Tolerability of multiphasic and monophasic combined hormonal contraceptives patients with uterine fibroids

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BACKGROUND

An increasing number of young women with uterine fibroids are postponing childbearing and using combined hormonal contraceptives (CHCs). 20-30% of users report side effects of CHCs, including changes in libido and mood.

OBJECTIVE

To study in a comparative aspect the tolerability of multiphasic and monophasic CHCs with ethinyl estradiol (EE) in patients with uterine fibroids.

MATERIALS AND METHODS

113 women (18—45 years old) were included. Group I (n=26): patients with uterine fibroids who used multiphasic CHCs, II (n=57) — monophasic CHCs; III (n=30) — healthy women who used monophasic CHCs. Side effects of CHCs, sexual function (Female Sexuality Index, FSFI), psychoemotional state (Beck Depression Inventory), quality of life (SF-36) and satisfaction with the use of drugs were assessed.

RESULTS

A more frequent occurrence of intermenstrual bleeding from the vagina was recorded in the first 3 months of using microdose monophasic (30%) compared to multiphasic (8%) CHCs in patients with uterine fibroids (p<0.05). When assessing sexual function, no changes were detected (FSFI): initially, after 3 and 6 months (24.6±8.9; 26.4±9.2; 26.4±9.2 (I); 25.8±7.4; 27.1±6.3; 26.9±6.3 (II); 27.8±4.7; 26.9±6.3; 28.2±4.2 (III); p>0.05). The psycho-emotional state of the participants did not change over 6 months of observation (7.5±3.1; 7.4±3.2; 7.2±3.9; p>0.05). Initially, a lower quality of life was noted in patients with uterine fibroids than in healthy women (SF-36 points): 95±5 (I—II); 103±11 (III) (p<0.05). After 6 months, patients with uterine fibroids using CHCs showed an increase in the overall SF-36 score from 94±4 to 101±10 (I) and from 95±6 to 101±9 (II) points, respectively (p<0.05). Satisfaction with the use of CHC was 98% and did not differ between study groups.

CONCLUSIONS

In the first 3 months of using multiphasic CHCs, less frequent episodes of irregular intermenstrual bleeding from the vagina were noted. The incidence of other side effects of CHCs did not differ between study groups and was not dependent on the daily dose of EE in the CHC. The use of multiphasic and monophasic CHCs with EE by study participants did not have a negative effect on their libido and mood. In patients with uterine fibroids, the use of both multiphasic and monophasic CHCs with EE leads to a significant improvement in the quality of life. 98% of study participants were satisfied with the use of CHCs of various phases.

Keywords:

uterine fibroids

multiphasic combined hormonal contraceptives

monophasic combined hormonal contraceptives

quality of life

sexual function

depression

Authors:

Aganezova N.V.

North-Western State Medical University named after I.I. Mechnikov

SPIN RSCI: 2961-5377
Scopus AuthorID: 57191916251
ORCID: 0000-0002-9676-1570

Aganezov S.S.

North-Western State Medical University named after I.I. Mechnikov

SPIN RSCI: 8186-6778
Scopus AuthorID: 55744676600
ORCID: 0000-0002-3523-9922

Buryak M.M.

North-Western State Medical University named after I.I. Mechnikov

ORCID: 0000-0002-7558-8342

Received:

17.04.2024

Accepted:

30.05.2024

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