Основные принципы диагностики и лечения заболеваний в составе синдрома гиперандрогении

Заболевания (состояния), связанные с избыточной продукцией андрогенов в женском организме или повышением чувствительности к ним гормонозависимых органов, объединяются понятием «синдром гиперандрогении» (СГА). Варианты СГА распределяются от изолированных поражений кожи и ее производных до системных заболеваний, сопровождающихся высоким риском нарушений менструального цикла, бесплодия, метаболических расстройств, сердечно-сосудистой патологии, канцерогенеза. Ведением больных с гиперандрогенизмом занимаются гинекологи, эндокринологи, дерматологи, терапевты общей практики, но в реальной жизни взаимодействие между представителями отдельных медицинских специальностей, ксожалению, наблюдается редко. Врезультате лечение пациентов с гиперандрогенизмом грешит полипрагмазией, неправомерными назначениями и игнорированием текущих потребностей женщин. Ситуация усугубляется тем, что лекарственных средств, аннотированных для терапии внешних проявлений гиперандрогенизма, практически нет, а число препаратов, способных оказать многоплановое действие, невелико. Одной из стратегий, позволяющих уменьшить лекарственную нагрузку и решить сразу несколько задач по компенсации андрогензависимых дермопатий и сохранению здоровья у пациенток с гиперандрогенизмом, является назначение комбинированной гормональной контрацепции. Определяющими факторами выбора гормонального контрацептива для женщин с гиперандрогенизмом должны быть наличие антиандрогенного эффекта прогестина в составе лекарственного средства и безопасность длительного применения препарата.

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