Obstetrics and GynecologyObstetrics and GynecologyАкушерство и гинекология0300-90922412-5679Bionika Media24801010.18565/aig.2017.3.154-9ArticlesСтатьиResearch ArticleNew technologies in gynecology: A fixed extended hormonal contraceptive regimenНовые технологии в гинекологии: фиксированный пролонгированный режим гормональной контрацепцииAganezovaNatalia V.АганезоваНаталия Владимировна

MD, Associate Professor, Department of Obstetrics and Gynecology

д.м.н., доцент, профессор кафедры акушерства и гинекологии

aganezova@mail.ruAganezovSergey S.АганезовСергей Станиславович

PhD, Associate Professor, Department of Obstetrics and Gynecology

к.м.н., доцент кафедры акушерства и гинекологии

aganezov@mail.ruI.I. Mechnikov North-West State Medical UniversityФГБОУ ВО СЗГМУ им. И.И. Мечникова Минздрава России150320173NO3 (2017)№3 (2017)15415918022023Copyright ©; 2017, Bionika MediaCopyright ©; 2017, ООО «Бионика Медиа»2017Bionika MediaООО «Бионика Медиа»https://journals.eco-vector.com/0300-9092/article/view/248010

Objective. To carry out a systematic analysis of the data available in the current literature on extended combined oral contraceptive regimens. Material and methods. The review includes data from foreign investigations published in the past 10 years and found in Pubmed on this topic. Results. The benefits of a 91-day fixed extended contraceptive regimen are described. The results of investigations of the efficacy, safety, and patient acceptability of a combination of ethinyl estradiol and levonorgestrel with 7-day low-dose ethinyl estradiol continuation are given. Information on a new combined contraceptive containing ethinyl estradiol and levonorgestrel is provided. Conclusion. Further investigations are needed to improve approaches to the individualized use of hormonal contraception.

Цель исследования. Провести систематический анализ данных, имеющихся в современной литературе, о пролонгированных режимах использования комбинированных оральных контрацептивов. Материал и методы. В обзор включены данные зарубежных исследований, найденных в Pubmed по данной теме, опубликованных за последние 10лет. Результаты. Описаны преимущества фиксированного пролонгированного 91-дневного режима контрацепции. Приведены результаты исследований эффективности, безопасности и приемлемости комбинации этинилэстрадиола илевоноргестрела с 7-дневным продолжением приема низких доз этинилэстрадиола. Представлена информация о новом комбинированном контрацептиве, содержащем этинилэстрадиол и левоноргестрел. Заключение. Необходимы дальнейшие исследования для совершенствования подходов к индивидуализированному использованию гормональной контрацепции.

