Merki-Feld G S
Department für Frauenheilkunde, UniversitätsSpital Zürich.
Ther Umsch. 2000 Oct;57(10):613-6. doi: 10.1024/0040-5930.57.10.613.
Perimenopausal women are still potentially fertile and pregnancy is attended with increased maternal and perinatal mortality. Several contraceptive methods can be used therapeutic for the treatment of climacteric symptoms like menstrual irregularities, flushes and vaginal dryness. Low-dose oral contraceptives (OC) prevent climacteric symptoms and additionally protect from perimenopausal bone loss. However, the individual cardiovascular risk increases with age and is even higher in perimenopausal women using OCs. Therefore for women with cardiovascular risk factors sterilization, barrier methods, progestin-only methods and intrauterine devices (IUD) are the better choice. Prolonged and heavy menses can be treated with the levonorgestrel-releasing IUD or injectable progestogens. If estrogen replacement is necessary, a low-dose treatment with natural estrogens can be combined with barrier methods, the levonorgestrel-releasing IUD and injectable progestogens. The variety of contraceptive options available to perimenopausal women allows individual counseling and thus may enhance compliance.
围绝经期女性仍有潜在的生育能力，怀孕会增加孕产妇和围产期死亡率。有几种避孕方法可用于治疗更年期症状，如月经不调、潮热和阴道干燥。低剂量口服避孕药（OC）可预防更年期症状，并额外预防围绝经期骨质流失。然而，个体心血管风险会随着年龄增长而增加，在使用OC的围绝经期女性中甚至更高。因此，对于有心血管危险因素的女性，绝育、屏障法、仅含孕激素的方法和宫内节育器（IUD）是更好的选择。月经过多或经期延长可用左炔诺孕酮宫内节育器或注射用孕激素治疗。如果需要进行雌激素替代治疗，低剂量天然雌激素治疗可与屏障法、左炔诺孕酮宫内节育器和注射用孕激素联合使用。围绝经期女性可选择的避孕方法多种多样，这使得个性化咨询成为可能，从而可能提高依从性。
