{"paper_id":"f2f916c2-a9b6-4c3d-a071-95b4581011f9","body_text":"Применение комбинированных оральных контрацептивов у больных эндометриозом\nhttps://doi.org/10.33667/2078-5631-2023-3-14-20\nАннотация\nЭндометриоз – доброкачественное воспалительное гормонозависимое заболевание характеризуется болью и бесплодием, которые серьезно влияют на женское здоровье. Будучи хроническим заболеванием, эндометриоз требует длительного лечения. В настоящее время для терапии эндометриоза наиболее широко используются гормональные препараты, что основано на эндокринных механизмах его патогенеза. Эстрогенная зависимость и резистентность к прогестерону являются ключевыми моментами, обеспечивающими имплантацию эктопических клеток эндометрия, снижение апоптоза и усиление окислительного стресса, воспаления и нейроангиогенеза. Гормональные и воспалительные изменения объясняют боль и бесплодие, а также системные заболевания и психические расстройства, часто сопутствующие эндометриозу. Гормональное лечение эндометриоза направлено на подавление овуляции посредством ингибирования оси гипоталамус-гипофиз-яичник, а также напрямую на эндометриоидные имплантаты. Агонисты и антагонисты гонадотропин-рилизинг гормона (ГнРГ), прогестины, комбинированные оральные контрацептивы (КОК) в настоящее время официально разрешены для использования с целью облегчения симптомов эндометриоза. В обзоре представлена информация о современных возможностях гормональной терапии эндометриоза, основанной на понимании патогенеза заболевания.\nОб авторе\nИ. В. КузнецоваРоссия\nКузнецова Ирина Всеволодовна, д.м.н., проф., зам. ген. директора по научно-исследовательской работе\nМосква\nСписок литературы\n1. Chapron C, Marcellin L, Borghese B, Santulli P. Rethinking mechanisms, diagnosis and management of endometriosis. Nat. Rev. Endocrinol. 2019;15(11):666–682. DOI: 10.1038/s41574–019–0245-z\n2. Kavoussi SK, Lim CS, Skinner BD, Lebovic DI, As-Sanie S. New paradigms in the diagnosis and management of endometriosis. Curr. Opin. Obstet. Gynecol. 2016;28(4):267–276. DOI: 10.1097/GCO.0000000000000288.\n3. Vannuccini S, Clemenza S, Rossi M, Petraglia F. Hormonal treatments for endometriosis: The endocrine background. Rev. Endocr. Metab. Disord. 2022;23(3):333–355. DOI: 10.1007/s11154–021–09666-w\n4. Zondervan KT, Becker CM, Koga K, Missmer SA, Taylor RN, Viganò P. Endometriosis. Nat. Rev. Dis Primers. 2018;4(1):9. DOI: 10.1038/s41572–018–0008–5\n5. Shafrir AL, Farland LV, Shah DK, Harris HR, Kvaskoff M, Zondervan K, Missmer SA. Risk for and consequences of endometriosis: A critical epidemiologic review. Best. Pract. Res. Clin. Obstet. Gynaecol. 2018;51:1–15. DOI: 10.1016/j.bpobgyn.2018.06.001\n6. Kobayashi H, Imanaka S, Nakamura H, Tsuji A. Understanding the role of epigenomic, genomic and genetic alterations in the development of endometriosis (review). Mol. Med. Rep. 2014 May;9(5):1483–505. DOI: 10.3892/mmr.2014.2057\n7. Reis FM, Petraglia F, Taylor RN. Endometriosis: hormone regulation and clinical consequences of chemotaxis and apoptosis. Hum. Reprod. Update. 2013;19(4):406–418. DOI: 10.1093/humupd/dmt010\n8. Reis FM, Coutinho LM, Vannuccini S, Batteux F, Chapron C, Petraglia F. Progesterone receptor ligands for the treatment of endometriosis: the mechanisms behind therapeutic success and failure. Hum. Reprod. Update. 