Aganezova NV, Aganezov SS. Prolonged hormonal contraception: current research and practice: A review. Gynecology. 2022;24(4):252–260. DOI: 10.26442/20795696.2022.4.201823
Пролонгированная гормональная контрацепция: современные научно-практические аспекты
Aganezova NV, Aganezov SS. Prolonged hormonal contraception: current research and practice: A review. Gynecology. 2022;24(4):252–260. DOI: 10.26442/20795696.2022.4.201823
В обзоре представлены сведения о демографических процессах в России, об актуальности использования высокоэффективных средств защиты от нежелательной беременности с целью профилактики артифициальных абортов. Приведены данные об имплантате с этоногестрелом (68 мг) – инновационном одностержневом подкожном импланте, варианте длительно действующей обратимой контрацепции, с высокой контрацептивной эффективностью (индекс Перля 0,05), идентичной при идеальном и типичном применении средства. Проанализированы результаты исследований, в которых отражены данные о благоприятном профиле безопасности имплантата с этоногестрелом с отсутствием какого-либо существенного влияния на риски тромботических осложнений, метаболические процессы, развитие депрессии, минеральную плотность костной ткани, характеристики репродуктивной функции после прекращения использования средства. Приведены сведения о возможных побочных эффектах в виде изменения характеристик менструальных кровотечений, незначительной прибавки массы тела, сопоставимой с естественным нарастанием данного показателя у взрослого человека при увеличении возраста. Подчеркнута важность квалифицированного консультирования пациенток перед выбором и в процессе использования имплантата с этоногестрелом.
This review presents information on demographic processes in Russia and the relevance of highly effective contraception for the prevention of artificial abortion.
We present data on the etonogestrel implant (68 mg), an innovative single-stranded subcutaneous implant, a long-acting reversible contraceptive option with high efficacy (Pearl index 0.05) with optimal and typical use of the product. We analyzed the results of the studies that showed a favorable safety profile of the etonogestrel implant with no significant effect on the risks of thrombotic events, metabolic processes, depression incidence, bone mineral density, and characteristics of reproductive function after discontinuation of the drug. The article presents data on possible side effects in the form of changes in the characteristics of menstrual bleeding and a slight increase in body weight, which is comparable with the natural gain in an adult with age. The importance of qualified counseling of patients before and during the use of etonogestrel implants is emphasized.
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9. Fuchs R, Taylor D, Jenkins WD, et al. Levonorgestrel release rates measured through analysis of two-rod contraceptive explants. Contracept X. 2020;2:100039. DOI:10.1016/j.conx.2020.100039
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11. Scala C, Maggiore ULR, Remorgida V, et al. Drug safety evaluation of desogestrel. Expert Opin Drug Saf. 2013;12(3):433-44. DOI:10.1517/14740338.2013.788147
12. Mäkäräinen L, van Beek A, Tuomivaara L, et al. Ovarian function during the use of a single contraceptive implant: Implanon compared with Norplant. Fertil Steril. 1998;69(4):714-21. DOI:10.1016/s0015-0282(98)00015-6
13. Palomba S, Falbo A, Di Cello A, et al. Nexplanon: the new implant for long-term contraception. A comprehensive descriptive review. Gynecol Endocrinol. 2012;28(9):710-21. DOI:10.3109/09513590.2011.652247
14. Graesslin O, Korver T. The contraceptive efficacy of Implanon: a review of clinical trials and marketing experience. Eur J Contracept Reprod Health Care. 2008;13(Suppl. 1):4-12. DOI:10.1080/13625180801942754
15. Hatcher RA, Trussell J, Nelson AL, et al. Contraceptive Technology: Twentieth Revised Edition. New York (NY): Ardent Media; 2011.
16. WHO. Medical eligibility criteria for contraceptive use. Fifth edition, 2015. Available at: https://apps.who.int/iris/bitstream/handle/10665/181468/9789241549158_eng.pdf?sequence=9/ Accessed: 26.06.2022.
