Department of Obstetrics and Gynecology, New York Medical College, Valhalla, NY, United States.
American Society for Emergency Contraception, Lawrenceville, NJ, United States.
Contraception. 2023 May;121:109958. doi: 10.1016/j.contraception.2023.109958. Epub 2023 Jan 21.
Emergency contraception (EC) refers to several contraceptive options that can be used within a few days after unprotected or under protected intercourse or sexual assault to reduce the risk of pregnancy. Current EC options available in the United States include the copper intrauterine device (IUD), levonorgestrel (LNG) 52 mg IUD, oral LNG (such as Plan B One-Step, My Way, Take Action), and oral ulipristal acetate (UPA) (ella). These clinical recommendations review the indications, effectiveness, safety, and side effects of emergency contraceptive methods; considerations for the use of EC by specific patient populations and in specific clinical circumstances and current barriers to emergency contraceptive access. Further research is needed to evaluate the effectiveness of LNG IUDs for emergency contraceptive use; address the effects of repeated use of UPA at different times in the same menstrual cycle; assess the impact on ovulation of initiating or reinitiating different regimens of regular hormonal contraception following UPA use; and elucidate effective emergency contraceptive pill options by body mass indices or weight.
紧急避孕(EC)是指在无保护性行为或保护不当性行为或性侵犯后几天内,可以使用几种避孕方法来降低怀孕的风险。目前在美国可用的紧急避孕方法包括铜宫内节育器(IUD)、左炔诺孕酮(LNG)52mg IUD、口服 LNG(如 Plan B One-Step、My Way、Take Action)和口服依托孕烯(UPA)(ella)。这些临床建议审查了紧急避孕方法的适应症、有效性、安全性和副作用;考虑了特定患者群体和特定临床情况下使用 EC 的情况,以及紧急避孕的现有障碍。需要进一步研究来评估 LNG IUD 在紧急避孕中的有效性;解决在同一月经周期的不同时间重复使用 UPA 的影响;评估在使用 UPA 后开始或重新开始不同常规激素避孕方案对排卵的影响;并根据体重指数或体重阐明有效的紧急避孕丸选择。