akusherstvoObstetrics, Gynecology and ReproductionАкушерство, Гинекология и Репродукция2313-73472500-3194IRBIS LLCakusherstvo-9Research ArticleGYNECOLOGYГИНЕКОЛОГИЯCONTRACEPTION IN PATIENTS WITH OBESITYКОНТРАЦЕПЦИЯ У ПАЦИЕНТОК С ОЖИРЕНИЕММакаровИ. О.MakarovI. O.БоровковаЕ. И.BorovkovaE. I.Katyanikitina@mail.ruГБОУ ВПО «Первый МГМУ имени И.М. Сеченова» Минздрава РФ, МоскваРоссияGBOU VPO “First Moscow state medical university named after I.M. Sechenov” of Ministry of Healthcare of RussiaRussian Federation201327052016713640Copyright © Makarov I.O., Borovkova E.I., 20162016Макаров И.О., Боровкова Е.И.Makarov I.O., Borovkova E.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.gynecology.su/jour/article/view/9

The article presents modern possibilities of the use of hormonal contraceptives in the form of combined estrogen-gestagenic agents, of gestagenic contraceptives, intrauterine equipment, implants and adhesive bandages. Discussedmainissuesof efficiency, safety and acceptability of the use of these funds in the high-risk group for the development of complications.

В статье представлены современные возможности применения гормональных контрацептивов в виде комбинированных эстрогенгестагенных препаратов, гестагенных контрацептивов, внутриматочнъх средств, имплантов и пластырей. Освещены основные вопросы эффективности, безопасности и приемлемости использования данных средств в группе высокого риска по развитию осложнений.

ОЖИРЕНИЕМЕТАБОЛИЧЕСКИЙ СИНДРОМКОНТРАЦЕПЦИЯКОМБИНИРОВАННЫЕ ОРАЛЬНЫЕ КОНТРАЦЕПТИВЫПЛАСТЫРЬВНУТРИМАТОЧНАЯ СПИРАЛЬИМПЛАНТobesitymetabolicsyndromecontraceptioncombined оральные contraceptivespatchintrauterinedeviceimplantReferencesAbdollahi M., Cushman M., Rosendaal F.R. Obesity: risk of venous thrombosis and the interaction with coagulation factor levels and oral contraceptive use. Thromb. Haemost. 2003; 89: 493.Abdollahi M., Cushman M., Rosendaal F.R. Obesity: risk of venous thrombosis and the interaction with coagulation factor levels and oral contraceptive use. Thromb. Haemost. 2003; 89: 493.Brunner Huber L.R., Toth J.L. Obesity and oral contraceptive failure: findings from the 2002 National Survey of Family Growth. Am. J. Epidemiol. 2007; 166: 1306.Brunner Huber L.R., Toth J.L. Obesity and oral contraceptive failure: findings from the 2002 National Survey of Family Growth. Am. J. Epidemiol. 2007; 166: 1306.Burkman R.T., Fisher A.C., Wan G.J. et al. Association between efficacy and body weight or body mass index for two low-dose oral contraceptives. Contraception 2009; 79: 424.Burkman R.T., Fisher A.C., Wan G.J. et al. Association between efficacy and body weight or body mass index for two low-dose oral contraceptives. Contraception 2009; 79: 424.Coney P., Washenik K., Langley R.G. et al. Weight change and adverse event incidence with a low-dose oral contraceptive: two randomized, placebo-controlled trials. Contraception 2001; 63: 297.Coney P., Washenik K., Langley R.G. et al. Weight change and adverse event incidence with a low-dose oral contraceptive: two randomized, placebo-controlled trials. Contraception 2001; 63: 297.Centers for Disease Control and Prevention (CDC). U S. Medical Eligibility Criteria for Contraceptive Use, 2010. MMWR Recomm. Rep. 2010; 59: 1.Centers for Disease Control and Prevention (CDC). U S. Medical Eligibility Criteria for Contraceptive Use, 2010. MMWR Recomm. Rep. 2010; 59: 1.Edelman A., Jensen J.T., Bulechowsky M., Cameron J. Combined oral contraceptives and body weight: do oral contraceptives cause weight gain? A primate model. Hum. Reprod. 2011; 26: 330.Edelman A., Jensen J.T., Bulechowsky M., Cameron J. Combined oral contraceptives and body weight: do oral contraceptives cause weight gain? A primate model. Hum. Reprod. 2011; 26: 330.Edelman A.B., Cherala G., Stanczyk F.Z. Metabolism and pharmacokinetics of contraceptive steroids in obese women: a review. Contraception 2010; 82: 314.Edelman A.B., Cherala G., Stanczyk F.Z. Metabolism and pharmacokinetics of contraceptive steroids in obese women: a review. Contraception 2010; 82: 314.Edelman A.B., Carlson N.E., Cherala G. et al.Impact of obesity on oral contraceptive pharmacokinetics and hypothalamic-pituitaryovarian activity. Contraception 2009; 80: 119.Edelman A.B., Carlson N.E., Cherala G. et al.Impact of obesity on oral contraceptive pharmacokinetics and hypothalamic-pituitaryovarian activity. Contraception 2009; 80: 119.Effect of different progestagens in low oestrogen oral contraceptives on venous thromboembolic disease. World Health Organization Collaborative Study of Cardiovascular Disease and Steroid Hormone Contraception. Lancet 1995; 346: 1582.Effect of different progestagens in low oestrogen oral contraceptives on venous thromboembolic disease. World Health Organization Collaborative Study of Cardiovascular Disease and Steroid Hormone Contraception. Lancet 1995; 346: 1582.Fishman J., Boyar R.M., Hellman L. Influence of body weight on estradiol metabolism in young women. J. Clin. Endocrinol. Metab. 