17. Moray KV, Chaurasia H, Sachin O, Joshi B. A systematic review on clinical effectiveness, side-effect profile and meta-analysis on continuation rate of etonogestrel contraceptive implant. Reprod Health. 2021;18(1):4. DOI:10.1186/s12978-020-01054-y
18. Lete I, Doval JL, Perez-Campos E, et al. Self-described impact of noncompliance among users of a combined hormonal contraceptive method. Contraception. 2008;77(4):276-82. DOI:10.1016/j.phrs.2018.11.036
19. Blumenthal PD, Gemzell-Danielsson K, Marintcheva-Petrova M. Tolerability and clinical safety of Implanon. Eur J Contracept Reprod Health Care. 2008;13 (Suppl. 1):29-36. DOI:10.1080/13625180801960012
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21. Волель Б.А., Рагимова А.А., Бурчаков Д.И., и др. Стресс-зависимые нарушения менструального цикла. Consilium Medicum. 2016;18(6):8-13 [Volel BA, Ragimova AA, Burchakov DI, et al. Stress-related menstrual disorders. Consilium Medicum. 2016;18(6):8-13 (in Russian)]. DOI:10.26442/2075-1753_2016.6.8-13
22. Tepper NK, Whiteman MK, Marchbanks PA, et al. Progestin-only contraception and thromboembolism: A systematic review. Contraception. 2016;94(6):678-700. DOI:10.1016/j.contraception.2016.04.014
23. Rott H. Birth Control Pills and Thrombotic Risks: Differences of Contraception Methods with and without Estrogen. Hamostaseologie. 2019;39(1):42-8. DOI:10.1055/s-0039-1677806
24. Rocca ML, Palumbo AR, Visconti F, Di Carlo C. Safety and Benefits of Contraceptives Implants: A Systematic Review. Pharmaceuticals (Basel). 2021;14(6):548. DOI:10.3390/ph14060548
25. Beerthuizen R, van Beek A, Massai R, et al. Bone mineral density during long-term use of the progestagen contraceptive implant Implanon compared to a non-hormonal m ethod of contraception. Hum Reprod. 2000;15(1):118-22. DOI:10.1093/humrep/15.1.118
26. Hadji P, Colli E, Regidor P-A. Bone health in estrogen-free contraception. Osteoporos Int. 2019;30(12):2391-400. DOI:10.1007/s00198-019-05103-6
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28. Zigler RE, McNicholas C. Unscheduled vaginal bleeding with progestin-only contraceptive use. Am J Obstet Gynecol. 2017;216(5):443-50. DOI:10.1016/j.ajog.2016.12.008
29. Mansour D, Korver T, Marintcheva-Petrova M, Fraser IS. The effects of Implanon on menstrual bleeding patterns. Eur J Contracept Reprod Health Care. 2008;13(Suppl. 1):13-28. DOI:10.1080/13625180801959931
30. Mansour D, Bahamondes L, Critchley H, et al. The management of unacceptable bleeding patterns in etonogestrel-releasing contraceptive implant users. Contraception. 2011;83(3):202-10. DOI:10.1016/j.contraception.2010.08.001
31. Weisberg E, Hickey M, Palmer D, et al. A randomized controlled trial of treatment options for troublesome uterine bleeding in Implanon users. Hum Reprod. 2009;24(8):1852-61. DOI:10.1093/humrep/dep081
32. Guiahi M, McBride M, Sheeder J, Teal S. Short-Term Treatment of Bothersome Bleeding for Etonogestrel Implant Users Using a 14-Day Oral Contraceptive Pill Regimen: A Randomized Controlled Trial. Obstet Gynecol. 2015;126(3):508-13. DOI:10.1097/AOG.0000000000000974
