Medical examinations
Before using MODEL MAM, you should carefully collect the anamnesis and conduct a thorough gynecological examination to exclude pregnancy. Before the appointment of the drug should establish the cause of menstrual irregularities, for example, oligomenorrhoea and amenorrhea. The interval between the control medical examinations is determined by the doctor in each individual case (the frequency of the examinations is less than 1 time in 6 months). If the prescribed drug can affect the latent or existing disease, an appropriate schedule of control medical examinations should be made.
Despite the regular administration of MODEL MAM, occasional spotting may occur.If bleeding is very frequent and irregular, consider using another method of contraception. If the above symptoms are stable, then in this case it is necessary to exclude organic pathology. Tactics in relation to amenorrhea during the application of MODEL MAM depends on whether the drug was taken in accordance with the instructions, and may include a pregnancy test. In case of pregnancy, the drug MODEL MAM should be stopped. With a significant increase in blood pressure or ineffectiveness of antihypertensive therapy with Modell MAM should stop taking the drug.
If a liver function disorder occurs, a woman should consult a specialist for examination and counseling.
Women with a predisposition to chloasma should avoid exposure to sunlight or ultraviolet radiation during the application of MODEL MAM.
Women should be informed that MODEL MAM does not protect against HIV infection and other sexually transmitted diseases.
Decreased efficiency
The effectiveness of gestagen containing oral contraceptives can be reduced if the drug is not taken, gastrointestinal disorders or when taking other medications.
Effects on the menstrual cycle
During the use of gestagen-containing contraceptives in some women, menstrual bleeding may become more frequent or more prolonged, while in others these bleeding may become more rare or even completely stop. These changes are often the reason that a woman refuses this method of contraception or ceases to strictly follow the doctor's instructions. With detailed consultation with women who decided to start taking MODEL MAM, the doctor should discuss the possibility of such changes in the nature of the menstrual cycle. The evaluation of irregular bleeding should be based on a clinical picture and may include an examination to exclude malignant neoplasms or pregnancy.
Development of follicles
With the intake of all low-dose hormonal contraceptives, follicles develop, and occasionally the size of the follicle can reach sizes larger than those in the normal cycle.These enlarged follicles disappear spontaneously, which often occurs without symptoms; only in some cases there is a slight pain in the lower abdomen. Surgical intervention is rarely required.
Lab tests
The data obtained with regard to COCs showed that the use of hormonal contraceptive drugs may affect the results of some laboratory tests, including indicators of liver, thyroid, adrenal and kidney function; the content of transport proteins in the blood plasma, for example, corticosteroid-binding globulin; lipid / lipoprotein fractions, carbohydrate metabolism and blood coagulation and fibrinolysis. Usually these changes remain within the normal range.
Mammary cancer
The risk of breast cancer increases with age. During the use of COC, the risk that a woman will be diagnosed with breast cancer increases slightly and gradually disappears within 10 years after cessation use of oral contraceptives, the risk of nc related duration application, and depends on the age of the woman during the application of COCs. Expected the number of diagnosed cases of breast cancer among 10,000 women who used COCs (within 10 years after discontinuation of their use), relative to women who have never taken medicines of this group for the same period are shown in the table below.
| Age group | Expected number of cases among women using COCs | Expected number of cases among women who did not use COCs |
| 16-19 years old | 4,5 | 4 |
| 20-24 years old | 17,5 | 16 |
| 25-29 years old | 48,7 | 44 |
| 30-34 years old | 110 | 100 |
| 35-39 years | 180 | 160 |
| 40-44 years | 260 | 230 |
The risk for women using oral contraceptive preparations containing only progestogen, for example, the MODEL MAM preparation, is similar to that of COCs.
The risk of breast cancer associated with taking COC is insignificant.
The increased risk of breast cancer in women using COCs may be due to earlier diagnosis, the biological effects of the drug, or a combination of these two factors.
Venous thromboembolism
In epidemiological studies, a link was established between the use of COCs and the increased incidence of venous thromboembolism (deep vein thrombosis and pulmonary embolism).Despite the fact that the clinical significance of these data for desogestrel as a contraceptive drug that does not contain estrogen is unknown, therapy with MODEL MDM should be discontinued in the case of thrombosis. Termination of MODEL MAM therapy should also be considered in the case of prolonged immobilization associated with an operation or disease.
Diabetes
The gestagens can affect peripheral insulin resistance and glucose tolerance, but there is no evidence that there is a need to change the therapeutic regimen in diabetics using gestagen containing oral contraceptives. Nevertheless, patients with diabetes should be carefully monitored during the first months of use of MODEL MAM.
Mineral density of bone tissue
When using the MODEL MAM preparation, the concentration of estradiol in the blood plasma can be reduced to the level corresponding to the early follicular phase.
It is not known whether this reduction has any clinically significant effect on bone mineral density.
Prevention of ectopic pregnancy
Prevention of ectopic pregnancy with gestagen-containing oral contraceptives is not as effective as in the use of COCs, as ovulation often occurs during their use. Despite the fact that the MODEL MAM product effectively inhibits ovulation, in the case of amenorrhea or abdominal pain, differential diagnosis should exclude an ectopic pregnancy.