2020;26(4):565–585. DOI: 10.1093/humupd/dmaa009\n9. Patel BG, Lenk EE, Lebovic DI, Shu Y, Yu J, Taylor RN. Pathogenesis of endometriosis: Interaction between Endocrine and inflammatory pathways. Best Pract. Res Clin. Obstet. Gynaecol. 2018;50:50–60. DOI: 10.1016/j.bpobgyn.2018.01.006\n10. Filippi I, Carrarelli P, Luisi S, Batteux F, Chapron C, Naldini A, Petraglia F. Different Expression of Hypoxic and Angiogenic Factors in Human Endometriotic Lesions. Reprod. Sci. 2016;23(4):492–497. DOI: 10.1177/1933719115607978\n11. Barbe AM, Berbets AM, Davydenko IS, Koval HD, Yuzko VO, Yuzko OM. Expression and Signifcance of Matrix Metalloproteinase-2 and Matrix Metalloproteinas-9 in Endometriosis. J. Med. Life. 2020;13(3):314–320. DOI: 10.25122/jml-2020–0117\n12. Han SJ, O’Malley BW. The dynamics of nuclear receptors and nuclear receptor coregulators in the pathogenesis of endometriosis. Hum. Reprod. Update. 2014;20(4):467–484. DOI: 10.1093/humupd/dmu002\n13. Benagiano G, Brosens I, Habiba M. Structural and molecular features of the endomyometrium in endometriosis and adenomyosis. Hum. Reprod. Update. 2014;20(3):386–402. DOI: 10.1093/humupd/dmt052\n14. Leyendecker G, Bilgicyildirim A, Inacker M, Stalf T, Huppert P, Mall G. et al. Adenomyosis and endometriosis. Re-visiting their association and further insights into the mechanisms of auto-traumatisation. An MRI study. Arch Gynecol. Obstet. 2015;291(4):917–932. DOI: 10.1007/s00404–014–3437–8\n15. Gori M, Luddi A, Belmonte G, Piomboni P, Tosti C, Funghi L. et al. Expression of microtubule associated protein 2 and synaptophysin in endometrium: high levels in deep infltrating endometriosis lesions. Fertil Steril. 2016;105(2):435–443. DOI: 10.1016/j.fertnstert.2015.10.024\n16. Guo SW. Fibrogenesis resulting from cyclic bleeding: the Holy Grail of the natural history of ectopic endometrium. Hum Reprod. 2018;33(3):353–356. DOI: 10.1093/humrep/dey015\n17. Chamié LP, Ribeiro DMFR, Tiferes DA, Macedo Neto AC, Serafni PC. Atypical Sites of Deeply Infltrative Endometriosis: Clinical Characteristics and Imaging Findings. Radiographics. 2018;38(1):309–328. DOI: 10.1148/rg.2018170093\n18. Vannuccini S, Tosti C, Carmona F, Huang SJ, Chapron C, Guo SW, Petraglia F. Pathogenesis of adenomyosis: an update on molecular mechanisms. Reprod Biomed Online. 2017;35(5):592–601. DOI: 10.1016/j.rbmo.2017.06.016\n19. Vannuccini S, Petraglia F. Recent advances in understanding and managing adenomyosis. F1000Res. 2019; 8: F1000 Faculty Rev-283. DOI: 10.12688/f1000research.17242.1\n20. Nirgianakis K, Ma L, McKinnon B, Mueller MD. Recurrence Patterns after Surgery in Patients with Different Endometriosis Subtypes: A Long-Term Hospital-Based Cohort Study. J. Clin. Med. 2020;9(2):496. DOI: 10.3390/jcm9020496\n21. Agarwal SK, Chapron C, Giudice LC, Laufer MR, Leyland N, Missmer SA. et al. Clinical diagnosis of endometriosis: a call to action. Am. J. Obstet. Gynecol. 2019;220(4):354.e1–354.e12. DOI: 10.1016/j.ajog.2018.12.039\n22. De Graaff AA, D’Hooghe TM, Dunselman GA, Dirksen CD, Hummelshoj L; WERF EndoCost Consortium; Simoens S. The signifcant effect of endometriosis on physical, mental and social wellbeing: results from an international cross-sectional survey. Hum. Reprod. 2013;28(10):2677–2685. DOI: 10.1093/humrep/det284\n23. Brandes I, Kleine-Budde K, Heinze N, Binder S, Klug C, Schippert C. et al. Cross-sectional study for derivation of a cut-off value for identifcation of an early versus delayed diagnosis of endometriosis based on analytical and descriptive research methods. BMC Womens Health. 