Modern methods of preventing inflammatory diseases of the pelvic organs in women and their complications: Protective potential of the prolonged mode of combined oral contraception
Objective. To determine the current trends and importance of contraception in the prevention of inflammatory diseases of the pelvic organs (PID) and their complications.Dikke G.B.
Subject and methods. An analysis of the materials of the Cochrane base, recommendations of international and domestic professional communities and studies published in the public domain was carried out.
Results. Information on the epidemiology, etiology and socio-economic significance of PID is given. It is shown that the prevention of PID and its complications includes preventive measures at the organizational and personal levels. The data of clinical studies on the effectiveness of contraceptives (barrier, COCs and IUDs), as methods to prevent not only unwanted pregnancy, but also prevention of STIs, PID and their complications are given.
Conclusion. Preventive measures can significantly reduce the incidence and consequences of PID in women. The prolonged mode of combined oral contraception increases its protective potential in relation to the risk of PID.
Keywords
vaginitis
cervicitis
pelvic inflammatory diseases
sexually transmitted infections
polymicrobial infections
resistance of microorganisms
References
1. Rein D.B., Kassler W.J., Irwin K.L., Rabiee L. Direct medical cost of pelvic inflammatory disease and its sequelae: Decreasing, but still substantial. Obstet. Gynecol. 2000; 95(3): 397-402.
2. Yeh J.M., Hook E.W., Goldie S.J. A refined estimate of the average lifetime cost of pelvic inflammatory disease. Sex. Transm. Dis. 2003; 30(5): 369.
3. Workowski K., Berman S. CDC. Sexually Transmitted Diseases Treatment Guidelines. MMWR Recom. Rep. 2010; 59 (RR-12): 1-110.
4. Westrom L., Joesoef R., Reynolds G. et al. Pelvic inflammatory disease and fertility. A cohort study of 1,844 women with laparoscopically verified disease and 657 control women with normal laparoscopic results. Sex. Transm. Dis. 1992; 19(4): 185-92.
5. Bohm M.K., Newman L., Satterwhite C.L. et al. Pelvic inflammatory disease among privately insured women, united states, 2001–2005. Sex. Transm. Dis. 2010; 37(3): 131-6.
6. Zarochentseva N.V., Arshakyan A.K., Menshikova N.S. Inflammatory diseases of the pelvic organs in women. Ginekologiya. 2013; 4: 65-9. (in Russian)
7. Khryanin A.A., Reshetnikov O.V. Rational therapy of combined urogenital infections: analysis of existing trends. Farmateka. 2016; 12: 29-36. (in Russian)
8. Shurshalina A.V. Chronic endometritis in women with pathology of reproductive function: author’s abstract. Dis. Dr. Med. Sciences. Moscow, 2007. 37p. (in Russian)
9. Simms I., Stephenson J.M., Mallinson H. et al. Risk factors associated with pelvic inflammatory disease. Sex. Transm. Infect. 2006; 82(6): 452-7.
10. Oroz C., Bailey H., Hollows K. et al. A national audit on the management of pelvic inflammatory disease in UK genitourinary medicine clinics. Int. J. STD AIDS. 2012; 23(1): 53-4.
11. Trent M., Chung S.E., Forrest L., Ellen J.M. Subsequent sexually transmitted infection after outpatient treatment of pelvic inflammatory disease. Arch. Pediatr. Adolesc. Med. 2008; 162(11): 1022-5.
12. Aral S.O., Brunham R.C., Cates W. et al. CDC. Pelvic Inflammatory Disease: Guidelines for Prevention and Management. MMWR. 1991; 40(RR-5): 1-25.
13. Mitchell C., Prabhu M. Pelvic inflammatory disease: current concepts in pathogenesis, diagnosis and treatment. Infect. Dis. Clin. North Am. 2013; 27(4): 10.1016/j.idc.2013.08.004. .
14. STD curriculum for clinical educators. Pelvic inflammatory disease (PID) module. CDC. October 2014. Accessed April 13, 2016. Available at: www2a.cdc.gov/
15. OCs protect users against PID, study shows. Contracept. Technol. Update. 1981; 2(8): 101-2.
16. Weller S., Davis K. Condom effectiveness in reducing heterosexual HIV transmission. Cochrane Database Syst. Rev. 2002; (1): CD003255.
