Center for Research in Reproductive Health (CEMICAMP), São Paulo, Brazil.
Center for Research in Reproductive Health (CEMICAMP), São Paulo, Brazil ; Prof Dr José Aristodemo Pinotti Women's Hospital, University of Campinas, São Paulo, Brazil.
Int J Womens Health. 2013 Nov 27;5:795-801. doi: 10.2147/IJWH.S52086. eCollection 2013.
The purpose of this study was to assess the attitudes and prescribing practices of Brazilian obstetricians and gynecologists regarding use of contraceptive methods to interfere with menstruation and/or induce amenorrhea.
We undertook a nationwide survey of Brazilian obstetricians and gynecologists selected using a computer-generated randomization system. Participants completed a questionnaire on prescription of contraceptives and extended/continuous regimens of combined oral contraceptives (COCs).
In total, 79.2% of Brazilian obstetricians and gynecologists reported that 20%-40% of their patients consulted them for menstrual-related complaints and 26%-34% of the gynecologists reported that 21%-40% of their patients consulted them for reduction in the intensity, frequency, and/or duration of menstrual bleeding. Overall, 93% stated that medically induced amenorrhea represents no risk to women's health and 82.5% said that they prescribed contraceptives to control menstruation or induce amenorrhea. The contraceptives most commonly prescribed were extended-cycle 24/4 or 26/2 COC regimens and the levonorgestrel-releasing intrauterine system. Poisson regression analysis showed that Brazilian obstetricians and gynecologists prescribing contraceptives to control menstruation or induce amenorrhea consider extended-use or continuous-use COC regimens to be effective for both indications (prevalence ratio 1.23 [95% confidence interval 1.09-1.40] and prevalence ratio 1.28 [95% confidence interval 1.13-1.46], respectively). They also prescribed COCs with an interval of 24/4 or 26/2 to control bleeding patterns (prevalence ratio 1.10 [95% confidence interval 1.01-1.21]).
Brazilian obstetricians and gynecologists were favorably disposed toward prescribing extended-use or continuous-use COC regimens for control of menstrual bleeding or to induce amenorrhea on patient demand.
本研究旨在评估巴西妇产科医生对使用避孕方法干扰月经和/或诱导闭经的态度和处方实践。
我们对巴西妇产科医生进行了一项全国性调查，通过计算机生成的随机系统选择参与者。参与者填写了一份关于避孕药具处方和复方口服避孕药（COC）延长/连续方案的问卷。
共有 79.2%的巴西妇产科医生报告说，他们有 20%-40%的患者因月经相关问题咨询他们，26%-34%的妇科医生报告说，他们有 21%-40%的患者因减少月经出血的强度、频率和/或持续时间咨询他们。总体而言，93%的人表示医源性闭经对女性健康没有风险，82.5%的人表示他们开避孕药具是为了控制月经或诱导闭经。最常开的避孕药具是延长周期 24/4 或 26/2 COC 方案和左炔诺孕酮释放宫内节育系统。泊松回归分析显示，开避孕药具控制月经或诱导闭经的巴西妇产科医生认为延长使用或连续使用 COC 方案对这两种适应症都有效（流行率比 1.23[95%置信区间 1.09-1.40]和流行率比 1.28[95%置信区间 1.13-1.46]）。他们还开了间隔为 24/4 或 26/2 的 COC 来控制出血模式（流行率比 1.10[95%置信区间 1.01-1.21]）。
巴西妇产科医生倾向于开延长使用或连续使用 COC 方案来控制月经出血或根据患者需求诱导闭经。
