Uterine bleedings and quality of woman's life
Keywords:resolution of Advisory Board, abnormal uterine bleeding, menstrual symptoms, combined oral contraceptives, hormonal free interval
On March 12, 2019, an Advisory Board on impact of uterine bleedings on the quality of life of a woman was held in Kyiv, with participation of leading Ukrainian and European experts.
According to opinion of international experts (guidelines of the UK National Institute for Health and Care Excellence and the International Federation of Gynecology and Obstetrics from 2018), the choice of patient management tactics is not determined by measuring blood loss, but by the patient’s well-being (distress, decrease of work ability, sexual activity and quality of life).
Menstrual inflammation is phisiological and menstrual symptoms are usually mild/minor or absent when three criteria are fulfilled: resolving (normal cytoarchitecture of the tissue is reconstructed, endometrium first); limited in time; adequate and sufficient by intensity to finalize the reconstruction to the histological and functional characteristics of the different tissues involved. At the same time, if local and systemic inflammation associated with menstruation is excessive by intensity and duration, it can cause different pathological symptoms. Severe menstrual symptoms are clinically correlated with local and systemic inflammation, which is not resolving (menstruation is excessive in duration and intensity). Therefore, reducing menstrual inflammation is important to reduce the frequency and intensity of menstrual symptoms and improve the quality of life of women of reproductive age.
Women need appropriate stable levels of estrogen and progesterone to optimize their physical and mental health. During combined oral contraceptives selection for healthy women it is reasonable to give preference to contraceptives with short hormonal free interval (24+4, 26+2) compared to the traditional regimen (21+7), since the reduction of this interval provides a more stable level of estradiol, reduces the risk of casual ovulation in case of missed pill, increases contraceptive efficacy in comparison with the traditional regimen and reduce the incidence of hormone-withdrawal associated symptoms.
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Copyright (c) 2019 Ю. Г. Антипкін, Ю. П. Вдовиченко, А. Грациоттін, В. В. Камінський, Т. Ф. Татарчук, О. В. Булавенко, О. В. Грищенко, З. М. Дубоссарська, Ю. О. Дубоссарська, Н. Я. Жилка, Г. В. Зайченко, В. П. Квашенко, Н. В. Косей, О. М. Макарчук, Н. Ю. Педаченко, В. І. Пирогова, Н. М. Рожковська
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