Interdisciplinary discussion on the potential use of a subcutaneous contraceptive implant in patients with chronic diseases

Yarmolinskaya M.I., Nedogoda S.V., Avdeev S.N., Tsareva N.A., Andreeva E.N., Samarina A.V., Amelina E.L., Gubonina I.V., Klimenchenko N.I.

1) D.O. Ott Research Institute of Obstetrics, Gynecology and Reproductive Medicine, St. Petersburg, Russia; 2) I.I. Mechnikov North-Western State Medical University, Ministry of Health of Russia, St. Petersburg, Russia; 3) Volgograd State Medical University, Ministry of Health of Russia, Volgograd, Russia; 4) I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia, Moscow, Russia; 5) National Medical Research Centre for Endocrinology, Ministry of Health of Russia, Moscow, Russia; 6) Russian University of Medicine, Ministry of Health of Russia, Moscow, Russia; 7) Pavlov First Saint Petersburg State Medical University, Ministry of Health of Russia, St. Petersburg, Russia; 8) Centre for Prevention and Control of AIDS and Infectious Diseases, St. Petersburg, Russia; 9) Federal Pulmonology Research Institute, Federal Medical and Biological Agency of Russia, Moscow, Russia; 10) Scandinavia Clinic (AVA-PETER LLC), St. Petersburg, Russia; 11) Academician V.I. Kulakov National Medical Research Centre for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, Moscow, Russia

There is a need for greater awareness of the use of modern contraceptive methods in today’s medical practice. This can be due to the low level of public knowledge about contraceptive methods and to the fact that contraception remains within the scope of obstetricians and gynecologists, who consult on the choice of contraceptive method, prescribe a contraceptive and then carry out routine follow-up. However, there are a number of chronic somatic diseases in which an unplanned pregnancy is a threat to the life and health of both the woman and her future child. The issue of contraceptive use and the assessment of drug interactions may be overlooked when patients with a variety of chronic conditions are referred to other specialists and prescribed treatment for their primary diagnosis. The panel discusses the potential use of the subcutaneous contraceptive implant releasing etonogestrel in patients with a variety of chronic diseases, including cardiovascular, pulmonary and endocrine pathologies, immune-mediated and orphan diseases, chronic viral infections and tuberculosis. The etonogestrel implant is a highly effective long-acting reversible hormonal contraceptive option and is the method of choice for women with chronic medical conditions that may limit the use of the estrogen component.
Conclusion: Interdisciplinary collaboration between obstetricians and gynecologists and other specialists is necessary for choosing the best contraceptive method for patients with chronic diseases. Interdisciplinary documents (methodological and/or clinical guidelines) on the use of contraception in specific groups of patients with contraindications to pregnancy could be developed in addition to the current National Medical Eligibility Criteria for Contraceptive Use (2023) and the draft clinical guidelines ‘Contraception. Contraceptive Surveillance’ (2024), which would expand relevant information on contraception for various medical specialists (including cardiologists, endocrinologists, pulmonologists, rheumatologists, infectious disease specialists, and others).

Authors' contributions: Yarmolinskaya M.I., Nedogoda S.V., Avdeev S.N., Tsareva N.A., Andreeva E.N., Samarina A.V., Amelina E.L., Gubonina I.V., Klimenchenko N.I. – concept and design, writing the text, editing.
Conflicts of interest: The authors declare no possible conflicts of interest.
Funding: The study was conducted without sponsorship.
For citation: Yarmolinskaya M.I., Nedogoda S.V., Avdeev S.N., Tsareva N.A., Andreeva E.N., Samarina A.V., Amelina E.L., Gubonina I.V., Klimenchenko N.I. Interdisciplinary discussion on the potential use of 
a subcutaneous contraceptive implant in patients with chronic diseases.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2024; (11): 40-55 (in Russian)
https://dx.doi.org/10.18565/aig.2024.288

Keywords

long-acting progestin-only contraception
subcutaneous etonogestrel-releasing implant
chronic diseases
multidisciplinary approach

