de Melo Nilson Roberto
Federaçao Brasileira das Sociedades de Ginecologia e Obstetricia (FEBRASGO), Rua Dr Diogo de Faria, 1087 conj.1103/1105, Vila Clementino 04037-003, São Paulo SP, Brazil.
Womens Health (Lond). 2010 Sep;6(5):721-35. doi: 10.2217/whe.10.36.
Although combined oral contraceptives (COCs) are commonly used and highly effective in preventing pregnancy, they may not be suitable for some women. COC use is associated with increased rates of cardiovascular events and is not recommended in nonbreastfeeding women in the immediate postpartum period or in breastfeeding women during the initial 6 months of breastfeeding. Moreover, estrogen-related adverse effects, such as headache, are common. Estrogen-free progestin-only pills (POPs) are a valuable option in women who prefer to take an oral hormonal contraceptive, but are ineligible for, or choose not to use, COCs. Although some POPs have been associated with lower contraceptive effectiveness than COCs, the POP containing desogestrel has shown similar contraceptive effectiveness to COCs. The most commonly reported complaints in women using all POPs are bleeding problems. Counseling women interested in using POPs about the variable bleeding patterns associated with this method may improve compliance and acceptance.
尽管复方口服避孕药（COCs）被广泛使用且在预防妊娠方面非常有效，但它们可能并不适合某些女性。使用COCs与心血管事件发生率增加有关，在产后立即的非哺乳期女性或母乳喂养最初6个月的哺乳期女性中不建议使用。此外，与雌激素相关的不良反应，如头痛，很常见。对于那些希望服用口服激素避孕药但不符合使用COCs条件或选择不使用COCs的女性，不含雌激素的单纯孕激素避孕药（POPs）是一个有价值的选择。尽管一些POPs的避孕效果低于COCs，但含去氧孕烯的POPs已显示出与COCs相似的避孕效果。使用所有POPs的女性中最常报告的抱怨是出血问题。向有兴趣使用POPs的女性咨询与这种方法相关的可变出血模式，可能会提高依从性和接受度。
