Contraception as a factor for preserving women’s reproductive health during war

During war women’s reproductive health (RH) becomes one of the most vulnerable links: “rejuvenation” of a number of precancerous and tumor gynecological diseases, an increased number of women with premature ovarian failure, an increased risk of sexually transmitted infections (STIs), and birth control occurs through the interruption of unwanted pregnancies.The objective: to determine the level of awareness of young women about modern hormonal contraceptives (HC) and the prevalence of their use during war.Materials and methods. From November 12, 2023 to March 20, 2024, a voluntary online survey of 311 women aged 14 to 35 years, who are legally considered young people, was conducted using the author’s questionnaire.The questionnaire contained 25 questions in Ukrainian and Hebrew, and was posted on the website of the Department of Obstetrics and Gynecology of the Luhansk State Medical University and on the social network Instagram. The participants of the study were divided into two groups by citizenship and country of residence: I group was formed by 190 citizens of Ukraine, II group – by 121 citizens of Israel.Results. The greatest interest in the survey was shown by respondents aged 18 to 27 years. Among young women, those with higher education predominated. A third of the respondents reported their sexual debut in adolescence. Also, a third of the respondents had unprotected first sexual intercourse. Every fourth respondent in the I group and every fifth respondent in the II group at the time of the first sexual intercourse had no idea about the available methods of preventing unplanned pregnancy and STIs.The most popular methods of preventing unwanted pregnancy among respondents in the I group is the male condom (37.9%), only 15.8% of the surveyed women used HC, some persons preferred spermicides (8.9%) and interrupted sexual intercourse (13.7%); the results of the survey of respondents in the II group after analysis: 10.6%, 67.8%, 1.7%, 9.9%, respectively. In the I group 24.2% of the surveyed women and 8.3% in the II group still experience difficulties in obtaining information about the impact of HC on the general state of reproductive health.The low level of use of combined oral contraception by the vast majority of respondents in the I group is associated with a lack of knowledge about its real possibilities and possible risks, lack of confidence of gynecologists during medical visits and their high price.Conclusions. The survey results prove that today there are real difficulties in obtaining sexual knowledge by young people: the vast majority of young women name exclusively social networks as their main source of information; only every second respondent considers that she has complete knowledge about modern contraceptives – manifestly unreasonable; the insignificant role of gynecologists, family medicine doctors, and families in the sexual education of young people.In order to ensure the prerequisites for preserving the nation’s reproductive health in war conditions, the paradigm of birth control should be changed towards safe and effective prevention of unplanned pregnancy. Increasing young people’s awareness of the real benefits of contraception is possible through the introduction of sexuality education and training into the educational programs of secondary education institutions, increasing the role of gynecologists and family doctors in educational work with adolescents.