2022;22(1):521. DOI: 10.1186/s12905–022–02044-x\n24. Tanbo T, Fedorcsak P. Endometriosis-associated infertility: aspects of pathophysiological mechanisms and treatment options. Acta. Obstet. Gynecol. Scand. 2017 96(6):659–667. DOI: 10.1111/aogs.13082\n25. Fuldeore MJ, Soliman AM. Prevalence and Symptomatic Burden of Diagnosed Endometriosis in the United States: National Estimates from a Cross-Sectional Survey of 59,411 Women. Gynecol. Obstet. Invest. 2017;82(5):453–461. DOI: 10.1159/000452660\n26. Peterson CM, Johnstone EB, Hammoud AO, Stanford JB, Varner MW, Kennedy A, et al; ENDO Study Working Group. Risk factors associated with endometriosis: importance of study population for characterizing disease in the ENDO Study. Am. J. Obstet. Gynecol. 2013;208(6):451.e1–11. DOI: 10.1016/j. ajog.2013.02.040\n27. Perelló M, Martínez-Zamora MA, Torres X, Munrós J, Llecha S, De Lazzari E, et al. Markers of deep infltrating endometriosis in patients with ovarian endometrioma: a predictive model. Eur. J. Obstet. Gynecol. Reprod. Biol. 2017;209:55–60. DOI: 10.1016/j.ejogrb.2015.11.024\n28. Saha R, Marions L, Tornvall P. Validity of self-reported endometriosis and endometriosis-related questions in a Swedish female twin cohort. Fertil. Steril. 2017;107(1):174–178.e2. DOI: 10.1016/j.fertnstert.2016.09.038\n29. Ashraf M, Sadatmahalleh SJ, Akhoond MR, Talebi M. Evaluation of Risk Factors Associated with Endometriosis in Infertile Women. Int. J. Fertil. Steril. 2016;10(1):11–21. DOI: 10.22074/ijfs.2016.4763\n30. Marinho MCP, Magalhaes TF, Fernandes LFC, Augusto KL, Brilhante AVM, Bezerra LRPS. Quality of Life in Women with Endometriosis: An Integrative Review. J. Womens Health (Larchmt). 2018;27(3):399–408. DOI: 10.1089/jwh.2017.6397\n31. Practice Committee of the American Society for Reproductive Medicine. Treatment of pelvic pain associated with endometriosis: a committee opinion. Fertil. Steril. 2014;101(4):927–935. DOI: 10.1016/j.fertnstert.2014.02.012\n32. Clemenza S, Sorbi F, Noci I, Capezzuoli T, Turrini I, Carriero C, et al. From pathogenesis to clinical practice: Emerging medical treatments for endometriosis. Best Pract.Res Clin. Obstet. Gynaecol. 2018;51:92–101. DOI: 10.1016/j.bpobgyn.2018.01.021\n33. Ceccaroni M, Bounous VE, Clarizia R, Mautone D, Mabrouk M. Recurrent endometriosis: a battle against an unknown enemy. Eur. J. Contracept. Reprod. Health Care. 2019;24(6):464–474. DOI: 10.1080/13625187.2019.1662391\n34. Ianieri MM, Mautone D, Ceccaroni M. Recurrence in Deep Infltrating Endometriosis: A Systematic Review of the Literature. J. Minim Invasive Gynecol. 2018;25(5):786–793. DOI: 10.1016/j.jmig.2017.12.025\n35. Ferrero S, Barra F, Leone Roberti Maggiore U. Current and Emerging Therapeutics for the Management of Endometriosis. Drugs. 2018;78(10):995–1012. DOI: 10.1007/s40265–018–0928–0\n36. Федеральные клинические рекомендации «Эндометриоз». 2020 г. Federal clinical guidelines «Endometriosis». 2020\n37. Becker CM, Bokor A, Heikinheimo O, Horne A, Jansen F, Kiesel L. et al. ESHRE Endometriosis Guideline Group. ESHRE guideline: endometriosis. Hum Reprod. Open. 2022;2022(2): hoac009. DOI: 10.1093/hropen/hoac009\n38. Capezzuoli T, Vannuccini S, Mautone D, Sorbi F, Chen H, Reis FM. et al. Long-term hormonal treatment reduces repetitive surgery for endometriosis recurrence. Reprod. Biomed Online. 