewed literature were included. Results. Many studies proved a beneficial effect of estradiol valerate (E2V) which is estrogen identical to natural one in a combination with dienogest (DNG) which is 4th generation progestin in a dynamic dosing regimen on quality of life and sexual function. This beneficial effect is achieved due to combined effects of both components of the drug as well as its reception mode. Conclusion. The combination of estradiol valerate (E2V) which is estrogen identical to natural one with dienogest (DNG) which is 4th generation progestin may be the optimal method of contraception for women of any age, including the young, with decreased libido while taking other COCs.
Key words: female sexual dysfunction, combined oral contraceptives.
1. Burrows LJ, Basha M, Goldstein AT. The effects of hormonal contraceptives on female sexuality: a review. J Sex Med 2012; 9: 2213–23.
2. Pastor Z, Holla K, Chmel R. The influence of combined oral contraceptives on female sexual desire: A systematic review. Eur J Contracept Reprod Health Care 2013; 18: 27–43.
3. Caruso S, Cianci S, Cariola M et al. Improvement of low sexual desire due to antiandrogenic combined oral contraceptives after switching to an oral contraceptive containing 17beta-estradiol. J Women’s Health 2017; 26: 728–73.
4. Wallwiener CW, Wallwiener LM, Seeger H et al. Prevalence of sexual dysfunction and impact of contraception in female German medical students. J Sex Med 2010; 7: 2139–48.
5. Čiaplinskienė L, Žilaitienė B, Verkauskienė R et al. The effect of a drospirenone-containing combined oral contraceptive on female sexual function: a prospective randomised study. Eur J Contracept Reprod Health Care 2016; 21: 395–400.
6. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-5). 5th ed. Washington, DC: American Psychiatric Association, 2013.
7. McCabe MP, Sharlip ID, Atalla E et al. Definitions of sexual dysfunctions in women and men: a Consensus Statement from the Fourth International Consultation on Sexual Medicine 2015. J Sex Med 2016; 13: 135–4313.
8. Reed GM, Drescher J, Krueger RB et al. Disorders related to sexuality and gender identity in the ICD-11: revising the ICD-10 classification based on current scientific evidence, best clinical practices, and human rights considerations. World Psychiatry 2016; 15: 205–21.
9. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 4th ed. Text Rev. Washington, DC: American Psychiatric Association, 2000.
10. Parish SJ, Goldstein AT, Goldstein SW et al. Toward a more evidence-based nosology and nomenclature for female sexual dysfunctions. Part II. J Sex Med 2016; 13: 1888–906.
11. Parish SJ, Hahn SR. Hypoactive sexual desire disorder: a review of epidemiology, biopsychology, diagnosis, and treatment. Sex Med Rev 2016; 4: 103–20.
12. Goldstein I, Kim NN, Clayton AH et al. Hypoactive Sexual Desire Disorder: International Society for the Study of Women’s Sexual Health (ISSWSH) Expert Consensus Panel Review. Mayo Clin Proc 2017; 92 (1): 114–28.
13. Shifren JL. Low sexual desire: Appropriate use of testosterone in menopausal women. OBG Management 2018; 30 (11): 21–8.
14. United Nations, Department of Economic and Social Affairs, Population Division. Trends in Contraceptive Use Worldwide 2015. http: //www.un.org/en/development/desa/population/publications/pdf/family/trendsContraceptiveUse 2015 Report.pdf
15. Fait T, Buryak D, Cirstoiu M-M et al. Needs and preferences of women users of oral contraceptives in selected countries in Central and Eastern Europe. Drugs Context 2018; 7 (7): 212510.
16. World Health Organization. Medical Eligibility Criteria for Contraceptive Use. 5th ed. 2015. http: //apps.who.int/iris/bitstream/10665/181468/1/9789241549158_eng.pdf
17. Curtis KM, Jatlaoui TC, Tepper NK et al. US Selected Practice Recommendations for Contraceptive Use, 2016. MMWR Recomm Rep 2016; 65: 1–66.