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Received 11.11.2024

Accepted 20.11.2024

About the Authors

Maria I. Yarmolinskaya, Dr. Med. Sci., Professor of the Russian Academy of Sciences, Head of the Department of Gynecology and Endocrinology, Head of the Center for Diagnostics and Treatment of Endometriosis, D.O. Ott Research Institute of Obstetrics, Gynecology and Reproductology, Saint-Petersburg, Russia; Professor at the Department of Obstetrics and Gynecology, I.I. Mechnikov North-Western State Medical University, Ministry of Health of Russia, Saint-Petersburg, Russia,
m.yarmolinskaya@gmail.com, Researcher ID: P-2183-2014, Scopus Author ID: 7801562649, SPIN: 3686-3605, https://orcid.org/0000-0002-6551-4147
Sergey V. Nedogoda, Dr. Med. Sci., Head of the Department of Internal Medicine, Institute of Continuous Medical and Pharmaceutical Education of Volgograd State Medical University, Ministry of Health of Russia, Volgograd, Russia, nedogodasv@mail.ru, Researcher ID: O-4656-2014, Scopus Author ID: 6507198479, SPIN: 7005-7846,
https://orcid.org/0000-0001-5981-1754
Sergey N. Avdeev, Dr. Med. Sci., Professor, Academician of Russian Academy of Sciences, Head of the Department of Pulmonology, N.V. Sklifosovsky Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University), Moscow, Russia, аvdeev_s_n@staff.sechenov.ru,
Researcher ID: G-6950-2015, Scopus Author ID: 7003292838, SPIN: 1645-5524, https://orcid.org/0000-0002-5999-2150
Natalya A. Tsareva, PhD, Associate Professor at the Department of Pulmonology, N.V. Sklifosovsky Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University), Moscow, Russia, +7(495)609-14-00, n_tsareva@mail.ru, Scopus Author ID: 967612, SPIN: 7722-8596,
https://orcid.org/0000-0001-9357-4924
Elena N. Andreeva, Dr. Med. Sci., Professor, Deputy Director of the Center – Head of the Institute of Reproductive Medicine, Head of the Department of Endocrine Gynecology, Endocrinology Research Center, Moscow, Russia; Professor at the Department of Reproductive Medicine and Surgery, Russian University of Medicine,
Moscow, Russia, endogin@mail.ru, Researcher ID: B-5889-2017, Scopus Author ID: 7102485410, SPIN: 1239-2937, https://orcid.org/0000-0002-5949-1815
Anna V. Samarina, Dr. Med. Sci., Professor at the Department of Socially Significant Infections and Phthisiopulmonology, Pavlov First Saint-Petersburg State Medical University, Ministry of Health of Russia; Head of the Department of Maternity and Childhood, Center for the Prevention and Control of AIDS and Infectious Diseases, St. Petersburg, Russia, avsamarina@mail.ru, Researcher ID: B-1693-2018, Scopus Author ID: 36999474200, SPIN: 2878-7130, https://orcid.org/0000-0003-1438-2399
Elena L. Amelina, PhD, Head of the Cystic Fibrosis Department, Pulmonology Scientific Research Institute of Federal Medical and Biological Agency of Russia,
Moscow, Russia, +7(926)205-03-91, eamelina@mail.ru, Scopus Author ID: 7003985681, SPIN: 6341-4662, https://orcid.org/0000-0002-5356-9415
Irina V. Gubonina, PhD, Head of Gastroenterology Department, Scandinavia Clinic (AVA-PETER LLC), St. Petersburg, Russia, giv70@bk.ru, Author ID: 886213,
Scopus ID: 8262853500, SPIN: 4457-1730, https://orcid.org/0000-0002-6302-7767
Natalia I. Klimenchenko, PhD, Senior Researcher at the 1st Obstetric Department of Pregnancy Pathology, Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, Moscow, Russia, natalite@list.ru, https://orcid.org/0000-0002-9901-225X

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