荷尔蒙避孕,过去,现在和未来的第二部分:优化联合口服避孕药,降低健康女性的风险
Manuela Farris1, Carlo Bastianelli2, Marwan Habiba3
1Obstetrics and Gynaecology, Unicamillus. Saint Camillus International University of Health and Medicine, Rome, Italy.
Expert review of clinical pharmacology
|June 10, 2025
概括
由于临床限制,口服避孕药从天然孕激素演变为合成孕激素和雌激素. 研究继续平衡有效性和安全性,考虑组合口服避孕药 (COC) 的各种孕激素特性.
科学领域:
- 生殖内分泌学 生殖内分泌学
- 荷尔蒙避孕药物的药理学
背景情况:
- 最初的荷尔蒙避孕研究集中在孕激素上,但其口服可用性较差和副作用需要合成孕激素.
- 联合口服避孕药 (COC) 与雌激素 (乙inyl estradiol) 为周期控制而开发,但早期人们对血栓塞栓症的担忧出现了.
- 对于较新的孕激素,已经报告了不良事件,这促使与已经确立的选择 (如levonorgestrel) 进行比较.
研究的目的:
- 审查组合口服避孕药 (COC) 的历史发展和药理方面的考虑.
- 讨论COC配方中的孕激素和雌激素成分的演变.
- 为了突出比较不同COC制剂所面临的挑战,由于孕激素活性配置不同.
主要方法:
- 关于荷尔蒙避孕药的历史研究和临床使用的文献综述.
- 分析不同孕激素和雌激素的药理性质.
- 检查各种COC配方报告的不良事件和风险-益处概况.
主要成果:
- 从天然孕激素转变为口服活性的孕激素,并添加乙雌激醇 (EE),标志着在避孕方面取得了重大进展.
- 由于对EE诱导的血栓塞栓症的担忧,导致COC中的EE含量减少.
- 不同的孕激素表现出独特的雄激素,抗雄激素,抗雌激素和矿物质皮质激素活性,影响它们的风险-益处概况.
结论:
- 碳化合物的开发涉及克服天然化合物的挑战,从而获得了更高效率和循环控制的合成替代品.
- 目前正在进行的研究和配方变化旨在最大限度地减少副作用,特别是与雌激素成分相关的血栓栓塞.
- 孕激素的各种药理特征需要在选择COC配方以满足个体患者需求时仔细考虑.
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