避妊 の 選択,有効 性,有害 な 影響: レビュー
Stephanie Teal1, Alison Edelman2
1Department of OB/GYN, University Hospitals Medical Center and Case Western Reserve University, Cleveland, Ohio.
JAMA
|December 28, 2021
まとめ
正しい避妊法を選ぶには 効果とリスクのバランスをとる必要があります 長期作用の逆転性避妊薬は最も有効であり,口服避妊薬は依然として人気がありますが,リスクは高まります.
科学分野:
- 生殖 健康
- 避妊方法について
- 女性 の 健康
背景:
- アメリカでは約87%の女性が 生涯にわたって避妊を行っています
- 口服避妊薬は最も一般的な可逆方法 (使用者の21. 9%).
- 長期作用の可逆避妊薬 (LARC) の使用率は6% (2008年) から17.8% (2016年) に増加した.
研究 の 目的:
- 避妊方法,その有効性,リスク,利益について検討する.
- 患者中心の避妊薬の選択の重要性を強調するためです
主な方法:
- 薬物/器具の有効性,受精能力,性交の頻度,遵守,継続に基づく避妊薬の有効性のレビュー
- 異なる避妊薬のカテゴリーに関連する妊娠率とリスクの比較
- ホルモン避妊薬の非避妊効果とリスクの分析
主要な成果:
- 口服避妊薬の年間妊娠率は4%から7%です.
- LARC (子宮内器具,皮下インプラント) の年間失敗率は<1%です.
- エストロゲンを含む方法は静脈栓塞のリスクを高め,プロゲスチンのみおよび非ホルモン療法ではリスクが低い.
結論:
- LARCは最も有効な避妊手段です
- 口服避妊薬は広く使用されていますが,LARCよりも効果が低く,リスクが高くなります.
- 最適な避妊手段の選択には 患者と臨床医の共同意思決定が必要で 個人の価値観や好みを考慮する必要があります
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