40歳以上の女性の避妊に関するコンセンサス会議の結果
Angelo Cagnacci1, Franca Fruzzetti2, Vincenzina Bruni3
1Obstetrics and Gynecology Clinic, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Pediatric Sciences, IRCCS-Policlinic Hospital San Martino, University of Genoa, Genoa, Italy.
まとめ
40歳以上の女性のホルモンによる避妊の選択は 専門家によるコンセンサスで決まっています プロゲスタゲンのみの方法は安全で,天然エストロゲンや低用量エチニルエストラディオールとの組み合わせは心臓血管に有益です.
科学分野:
- 生殖医学
- 婦人科
- 内分泌学
背景:
- 40歳以上の女性のホルモン避妊薬の使用は,心血管疾患のリスク,月経の健康,骨の密度,性機能を慎重に考慮する必要があります.
- 患者の最適なケアをするために これらの複雑な要因を把握するために 専門家の指導が必要です
研究 の 目的:
- 40歳以上の女性のホルモン避妊薬の選択に関する専門家のコンセンサスを確立する.
- 避妊効果と非避妊効果の両方を考慮して,証拠に基づいた勧告を提供すること.
主な方法:
- 2024年10月まで,体系的な文献レビューが行われました.
- 多学科のパネルがコンセンサス声明を策定し,専門家会議と匿名投票で精査した (≥75%の同意).
主要な成果:
- 心血管安全は最重要であり,プロゲスタゲンのみの方法は安全と考えられています. ホルモン避妊薬と天然エストロゲンまたは低用量エチニルエストラディオルの組み合わせは,心臓血管のプロファイルで好ましい.
- レボノルゲストレルIUD,エストラディオールバレレート/ディエノゲスト,そして輪は月経管理に優れている. インプラントや輪は 性機能に良い影響を与えます
- ホルモンの併用避妊薬は骨密度を高め プロゲスタゲンのみの避妊薬は 中性効果を発揮する.
結論:
- このイタリアのコンセンサスは,40歳以上の女性のホルモンの避妊薬の選択のための証拠に基づいたガイドラインを提供します.
- 推薦は避妊手段以外の効果を統合し,更年期前の個別化されたケアを容易にする.
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