Williams William V, Brind Joel, Haynes Laura, Manhart Michael D, Klaus Hanna, Lanfranchi Angela, Migeon Gerard, Gaskins Mike, Seman Elvis I, Ruppersberger Lester, Raviele Kathleen M
BriaCell Therapeutics Corporation, Berkeley, CA, USA.
University of Pennsylvania, Philadelphia, PA, USA.
Linacre Q. 2021 May;88(2):126-148. doi: 10.1177/0024363920982709. Epub 2021 Jan 27.
Hormonal contraceptives have been on the market for over fifty years and, while their formulations have changed, the basic mechanism of action has remained the same. During this time, numerous studies have been performed documenting side effects, some of which appear over time, some within weeks or months, but all can have a serious impact on health and quality of life. An effort was made to perform a series of comprehensive literature surveys to better understand immediate and long-term side effects of these agents. The results of this literature review uncovered a number of potential side effects, some of which are acknowledged and many of which are not noted in the prescribing information for these agents. Among the unacknowledged side effects are: an increased risk of HIV transmission for depot medroxyprogesterone acetate (DMPA), and for combination contraceptives breast cancer, cervical cancer, Crohn's disease, ulcerative colitis, systemic lupus erythematosus, depression, mood disorders and suicides (especially among women twenty-five years of age and younger, in the first six months of use), multiple sclerosis, interstitial cystitis, female sexual dysfunction, osteoporotic bone fractures (especially for progesterone-only contraceptives), and fatty weight gain. Misleading prescribing information regarding cardiovascular and thrombotic risks are also noted. Women seeking birth control have a right to be informed and educated about risk avoidance through the use of effective nonhormonal methods like fertility awareness methods. In one case-that of DMPA-the increased risk of HIV acquisition has been conclusively demonstrated to be both real and unique to this drug. Considering the availability of numerous alternatives, there is no justification for the continued marketing of DMPA to the public.
We reviewed the effect of hormonal contraceptives on women's health. A number of potential side effects were noted including increased risks of breast cancer, cervical cancer, inflammatory bowel disease, lupus, multiple sclerosis, cystitis, bone fractures, depression, mood disorders and suicides, fatty weight gain, and female sexual dysfunction. With the long-acting injectable contraceptives there is an increased risk of getting HIV. Misleading prescribing information regarding the risks of heart attacks, strokes and blood clotting problems were also noted. Women seeking birth control have a right to know about how to avoid these risks by using effective hormone-free Fertility Awareness Methods.
激素类避孕药已上市五十多年，虽然其配方有所变化，但其基本作用机制保持不变。在此期间，进行了大量研究记录其副作用，其中一些副作用随时间出现，一些在数周或数月内出现，但所有这些副作用都可能对健康和生活质量产生严重影响。我们努力进行了一系列全面的文献调查，以更好地了解这些药物的即时和长期副作用。该文献综述的结果揭示了许多潜在的副作用，其中一些已得到认可，而许多在这些药物的处方信息中并未提及。未被认可的副作用包括：醋酸甲羟孕酮长效注射剂（DMPA）导致艾滋病毒传播风险增加，复方避孕药导致乳腺癌、宫颈癌、克罗恩病、溃疡性结肠炎、系统性红斑狼疮、抑郁症、情绪障碍和自杀（尤其是25岁及以下女性，在使用的前六个月）、多发性硬化症、间质性膀胱炎、女性性功能障碍、骨质疏松性骨折（特别是仅含孕激素的避孕药）以及脂肪性体重增加。还注意到有关心血管和血栓形成风险的误导性处方信息。寻求避孕的女性有权通过使用有效的非激素方法（如生育意识方法）了解并接受如何避免风险的教育。在DMPA这种情况下，感染艾滋病毒风险增加已被确凿证明是真实的且是该药物所特有的。考虑到有众多替代药物可供选择，没有理由继续向公众销售DMPA。
我们回顾了激素类避孕药对女性健康的影响。注意到许多潜在的副作用，包括乳腺癌、宫颈癌、炎症性肠病、狼疮、多发性硬化症、膀胱炎、骨折、抑郁症、情绪障碍和自杀、脂肪性体重增加以及女性性功能障碍的风险增加。长效注射避孕药会增加感染艾滋病毒的风险。还注意到有关心脏病发作、中风和血液凝固问题风险的误导性处方信息。寻求避孕的女性有权了解如何通过使用有效的无激素生育意识方法来避免这些风险。
