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口服激素避孕药的非避孕益处。

Non-contraceptive benefits of oral hormonal contraceptives.

作者信息

Schindler Adolf E

机构信息

Institute for Medical Research and Education, Essen, Germany.

出版信息

Int J Endocrinol Metab. 2013 Winter;11(1):41-7. doi: 10.5812/ijem.4158. Epub 2012 Dec 21.

Abstract

It is becoming evident that oral hormonal contraceptives-besides being well established contraceptives-seem to become important medications for many functional or organic disturbances. So far, clinical effectiveness has been shown for treatment as well as prevention of menstrual bleeding disorders and menstrual-related pain symptoms. Also this is true for premenstrual syndrome (PMS) and premenstrual disphoric disorder (PMDD). Particular oral contraceptives (OCs) containing anti-androgenic progestogens were shown to be effective medications for treatment of androgenisation symptoms (seborrhea, acne, hirsutism, alopecia). Through perfect suppression of the hypothalamic-pituitary-ovarian axis OCs have proven to be effective in elimination of persistent follicular cysts. Endometriosis/adenomyosis related pain symptoms are well handled similar to other drugs like Gonadotropine Releasing Hormone agonists but are less expensive, with less side effects, and possibility to be used for longer periods of time. This is also true for myoma. Pelvic inflammatory disease, rheumatoid arthritis, menstrual migraine, and onset of multiple sclerosis are prevented or delayed. Bone density is preserved and asthma symptoms improved. Endometrial hyperplasia and benign breast disease can be controlled. There is definitely a significant impact on risk reduction regarding endometrial, ovarian, and colon cancers. In conclusion, it needs to be recognized that oral combined hormonal contraceptives (estrogen/ progestogen combination) are - besides being reliable forms of contraception - are cost-effective medications for many medical disorders in women. Therefore, these contraceptives drugs are important for female and global health and should be used in clinical practice.

摘要

越来越明显的是,口服激素避孕药——除了是成熟的避孕药物外——似乎正成为治疗许多功能性或器质性疾病的重要药物。到目前为止,已显示出其在治疗和预防月经出血紊乱及与月经相关的疼痛症状方面的临床有效性。对于经前综合征(PMS)和经前烦躁障碍(PMDD)也是如此。含有抗雄激素孕激素的特定口服避孕药(OCs)已被证明是治疗雄激素化症状(脂溢性皮炎、痤疮、多毛症、脱发)的有效药物。通过完美抑制下丘脑 - 垂体 - 卵巢轴,OCs已被证明可有效消除持续性卵泡囊肿。与促性腺激素释放激素激动剂等其他药物类似,子宫内膜异位症/子宫腺肌病相关的疼痛症状能得到很好的控制,但成本更低,副作用更少,且可长期使用。子宫肌瘤也是如此。盆腔炎、类风湿性关节炎、月经性偏头痛和多发性硬化症的发病可得到预防或延迟。骨密度得以保持,哮喘症状得到改善。子宫内膜增生和良性乳腺疾病可得到控制。对降低子宫内膜癌、卵巢癌和结肠癌的风险肯定有显著影响。总之,需要认识到口服复方激素避孕药(雌激素/孕激素组合)——除了是可靠的避孕方式外——是治疗女性多种医学疾病的经济有效的药物。因此,这些避孕药物对女性健康和全球健康都很重要,应在临床实践中使用。

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