Department of Obstetrics and Gynecology, University of California, Davis, Sacramento, California.
Obstet Gynecol. 2022 Nov 1;140(5):883-897. doi: 10.1097/AOG.0000000000004967. Epub 2022 Oct 5.
Long-acting reversible contraceptive (LARC) methods are effective options for pregnancy prevention. Currently available products in the United States include an etonogestrel implant, a copper intrauterine device (IUD), and several levonorgestrel IUDs. With increasing prevalence and duration of use, our understanding of efficacy, risks, and benefits has evolved. In addition to a brief discussion on nomenclature and LARC use within a framework of bodily autonomy and reproductive justice, this review covers clinical challenges with placement and removal, evidence-based duration of use, and how to mitigate side effects. Although all obstetrician-gynecologists as well as primary care clinicians can safely provide LARCs, complex family planning specialists are an expert referral source for challenging cases and evidence-based care as contraceptive technology continues to develop.
长效可逆避孕方法(LARC)是预防怀孕的有效选择。目前在美国可用的产品包括依托孕烯植入物、铜宫内节育器(IUD)和几种左炔诺孕酮 IUD。随着使用的普及和时间的推移,我们对其疗效、风险和益处的理解也在不断发展。除了简要讨论在身体自主权和生殖正义框架内的命名法和 LARC 的使用外,本综述还涵盖了放置和取出的临床挑战、基于证据的使用期限以及如何减轻副作用。虽然所有妇产科医生以及初级保健临床医生都可以安全地提供 LARCs,但在避孕技术不断发展的情况下,对于复杂的计划生育专家来说,他们是具有挑战性病例和基于证据的护理的专家转诊来源。