Hormonal contraception in women of reproductive age: Endocrinological aspects [Гормональная контрацепция у женщин репродуктивного возраста: эндокринные аспекты]

Relevance. Woman’s late reproductive age is a period of complex hormonal adjustment, a preparation for menopause onset. Despite a decline in a reproductive potential and accumulation of gynecological and extragenital diseases in this population a gynecologist has to deal with their contraception as well as a treatment of menstrual disorders and a prevention of hyperplastic processes in the genitals. A search for safe and reliable drugs to solve these problems is extremely important in women of late reproductive period. Aim. Based on date of modern clinical and scientific research a relevance of combined oral contraceptives (COCs) for a safe and reliable contraception as well as for some gynecological diseases treatment and female genital organs hyperplastic and neoplastic diseases prevention was determined. Materials and methods. To write this review a search for domestic and foreign publications in Russian and international search systems (PubMed, eLIBRARY, etc.) for the last 10 years was conducted. The review includes articles from peer-reviewed literature, data of domestic and foreign clinical guidelines on contraceptive issues and Cochrane Library reviews. Results. Use administration of microdose COCs in the late reproductive period, when taking into account criteria for their acceptability, provides reliable contraception. Based on Cochrane database systematic reviews (2011–2018) reliable data on COCs non-contraceptive therapeutic and prophylactic properties at menstrual cycle disorders, endometriosis, hyperandrogenemia, premenstrual syndrome and polycystic ovary syndrome are presented. Conclusion. A choice of COC containing ethinyl estradiol 20 µg and gestodene (progestogen III generation) 75 µg, given contraindications and current observation, is a rational, effective and safe. This provides effective family planning and maintenance of reproductive health of women of late and perimenopausal age due to its wide therapeutic and prophylactic properties given woman's body features. © 2019 Consilium Medikum. All right reserved.