Tolaymat Lama L, Kaunitz Andrew M
Department of Obstetrics and Gynecology, University of Florida College of Medicine, Jacksonville, Florida 32207, USA.
Curr Opin Obstet Gynecol. 2007 Oct;19(5):453-60. doi: 10.1097/GCO.0b013e3282ef1cd2.
To help clinicians guide adolescent patients to sound choices regarding long-acting contraceptives. The safety, side effects and non-contraceptive benefits of injectable, implantable and intrauterine contraception are detailed.
The use of depot medroxyprogesterone acetate contraceptive injections has been associated with declines in teenage pregnancies in the United States. Although the US Food and Drug Administration has placed a black box warning concerning skeletal health and depot medroxyprogesterone acetate, data in adolescents confirm that declines in bone mineral density with depot medroxyprogesterone acetate are fully reversible. Concerns regarding skeletal health should not restrict the initiation or continuation of depot medroxyprogesterone acetate in adolescents. A highly effective, convenient, and easy to insert/remove single rod progestin-only contraceptive implant (Implanon) is now available in the United States. Although not widely used in adolescents, intrauterine devices offer selected adolescents convenient, highly effective, safe birth control. Use of the progestin-releasing intrauterine device (Mirena) is also associated with important non-contraceptive benefits.
The efficacy and convenience associated with long-acting contraceptives make them indispensable for adolescent patients. This review will help clinicians guide teenage patients towards sound contraceptive choices and the successful long-term use of injectable, implantable and intrauterine methods of birth control.
帮助临床医生指导青少年患者就长效避孕措施做出明智选择。详细介绍了注射用、植入式和宫内避孕方法的安全性、副作用及非避孕益处。
在美国，使用醋酸甲羟孕酮避孕针与青少年怀孕率下降有关。尽管美国食品药品监督管理局已针对骨骼健康问题对醋酸甲羟孕酮发出黑框警告，但青少年的数据证实，使用醋酸甲羟孕酮导致的骨密度下降是完全可逆的。对骨骼健康的担忧不应限制青少年开始或继续使用醋酸甲羟孕酮。一种高效、便捷且易于插入/取出的单棒式仅含孕激素的避孕植入物（依伴侬）现已在美国上市。宫内节育器虽未在青少年中广泛使用，但为部分青少年提供了方便、高效、安全的避孕方式。使用释放孕激素的宫内节育器（曼月乐）还具有重要的非避孕益处。
长效避孕措施的有效性和便捷性使其对青少年患者不可或缺。本综述将帮助临床医生指导青少年患者做出明智的避孕选择，并成功长期使用注射、植入及宫内节育等避孕方法。