18. Zethraeus N, Dreber A, Ranehill E et al. Combined Oral Contraceptives and Sexual Function in Women-a Double-Blind, Randomized, Placebo-Controlled Trial. J Clin Endocrinol Metab 2016; 101 (11): 4046–53.
19. Caruso S, Agnello C, Romano M et al. Preliminary Study on the Effect of Four-phasic Estradiol Valerate and Dienogest (E2V/DNG) Oral Contraceptive on the Quality of Sexual Life. Sex Med 2011; 8: 2841–50.
20. Simon JA, Goldstein I, Kim NN et al. The role of androgens in the treatment of genitourinary syndrome of menopause (GSM): International Society for the Study of Women’s Sexual Health (ISSWSH) expert consensus panel review. Menopause 2018; 25 (7): 837–47.
21. Reed B, Harlow S, Legocki L et al. Oral contraceptive use and risk of vulvodynia: a population-based longitudinal study. BJOG 2013; 120 (13): 1678–84.
22. Davis SR, Bitzer J, Giraldi A et al. Change to either a nonandrogenic or androgenic progestin-containing oral contraceptive preparation is associated with improved sexual function in women with oral contraceptive-associated sexual dysfunction. J Sex Med 2013; 10: 3069–79.
23. De Seta F, Restaino S, Banco R et al. Effects of estroprogestins containing natural estrogen on vaginal flora. Gynecol Endocrinol 2014; 30 (11): 830–5.
24. Di Carlo C, Gargano V, De Rosa N et al. Effects of estradiol valerate and dienogest on quality of life and sexual function according to age. Gynecol Endocrinol 2014; 30 (12): 925–8.
25. Ruan X, Seeger H, Mueck AO. The pharmacology of dienogest. Maturitas 2012; 71: 337–44.
26. Sitruk-Ware R, Nath A. Characteristics and metabolic effects of estrogen and progestins contained in oral contraceptive pills. Best Pract Res Clin Endocrinol Metab 2013; 27: 13–24.
27. Роговская С.И. Вульвовагинальный и цервикальный эпителий и гормональные средства. Status Praesens. 2014; 6 (17): 41–7.
[Rogovskaya S.I. Vul'vovaginal'nyi i tservikal'nyi epitelii i gormonal'nye sredstva. Status Praesens. 2014; 6 (17): 41–7 (in Russian).]
28. Jensen JT, Mellinger U, Serrani M, Mabey RG. Hormone withdrawal-associated symptoms: comparison of oestradiol valerate/dienogest versus ethinylestradiol/norgestimate. Eur J Contracept Reprod Health Care 2013; 18 (4): 274–83.
29. Macias G, Merki-Feld GS, Parke S et al. Effects of a combined oral contraceptive containing oestradiol valerate/dienogest on hormone withdrawal-associated symptoms: results from the multicentre, randomised, double-blind, active-controlled HARMONY II study. J Obstet Gynaecol 2013; 33: 591–6.
30. Petraglia F, Parke S, Serrani M et al. Estradiol valerate plus dienogest versus ethinylestradiol plus levonorgestrel for the treatment of primary dysmenorrhea. Int J Gynaecol Obstet 2014; 125 (3): 270–4.
31. Fraser IS, Parke S, Mellinger U et al. Effective treatment of heavy and/or prolonged menstrual bleeding without organic cause: pooled analysis of two multinational, randomised, double-blind, placebo-controlled trials of oestradiol valerate and dienogest. Eur J Contracept Reprod Health Care 2011; 16: 258–69.
32. Palacios S, Wildt L, Parke S et al. Efficacy and safety of a novel oral contraceptive based on oestradiol (oestradiol valerate/dienogest): a Phase III trial. Eur J Obstet Gynecol Reprod Biol 2010; 149: 57–62.