33. Hou MY, McNicholas C, Creinin MD. Combined oral contraceptive treatment for bleeding complaints with the etonogestrel contraceptive implant: a randomised controlled trial. Eur J Contracept Reprod Health Care. 2016;21(5):361-6. DOI:10.1080/13625187.2016.1210122
34. Simmons KB, Edelman AB, Fu R, Jensen JT. Tamoxifen for the treatment of breakthrough bleeding with the etonogestrel implant: a randomized controlled trial. Contraception. 2017;95(2):198-204. DOI:10.1016/j.contraception.2016.10.001
35. Edelman AB, Kaneshiro B, Simmons KB, et al. Treatment of Unfavorable Bleeding Patterns in Contraceptive Implant Users: A Randomized Controlled Trial. Obstet Gynecol. 2020;136(2):323-32. DOI:10.1097/AOG.0000000000003896
36. Dickson J, Hoggart L, Newton VL. Unanticipated bleeding with the etonogestrel implant: advice and therapeutic interventions. J Fam Plann Reprod Health Care. 2014;40(3):158-60. DOI:10.1136/jfprhc-2013-100817
37. Lopez LM, Ramesh S, Chen M, et al. Progestin-only contraceptives: effects on weight. Cochrane Database Syst Rev. 2016;2016(8):CD008815. DOI:10.1002/14651858.CD008815.pub4
38. Bahamondes L, Brache V, Ali M, Habib N; WHO study group on contraceptive implants for women. A multicenter randomized clinical trial of etonogestrel and levonorgestrel contraceptive implants with nonrandomized copper intrauterine device controls: effect on weight variations up to 3 years after placement. Contraception. 2018;98(3):181-7. DOI:10.1016/j.contraception.2018.05.009
39. Worly BL, Gur TL, Schaffir J. The relationship between progestin hormonal contraception and depression: a systematic review. Contraception. 2018;97(6):478-89. DOI:10.1016/j.contraception.2018.01.010
40. Bhatia P, Nangia S, Aggarwal S, Chitra Tewari C. Implanon: subdermal single rod contraceptive implant. J Obstet Gynaecol India. 2011;61(4):422-5. DOI:10.1007/s13224-011-0066-z
41. Girum T, Wasie A. Return of fertility after discontinuation of contraception: a systematic review and meta-analysis. Contracept Reprod Med. 2018;3:9.
DOI:10.1186/s40834-018-0064-y
________________________________________________
1. The Demographic Yearbook of Russia. Statistical Handbook Rosstat. Moscow, 2021, 256 p. (in Russian).
2. Vsemirnaia organizatsiia zdravookhraneniia. Informatsionnye biulleteni. Planirovanie sem'i/metody kontratseptsii. Available at: https://www.who.int/ru/news-room/fact-sheets/detail/family-planning-contraception/ Accessed: 26.06.2022 (in Russian).
3. The main indicators of maternal and child health, the activities of the child protection and obstetric services in the Russian Federation. Central Research Institute for Organization and Informatization of Health Care of the Ministry of Health of the Russian Federation. Moscow, 2020 (in Russian).
4. Aganezova NV, Aganezov SS, Gugalo NV. Contraception: awareness and choice of young users. Gynecology. 2020;22(6):50-5 (in Russian).
5. Dikke GB, Erofeeva LV. Contraception in Russia today: Use and awareness (A population-based study). Obstetrics and Gynecology. 2016;2:108-13 (in Russian). DOI:10.18565/aig.2016.2.108-113
6. World Health Organization. Model List of Essential Medicines: 21st list. Geneva, 2019. Available at: https://apps.who.int/iris/bitstream/handle/10665/325771/WHO-MVP-EMP-IAU-2019.06-eng.pdf/ Accessed: 26.06.2022.
