选择避孕药,有效性和不良影响:一篇综述
Stephanie Teal1, Alison Edelman2
1Department of OB/GYN, University Hospitals Medical Center and Case Western Reserve University, Cleveland, Ohio.
JAMA
|December 28, 2021
概括
选择正确的避孕方法需要平衡有效性和风险. 长效可逆避孕药效果最高,而口服避孕药仍然很受欢迎,但风险更高.
科学领域:
- 生殖健康
- 避孕措施
- 女性健康
背景情况:
- 约有87%的美国女性在一生中使用避孕措施.
- 口服避孕药是最常见的可逆方法 (21.9%的使用者).
- 长效可逆避孕药 (LARC) 的使用量从2008年的6%增加到2016年的17. 8%.
研究的目的:
- 审查避孕方法及其有效性,风险和益处.
- 强调以患者为中心的避孕选择的重要性.
主要方法:
- 基于药物/设备的疗效,生育能力,性交频率,坚持和延续的避孕疗法的有效性审查.
- 与不同类别的避孕药相关的怀孕率和风险的比较.
- 对荷尔蒙避孕药的非避孕益处和风险的分析.
主要成果:
- 口服避孕药每年有4%-7%的怀孕率.
- 每年LARC (子宫内器械,皮下植入物) 的失效率低于1%.
- 含有雌激素的方法增加了静脉血栓形成的风险;仅用孕激素和非激素的方法的风险较低.
结论:
- 这些药物具有最高的避孕效果.
- 口服避孕药是广泛使用的,但效果较差,风险比LARC更高.
- 最佳的避孕选择需要患者和临床医生共同做出决定,考虑个人价值观和偏好.
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