33. Nelson A1, Parke S, Mellinger U et al. Efficacy and safety of a combined oral contraceptive containing estradiol valerate/dienogest: results from a clinical study conducted in North America. J Womens Health (Larchmt) 2014; 23: 204–10.
34. Barnett C, Hagemann C, Dinges J. Fertility and combined oral contraceptives – unintended pregnancies and planned pregnancies following oral contraceptive use – results from the INAS-SCORE study. Eur J Contracept Reprod Health Care 2017; 22: 17–23.
35. Briggs P, Serrani M, Vogtländer K, Parke S. Continuation rates, bleeding profile acceptability, and satisfaction of women using an oral contraceptive pill containing estradiol valerate and dienogest versus a progestogen-only pill after switching from an ethinylestradiol-containing pill in a real-life setting: results of the CONTENT study. Int J Womens Health 2016; 8: 477–87.
36. Mashchak CA, Lobo RA, Dozono-Takano R et al. Comparison of pharmacodynamic properties of various estrogen formulations. Am J Obstet Gynecol 1982; 144: 511–8.
37. Endrikat J, Parke S, Trummer D et al. Ovulation inhibition with four variations of a four-phasic estradiol valerate/dienogest combined oral contraceptive: results of two prospective, randomized, open-label studies. Contraception 2008; 78: 218–25.
38. Data on file; clinical trial report B709, 2000.
39. Lindberg UB, Crona N, Stigendal L et al. A comparison between effects of estradiol valerate and low dose ethinyl estradiol on haemostasis parameters. Thromb Haemost 1989; 61: 65–9.
40. Wiegratz I, Lee JH, Kutschera E et al. Effect of four oral contraceptives on hemostatic parameters. Contraception 2004; 70: 97–106.
41. Helgason S. Estrogen replacement therapy after the menopause. Estrogenicity and metabolic effects. Acta Obstet Gynecol Scand 1982; 107 (Suppl.): 1–29.
________________________________________________
1. Burrows LJ, Basha M, Goldstein AT. The effects of hormonal contraceptives on female sexuality: a review. J Sex Med 2012; 9: 2213–23.
2. Pastor Z, Holla K, Chmel R. The influence of combined oral contraceptives on female sexual desire: A systematic review. Eur J Contracept Reprod Health Care 2013; 18: 27–43.
3. Caruso S, Cianci S, Cariola M et al. Improvement of low sexual desire due to antiandrogenic combined oral contraceptives after switching to an oral contraceptive containing 17beta-estradiol. J Women’s Health 2017; 26: 728–73.
4. Wallwiener CW, Wallwiener LM, Seeger H et al. Prevalence of sexual dysfunction and impact of contraception in female German medical students. J Sex Med 2010; 7: 2139–48.
5. Čiaplinskienė L, Žilaitienė B, Verkauskienė R et al. The effect of a drospirenone-containing combined oral contraceptive on female sexual function: a prospective randomised study. Eur J Contracept Reprod Health Care 2016; 21: 395–400.
6. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-5). 5th ed. Washington, DC: American Psychiatric Association, 2013.
7. McCabe MP, Sharlip ID, Atalla E et al. Definitions of sexual dysfunctions in women and men: a Consensus Statement from the Fourth International Consultation on Sexual Medicine 2015. J Sex Med 2016; 13: 135–4313.
8. Reed GM, Drescher J, Krueger RB et al. Disorders related to sexuality and gender identity in the ICD-11: revising the ICD-10 classification based on current scientific evidence, best clinical practices, and human rights considerations. World Psychiatry 2016; 15: 205–21.
9. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 4th ed. Text Rev. Washington, DC: American Psychiatric Association, 2000.
10. Parish SJ, Goldstein AT, Goldstein SW et al. Toward a more evidence-based nosology and nomenclature for female sexual dysfunctions. Part II. J Sex Med 2016; 13: 1888–906.
