Gridina I. Optimization of choice of hormonal contraception method for overweight women

growing epidemic of obesity attracts attention of accoucheurs and gynaecologists for a long time. There exists many research papers concerning this problem. However, the questions of the efficacy of hormonal contraception are far from being solved . The majority of gynaecologists and family doctors in particular suppose overweight and obesity as contra-indications for prescribing hormonal conraceptives that leads to the increase of level of unintended pregnancies and abortions. The thesis demonstrates the solution of the scientific task of current interest that consists of the elaboration of the algorithm of choice of methods of hormonal contraception. It is based on the study of efficiency of these methods and their influence on obese women’s health and life quality. It is a complex research that shows the necessity of complex inspection of overweight women for the sake of more efficient hormonal contraceptive guidance. Influence of different methods of hormonal contraception on the reproductive health and quality of life of obese women was studied. Obese patients receiving hormonal methods of contraception demonstrated the inconceivable weight gain in 3 month period (I group-for 3.5%, II group-for 4.6%, III group-for 2.6%, p<0,05). Until the end of the sixth month of contraception the body mass lowered to the initial level. There was no reliable difference in the body mas dynamics while receiving the methods of hormonal contraception under study. Obese patients receiving hormonal methods of contraception did not show the negative effect on the level of lipid blood spectrum indicators. There was no reliable difference in the lipid blood spectrum indicators while receiving the methods of hormonal contraception under study. Obese patients in the process of using of intravaginal hormonal contraception did not show insulin resistance. Using oral hormonal contraception promotes development of insulin resistance, that is confirmed with the HOMA index (Homeostasis Model Assessment of Insulin Resistance) increase up to 72.6% and 65.7% correspondingly in groups II and III (p<0.05). Applying modern hormonal contraception to obese women does not worsen the state of the neck of the uterus epithelium and does not lead to the appearance of atypically changed cells. Modern hormonal contraceptives are the high-efficiency methods of warning of undesirable pregnancy for obese women of reproductive age. For this group of women the use of the hormonal system, namely the contraceptive intravaginal ring should be considered in the first turn.