GynecologyGynecologyГинекология2079-56962079-5831Consilium Medicum3013010.26442/20795696.2019.1.190184ArticlesСтатьиReview ArticleCombined oral contraceptives with natural estrogen and sexual function: the optimal method of contraception for women of different agesКомбинированные оральные контрацептивы с натуральным эстрогеном и сексуальная функция: оптимальный метод контрацепции для женщин разного возрастаYurenevaSvetlana VЮреневаСветлана Владимировна

PhD, Professor of obstetrics and gynecology Department, Leading Researcher of the Department of Gynecological Endocrinology

д.м.н., профессор кафедры акушерства и гинекологии, ведущий научный сотрудник отделения гинекологической эндокринологии

syureneva@gmail.comIlinaLiliia MИльинаЛилия Михайловна

MD, medical advisor for menopause of the Association of Gynecologists - Endocrinologists, Department of Gynecological Endocrinology

канд. мед. наук, медицинский советник по менопаузе Ассоциации гинекологов-эндокринологов.

bseiljina@mail.ruV.I.Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology of the Ministry of Health of the Russian FederationФГБУ «НМИЦ АГП им. акад. В.И.Кулакова»Association of Gynecologists-Endocrinologists15022019211VOL 21, NO1 (2019)ТОМ 21, №1 (2019)333709042020Copyright ©; 2019, Consilium MedicumCopyright ©; 2019, ООО "Консилиум Медикум"2019Consilium MedicumООО "Консилиум Медикум"https://creativecommons.org/licenses/by-nc-sa/4.0https://gynecology.orscience.ru/2079-5831/article/view/30130

Background. Combined oral contraceptives (COCs) are the most common method of prevention of unwanted pregnancies in women from the early reproductive period to perimenopause, therefore their impact on quality of life, sexual function and general well-being remains the subject of active discussion. Some studies revealed various manifestations of sexual dysfunction in patients receiving COCs, therefore such questions, as well as the advantages / disadvantages of individual components (their type and dose) of drugs, are of interest to the clinician. Aim. Assess mechanisms of influence of COCs on female sexual function. Materials and methods. In order to write this review domestic and foreign publications were searched in Russian and international search systems (PubMed, elibrary, etc.) for the last 2-15 years. Relevant articles from the peer-reviewed literature were included. Results. Many studies proved a beneficial effect of estradiol valerate (E2V) which is estrogen identical to natural one in a combination with dienogest (DNG) which is 4th generation progestin in a dynamic dosing regimen on quality of life and sexual function. This beneficial effect is achieved due to combined effects of both components of the drug as well as its reception mode. Conclusion. The combination of estradiol valerate (E2V) which is estrogen identical to natural one with dienogest (DNG) which is 4th generation progestin may be the optimal method of contraception for women of any age, including the young, with decreased libido while taking other COCs.

Обоснование. Комбинированные оральные контрацептивы (КОК) являются наиболее распространенным методом предупреждения нежелательной беременности у женщин от раннего репродуктивного периода до перименопаузы, поэтому их влияние на качество жизни, сексуальную функцию и общее благополучие остается предметом активного обсуждения. Некоторые исследования выявили различные проявления сексуальной дисфункции на фоне приема КОК, поэтому подобные вопросы, а также преимущества/недостатки отдельных компонентов препаратов представляют интерес для клинициста. Цель. Оценить механизмы влияния КОК на сексуальную функцию женщины. Материалы и методы. Для написания данного обзора был осуществлен поиск отечественных и зарубежных публикаций в российских и международных системах поиска (PubMed, eLibrary и пр.) за последние 2-15 лет. В обзор были включены статьи из рецензируемой литературы. Результаты. Во многих исследованиях доказано благоприятное влияние комбинации эстрогена, идентичного натуральному, - эстрадиола валерата и прогестина IV поколения диеногеста в динамическом режиме дозирования на качество жизни и сексуальную функцию, благодаря сочетанным эффектам обоих компонентов препарата и режима приема. Заключение. Сочетание эстрогена, идентичного натуральному, - эстрадиола валерата и прогестина IV поколения диеногеста может быть оптимальным методом контрацепции для женщин любого возраста, в том числе и молодых, со снижением либидо на фоне приема других КОК.

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