17. Niccolai L., Rowhani-Rahbar A., Jenkins H. et al. Condom effectiveness for prevention of Chlamydia trachomatis infection. Sex. Transm. Infect. 2005; 81(4): 323-5.
18. Lee W., Newman D.R., Austin H.D. et al. Condom effectiveness for reducing transmission of gonorrhea and chlamydia: the importance of assessing partner infection status. Am. J. Epidemiol. 2004; 159(3): 242-51.
19. Winer R.L., Hughes J.P., Feng Q. et al. Condom use and the risk of genital human papillomavirus. Infection in young women. N. Engl. J. Med. 2006; 354:2645-54.
20. Crosby R.A., Yarber W.L., Sanders S.A., Graham C.A. Condom discomfort and associated problems with their use among university students. Am. J. Coll. Health. 2000; 54: 143-8.
21. Washington A.E., Gove S., Schachter J., Sweet R.L. Oral contraceptives, Chlamydia trachomatis infection and pelvic inflammatory disease: a word of caution about protection. JAMA. 1985; 253: 2246-50.
22. Senanayake P., Kramer D.G. Contraception and the etiology of pelvic inflammatory disease: new perspectives. Am. J. Obstet. Gynecol. 1980; 138(2): 852-60.
23. Wølner-Hanssen P., Eschenbach D.A., Paavonen J. et al. Decreased risk of symptomatic chlamydial pelvic inflammatory disease associated with oral contraceptive use. JAMA. 1990; 263(1): 54-9.
24. Kaunitz A.M. Oral contraceptive health benefits: perception versus reality. Contraception. 1999; 59(Suppl. 1): 29S-33S.
25. Rubin G.L., Ory H.W., Layde P.M. Oral contraceptives and pelvic inflammatory disease. Am. J. Obstet. Gynecol. 1982; 144(6): 630-5.
26. Peterson H.B., Lee N.C. The health effects of oral contraceptives: Misperceptions, controversies, and continuing good news. Clin. Obstet. Gynecol. 1989; 32: 339-55.
27. Schindler A.E. Non-contraceptive benefits of oral hormonal contraceptives. Int. J. Endocrinol. Metab. 2013; 11(1): 41-7.
28. Huber J.C., Bentz E.K., Ott J., Tempfer C.B. Non-contraceptive benefits of oral contraceptives. Exp. Opin. Pharmacother. 2008; 9(13): 2317-25.
29. Eschenbach D.A., Harnisch J.P., Holmes K.K. Pathogenesis of acute pelvic inflammatory disease: role of contraception and other risk factors. Am. J. Obstet. Gynecol. 1977; 128(8): 838-50.
30. Gursahaney P.R., Meyn L.A., Hillier S.L. et al. Combined hormonal contraception may be protective against Neisseria gonorrhoeae infection. Sex. Transm. Dis. 2010; 37(6): 356-60.
31. Bradshaw C.S., Brotman R.M. Making inroads into improving treatment of bacterial vaginosis–striving for long-term cure. BMC Infect. Dis. 2015; 15(1): 292.
32. Vodstrcil L.A., Hocking J.S., Law M. et al. Hormonal contraception is associated with a reduced risk of bacterial vaginosis: A systematic review and meta-analysis. PLoS One. 2013; 8(9): e73055.
33. Burkman R.T. Oral contraceptives: current status. Clin. Obstet. Gynecol. 2001; 44(1): 62-72.
34. Andrist L.C., Arias R.D., Nucatola D. et al. Women’s and providers’ attitudes toward menstrual suppression with extended use of oral contraceptives. Contraception. 2004; 70: 359-63.
35. Romero R., Hassan S.S., Gajer P. et al. The composition and stability of the vaginal microbiota of normal pregnant women is different from that of non-pregnant women. Microbiome. 2014; 2: 4.
