The use of combined hormonal contraception in the context of the COVID-19 pandemic

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV2) was declared the cause of a global pandemic in early 2020. Patients with COVID-19 are at high risk for thrombotic occlusions of the arteries and veins. There are many ways that explain the high risk of thrombosis in COVID-19, they are conditionally divided into two main categories: mechanisms in which the renin-angiotensinaldosterone system is involved and mechanisms that affect the regulation of the immune response. It is assumed that the uncomplicated course of the disease is characterized by endothelial dysfunction, but if the process progresses with a pronounced immune response, plasma coagulation factors may also be involved, which significantly increases the risks of thromboembolic complications. The use of combined hormonal contraception (CHC) in the current conditions raises a number of concerns. According to some researchers, disorders of the hemostasis system observed in patients with COVID-19 may worsen while taking CHC and increase the risk of thromboembolic complications, which is especially important in severe disease with prolonged immobilization. However, with the use of CHC, the increase in thrombotic risks is explained primarily by changes in the plasma component of the hemostasis sys tem. At first glance, the recommendations to stop hormone therapy with confirmed COVID-19 seem logical, but they are based only on the procoagulant activity of estrogens, and not on real evidence. In patients with COVID-19, the increase in coagulation is associ ated with massive damage to the vascular endothelium (the so-called «external» coagulation pathway) and the immune response, and not with a primary increase in the level of coagulation factors per se. At the same time, stopping the intake of estrogens deprives the patient of their important protective effect. Thus, it became necessary to develop clinical guidelines for the management of women using contraception in the context of the COVID-19 pandemic

Non-surgical treatment of uterine fibroids. Efficacy of the selective progesterone receptor modulator

The leading role of ovarian steroid hormones in the pathogenesis of uterine fibroids is confirmed by epidemiological, clinical and experimental studies. The new approaches to the treatment of this disease may be developed on the basis of the biological and genetic mechanisms underlying the occurrence and development of leiomyomas. The use of ulipristal acetate in patients with uterine leiomyoma may be a promising method for preparing them to the surgical procedures, but also for avoiding surgical treatment and related hypoestrogenic conditions, which results in the improvement of the women’s quality of life

ACTIVATED GLYCYRRHIZIC ACID IN COMPLEX THERAPY OF RECURRENT GENITAL HERPES

In recent years viral infections take the worldwide leading place due to their damaging effect on the body in general and reproductive system in particular. Herpes infection is a serious medico-social problem, which is one of the most common human viral infections. More than 90% of the population worldwide are infected with one or more serotypes of the herpes virus. Recurrent herpes virus diseases affects 2--12% of the population

PRECANCEROUS CERVICAL LESIONS

Treatment approach Neoplastic epithelial changes (cervical intraepithelial neoplasia, CIN) can be precancerous. Human papillomavirus is considered to be the cause of neoplastic processes

NEW MODE OF PROLONGED HORMONAL CONTRACEPTION

Hormonal contraception continues to be one of the most effective methods of protection against unwanted pregnancies. Many research trials are aimed at improving of various methods of hormonal contraception, which in turn allows couples to plan for pregnancy. Combined oral contraception is one of the most common methods to prevent unwanted pregnancies worldwide. To date hormonal contraceptives differ between the way they are introduced into the body, the mode of indication, the expression of gestagenic influence, the presence or absence of androgenic, antiandrogenic, antimineralocorticoid, glucocorticoid and other activity

Use of fluconazole in women of reproductive age with vulvovaginal candidiasis

Topicality: vulvovaginal candidiasis (VVC) is a common disease caused by the infectious damage of the vulva and vagina by yeast-like fungi from Candida genus. According to the literature, a VVC episode occurs in 75% of women, and 5-8% of them get a recurring course of the disease. Frequent recurrences of the disease may result in the psychosexual disorder and reduce the women’s quality of life and recurrent vulvovaginal candidiasis (VVC) therapy is still a very difficult task.Purpose of the study: evaluate the efficacy of fluconazole (150 mg) in acute and recurrent vulvovaginal candidiasis.Materials and methods: A total of 89 women of reproductive age with acute and recurrent HCV were enrolled in the study, which were subdivided into 2 groups: the first group included women with acute vulvovaginal candidiasis (AVVC) (n = 51), and the second group - women with recurrent vulvovaginal candidiasis (RVVC) (n = 38). The Group I (AVVC) received fluconazole 150 mg once. Depending on the prescribed therapy, the second group (RVVC) was subdivided into two subgroups: patients in the IIa subgroup received fluconazole 150 mg intravenously, three times, at intervals of 2 days, and women in the IIb subgroup received fluconazole 150 mg for a period of 6 months in addition to the three-fold intake of fluconazole weekly. The follow-up period was 6 months after the end of therapy, during which the frequency of VVC recurrence and the effectiveness of the therapy was evaluated.Results of the study: our data showed that all patients with acute VVC had a discontinuation of symptoms of the disease and a normalization of laboratory parameters after treatment with fluconazole, and after the anti-relapse therapy course the incidence of VVC recurrences was significantly lower compared to the period before anti-relapse therapy (p = 0.038). It was shown that all the investigated strains of C. albicans (100%) were sensitive to fluconazole, and resistance was detected only in 1 strain of C. glabrata and 1 strain of C. krusei