7. Eliseev AG, Shilov VN, Gitun TV. Big Medical Encyclopedia. Ed. P Vyatkina. Moscow: Eksmo, 2014 (in Russian).
8. Committee on Contraceptive Research and Development. Contraceptive Research, Introduction, and Use: Lessons from Norplant. Eds: PF Harrison, A Rosenfield. Washington (D.C.): Institute of Medicine, National Academy Press, 1998. DOI:10.17226/6403
9. Fuchs R, Taylor D, Jenkins WD, et al. Levonorgestrel release rates measured through analysis of two-rod contraceptive explants. Contracept X. 2020;2:100039. DOI:10.1016/j.conx.2020.100039
10. Newton JR Classification and comparison of oral contraceptives containing new generation progestogens. Hum Reprod Update.1995;1(3):231-63. DOI:10.1093/humupd/1.3.231
11. Scala C, Maggiore ULR, Remorgida V, et al. Drug safety evaluation of desogestrel. Expert Opin Drug Saf. 2013;12(3):433-44. DOI:10.1517/14740338.2013.788147
12. Mäkäräinen L, van Beek A, Tuomivaara L, et al. Ovarian function during the use of a single contraceptive implant: Implanon compared with Norplant. Fertil Steril. 1998;69(4):714-21. DOI:10.1016/s0015-0282(98)00015-6
13. Palomba S, Falbo A, Di Cello A, et al. Nexplanon: the new implant for long-term contraception. A comprehensive descriptive review. Gynecol Endocrinol. 2012;28(9):710-21. DOI:10.3109/09513590.2011.652247
14. Graesslin O, Korver T. The contraceptive efficacy of Implanon: a review of clinical trials and marketing experience. Eur J Contracept Reprod Health Care. 2008;13(Suppl. 1):4-12. DOI:10.1080/13625180801942754
15. Hatcher RA, Trussell J, Nelson AL, et al. Contraceptive Technology: Twentieth Revised Edition. New York (NY): Ardent Media; 2011.
16. WHO. Medical eligibility criteria for contraceptive use. Fifth edition, 2015. Available at: https://apps.who.int/iris/bitstream/handle/10665/181468/9789241549158_eng.pdf?sequence=9/ Accessed: 26.06.2022.
17. Moray KV, Chaurasia H, Sachin O, Joshi B. A systematic review on clinical effectiveness, side-effect profile and meta-analysis on continuation rate of etonogestrel contraceptive implant. Reprod Health. 2021;18(1):4. DOI:10.1186/s12978-020-01054-y
18. Lete I, Doval JL, Perez-Campos E, et al. Self-described impact of noncompliance among users of a combined hormonal contraceptive method. Contraception. 2008;77(4):276-82. DOI:10.1016/j.phrs.2018.11.036
19. Blumenthal PD, Gemzell-Danielsson K, Marintcheva-Petrova M. Tolerability and clinical safety of Implanon. Eur J Contracept Reprod Health Care. 2008;13 (Suppl. 1):29-36. DOI:10.1080/13625180801960012
20. Kuznetsova IV, Burchakova MN, Burchakov DI, et al. Psychogenic stress-dependent disorders of menstrual cycle: role of nonhormonal correction. Medical alphabet. 2017;2(10):54-61 (in Russian).
21. Volel BA, Ragimova AA, Burchakov DI, et al. Stress-related menstrual disorders. Consilium Medicum. 2016;18(6):8-13 (in Russian). DOI:10.26442/2075-1753_2016.6.8-13
22. Tepper NK, Whiteman MK, Marchbanks PA, et al. Progestin-only contraception and thromboembolism: A systematic review. Contraception. 2016;94(6):678-700. DOI:10.1016/j.contraception.2016.04.014
23. Rott H. Birth Control Pills and Thrombotic Risks: Differences of Contraception Methods with and without Estrogen. Hamostaseologie. 2019;39(1):42-8. DOI:10.1055/s-0039-1677806
24. Rocca ML, Palumbo AR, Visconti F, Di Carlo C. Safety and Benefits of Contraceptives Implants: A Systematic Review. Pharmaceuticals (Basel). 2021;14(6):548. DOI:10.3390/ph14060548
25. Beerthuizen R, van Beek A, Massai R, et al. Bone mineral density during long-term use of the progestagen contraceptive implant Implanon compared to a non-hormonal m ethod of contraception. Hum Reprod. 2000;15(1):118-22. DOI:10.1093/humrep/15.1.118
