Martin C, Tanguy M, Aspeele F, Fanello S
Centre d'orthogénie Flora-Tristan, CHU d'Angers, 4, rue Larrey, 49933 Angers cedex 09, France.
J Gynecol Obstet Biol Reprod (Paris). 2010 Dec;39(8):632-6. doi: 10.1016/j.jgyn.2010.09.005. Epub 2010 Oct 20.
While contraceptive methods increased in number, the number of abortions has remained stable. The aim of this study was to estimate the satisfaction of women toward a contraceptive implant (Implanon(®)) available in France in order to clarify prescription.
The survey concerned 127 women who visited Angers and Nantes family planning centres between January2009 and January2010 in two implant prescription contexts (postabortion or not). They agreed to answer a first questionnaire describing the reasons for their choice. A second questionnaire was sent six months after to assess its tolerance.
In our study, 82% of patients were using a contraceptive method prior to implant (68% in postabortion and 88% in the other group). The first reason for choosing the implant was the fear of forgetting - it was more important in the postabortion group (88% vs. 61%). The main side effects were amenorrhea (50%), weight gain (30%) and mood disorders (19%). More than one in two women (54%) was very satisfied by the implant. It should be noted that in one quarter of cases, women seek early withdrawal of the contraceptive implant (23% in postabortion and 21% in the other group), a rate that is 39% in patients under 25years and 47% in patients who reported a mood disorder.
There is a tendency to better tolerance of the implant out of a context of abortion. Furthermore, mood disorders appear to be poorly tolerated. These elements encourage greater caution in prescribing the contraceptive implant in postabortion, situation in which patients have already psychological disorders, and even more among younger patients.
尽管避孕方法的种类有所增加,但堕胎数量却一直保持稳定。本研究的目的是评估法国可用的一种避孕植入剂(依伴侬(®))的女性满意度,以明确其处方情况。
该调查涉及2009年1月至2010年1月期间在两种植入剂处方背景下(堕胎后与否)前往昂热和南特计划生育中心就诊的127名女性。她们同意回答第一份描述其选择原因的问卷。六个月后发送第二份问卷以评估其耐受性。
在我们的研究中,82%的患者在植入前使用了避孕方法(堕胎后组为68%,另一组为88%)。选择植入剂的首要原因是担心忘记服药——这在堕胎后组更为重要(88%对61%)。主要副作用为闭经(50%)、体重增加(30%)和情绪障碍(19%)。超过半数的女性(54%)对植入剂非常满意。应当指出的是,在四分之一的病例中,女性寻求提前取出避孕植入剂(堕胎后组为23%,另一组为21%),25岁以下患者的这一比例为39%,报告有情绪障碍的患者为47%。
在堕胎背景之外,对植入剂的耐受性有改善的趋势。此外,情绪障碍似乎耐受性较差。这些因素促使在堕胎后这种患者已有心理障碍的情况下,尤其是在年轻患者中,更谨慎地开具避孕植入剂的处方。