Combined oral contraceptives: update recommendations of the Latin American contraceptive association

被引:1
作者
Palacios, Santiago [1 ]
Ayala, Gabriela [2 ]
Gonzalez, Gemarilis [3 ]
Badilla-Apuy, Can L. [4 ]
Marchena, Jeannette [5 ]
Martinez, Katia [6 ]
Mostajo, Desiree [7 ]
Vernaza, Maria S. [8 ]
Paradas, Alejandro [9 ]
Hernandez, Luis [10 ]
Vasquez-Awad, David [11 ]
Celis-Gonzalez, Cuauhtemoc [12 ]
de Melo, Nilson Roberto [13 ]
机构
[1] Clin Palacios Salud Mujer, Ginecol & Obstet Dept, Calle Antonio Acuna 9, Madrid, Spain
[2] Hosp Metropolitano, Ginecol & Obstet Dept, Quito, Afghanistan
[3] Consultorio Amer, Ginecol & Obstet Dept, Ciudad De Panama, Panama
[4] Oncogine Serv Med SA, Ginecol & Obstet Dept, San Jose, Costa Rica
[5] Coordinadora Unidad Med Reprod Clin AUNA & Clin D, Ginecol & Obstet Dept, Lima, Peru
[6] Hlth Serv Med Ctr, Ctr Obstet & Ginecol, Santo Domingo, Dominican Rep
[7] Jefe Med Ctr Med PERINAT, Santa Cruz, Bolivia
[8] Clin IMBANACO, Ginecol & Obstet Dept, Laparoscopia Ginecol, Cali, Colombia
[9] Hosp Univ Matern La Altagracia, Obstet & Gynecol Dept, Santo Domingo, Dominican Rep
[10] Hosp Herrera Llerandi, Dept Ginecol & Obstet, Ciudad De Guatemala, Guatemala
[11] Acad Nacl Med, Ginecol & Obstet Dept, Bogota, Colombia
[12] Federac Mexicana Colegios Obstet & Ginecol, Ciudad De Mexico, Mexico
[13] Univ Sao Paulo, Fac Med, Sao Paulo, Brazil
关键词
Combined oral contraception; hormonal; estrogens; progestogens; benefits; risks; individualization; HORMONAL CONTRACEPTIVES; VENOUS THROMBOEMBOLISM; PHARMACOLOGY; RISK; DROSPIRENONE; 17-BETA-ESTRADIOL; ETHINYLESTRADIOL; PHARMACODYNAMICS; PHARMACOKINETICS; TOLERABILITY;
D O I
10.1080/09513590.2023.2271072
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: In recent years, new combined oral contraceptives (COCs) have become available, representing an advance in terms of individualization and compliance by users.Objective: To provide recommendations regarding COCs: formulations, use, efficacy, benefits and safety.Method: For these recommendations, we have used the modified Delphi methodology and carried out a systematic review of studies found in the literature and reviews performed in humans, published in English and Spanish in Pubmed, Medline and advanced medicine and computer networks until the year 2021, using the combination of terms: 'oral contraceptives', 'estroprogestins' and 'combined oral contraceptives'.Results: Regarding the estrogen component, initially switching from mestranol (the pro-drug of ethinylestradiol) to ethinylestradiol (EE) and then reducing the EE dose helped reduce side effects and associated adverse events. Natural estradiol and estradiol valerate are already available and represent a valid alternative to EE. The use of more potent 19-nortestosterone-derived progestins, in order to lower the dose and then the appearance of non-androgenic progestins with different endocrine and metabolic characteristics, has made it possible to individualize the prescription of COC according to the profile of each woman.Conclusion: Advances in the provision of new COCs have improved the risk/benefit ratio by increasing benefits and reducing risks. Currently, the challenge is to tailor contraceptives to individual needs in terms of safety, efficacy, and protection of female reproductive health.
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页数:6
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