11. Parish SJ, Hahn SR. Hypoactive sexual desire disorder: a review of epidemiology, biopsychology, diagnosis, and treatment. Sex Med Rev 2016; 4: 103–20.
12. Goldstein I, Kim NN, Clayton AH et al. Hypoactive Sexual Desire Disorder: International Society for the Study of Women’s Sexual Health (ISSWSH) Expert Consensus Panel Review. Mayo Clin Proc 2017; 92 (1): 114–28.
13. Shifren JL. Low sexual desire: Appropriate use of testosterone in menopausal women. OBG Management 2018; 30 (11): 21–8.
14. United Nations, Department of Economic and Social Affairs, Population Division. Trends in Contraceptive Use Worldwide 2015. http: //www.un.org/en/development/desa/population/publications/pdf/family/trendsContraceptiveUse 2015 Report.pdf
15. Fait T, Buryak D, Cirstoiu M-M et al. Needs and preferences of women users of oral contraceptives in selected countries in Central and
Eastern Europe. Drugs Context 2018; 7 (7): 212510.
16. World Health Organization. Medical Eligibility Criteria for Contraceptive Use. 5th ed. 2015. http: //apps.who.int/iris/bitstream/10665/181468/1/9789241549158_eng.pdf
17. Curtis KM, Jatlaoui TC, Tepper NK et al. US Selected Practice Recommendations for Contraceptive Use, 2016. MMWR Recomm Rep 2016; 65: 1–66.
18. Zethraeus N, Dreber A, Ranehill E et al. Combined Oral Contraceptives and Sexual Function in Women-a Double-Blind, Randomized, Placebo-Controlled Trial. J Clin Endocrinol Metab 2016; 101 (11): 4046–53.
19. Caruso S, Agnello C, Romano M et al. Preliminary Study on the Effect of Four-phasic Estradiol Valerate and Dienogest (E2V/DNG) Oral Contraceptive on the Quality of Sexual Life. Sex Med 2011; 8: 2841–50.
20. Simon JA, Goldstein I, Kim NN et al. The role of androgens in the treatment of genitourinary syndrome of menopause (GSM): International Society for the Study of Women’s Sexual Health (ISSWSH) expert consensus panel review. Menopause 2018; 25 (7): 837–47.
21. Reed B, Harlow S, Legocki L et al. Oral contraceptive use and risk of vulvodynia: a population-based longitudinal study. BJOG 2013; 120 (13): 1678–84.
22. Davis SR, Bitzer J, Giraldi A et al. Change to either a nonandrogenic or androgenic progestin-containing oral contraceptive preparation is associated with improved sexual function in women with oral contraceptive-associated sexual dysfunction. J Sex Med 2013; 10: 3069–79.
23. De Seta F, Restaino S, Banco R et al. Effects of estroprogestins containing natural estrogen on vaginal flora. Gynecol Endocrinol 2014; 30 (11): 830–5.
24. Di Carlo C, Gargano V, De Rosa N et al. Effects of estradiol valerate and dienogest on quality of life and sexual function according to age. Gynecol Endocrinol 2014; 30 (12): 925–8.
25. Ruan X, Seeger H, Mueck AO. The pharmacology of dienogest. Maturitas 2012; 71: 337–44.
26. Sitruk-Ware R, Nath A. Characteristics and metabolic effects of estrogen and progestins contained in oral contraceptive pills. Best Pract Res Clin Endocrinol Metab 2013; 27: 13–24.
27. Rogovskaya S.I. Vul'vovaginal'nyi i tservikal'nyi epitelii i gormonal'nye sredstva. Status Praesens. 2014; 6 (17): 41–7 (in Russian).
28. Jensen JT, Mellinger U, Serrani M, Mabey RG. Hormone withdrawal-associated symptoms: comparison of oestradiol valerate/dienogest versus ethinylestradiol/norgestimate. Eur J Contracept Reprod Health Care 2013; 18 (4): 274–83.
