Wagatsuma T
Department of International Cooperation, National Medical Center Hospital, Tokyo.
Nihon Sanka Fujinka Gakkai Zasshi. 1988 Aug;40(8):1067-72.
In Japan, most couples use traditional methods, with about 80% relying on the condom and a further significant proportion on the rhythm method. In fact a combination of both methods is common among married couples. The oral contraceptives have the following advantages: Reversibility, simple and easy to use, coitally independent, no skill or knowledge required for its use, high acceptability, no pain or discomfort at use, self-administration, while they have the following disadvantages: Inadequate during lactation, sustained motivation in the female side required, clinical contraindication exists, possible side-effects such as nausea, vomiting, breast tenderness, weight gain, questionable possibility of serious side effects such as hypertension, thromboembolic diseases etc., medical supervision and follow up required, expensive cost. The use of the steroidal preparations for contraceptive purpose in Japan awaits official approval. Under present regulations, it is not illegal for the physicians to prescribe the pill, and currently six preparations are available and all contain 50 microgram of estrogen. The reduction in the estrogen and progestogen content of the pill did not appreciably compromise contraceptive potential while untoward effects were considerably lowered. The development and use of the new progestogen also contributed to minimize the possible side effects. Efforts are now being directed at a pill which minimizes metabolic change, decreases the incidence of breakthrough bleeding or spotting, without compromising efficacy. It is with these goals in mind that the multi-phasic pills have been developed in the belief that many of the undesirable side-effects can be circumvented while maintaining almost 100% conception control.(ABSTRACT TRUNCATED AT 250 WORDS)
在日本,大多数夫妻采用传统方法,约80%依靠避孕套,另有相当比例的人采用安全期避孕法。实际上,两种方法结合使用在已婚夫妇中很常见。口服避孕药有以下优点:可逆性、使用简单方便、与性交无关、使用时无需技巧或知识、接受度高、使用时无疼痛或不适、可自行用药;而其缺点如下:哺乳期效果不佳、女性一方需要持续的意愿、存在临床禁忌证、可能有恶心、呕吐、乳房胀痛、体重增加等副作用、有患高血压、血栓栓塞性疾病等严重副作用的可疑可能性、需要医疗监督和随访、费用昂贵。在日本,将甾体类制剂用于避孕目的尚待官方批准。根据现行规定,医生开避孕药并不违法,目前有六种制剂可供使用,均含50微克雌激素。避孕药中雌激素和孕激素含量的降低并未明显损害避孕效果,同时不良反应大幅减少。新型孕激素的研发和使用也有助于将可能的副作用降至最低。目前正在致力于研发一种能将代谢变化降至最低、减少突破性出血或点滴出血发生率且不影响避孕效果的避孕药。正是出于这些目标,才研发出多相避孕药,相信在保持几乎100%避孕效果的同时,许多不良副作用是可以避免的。(摘要截选至250词)