Baker Courtney C, Chen Melissa J
Department of Obstetrics and Gynecology, University of California, Davis, 4860 Y Street, Suite 2500, Sacramento, CA 95817, USA.
Curr Obstet Gynecol Rep. 2022 Mar;11(1):21-27. doi: 10.1007/s13669-021-00321-4. Epub 2022 Jan 6.
In this review, we discuss the efficacy, safety, and benefits of four new contraceptive products available in the USA, specifically Annovera, Phexxi, Slynd, and Twirla.
Annovera is a vaginal ring releasing ethinyl estradiol and segesterone acetate that can be used for up to one year (13 cycles), offering patients an effective, user-controlled option that may improve contraceptive access for those in low-resource settings or those with barriers to retrieving monthly prescriptions; however, given limited efficacy and safety data in people with body mass index (BMI) > 29 kg/m, clinicians may consider whether Annovera is an appropriate contraceptive method for obese patients if there are other acceptable alternatives. Phexxi prescription-only vaginal gel is a user-controlled, non-hormonal, on-demand contraceptive method that represents a novel addition to the market with its additional uses as a personal lubricant and as a potential microbicide for urogenital infection prevention. Slynd, a drospirenone-only pill, provides more flexibility for delayed or missed pills while maintaining efficacy and a more favorable bleeding profile compared with previously available progestin-only pills. Lastly, Twirla is a transdermal patch releasing ethinyl estradiol and levonorgestrel that offers users an additional option for a user-controlled, combined hormonal contraceptive method without daily dosing; however, prescription is limited to patients with BMI < 30 kg/m due to decreased efficacy and VTE events in people with obesity.
The addition of these products expands the available options for pregnancy prevention to address unmet contraceptive needs.
在本综述中，我们讨论了美国市场上四种新型避孕产品的有效性、安全性和益处，具体为安诺vera、菲克西、斯林德和特维拉。
安诺vera是一种释放乙炔雌二醇和醋酸炔诺酮的阴道环，可使用长达一年（13个周期），为患者提供了一种有效且用户可控的选择，这可能改善资源匮乏地区人群或那些在获取每月处方方面存在障碍的人群的避孕途径；然而，鉴于体重指数（BMI）>29kg/m²的人群中疗效和安全性数据有限，如果有其他可接受的替代方法，临床医生可能需要考虑安诺vera对肥胖患者是否是一种合适的避孕方法。菲克西是一种仅凭处方使用的阴道凝胶，是一种用户可控的非激素按需避孕方法，作为个人润滑剂以及预防泌尿生殖系统感染的潜在杀菌剂有额外用途，这使其成为市场上的新成员。斯林德是一种仅含屈螺酮的药丸，与之前的纯孕激素药丸相比，在漏服或延迟服药时提供了更大的灵活性，同时保持疗效且出血情况更有利。最后，特维拉是一种释放乙炔雌二醇和左炔诺孕酮的透皮贴剂，为用户提供了另一种用户可控的复方激素避孕方法选择，无需每日服药；然而，由于肥胖人群中疗效降低和静脉血栓栓塞事件，其处方仅限于BMI<30kg/m²的患者。
这些产品的增加扩大了预防妊娠的可用选择，以满足未满足的避孕需求。