29. Macias G, Merki-Feld GS, Parke S et al. Effects of a combined oral contraceptive containing oestradiol valerate/dienogest on hormone withdrawal-associated symptoms: results from the multicentre, randomised, double-blind, active-controlled HARMONY II study. J Obstet Gynaecol 2013; 33: 591–6.
30. Petraglia F, Parke S, Serrani M et al. Estradiol valerate plus dienogest versus ethinylestradiol plus levonorgestrel for the treatment of primary dysmenorrhea. Int J Gynaecol Obstet 2014; 125 (3): 270–4.
31. Fraser IS, Parke S, Mellinger U et al. Effective treatment of heavy and/or prolonged menstrual bleeding without organic cause: pooled analysis of two multinational, randomised, double-blind, placebo-controlled trials of oestradiol valerate and dienogest. Eur J Contracept Reprod Health Care 2011; 16: 258–69.
32. Palacios S, Wildt L, Parke S et al. Efficacy and safety of a novel oral contraceptive based on oestradiol (oestradiol valerate/dienogest): a Phase III trial. Eur J Obstet Gynecol Reprod Biol 2010; 149: 57–62.
33. Nelson A1, Parke S, Mellinger U et al. Efficacy and safety of a combined oral contraceptive containing estradiol valerate/dienogest: results from a clinical study conducted in North America. J Womens Health (Larchmt) 2014; 23: 204–10.
34. Barnett C, Hagemann C, Dinges J. Fertility and combined oral contraceptives – unintended pregnancies and planned pregnancies following oral contraceptive use – results from the INAS-SCORE study. Eur J Contracept Reprod Health Care 2017; 22: 17–23.
35. Briggs P, Serrani M, Vogtländer K, Parke S. Continuation rates, bleeding profile acceptability, and satisfaction of women using an oral contraceptive pill containing estradiol valerate and dienogest versus a progestogen-only pill after switching from an ethinylestradiol-containing pill in a real-life setting: results of the CONTENT study. Int J Womens Health 2016; 8: 477–87.
36. Mashchak CA, Lobo RA, Dozono-Takano R et al. Comparison of pharmacodynamic properties of various estrogen formulations. Am J Obstet Gynecol 1982; 144: 511–8.
37. Endrikat J, Parke S, Trummer D et al. Ovulation inhibition with four variations of a four-phasic estradiol valerate/dienogest combined oral contraceptive: results of two prospective, randomized, open-label studies. Contraception 2008; 78: 218–25.
38. Data on file; clinical trial report B709, 2000.
39. Lindberg UB, Crona N, Stigendal L et al. A comparison between effects of estradiol valerate and low dose ethinyl estradiol on haemostasis parameters. Thromb Haemost 1989; 61: 65–9.
40. Wiegratz I, Lee JH, Kutschera E et al. Effect of four oral contraceptives on hemostatic parameters. Contraception 2004; 70: 97–106.
41. Helgason S. Estrogen replacement therapy after the menopause. Estrogenicity and metabolic effects. Acta Obstet Gynecol Scand 1982; 107 (Suppl.): 1–29.
Авторы
С.В.Юренева*1, Л.М.Ильина1,2
1. ФГБУ «Национальный медицинский исследовательский центр акушерства, гинекологии и перинатологии им. акад. В.И.Кулакова» Минздрава России. 117997, Россия, Москва, ул. Академика Опарина, д. 4;
2. МОО «Ассоциация гинекологов-эндокринологов». 117997, Россия, Москва, ул. Академика Опарина, д. 4
*syureneva@gmail.com
________________________________________________
Svetlana V. Yureneva*1, Liliia M. Ilina1,2
1. V.I.Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology of the Ministry of Health of the Russian Federation. 4, Akademika Oparina st., Moscow, 117997, Russian Federation;
2. Association of Gynecologists-Endocrinologists. 4, Akademika Oparina st., Moscow, 117997, Russian Federation
*syureneva@gmail.com