1975; 41: 989.Fishman J., Boyar R.M., Hellman L. Influence of body weight on estradiol metabolism in young women. J. Clin. Endocrinol. Metab. 1975; 41: 989.Funk S., Miller M.M., Mishell D.R. Jr. et al. Safety and efficacy of Implanon, a single-rod implantable contraceptive containing etonogestrel. Contraception 2005; 71: 319.Funk S., Miller M.M., Mishell D.R. Jr. et al. Safety and efficacy of Implanon, a single-rod implantable contraceptive containing etonogestrel. Contraception 2005; 71: 319.Holt V.L., Scholes D., Wicklund K.G. et al. Body mass index, weight, and oral contraceptive failure risk. Obstet. Gynecol. 2005; 105: 46.Holt V.L., Scholes D., Wicklund K.G. et al. Body mass index, weight, and oral contraceptive failure risk. Obstet. Gynecol. 2005; 105: 46.Holt V.L., Cushing-Haugen K.L., Daling J.R. Body weight and risk of oral contraceptive failure. Obstet. Gynecol. 2002; 99: 820.Holt V.L., Cushing-Haugen K.L., Daling J.R. Body weight and risk of oral contraceptive failure. Obstet. Gynecol. 2002; 99: 820.Grimes D.A., Shields W.C. Family planning for obese women: challenges and opportunities. Contraception 2005; 72: 1.Grimes D.A., Shields W.C. Family planning for obese women: challenges and opportunities. Contraception 2005; 72: 1.Gu S., Sivin I., Du M. et al. Effectiveness of Norplant implants through seven years: a largescale study in China. Contraception 1995; 52: 99.Gu S., Sivin I., Du M. et al. Effectiveness of Norplant implants through seven years: a largescale study in China. Contraception 1995; 52: 99.Gu S.J., Du M.K., Zhang L.D. et al. A 5-year evaluation of NORPLANT contraceptive implants in China. Obstet. Gynecol. 1994; 83: 673.Gu S.J., Du M.K., Zhang L.D. et al. A 5-year evaluation of NORPLANT contraceptive implants in China. Obstet. Gynecol. 1994; 83: 673.Grubb G.S., Moore D., Anderson N.G. Preintroductory clinical trials of Norplant implants: a comparison of seventeen countries' experience. Contraception. 1995; 52: 287.Grubb G.S., Moore D., Anderson N.G. Preintroductory clinical trials of Norplant implants: a comparison of seventeen countries' experience. Contraception. 1995; 52: 287.Goldzieher J.W., Moses L.E., Averkin E. et al. A placebo-controlled double-blind crossover investigation of the side effects attributed to oral contraceptives. Fertil. Steril. 1971; 22: 609.Goldzieher J.W., Moses L.E., Averkin E. et al. A placebo-controlled double-blind crossover investigation of the side effects attributed to oral contraceptives. Fertil. Steril. 1971; 22: 609.Gallo M.F., Lopez L.M., Grimes D.A. et al. Combination contraceptives: effects on weight. Cochrane Database Syst. Rev. 2006;CD003987.Gallo M.F., Lopez L.M., Grimes D.A. et al. Combination contraceptives: effects on weight. Cochrane Database Syst. Rev. 2006;CD003987.Kaunitz A.M. Injectable depot medroxyprogesterone acetate contraception: an update for U.S. clinicians. Int. J. Fertil. Womens. Med. 1998; 43: 73.Kaunitz A.M. Injectable depot medroxyprogesterone acetate contraception: an update for U.S. clinicians. Int. J. Fertil. Womens. Med. 1998; 43: 73.Medical Eligibility Criteria for Contraceptive Use (UK MEC 2005/2006), Faculty of Family Planning and Reproductive Health Care, London. 2006.Medical Eligibility Criteria for Contraceptive Use (UK MEC 2005/2006), Faculty of Family Planning and Reproductive Health Care, London. 2006.Mornar S., Chan L.N., Mistretta S. et al. Pharmacokinetics of the etonogestrel contraceptive implant in obese women. Am. J. Obstet. Gynecol. 2012; 207: 110.e1.Mornar S., Chan L.N., Mistretta S. et al. Pharmacokinetics of the etonogestrel contraceptive implant in obese women. Am. J. Obstet. Gynecol. 