Postgraduate Program in Epidemiology, Federal University of Pelotas, RS, Brazil.
Postgraduate Program in Epidemiology, Federal University of Pelotas, RS, Brazil.
Sex Reprod Healthc. 2021 Feb;27:100587. doi: 10.1016/j.srhc.2020.100587. Epub 2020 Dec 27.
Combined hormonal contraceptives (CHC), containing estrogen, remain the most popular choice of contraceptive among women. While the method offers many benefits, the use of CHC involves potential health risks. The aim of this study was to analyze the available evidence on the prevalence of CHC use among women with contraindications to their use according to the WHO recommendations (2015).
Pubmed, Lilacs, and Web of Sciences databases were searched. Selection was based on articles that described the use of combined hormonal contraceptives according to the characteristics that are listed as contraindications in WHO medical eligibility criteria for contraceptive use.
A total of 4363 articles were identified and 18 articles were selected for the review. The most prevalent contraindications against use of CHC were systemic arterial hypertension, migraine, and smoking (in women aged 35 years or older). Prevalence rates of contraindications against use of CHC ranged from 5.9% to 41.9%.
A high proportion of women still use CHC when contraindicated to do so according to the WHO criteria. Health policies should focus on highlighting the importance of a detailed health evaluation on CHC candidates, to reduce the proportion of inappropriate prescriptions.
含雌激素的复方激素避孕药（CHC）仍然是女性最受欢迎的避孕选择。虽然该方法有许多益处，但使用 CHC 涉及潜在的健康风险。本研究旨在分析根据世界卫生组织（2015 年）建议的禁忌症，对符合 CHC 使用禁忌证的女性使用 CHC 的现有证据进行分析。
在 Pubmed、Lilacs 和 Web of Sciences 数据库中进行了检索。选择的标准是描述了根据世卫组织避孕医学资格标准中列出的禁忌症使用复方激素避孕药的特征的文章。
共确定了 4363 篇文章，并选择了 18 篇文章进行综述。最常见的 CHC 使用禁忌症是系统性动脉高血压、偏头痛和吸烟（35 岁及以上的女性）。使用 CHC 的禁忌症的流行率范围为 5.9%至 41.9%。
根据世卫组织的标准，仍有相当一部分女性在禁忌使用 CHC 的情况下使用 CHC。卫生政策应侧重于强调对 CHC 候选者进行详细健康评估的重要性，以降低不适当处方的比例。