hormonal contraceptionlevonorgestrelethinyl estradiolfixed extended regimenModell Liberagestagensгормональная контрацепциялевоноргестрелэтинилэстрадиолфиксированный пролонгированный режиммодэлль либерагестагеныEdelman A., Lew R., Cwiak C., Nichols M., Jensen J. Acceptability of contraceptive-induced amenorrhea in a racially diverse group of US women. Contraception. 2007; 75(6): 450-3.Ferrero S., Abbamonte L.H., Giordano M., Alessandri F., Anserini P., Remorgida V., Ragni N. What is the desired menstrual frequency of women without menstruation-related symptoms? Contraception. 2006; 73(5): 537-41.Bonnema R.A., Spencer A.L. The new extended-cycle levonorgestrel-ethinyl estradiol oral contraceptives. Clin. Med. Insights Reprod. Health. 2011; 5: 49-54. doi: 10.4137/CMRH.S5030. eCollection 2011.Schlaff W.D., Lynch A.M., Hughes H.D., Cedars M.I., Smith D.L. Manipulation of the pill-free interval in oral contraceptive pill users: the effects on follicular suppression. Am. J. Obstet. Gynecol. 2004; 190(4): 943-51.Sulak P.J., Scow R.D., Preece C., Riggs M.W., Kuehl T.J. Hormone withdrawal symptoms in oral contraceptive users. Obstet. Gynecol. 2000; 95(2): 261-6.Coffee A., Kuehl T.K., Willis S.A., Sulak P.J. Oral contraceptives and premenstrual symptoms: comparison of a 21/7 and extended regimen. Am. J. Obstet. Gynecol. 2006; 195(5): 1311-9.Vandever M.A., Kuehl T.J., Sulak P.J., Witt I., Coffee A., Wincek T.J., Reape K.Z. Evaluation of pituitary-ovarian axis suppression with three oral contraceptive regimens. Contraception. 2008; 77(3): 162-70.Edelman A.B., Gallo M.F., Jensen J.T., Nichols M.D., Schulz K.F., Grimes D.A. Continuous or extended cycle vs. cyclic use of combined oral contraceptives for contraception. Cochrane Database Syst. Rev. 2005; (3): CD004695.Yonkers K.A., Brown C., Pearlstein T.B., Foegh M., Sampson-Landers C., Rapkin A. Efficacy of a new low dose oral contraceptive with drospirenone in premenstrual dysphoric disorder. Obstet. Gynecol. 2005; 106(3): 492-501.Archer D.F., Jensen J.T., Johnson J.V., Borisute H., Grubb G.S., Constantine G.D. Evaluation of a continuous regimen of levonorgestrel/ethinyl estradiol: phase 3 study results. Contraception. 2006; 74(6): 439-45.Davis A.R., Kroll R., Soltes B., Haudiquet V., Constantine G., Grubb G. Return to menses after continuous use of a low-dose oral contraceptive. Obstet. Gynecol. 2006; 107(4, Suppl.): 3S.Shrader S.P., Dickerson L.M. Extended- and continuous-cycle oral contraceptives. Pharmacotherapy. 2008; 28(8): 1033-40.Spona J., Elstein M., Feichtinger W., Sullivan H., Lüdicke F., Müller U., Düsterberg B. Shorter pill-free interval in combined oral contraceptives decreases follicular development. Contraception. 1996; 54(2): 71-7.Reape K.Z., DiLiberti C.E., Hendy C.H., Volpe E.J. Effects on serum hormone levels of low-dose estrogen in place of placebo during the hormone-free interval of an oral contraceptive. Contraception. 2008; 77(1): 34-9.Sullivan H., Furniss H., Spona J., Elstein M. Effect of 21-day and 24-day oral contraceptive regimens containing gestodene (60 microg) and ethinyl estradiol (15 microg) on ovarian activity. Fertil. Steril. 1999; 72(1): 115-20.Trussell J. Contraceptive failure in the United States. Contraception. 2011; 83(5): 397-404. doi: 10.1016/j.contraception.2011.01.021.Wiegratz I., Kuhl H. Metabolic and clinical effects of progestogens. Eur. J. Contracept. Reprod. Health Care. 2006; 11(3): 153-61.Committee for Medicinal Products for Human Use. Guideline on clinical investigation of steroid contraceptives in women. In EMEA/CPMP/EWP/519/98 Rev 1, 2005.Archer D.F., Maheux R., DelConte A., O’Brien F.B. Efficacy and safety of a low-dose monophasic combination oral contraceptive containing 100 pg levonorgestrel and 20 pg ethinyl estradiol (Alesse). Am. J. Obstet. Gynecol. 1999; 181(5, Pt 2): S39-44. doi: 10.1016/S0002-9378(99)70362-5.Lidegaard O., Nielsen L.H., Skovlund C.W., Lokkegaard E. Venous thrombosis in users of non-oral hormonal contraception: follow-up study, Denmark 2001-10. BMJ. 2012; 344: e2990.Krishnan S., Kiley J. The lowest-dose, extended-cycle combined oral contraceptive pill with continuous ethinyl estradiol in the United States: a review of the literature on ethinyl estradiol 20 pg/levonorgestrel 100 pg + ethinyl estradiol 10 pg. Int. J. Women’s Health. 2010; 2: 235-9.http://grls.rosminzdrav.ru/Grls_View_v2.aspx?routingGuid=b29d6e2c-dd83-4ac0-8085-b7359474ead5&tThomas S.L., Ellertson C. Nuisance or natural and healthy: should monthly menstruation be optional for women? Lancet. 2000; 355(9207): 922-4.Summary review NDA 22-262 10.24.2008. Available at: http://www.accessdata. fda.gov/drugsatfda_docs/nda/2008/022262s000_SumR.pdf от 28.11.2016Kroll R., Reape K.Z., Margolis M. The efficacy and safety of a low-dose, 91-day, extended-regimen oral contraceptive with continuous ethinyl estradiol. Contraception. 2010; 81(1): 41-8.Archer D.F. Menstrual-cycle-related symptoms: a review of the rationale for continuous use of oral contraceptives. Contraception. 2006; 74(5): 359-66.Anderson F.D., Gibbons W., Portman D. Safety and efficacy of an extended-regimen oral contraceptive utilizing continuous low-dose ethinyl estradiol. Contraception. 2006; 73(3): 229-34.Akerlund M., Røde A., Westergaard J. Comparative profiles of reliability, cycle control and side effects of two oral contraceptive formulations containing 150 micrograms desogestrel and either 30 micrograms or 20 micrograms ethinyl oestradiol. Br. J. Obstet. Gynaecol. 1993; 100(9): 832-8.Sitruk-Ware R. Pharmacological profile of progestins. Maturitas. 2008; 61(1-2): 151-7.Wichianpitaya J., Taneepanichskul S. A comparative efficacy of low-dose combined oral contraceptives containing desogestrel and drospirenone in premenstrual symptoms. Obstet. Gynecol. Int. 2013; 2013: 487143. doi: 10.1155/2013/487143.Caprio M., Antelmi A., Chetrite G., Muscat A., Mammi C., Marzolla V. et al. Antiadipogenic effects of the mineralocorticoid receptor antagonist drospirenone: potential implications for the treatment of metabolic syndrome. Endocrinology. 2011; 152(1): 113-25.Bjarnadöttir R.I., Gottfredsdöttir H., Sigurdardöttir K., Geirsson R.T., Dieben T.O. Comparative study of the effects of a progestogen-only pill containing desogestrel and an intrauterine contraceptive device in lactating women. BJOG. 2001; 108(11): 1174-80.WHO Medical eligibility criteria for contraceptive use. 5th ed. Geneva: WHO; 2015.