Target groups of young women for triphasic combined hormonal contraception

Abstract

Hormonal contraception is widely used to prevent unintended pregnancies and is represented by a large number of drugs that allow to personalize the choice of contraceptives for each woman. Combined oral contraceptive (COC) variants include not only drugs that differ in qualitative composition, but also modifications of the dosage regimen. Among the non-trivial regimens are triphasic active ingredient dosing that enables to achieve a reduction in progestogen burden while maintaining contraceptive efficacy. This approach is important in prescribing COCs to women who have previously experienced or may potentially experience adverse reactions to progestogens. Identification of target groups of women predisposed to progestogen-dependent side effects helps to correctly prescribe COCs and improve adherence to the contraceptive method. Thus, changes in bleeding characteristics during the use of hormonal contraceptives may lead to refusal of COCs. With the exception of patients who are prescribed COCs for additional therapeutic purposes to control the menstrual cycle rhythmicity and intensity, women expect that they keep the usual pattern of their cycle and react negatively to any changes or deviations from the reference ranges. Meanwhile, the bleeding profile during the use of hormonal contraceptives can change significantly. Characteristics such as the intensity and predictability of uterine bleeding are important for the assessment of the effect of a contraceptive on uterine bleeding. This analytical review presents groups of young women for whom initial use of triphasic COCs may be the best choice.