Affiliation:
1. Pirogov Russian National Research Medical University
Abstract
Protection of women’s reproductive health and fertility is one of the priorities for the modern medicine. The prevention of an unintended pregnancy is critical for successful solving of this problem. Prevention of unwanted pregnancy and abortion, medical and social counselling are an integral part of the obstetrician-gynecologist activities. The effectiveness of preventing an unwanted pregnancy is a major factor in choosing a remedy, as well as the ease of use. The article presents information on the new modern contraception methods, including prolonged forms of combined hormonal contraception. A comparative analysis of oral and parenteral contraceptives is provided. The authors gave criteria of efficacy and principles for rational choice of contraceptives. The mechanism of action of a hormonal contraceptive drug containing etonogestrel and ethinyl estradiol is described. The article reviews the main advantages, indications for use and side effects of hormonal releasing systems, which contraceptive effect is provided by a combination of various factors. The suppression of ovulation is the most important of these factors. The researchers provided an analysis of the effect of the vaginal hormonal ring on the biocenosis of vagina and cervical mucosa, on the course of background cervix diseases and the possibility of preventing the development of pathogenic flora, as well as the benefits of its use in women with uncomplicated ectopia of the cervix: the effect on the epithelization of ectopia of columnar epithelium and the beneficial effect on endometrioid heterotopia. The article presents data on the frequency of adverse effects associated with the use of the contraceptive method, as well as risk factors that may become a contraindication to the use of the vaginal hormonal ring. Clear guidelines for postabortion contraception are provided.
Reference27 articles.
1. Surinov A.E. Healthcare in Russia. 2013. Statistical Digest. Мoscow: Rosstat; 2013. 380 p. (In Russ.)
2. Prilepskaya V.N., Mezhevitinova E.A., Sheshko E.L. Medical eligibility criteria for using various methods of contraception. Ginekologiya = Ginecology. 2014;(1):13–21. (In Russ.) Available at: https://con-med.ru/magazines/gynecology/gynecology-01-2014/meditsinskie_kriterii_priemlemosti_dlya_ispolzovaniya_metodov_kontratseptsii.
3. Radzinskiy V.E. (ed.). Prolonged contraception. Ease of use as assurance of reliability. Moscow: Status Praesens; 2014. 24 p. (In Russ.) Available at: https://docplayer.ru/49411417-Prolongirovannaya-kontracepciya-udobstvokak-zalog-nadyozhnosti.html.
4. Khashukoeva A.Z., Sukhova T.N. Vaginal hormonal releasing system: a safe and reliable contraception method. Medica mente. Lechim s umom = Medica mente. Treating reasonably. 2016;(2):34–38. (In Russ.) Available at: https://www.elibrary.ru/item.asp?id=28173578.
5. Dieben T.O., Roumen F.J., Apter D. Efficacy, cycle control and user acceptability of a novel combined contraceptive vaginal ring. Obsteteics &Gynecology. 2002;100(3):585–593. doi: 10.1016/s0029-7844(02)02124-5.