26. Hadji P, Colli E, Regidor P-A. Bone health in estrogen-free contraception. Osteoporos Int. 2019;30(12):2391-400. DOI:10.1007/s00198-019-05103-6
27. Federal clinical guidelines for the diagnosis, treatment and prevention of osteoporosis. Osteoporosis and osteopathy. 2021;24(2):4-47 (in Russian). DOI:10.14341/osteo12930
28. Zigler RE, McNicholas C. Unscheduled vaginal bleeding with progestin-only contraceptive use. Am J Obstet Gynecol. 2017;216(5):443-50. DOI:10.1016/j.ajog.2016.12.008
29. Mansour D, Korver T, Marintcheva-Petrova M, Fraser IS. The effects of Implanon on menstrual bleeding patterns. Eur J Contracept Reprod Health Care. 2008;13(Suppl. 1):13-28. DOI:10.1080/13625180801959931
30. Mansour D, Bahamondes L, Critchley H, et al. The management of unacceptable bleeding patterns in etonogestrel-releasing contraceptive implant users. Contraception. 2011;83(3):202-10. DOI:10.1016/j.contraception.2010.08.001
31. Weisberg E, Hickey M, Palmer D, et al. A randomized controlled trial of treatment options for troublesome uterine bleeding in Implanon users. Hum Reprod. 2009;24(8):1852-61. DOI:10.1093/humrep/dep081
32. Guiahi M, McBride M, Sheeder J, Teal S. Short-Term Treatment of Bothersome Bleeding for Etonogestrel Implant Users Using a 14-Day Oral Contraceptive Pill Regimen: A Randomized Controlled Trial. Obstet Gynecol. 2015;126(3):508-13. DOI:10.1097/AOG.0000000000000974
33. Hou MY, McNicholas C, Creinin MD. Combined oral contraceptive treatment for bleeding complaints with the etonogestrel contraceptive implant: a randomised controlled trial. Eur J Contracept Reprod Health Care. 2016;21(5):361-6. DOI:10.1080/13625187.2016.1210122
34. Simmons KB, Edelman AB, Fu R, Jensen JT. Tamoxifen for the treatment of breakthrough bleeding with the etonogestrel implant: a randomized controlled trial. Contraception. 2017;95(2):198-204. DOI:10.1016/j.contraception.2016.10.001
35. Edelman AB, Kaneshiro B, Simmons KB, et al. Treatment of Unfavorable Bleeding Patterns in Contraceptive Implant Users: A Randomized Controlled Trial. Obstet Gynecol. 2020;136(2):323-32. DOI:10.1097/AOG.0000000000003896
36. Dickson J, Hoggart L, Newton VL. Unanticipated bleeding with the etonogestrel implant: advice and therapeutic interventions. J Fam Plann Reprod Health Care. 2014;40(3):158-60. DOI:10.1136/jfprhc-2013-100817
37. Lopez LM, Ramesh S, Chen M, et al. Progestin-only contraceptives: effects on weight. Cochrane Database Syst Rev. 2016;2016(8):CD008815. DOI:10.1002/14651858.CD008815.pub4
38. Bahamondes L, Brache V, Ali M, Habib N; WHO study group on contraceptive implants for women. A multicenter randomized clinical trial of etonogestrel and levonorgestrel contraceptive implants with nonrandomized copper intrauterine device controls: effect on weight variations up to 3 years after placement. Contraception. 2018;98(3):181-7. DOI:10.1016/j.contraception.2018.05.009
39. Worly BL, Gur TL, Schaffir J. The relationship between progestin hormonal contraception and depression: a systematic review. Contraception. 2018;97(6):478-89. DOI:10.1016/j.contraception.2018.01.010
40. Bhatia P, Nangia S, Aggarwal S, Chitra Tewari C. Implanon: subdermal single rod contraceptive implant. J Obstet Gynaecol India. 2011;61(4):422-5. DOI:10.1007/s13224-011-0066-z
41. Girum T, Wasie A. Return of fertility after discontinuation of contraception: a systematic review and meta-analysis. Contracept Reprod Med. 2018;3:9.
DOI:10.1186/s40834-018-0064-y
Авторы
Н.В. Аганезова*, С.С. Аганезов
ФГБОУ ВО «Северо-Западный государственный медицинский университет им. И.И. Мечникова» Минздрава России, Санкт-Петербург, Россия
*aganezova@mail.ru
________________________________________________
Natalia V. Aganezova*, Sergey S. Aganezov
Mechnikov North-Western State Medical University, Saint Petersburg, Russia
*aganezova@mail.ru