Chabbert-Buffet Nathalie, Jamin Christian, Lete Iñaki, Lobo Paloma, Nappi Rossella E, Pintiaux Axelle, Häusler Günther, Fiala Christian
a Department of Obstetrics and Gynaecology , APHP Tenon Hospital, Pierre and Marie Curie University , Paris , France.
b Independent Researcher , Paris , France.
Eur J Contracept Reprod Health Care. 2017 Jun;22(3):165-169. doi: 10.1080/13625187.2017.1295437. Epub 2017 Mar 9.
Oral hormonal contraception is an effective contraceptive method as long as regular daily intake is maintained. However, a daily routine is a constraint for many women and can lead to missed pills, pill discontinuation and/or unintended pregnancy. This article describes the frequency of inconsistent use, the consequences, the risk factors and the possible solutions.
The article comprises a narrative review of the literature.
Forgetting one to three pills per cycle is a frequent problem among 15-51% of users, generally adolescents. The reasons for this are age, inability to establish a routine, pill unavailability, side effects, loss of motivation and lack of involvement in the initial decision to use oral contraceptives. The consequences are 'escape ovulations' and, possibly, unintended pregnancy. Solutions are either to use a long-acting method or, for women who prefer to take oral contraceptives, use a continuous or long-cycle regimen to reduce the risks of follicular development and thus the likelihood of ovulation and unintended pregnancy. A progestogen with a long half-life can increase ovarian suppression.
For women deciding to use oral contraceptives, a shortened or eliminated hormone-free interval and a progestogen with a long half-life may be an option to reduce the negative consequences of missed oral contraceptive pills.
只要保持每日规律服用，口服激素避孕法就是一种有效的避孕方法。然而，每日服药的规律对许多女性来说是一种限制，可能导致漏服、停药和/或意外怀孕。本文描述了不规律用药的频率、后果、风险因素及可能的解决办法。
本文是一篇文献综述。
每个周期漏服1至3片药是15%至51%的使用者（通常为青少年）中常见的问题。原因包括年龄、无法养成规律、药物无法获取、副作用、动力丧失以及对最初使用口服避孕药的决定缺乏参与感。后果是“突破性排卵”，并可能导致意外怀孕。解决办法要么是采用长效方法，要么对于更喜欢服用口服避孕药的女性，采用连续或长周期服药方案，以降低卵泡发育的风险，从而减少排卵和意外怀孕的可能性。半衰期长的孕激素可增强对卵巢的抑制作用。
对于决定使用口服避孕药的女性，缩短或消除无激素间隔期以及使用半衰期长的孕激素可能是减少漏服口服避孕药负面影响的一种选择。
