保护女军人的生殖健康:全球经验与乌克兰现实

Q4 Medicine
Y. Antypkin, I. Lurin, T. Tatarchuk, N. Kosei, V.M. Yakimets, O.Y. Nazarenko, T.E. Krysenko, Y.M. Bondarenko
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引用次数: 0

摘要

对世界文献和乌克兰关于女军人向妇科医生提出的最常见要求、病理结构和治疗方法的研究进行了综述。特别关注的是激素避孕,即常规和连续方案(避免无激素间歇期)中的复方口服避孕药(COCs)和左炔诺孕酮释放宫内节育器(LNG-IUDs)。研究考虑了全球延长方案中使用 COCs 的案例,结果显示 1156 名妇女中有 47.2%选择了延长方案中的 COCs,其主要原因是希望避免与月经有关的症状。我们认为这种选择对女军人来说是非常积极的,因为一些研究表明,连续服用 COCs 的女军人对这种药物的接受程度几乎是定期使用的女军人的两倍。LNG-宫内节育器在女军人中使用的积极方面包括:预防异常子宫出血;降低可能失血时缺铁的风险;降低军事条件下痛经这一消极因素的强度。此外,还考虑了如何提高妇科医生和女军人之间的依从性,以全球研究为例,这些研究证明,患者对在延长疗程中使用 COCs 的可能方式和积极作用认识不足,从而降低了患者选择新疗程的决心。在当今的现实情况下,我国的妇科服务面临着许多新问题,需要采取战略性的方法加以解决。世界实践和国内研究证明,应激引起的女军人内分泌失调,如异常子宫出血、月经周期紊乱、痛经等,是作战条件下的负面因素,需要引起医生的重视并加以解决。解决这一问题的方案之一可以是按照常规和扩展方案使用宫内节育器或使用液化天然气宫内节育器。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Preservation of the reproductive health of military women: global experience and realities of Ukraine
A review of world literature and Ukrainian researches on the most common requests to gynecologists among military women, on the structure of pathology and treatment methods was made. Special attention is paid to the hormonal contraception, namely combined oral contraceptives (COCs) in the usual and continuous regime (avoiding the hormone-free interval) and the levonorgestrel-releasing intrauterine systems (LNG-IUDs).Cases of global practice of using COCs in extended regimen were considered, which showed that 47.2% of 1156 women chose a prolonged regimen of COCs, the main reason for this was the desire to avoid symptoms associated with menstruation. We consider this option very positive for military women, because some studies show that military women who took COCs in a continuous regimen were almost twice as favorable to their reception as those who used them in a regular mode.The positive aspects of the LNG-IUDs use in military women are presented, as a factor in the prevention of abnormal uterine bleeding, reducing the risk of iron deficiency in case of possible blood loss, and reducing the intensity of dysmenorrhea as a negative factor in the military conditions.Ways to increase compliance between a gynecologist and a military woman are also considered, using the example of global studies, which prove that insufficient awareness of patients about the possible ways and positive effects of using COCs in extended regimen reduced patients’ commitment to choosing new regimens.Conclusions. In today’s realities, the gynecological service in our country faces a number of new problems that require a strategic approach and solution. World practice and national studies prove that stress-induced hormonal disorders in military women, such as abnormal uterine bleeding, menstrual cycle disorders, dysmenorrhea, are negative factors in combat conditions, require the attention and resolution by doctors. One of the options for solving this problem can be the appointment of COCs according to the usual and extended scheme or appointment of LNG-IUDs.
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来源期刊
Reproductive Endocrinology
Reproductive Endocrinology Medicine-Obstetrics and Gynecology
CiteScore
0.50
自引率
0.00%
发文量
13
审稿时长
8 weeks
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