Division of Family Planning, Department of Obstetrics and Gynecology.
Division of Endocrinology, Gerontology and Metabolism, Department of Medicine, Stanford University Medical Center, Stanford, California, USA.
Curr Opin Obstet Gynecol. 2020 Dec;32(6):399-407. doi: 10.1097/GCO.0000000000000667.
Perimenopause is a time of reduced fertility, and yet unintended pregnancies can occur making comprehensive contraceptive counseling essential for these women. Concern over potential contraceptive risks has unnecessarily limited access and use of certain hormonal methods in this population. This review summarizes the available data on the use and effectiveness of contraceptive options during perimenopause.
All contraceptive options may be appropriate during perimenopause and no method is contraindicated based on age alone. Combined hormonal contraception has the added benefit of relieving perimenopausal symptoms including controlling menstrual irregularities. Progestin-only methods have the advantage of being taken either alone or in combination with estrogen replacement therapy to address both perimenopausal symptoms and contraceptive needs. Nonhormonal options exist for those wishing to avoid hormonal methods.
Extensive contraceptive options are available for perimenopausal women as they transition into menopause. Consideration of patient preference, medical co-morbidities, and perimenopausal symptoms will allow women to use the option that best serves her needs.
围绝经期是生育力降低的时期，但仍可能发生意外怀孕，因此全面的避孕咨询对这些女性至关重要。对潜在避孕风险的担忧不必要地限制了某些激素方法在该人群中的使用。本文综述了围绝经期使用和有效性的现有数据避孕选择。
所有的避孕方法在围绝经期都可能适用，没有一种方法仅因年龄而被禁止。复方激素避孕药还有缓解围绝经期症状的额外益处，包括控制月经不规律。孕激素仅方法的优点是可以单独使用或与雌激素替代疗法联合使用，以解决围绝经期症状和避孕需求。对于那些希望避免激素方法的人，也有非激素选择。
随着女性进入绝经期，有广泛的避孕选择可供围绝经期女性使用。考虑患者的偏好、合并症和围绝经期症状将使女性能够使用最适合她需求的方法。
