Kirkham Yolanda A, Ornstein Melanie P, Aggarwal Anjali, McQuillan Sarah
Toronto, ON.
Calgary, AB.
J Obstet Gynaecol Can. 2019 Feb;41(2):e7-e17. doi: 10.1016/j.jogc.2018.11.030.
To provide a Canadian consensus document for health care providers with recommendations for menstrual suppression in patients with physical and/or cognitive challenges or those who are undergoing cancer treatment in whom menstruation may have a deleterious effect on their health.
This document reviews the options available for menstrual suppression, its specific indications, contraindications, and side effects, both immediate and long-term, and the investigations and monitoring necessary throughout suppression.
Clinicians will be better informed about the options and indications for menstrual suppression in patients with cognitive and/or physical disabilities and patients undergoing chemotherapy, radiation, or other treatments for cancer.
Published literature was retrieved through searches of Medline, EMBASE, OVID, and the Cochrane Library using appropriate controlled vocabulary and key words (heavy menstrual bleeding, menstrual suppression, chemotherapy/radiation, cognitive disability, physical disability, learning disability). Results were restricted to systematic reviews, randomized controlled trials, observation studies, and pilot studies. There were no language or date restrictions. Searches were updated on a regular basis and new material was incorporated into the guideline until September 2013. Grey (unpublished) literature was identified through searching websites of health technology assessment and health technology-related agencies, clinical practice guideline collections, clinical trial registries, and national and international medical specialty societies.
The quality of evidence was rated using the criteria described in the Report of the Canadian Task Force on Preventive Health Care (Table 1).
BENEFITS, HARMS, AND COSTS: There is a need for specific guidelines on menstrual suppression in at-risk populations for health care providers.
为医疗保健提供者提供一份加拿大共识文件，针对身体和/或认知有障碍的患者或正在接受癌症治疗且月经可能对其健康产生有害影响的患者，给出月经抑制的建议。
本文回顾了可用于月经抑制的方法、其具体适应症、禁忌症以及即时和长期的副作用，以及在整个抑制过程中所需的检查和监测。
临床医生将更好地了解认知和/或身体残疾患者以及接受化疗、放疗或其他癌症治疗的患者进行月经抑制的方法和适应症。
通过使用适当的控制词汇和关键词（月经过多、月经抑制、化疗/放疗、认知残疾、身体残疾、学习障碍）在Medline、EMBASE、OVID和Cochrane图书馆中进行检索，获取已发表的文献。结果仅限于系统评价、随机对照试验、观察性研究和试点研究。没有语言或日期限制。检索定期更新，新材料纳入指南直至2013年9月。通过搜索卫生技术评估和与卫生技术相关机构的网站、临床实践指南汇编、临床试验注册库以及国家和国际医学专业协会，识别灰色（未发表）文献。
使用加拿大预防性医疗保健工作组报告中描述的标准对证据质量进行评级（表1）。
益处、危害和成本：医疗保健提供者需要针对高危人群月经抑制的具体指南。
