Hall & Partners Health, New York, NY, USA.
J Eval Clin Pract. 2011 Jun;17(3):493-502. doi: 10.1111/j.1365-2753.2010.01465.x. Epub 2010 Jun 10.
RATIONALE, AIMS AND OBJECTIVES: Many women are prescribed oestrogen-containing contraceptives for whom oestrogen-containing methods may be less suitable.
Two surveys examining contraceptive prescription practices among doctors (n = 419) and attitudes towards contraception among women (n = 1623) in France, Germany, Spain, Italy and Russia were evaluated.
Progestin-only pills and hormone-free intrauterine devices were the most commonly prescribed contraceptives for women with medical conditions for which oestrogen-containing methods are not preferred (40% and 20%, respectively), those suffering from oestrogen-related side effects (32% and 21%) and those with concerns about the safety of oestrogen-containing methods (28% and 24%). Combined oral contraceptives (COC) were prescribed to ≥ 10% in these two groups. One-quarter of contraceptive users had asked to be switched from one COC to another because of oestrogen-related side effects; a similar proportion had been switched by their doctor for this reason. Half of the women surveyed did not want or had concerns about foreign/additional oestrogen, and about 80% said that they would consider switching to a different hormonal contraceptive to minimize oestrogen exposure. Although most doctors were aware of the World Health Organization medical eligibility criteria for contraceptive use, they still prescribed COCs or other oestrogen-containing contraceptives to women with medical conditions for which oestrogen-containing options are not favoured, suggesting a need for additional education.
By complying with guidelines and heeding women's concerns, doctors can individualize their contraceptive recommendation to improve safety, acceptance and compliance and, ultimately, reduce the risk of an unintended pregnancy.
背景、目的和目标：许多妇女被开具含雌激素的避孕药，而这些方法可能并不适合她们。
评估了在法国、德国、西班牙、意大利和俄罗斯进行的两项调查，一项调查了医生开具避孕药的做法（n=419），另一项调查了女性对避孕的态度（n=1623）。
对于患有不适合使用含雌激素方法的疾病（分别为 40%和 20%）、有雌激素相关副作用（分别为 32%和 21%）或对含雌激素方法的安全性有顾虑（分别为 28%和 24%）的妇女，最常开具的避孕药是单纯孕激素避孕药和不含激素的宫内节育器。在这两组人群中，有≥10%的人被开具复方口服避孕药（COC）。四分之一的避孕药使用者因雌激素相关副作用而要求更换另一种 COC；出于同样的原因，也有类似比例的人被医生更换。一半接受调查的女性表示不希望或担心雌激素的额外添加，约 80%的人表示会考虑改用另一种激素避孕药，以尽量减少雌激素暴露。尽管大多数医生都了解世界卫生组织关于避孕的医学资格标准，但他们仍会给患有不适合使用含雌激素方法的疾病的妇女开具 COC 或其他含雌激素的避孕药，这表明需要进一步教育。
通过遵守指南和关注女性的担忧，医生可以根据个人情况为其推荐避孕药，以提高安全性、接受度和依从性，最终降低意外怀孕的风险。
