Reproductive health of adolescents in Russia: statistics, problems and prospects of improvement

Abstract

At the beginning of the 21st century we still face the problem of reproductive health of women, children and adolescents in Russia. Final overcoming of the "Russian Cross" primarily relates to preventing further decline of women in reproductive age and children aged 0-17 years.The following medico-social determinants of women's reproductive health are considered: family prosperity, somatic growth and sexual maturation, chronic extragenital diseases, sexual and reproductive behavior, environmental wellbeing of territory and gynecological care organization. Analysis of gynecological morbidity of Russian girls and adolescents at the beginning of this century spots an upward trend. The results of our anonymous questionnaire survey of socially adapted students among 3327 girls of 13-19 years testify that 59.9% of respondents in this age cohort do not practice daily genitalia toilet. According to our population-based studies, 24.0% of women have first pregnancy at the juvenile age followed by labor in 18.4% of young women, abortion in 81.6%. Menstrual disorders represent the most common symptoms and strong indications of reproductive health problems related, inter alia, to progesterone deficiency which can lead to serious consequences (infertility, miscarriage, breast disease). The choice of medication for the menstrual disorders treatment should consider instruction indications, the lack of limitations and contraindications, need for contraception, concomitant diseases and states, proved efficacy of the medication. Prospects of solving reproductive and demographic problems in the twenty-first century are largely beyond the control of clinicians being aggravated by unresolved environmental and social problems.

Targeting factors for change: contraceptive counselling and care of female adolescents

“…[18,32,33] (see Figure 2) and many will have had more than one partner. [32][33][34][35] In the Canadian Community Health Survey, [32] 35% of 15-to 17-year-old and 39% of 18-to 19-year-old adolescents reporting having sex with more than one partner. In Finland, Leikko et al [33] report that, by the age of 22 years, 53% of women will have had five partners or more, irrespective of the age they first had sexual intercourse.…”

“…Estimates from four national US surveys conducted between 1988 and 1997 showed that almost 20% of adolescent women aged 15-17 years had two or more sexual partners in the previous three months. [34] Data from an anonymous survey conducted amongst 3327 Russian females aged between 13 and 19 years show that 25% have had three or more sexual partners by the age of 19 [35] and almost one in five report having an ongoing sexual relationship with two or more partners at the same time. [35] The age at first intercourse influences the likelihood of using contraception.…”

“…[34] Data from an anonymous survey conducted amongst 3327 Russian females aged between 13 and 19 years show that 25% have had three or more sexual partners by the age of 19 [35] and almost one in five report having an ongoing sexual relationship with two or more partners at the same time. [35] The age at first intercourse influences the likelihood of using contraception. Adolescents who have sex at age 14 or younger are less likely than older teens to have used contraception at first intercourse and more likely to delay the use of contraception until later, in some cases up to the age of 22 years.…”

Pathogenetic role of vitamin D deficiency in the development of menstrual dysfunction in pubertal girls: a literature review

“…A particular attention should be drawn to girls at the pubertal period, since adolescents require vitamin D supplements during their intensive growth, but they extremely rare take low-dose Vitamin D to prevent deficiency [35].…”