CONTRACEPTION AS A FACTOR FOR PRESERVING WOMEN'S REPRODUCTIVE HEALTH DURING WAR

Abstract

During the war, women's reproductive health (RH) becomes one of the most vulnerable links: the “rejuvenation” of many precancerous and tumorous gynaecological diseases, an increase in the number of women with premature ovarian failure, an increase in the risk of sexually transmitted infections (STIs), and fertility control occurs by terminating an unwanted pregnancy. The purpose of the research is to examine the level of awareness among young women about modern hormonal contraceptives (HC) and the prevalence of their use during wartime. Materials and methods. In order to achieve this purpose, between November 12, 2023, and March 20, 2024, according to the author's questionnaire, which contained 25 questions in Ukrainian and Hebrew and was posted on the website of the Department of Obstetrics and Gynaecology of the SI “Lugansk State Medical University” and on the Instagram social network, a voluntary online survey of 311 women aged 14 to 35 years, who are legally considered young. The surveyed women were divided into two groups by citizenship and country of residence: I was formed by 190 citizens of Ukraine, II – 121 citizens of Israel. The results. Female respondents aged 18 to 27 showed the greatest interest in the survey. Among the young women, female students of higher education dominated. A third of the female respondents stated their sexual debut in adolescence. Also, a third of the respondents had unprotected first sexual intercourse. Every fourth Ukrainian woman and every fifth Israeli woman at the time of their first sexual intercourse had no idea about the available means of unplanned pregnancy and STD prevention. The results of the survey prove that there are real difficulties today in the acquisition of sexual knowledge by young people: the vast majority of young women cite only social networks as their main source of information; only one in two respondents considers herself to be fully aware of modern contraceptive methods – which is unreasonable; the low role of gynaecologists, family doctors and the family in the sexual education of young people. Based on the obtained results, the male condom is the most popular means of unwanted pregnancy prevention among Ukrainian women (41.9%), oral contraceptives are used by only 17.4% of surveyed women І Group, some prefer spermicides (9.9%) and interrupted sexual intercourse (15.1%), regarding the surveyed women ІІ Group, after the analysis we have: 10.7%, 67.8%, 1.7%, 9.9%, respectively; 24.2% of surveyed women І group and 8.3% of surveyed women ІІ group still experience difficulties in obtaining information about the influence of hormonal contraceptives (HC) on the general state of RH; the low level of oral contraception application is attributed by the vast majority of female respondents from the І group to a lack of knowledge about its real possibilities and possible risks, the lack of confidence of gynaecologists during appointments and the negative attitude of doctors of related specialities. Conclusions. It is necessary to change the paradigm of fertility regulation towards safe and effective prevention of unplanned pregnancies in order to create conditions for maintaining the reproductive health of the population in war conditions. The introduction of sex education into the programme of high schools and the strengthening of the role of gynaecologists and family doctors in the educational work with teenagers will make it possible to increase the awareness of young people about the real benefits of contraception.