[避孕药和偏头痛] 这是一个很大的问题.
Lorraine Maitrot-Mantelet1, Geneviève Plu-Bureau2
1Service de gynécologie médicale, hôpital Cochin Port-Royal, Paris, France.
La Revue du praticien
|June 23, 2025
概括
患有偏头痛的女性应与医生讨论避孕选择. 如果没有动脉风险因素,组合激素避孕药 (CHC) 可能适用于没有光环的偏头痛.
科学领域:
- 产科和妇科 产科和妇科
- 神经学 神经学
背景情况:
- 偏头痛是一种常见的神经疾病,影响许多生育年龄的女性.
- 荷尔蒙避孕药,特别是联合荷尔蒙避孕药 (CHC),存在潜在风险,在偏头痛妇女中需要仔细考虑.
研究的目的:
- 在处方或更新组合激素避孕药 (CHC) 之前,概述了偏头痛和动脉风险因素的基本查程序.
- 为患有偏头痛的妇女提供有关适当避孕选择的指导,考虑到光环和动脉风险因素的存在或缺乏.
主要方法:
- 审查当前的临床指南和关于偏头痛妇女避孕的证据.
- 风险评估与偏头痛状态 (有或没有光环) 结合的动脉因素.
主要成果:
- 在没有动脉风险因素的情况下,可以为没有光环的偏头痛的女性开处方CHC,前提是没有动脉风险因素.
- 对于患有带有光环的偏头痛或没有光环的偏头痛的妇女来说,如果存在动脉风险因素,CHC是禁忌的. 建议仅使用孕激素或非荷尔蒙方法.
- 对于在使用荷尔蒙避孕药时经历令人烦的月经偏头痛的女性,应考虑持续使用或缩短无激素间隔.
结论:
- 在启动或继续慢性心脏病之前,对偏头痛和动脉风险因素的彻底查至关重要.
- 偏头痛妇女的避孕管理需要个性化评估,以平衡有效性和安全性,必要时优先考虑非动脉风险的方法.
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