A rational approach to choosing a method of contraceptionfrom the standpoint of metabolicneutrality

Abstract

The aim of the study is to substantiate a rational approach to choosing a method of contraception from the standpoint of metabolic neutrality in an obese woman based on a clinical case study. The object of our research is the medical history of patient Z., 43 years old. The patient applied to select a method of contraception for her. When applying, an examination was conducted, which included the collection of complaints, anamnesis, blood pressure measurement, general examination, with examination and palpation of the mammary glands, determination of body mass index (BMI), gynecological and ultrasound examination of the pelvic organs, mammography, general and biochemical blood tests, taking swabs for oncocytology, the degree of purity of the vagina, gonorrhea. Diagnosis: Uterine leiomyoma (intramural, intramural - subserous). Heavy menstruation with a regular cycle. Chronic posthemorrhagic iron deficiency anemia of mild degree. Grade 1 obesity (BMI 31.8). The patient was recommended to administer levonogrestrel - releasing intrauterine system (levonorgestrel in the form of an intrauterine therapeutic system) (LNH - IUD) as well as taking iron supplements. During an examination conducted three months after the installation of the LNH-IUD, the woman did not complain, menstruation became moderate, lasting up to three days. Ultrasound of the pelvic organs showed a decrease in the size of myomatous nodes, and the endometrium was free of pathology. 10 months after the introduction of the LNH - IUD, menstruation is scanty and spotty, amenorrhea occurs for 13 months. Subsequently, no growth of myomatous nodes was detected. The weight dropped to 72 kg. The BMI was 24.24 (normal). At the end of the five-year period of use of the LNH-IUD in this patient, it was removed and a new one was introduced to ensure a contraceptive effect and the prospect of further use as a component of MGT. Thus, the use of intrauterine contraception using the LNH-IUD is the most rational method for obese women, as it is a highly effective and safest method.