Abnormal uterine bleeding (AUB) is one of the most common frequent reasons for contacting a gynecologist and conducting intrauterine interventions. AUB causes iron deficiency anemia and a decrease quality of life of women, which in turn is the reason of their social and clinical significance. Based on the analysis of literature and international data recommendations, the review outlines the basic principles of AUB diagnosis, non-hormonal and hormone therapy Advantages of continuous regimen for the administration of progestogens, in particular the LNG-IUS, and COCs containing estradiol valerate, to reduce menstrual flow blood loss are presented in the article. The need for a differentiated approach of choosing the therapy based on age, causes of bleeding, and balance benefits and risks of medicines.

В настоящее время в Европе средняя продолжи-тельность жизни женщин превышает 80 лет, а по-скольку возраст наступления менопаузы значитель-но не изменился (в среднем 51,3 года), длительность постменопаузы составляет 30-40% от общей про-должительности жизни. К 2050 г. популяция жен-щин в возрасте 60 лет и старше составит более 30% от их общего числа, поэтому вопросы сохранения здо-ровья, жизненной активности и работоспособности приобретают огромное значение [1].Современные женщины не только дольше жи-вут, но больше работают и позже оставляют работу. Многие женщины продолжают работать после 50, 60 и даже 70 лет, некоторые возвращаются на работу, когда семейные обстоятельства позволяют им это сделать, потому что не хотят сидеть дома. Гендерные проблемы здравоохранения работающих женщин чаще всего касаются отпусков по уходу за беремен-ностью, а любые другие, в том числе связанные с ме-нопаузой, обсуждаются редко, при том, что женщи-

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Background. Combined oral contraceptives (COCs) are the most common method of prevention of unwanted pregnancies in women from the early reproductive period to perimenopause, therefore their impact on quality of life, sexual function and general well-being remains the subject of active discussion. Some studies revealed various manifestations of sexual dysfunction in patients receiving COCs, therefore such questions, as well as the advantages / disadvantages of individual components (their type and dose) of drugs, are of interest to the clinician. Aim. Assess mechanisms of influence of COCs on female sexual function. Materials and methods. In order to write this review domestic and foreign publications were searched in Russian and international search systems (PubMed, elibrary, etc.) for the last 2-15 years. Relevant articles from the peer-reviewed literature were included. Results. Many studies proved a beneficial effect of estradiol valerate (E2V) which is estrogen identical to natural one in a combination with dienogest (DNG) which is 4th generation progestin in a dynamic dosing regimen on quality of life and sexual function. This beneficial effect is achieved due to combined effects of both components of the drug as well as its reception mode. Conclusion. The combination of estradiol valerate (E2V) which is estrogen identical to natural one with dienogest (DNG) which is 4th generation progestin may be the optimal method of contraception for women of any age, including the young, with decreased libido while taking other COCs.

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