ADMINISTRATION OF A COMBINED ORAL CONTRACEPTIVE CONTAINING ESTRADIOL VALERATE/DIENOGEST (E2V/DNG) BY WOMEN WITH MENORRHAGIA

Menorrhagia is the pathological condition which is negatively affecting physical, emotional and social quality life of the woman. Medicines of the choice of therapy of uterine bleedings are the combined oral contraceptives (COC). The estradiol valerate/ dienogest (E2V/DNG), represents the combined oral contraceptive (COC) recommended for women as contraceptive. Gives to feature of influence of medicine on endometrium the chance of its application in case of uterine bleedings. The hormones which are a part suppress excessive proliferation of endometrium that leads to reduction of amount of menstrual allocations. Results of a research which confirm successful application of E2V/DNG in case of the menorrhagia at the women of reproductive age in clinical situations who aren’t requiring operational treatment are provided

PROSPECTS FOR THE USE OF MEDICATIONS CONTAINING DICLOFENAC AND B VITAMINS IN THE TREATMENT OF PRIMARY DYSMENORRHEA

Menstrual irregularities are an eternal female problem, in the treatment of which ever new aspects are opening. One of the most common problems is pain in the abdomen during menstruation. This form of menstrual disorder requires special attention, since, according to different authors, menstrual cramps of various severity are registered by 30 to 75% of women. However, about 10% of women, along with sharp pain, speak about deterioration of the general condition to the extent of temporary disability. Moreover, it is known that pain affects the emotional sphere, mental and general condition of the woman, and as a consequence, the relations within the family, thus making it a relevant healthcare and social problem (Smetnik V.P., Tumilovich L.P., 1998)

Comprehensive assessment of efficacy, tolerability and safety of a third-generation combined hormonal contraceptive

Planning for pregnancy and delaying pregnancy without health consequences are especially challenging today. Combined hormonal contraceptives are among the most effective methods of preventing unwanted pregnancies, providing high contraceptive reliability, availability and ease of use, safety and reversibility, as well as therapeutic and preventive action in various states. However, according to the State Statistics Committee of Russia, hormonal contraception is used only by 13.4% of women (2009) in this country. This is caused by suspicions both of patients and physicians about side effects of hormonal contraceptives and feasibility of the method in general

ROLE OF GENOTYPING FEATURES IN THE DEVELOPMENT OF RECURRENT VULVOVAGINAL CANDIDIASIS AND THERAPY TACTICS

Relevance: According to the literature, Vulvovaginal candidiasis (VVC) is diagnosed in 75% of women during life, and in 5-8% of women its recurrent course is developed (four or more episodes of exacerbation during 12 months). Recurrent vulvovaginal candidiasis (RVVC) is often observed in the presence of development risk factors, but often the recurrent course of the disease is developing among women without obvious risk factors. The literature shows that the development of a recurrent fungal infection is often caused by a violation of the local immune response, which is associated with the polymorphism of the immune system genes.Objective of the study: To develop criteria for forecasting the recurrent current volvovaginal candidiasis to improve the effectiveness of therapy.Study results: As a result of our study, it has been found that C. albicans remains the leading fungal species in the acute and recurrent VVC, but women with the recurrent course of VVC the prevalance of non-C. Albicans fungi is reliably higher than the patients with acute VVC (P = 0.037). Also, the sensitivity data obtained shows that most of the studied yeast fungi (97.5%) are sensitive to fluconazole. However, only in 10.5% of the non-C.Albicans strains resistance was detected. The determination of genetic predisposition to develop the recurrent current VVC, using the prediction model derived from our study, revealed that 77.8% of women with a genetic predisposition are developing a relapse of VVC. In view of these results and based on international recommendations (CDC, WHO, 2011) that it is appropriate to indicate the anti-recurring antifungal treatment to RVVC, it can be concluded that for patients with genetic predisposition to the development of recurrent VVC it is advisable to indicate the anti-recurrent antifungal therapy