2021;42(2):451–456. DOI: 10.1016/j.rbmo.2020.09.018\n39. Barra F, Scala C, Ferrero S. Current understanding on pharmacokinetics, clinical effcacy and safety of progestins for treating pain associated to endometriosis. Expert Opin. Drug Metab. Toxicol. 2018;14(4):399–415. DOI:10.1080/17425255.2018.1461840\n40. Оразов М.Р., Орехов Р.Е. Персонификация терапии пациенток, страдающих поверхностным и глубоким инфильтративным эндометриозом // Женская клиника. 2022;1:37–47.\n41. Оразов М.Р. «Спасательный круг» для пациенток, страдающих тазовой болью, обусловленной эндометриозом // Женская клиника. 2021;2:6–12.\n42. Murji A, Biberoğlu K, Leng J, Mueller MD, Römer T, Vignali M, Yarmolinskaya M. Use of dienogest in endometriosis: a narrative literature review and expert commentary. Curr. Med. Res Opin. 2020;36(5):895–907. DOI: 10.1080/03007995.2020.1744120\n43. Chantalat E, Valera MC, Vaysse C, Noirrit E, Rusidze M, Weyl A. et al. Estrogen Receptors and Endometriosis. Int. J. Mol. Sci. 2020;21(8):2815. DOI: 10.3390/ijms21082815\n44. Dyson MT, Roqueiro D, Monsivais D, Ercan CM, Pavone ME, Brooks DC. et al. Genome-wide DNA methylation analysis predicts an epigenetic switch for GATA factor expression in endometriosis. PLoS Genet. 2014;10(3): e1004158. DOI: 10.1371/journal.pgen.1004158\n45. Sophonsritsuk A, Tantanavipas S, Tingthanatikul Y, Lertvikool S, Dittharot K, Waiyaput W. Effects of Ethinyl Estradiol in Combined Oral Contraceptives on Cell Proliferation and Apoptosis in Ectopic Endometrial Tissue: A Randomized Controlled Study. J. Family. Reprod. Health. 2021;15(1):45–52.\n46. Bedaiwy M, Allaire C, Yong P. et al. Medical Management of Endometriosis in Patients with Chronic Pelvic Pain. Semin. Reprod. Med. 2017;35(1):38–53.\n47. Koga K, Takamura M, Fujii T, Osuga Y. Prevention of the recurrence of symptom and lesions after conservative surgery for endometriosis. Fertil. Steril. 2015;104(4):793–801. DOI: 10.1016/j.fertnstert.2015.08.026\n48. Dunselman GAJ, Vermeulen N, Becker C. et al. ESHRE guideline: management of women with endometriosis. Hum. Reprod. 2014;29(3):400–412.\n49. Brown J, Crawford TJ, Datta S, Prentice A. Oral contraceptives for pain associated with endometriosis. Cochrane Database Syst. Rev. 2018;5(5): CD 001019. DOI: 10.1002/14651858.CD001019.pub3\n50. Ulrich U, Buchweitz O, Greb R. et al. For the German and Austrian Societies for Obstetrics and Gynecology. National German Guideline (S 2k): Guideline for the Diagnosis and Treatment of Endometriosis: Long Version – AWMF Registry No. 015–045. Geburtshilfe Frauenheilkd 2014;74(12):1104–1118.\n51. Caruso S, Iraci M, Cianci S, Fava V, Casella E, Cianci A. Comparative, open-label prospective study on the quality of life and sexual function of women affected by endometriosis-associated pelvic pain on 2 mg dienogest/30 µg ethinyl estradiol continuous or 21/7 regimen oral contraceptive. J. Endocrinol Invest. 2016;39(8):923–931.\n52. Zakhari A, Delpero E, McKeown S, Tomlinson G, Bougie O, Murji A. Endometriosis recurrence following post-operative hormonal suppression: a systematic review and meta-analysis. Hum. Reprod. Update. 2021;27(1):96–107. DOI: 10.1093/humupd/dmaa033\n53. Becker CM, Gattrell WT, Gude K, Singh SS. Reevaluating response and failure of medical treatment of endometriosis: a systematic review. Fertil. Steril. 