关于40岁以上妇女避孕的共识会议结果
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.
概括
专家一致认为40岁以上的女性可以选择荷尔蒙避孕药. 仅使用孕激素的方法是安全的;与天然雌激素或低剂量的乙类雌激素相结合的选择为心血管提供了好处.
科学领域:
- 生殖医学
- 妇科医生
- 内分泌学
背景情况:
- 在40岁以上的女性使用荷尔蒙避孕药需要仔细考虑心血管风险,月经健康,骨密度和性功能.
- 需要专家指导来应对这些复杂因素, 以获得最佳的患者护理.
研究的目的:
- 为40岁及以上女性选择荷尔蒙避孕药建立专家共识.
- 提供基于证据的建议,考虑避孕有效性和非避孕益处.
主要方法:
- 进行了系统的文献审查,直到2024年10月.
- 一个多学科的小组制定了共识声明,通过专家会议和匿名投票 (≥75%的同意) 改进.
主要成果:
- 心血管安全至关重要;仅使用孕激素的方法被认为是安全的. 与天然雌激素或低剂量的乙类雌激素结合的荷尔蒙避孕药是心血管特征的首选.
- 在月经管理方面, 利沃诺格斯特勒 (levonorgestrel) 避孕套, 雌激素瓦莱拉酸/代诺格斯特 (dienogest) 和阴道环非常出色. 植入物和阴道环可能会对性功能产生积极影响.
- 组合激素避孕药支持骨密度,而仅用孕激素的方法具有中性的效果.
结论:
- 这项意大利共识为40岁以上女性选择激素避孕药提供了基于证据的指导.
- 建议包括非避孕效应,以方便个性化的更年期前护理.
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