2012; 207: 110.e1.Nightingale A.L., Lawrenson R.A., Simpson E.L. et al. The effects of age, body mass index, smoking and general health on the risk of venous thromboembolism in users of combined oral contraceptives. Eur. J. Contracept. Reprod. Health. Care 2000; 5: 265.Nightingale A.L., Lawrenson R.A., Simpson E.L. et al. The effects of age, body mass index, smoking and general health on the risk of venous thromboembolism in users of combined oral contraceptives. Eur. J. Contracept. Reprod. Health. Care 2000; 5: 265.Ogden C.L., Carroll M.D., Curtin L.R. et al. Prevalence of overweight and obesity in the United States, 1999-2004. JAMA 2006; 295: 1549.Ogden C.L., Carroll M.D., Curtin L.R. et al. Prevalence of overweight and obesity in the United States, 1999-2004. JAMA 2006; 295: 1549.Pelkman C.L., Chow M., Heinbach R.A., Rolls B.J. Short-term effects of a progestational contraceptive drug on food intake, resting energy expenditure, and body weight in young women. Am. J. Clin. Nutr. 2001; 73: 19.Pelkman C.L., Chow M., Heinbach R.A., Rolls B.J. Short-term effects of a progestational contraceptive drug on food intake, resting energy expenditure, and body weight in young women. Am. J. Clin. Nutr. 2001; 73: 19.Riphagen F.E., Fortney J.A., Koelb S. Contraception in women over forty. J. Biosoc. Sci 1988; 20: 127.Riphagen F.E., Fortney J.A., Koelb S. Contraception in women over forty. J. Biosoc. Sci 1988; 20: 127.Speerhas R. Drug metabolism in malnutrition and obesity: clinical concerns. Cleve Clin. J. Med. 1995; 62: 73.Speerhas R. Drug metabolism in malnutrition and obesity: clinical concerns. Cleve Clin. J. Med. 1995; 62: 73.Stadel B.V., Sternthal P.M., Schlesselman J.J. et al. Variation of ethinylestradiol blood levels among healthy women using oral contraceptives. Fertil. Steril. 1980; 33: 257.Stadel B.V., Sternthal P.M., Schlesselman J.J. et al. Variation of ethinylestradiol blood levels among healthy women using oral contraceptives. Fertil. Steril. 1980; 33: 257.Samama M.M. An epidemiologic study of risk factors for deep vein thrombosis in medical outpatients: the Sirius study. Arch. Intern. Med. 2000; 160: 3415.Samama M.M. An epidemiologic study of risk factors for deep vein thrombosis in medical outpatients: the Sirius study. Arch. Intern. Med. 2000; 160: 3415.Trussell J., Schwarz E.B., Guthrie K. Obesity and oral contraceptive pill failure. Contraception 2009; 79: 334. 31. Trussell J., Guthrie K.A., Schwarz E.B. Much ado about little: obesity, combined hormonal contraceptive use and venous thrombosis. Contraception. 2008; 77: 143.Trussell J., Schwarz E.B., Guthrie K. Obesity and oral contraceptive pill failure. Contraception 2009; 79: 334. 31. Trussell J., Guthrie K.A., Schwarz E.B. Much ado about little: obesity, combined hormonal contraceptive use and venous thrombosis. Contraception. 2008; 77: 143.Vessey M. Oral contraceptive failures and body weight: findings in a large cohort study. J. Fam. Plann. Reprod. Health Care 2001; 27: 90.Vessey M. Oral contraceptive failures and body weight: findings in a large cohort study. J. Fam. Plann. Reprod. Health Care 2001; 27: 90.Westhoff C.L., Torgal A.H., Mayeda E.R. et al. Pharmacokinetics of a combined oral contraceptive in obese and normal-weight women. Contraception 2010; 81: 474.Westhoff C.L., Torgal A.H., Mayeda E.R. et al. Pharmacokinetics of a combined oral contraceptive in obese and normal-weight women. Contraception 2010; 81: 474.U.S. Medical Eligibility Criteria for Contraceptive Use, 2010. Adapted from the World Health Organization Medical Eligibility Criteria for Contraceptive Use, 4th edition. http://www.cdc.gov/mmwr/pdf/rr/rr59e0528.pdf (Accessed on August 03, 2011).U.S. Medical Eligibility Criteria for Contraceptive Use, 2010. Adapted from the World Health Organization Medical Eligibility Criteria for Contraceptive Use, 4th edition. http://www.cdc.gov/mmwr/pdf/rr/rr59e0528.pdf (Accessed on August 03, 2011).Xu H., Wade J.A., Peipert J.F. et al. Contraceptive failure rates of etonogestrel subdermal implants in overweight and obese women. Obstet. Gynecol. 2012; 120: 21.Xu H., Wade J.A., Peipert J.F. et al. Contraceptive failure rates of etonogestrel subdermal implants in overweight and obese women. Obstet. Gynecol. 2012; 120: 21.Zieman M., Guillebaud J., Weisberg E. et al. Contraceptive efficacy and cycle control with the Ortho Evra/Evra transdermal system: the analysis of pooled data. Fertil. Steril. 2002; 77: 13.Zieman M., Guillebaud J., Weisberg E. et al. Contraceptive efficacy and cycle control with the Ortho Evra/Evra transdermal system: the analysis of pooled data. Fertil. Steril. 2002; 77: 13.

The authors declare that there are no conflicts of interest present.