2017;108(1):125–136. DOI: 10.1016/j.fertnstert.2017.05.004\n54. Caruso S, Iraci M, Cianci S, Vitale SG, Fava V, Cianci A. Effects of long-term treatment with Dienogest on the quality of life and sexual function of women affected by endometriosis-associated pelvic pain. J. Pain. Res. 2019;12:2371–2378. DOI: 10.2147/JPR.S207599\n55. Leone Roberti Maggiore U, Remorgida V, Scala C, Taf E, Venturini PL, Ferrero S. Desogestrel-only contraceptive pill versus sequential contraceptive vaginal ring in the treatment of rectovaginal endometriosis infltrating the rectum: a prospective open-label comparative study. Acta. Obstet. Gynecol. Scand. 2014;93(3):239–247. DOI: 10.1111/aogs.12326\n56. Morotti M, Remorgida V, Venturini PL, Ferrero S. Progestogen-only contraceptive pill compared with combined oral contraceptive in the treatment of pain symptoms caused by endometriosis in patients with migraine without aura. Eur. J. Obstet. Gyneco.l Reprod. Biol. 2014;179:63–68. DOI: 10.1016/j.ejogrb.2014.05.016\n57. Vercellini P, Bracco B, Mosconi P, Roberto A, Alberico D, Dhouha D, Somigliana E. Norethindrone acetate or dienogest for the treatment of symptomatic endometriosis: a before and after study. Fertil Steril. 2016;105(3):734–743.e3. DOI: 10.1016/j.fertnstert.2015.11.016\n58. Carr B, Dmowski WP, O’Brien C, Jiang P, Burke J, Jimenez R. et al. Elagolix, an oral GnRH antagonist, versus subcutaneous depot medroxyprogesterone acetate for the treatment of endometriosis: effects on bone mineral density. Reprod. Sci. 2014;21(11):1341–1351. DOI: 10.1177/1933719114549848\n59. Taylor HS, Giudice LC, Lessey BA, Abrao MS, Kotarski J, Archer DF, et al. Treatment of Endometriosis-Associated Pain with Elagolix, an Oral GnRH Antagonist. N. Engl.J. Med. 2017;377(1):28–40. DOI: 10.1056/NEJMoa1700089\n60. Tsai HW, Wang PH, Huang BS, Twu NF, Yen MS, Chen YJ. Low-dose add-back therapy during postoperative GnRH agonist treatment. Taiwan J Obstet Gynecol. 2016;55(1):55–59. DOI: 10.1016/j.tjog.2015.04.004\n61. Priya K, Rajaram S, Goel N. Comparison of combined hormonal vaginal ring and low dose combined oral hormonal pill for the treatment of idiopathic chronic pelvic pain: a randomised trial. Eur J Obstet Gynecol Reprod Biol. 2016;207:141–146. DOI: 10.1016/j.ejogrb.2016.10.026\n62. Grandi G, Barra F, Ferrero S, Sileo FG, Bertucci E, Napolitano A, Facchinetti F. Hormonal contraception in women with endometriosis: a systematic review. Eur. J. Contracept. Reprod. Health Care. 2019;24(1):61–70. DOI:10.1080/13625187.2018.1550576\n63. Muzii L, Di Tucci C, Achilli C, Di Donato V, Musella A, Palaia I, Panici PB. Continuous versus cyclic oral contraceptives after laparoscopic excision of ovarian endometriomas: a systematic review and metaanalysis. Am J Obstet Gynecol. 2016;214(2):203–211. DOI: 10.1016/j.ajog.2015.08.074\nРецензия\nДля цитирования:\nКузнецова И.В. Применение комбинированных оральных контрацептивов у больных эндометриозом. Медицинский алфавит. 2023;(3):14-20. https://doi.org/10.33667/2078-5631-2023-3-14-20\nFor citation:\nKuznetsova I.V. The use of combined oral contraceptives in patients with endometriosis. Medical alphabet. 2023;(3):14-20. (In Russ.) https://doi.org/10.33667/2078-5631-2023-3-14-20\nJATS XML","source_license":"CC0","license_restricted":false}