Creativity and individuality in matters of hormonal contraception

М. Ю. Сергиенко, В. Г. Сюсюка, Н. Г. Колокот

Abstract


The relevance of the discussion about therapeutic and preventive effects of combined oral contraceptives is caused to the fact that their impact is quite often the primary motivation for the appointment and intake the drugs.

“Therapeutic portrait” of the hormonal contraceptive is mainly determined by component of progestin. Knowledge and ability to use the variety of pharmacological effects, metabolic characteristics of progestins and application regimens of combined oral contraceptives allows to achieve the maximum benefit from the appointment of the drug and increases the number of adherents of hormonal contraception among patients and doctors.

The authors reveal the possibility of a creative approach to the appointment of combined oral contraceptives on the example of the combination of 30 mcg of ethinyl estradiol and 2 mg of dienogest, which unites the positive properties of 19-nor progestins and progesterone derivatives. A feature of dienogest is high selectivity for the progesterone receptors, absence of estrogenic, anti-estrogenic and androgenic properties, metabolic neutrality, slight suppression of gonadotropin secretion, pronounced anti-proliferative effect on the endometrium.

This allows to recommend the preparation containing 2 mg of dienogest and 30 mcg of ethinyl estradiol for contraception of conditionally healthy women during the whole reproductive period, without fear to cause hormonal or metabolic disorders, weight gain, decrease of libido. Non-contraceptive benefits of this combination make it preferable for women who suffer from dysmenorrhea, endometriosis, acne, chronic abnormal uterine bleedings.

The decision to choose one or another of drugs is taken individually in each case, taking in attention the severity of clinical manifestations, concomitant somatic and gynecological pathology, previous experience and expectations of patients. However, great importance in the formation of adherence to therapy, particularly in respect of long-term use of schemes, has a price of hormonal contraceptive. The absence of any significant differences in the profiles of the solubility and bioavailability of the generic zhastinda (Alvogen) and original drug allows to reckon them as bioequivalent and makes dienogest in combination with ethinyl estradiol the most available drug for the consumer.


Keywords


ethinyl estradiol; dienogest; hormone therapy; prevention; zhastinda

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DOI: http://dx.doi.org/10.18370/2309-4117.2016.31.54-59

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