36. Korkhov V.V., Tapilskaya N.I. Gestagens in obstetric-gynecological practice. A guide for doctors. St. Petersburg: SpetsLit; 2005. (in Russian)
37. Klipping C., Duijkers I., Fortier M.P. et al. Long-term tolerability of ethinylestradiol 20 μg/drospirenone 3 mg in a flexible extended regimen: results from a randomised, controlled, multicentre study. J. Fam. Plann. Reprod. Health Care 2012; 38: 84-93.
38. Van de Wijgert J.H., Verwijs M.C., Turner A.N., Morrison C.S. Hormonal contraception decreases bacterial vaginosis but oral contraception may increase candidiasis: implications for HIV transmission. AIDS. 2013; 27(13): 2141-53.
39. Ferrero S., Abbamonte L.H., Giordano M. et al. What is the desired menstrual frequency of women without menstruationrelated symptoms? Contraception. 2006; 73: 537-41.
40. Legro R.S., Pauli J.G., Kunselman A.R. et al. Effects of continuous versus cyclical oral contraception: a randomized controlled trial. J. Clin. Endocrinol. Metab. 2008; 93: 420-9.
41. Radzinsky V.E., Ipastova I.D. Subclinical PID: from awareness of danger to a program of action. Asymptomatic and low-symptom PID in the practice of an obstetrician-gynecologist: newsletter. Moscow: Editorial Board of the journal StatusPraesens, 2017. 24p. (in Russian)
42. Prilepskaya V.N., Khlebkova Yu.S. Prolonged contraception. Modern opportunities, efficiency, prospects: A review of the literature. Ginekologiya. 2016; 18(1): 88-91. (in Russian)
43. Strowitzki T., Kirsch B., Elliesen J. Efficacy of ethinylestradiol 20 μg/drospirenone 3 mg in a flexible extended regimen in women with moderatetosevere primary dysmenorrhoea: an open-label, multicentre, randomised, controlled study. J. Fam. Plann. Reprod. Health Care. 2012; .38: 94-101.
44. Viberga I., Odlind V., Lazdane G. et al. Microbiology profile in women with pelvic inflammatory disease in relation to IUD use. Infect. Dis. Obstet. Gynecol. 2005; 13: 183-90.
45. Sivin I., Stern J., Diaz J. et al. Two years of intrauterine contraception with levonorgestrel and with copper: A randomized comparison of the tcu 380ag and levonorgestrel 20 mcg/day devices. Contraception. 1987; 35(3): 245-55.
46. Sufrin C.B., Postlethwaite D., Armstrong M.A. et al. Neisseria gonorrhea and chlamydia trachomatis screening at intrauterine device insertion and pelvic inflammatory disease. Obstet. Gynecol. 2012; 120(6): 1314-21.
47. Mohllajee A.P., Curtis K.M., Peterson H.B. Does insertion and use of an intrauterine device increase the risk of pelvic inflammatory disease among women with sexually transmitted infection? A systematic review. Contraception. 2006; 73(2): 145-53.
48. Soderberg G., Lindgren S. Influence of an intrauterine device on the course of an acute salpingitis. Contraception. 1981; 24(2): 137-43.
49. Tepper N.K., Steenland M.W., Gaffield M.E. et al. Retention of intrauterine devices in women who acquire pelvic inflammatory disease: a systematic review. Contraception. 2013; 87: 655-60.
50. Martínez F., López-Arregui E. Infection risk and intrauterine devices. Acta Obstet. Gynecol. Scand. 2009; 88(3): 246-50. QA
Received 10.02.2017
Accepted 17.02.2017
About the Authors
Dikke Galina B., Honoured Science and Education, MD, professor of obstetrics, gynecology and reproductive medicine, faculty of continuing medical education,Peoples’ Friendship University of Russia. 117198, Russia, Moscow, Miklukho-Maklaya str. 8. Tel.: +74954345300. E-mail: galadikke@yandex.ru
For citations: Dikke G.B. Modern methods of preventing inflammatory
diseases of the pelvic organs in women and their complications:
Protective potential of the prolonged mode of combined oral contraception.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2017; (5): 44-9. (in Russian)
http://dx.doi.org/10.18565/aig.2017.5.44-9
