Kubba Ali, Gemzell-Danielsson Kristina, Palacios Santiago, Wiegratz Inka, Grandi Giovanni, Colli Enrico, Regidor Pedro Antonio
Gynaecology, Guy's Hospital, London, UK.
Department of Women´s and Children´s Health, Karolinska Institutet and WHO-centre, Karolinska University Hospital, Stockholm, Sweden.
Eur J Contracept Reprod Health Care. 2023 Feb;28(1):36-43. doi: 10.1080/13625187.2022.2164186.
Progestins used in contraception are either components of combined hormonal contraceptives or are used as a single active ingredient. Progestins are highly effective in long-term contraception and have a very good safety profile with very few contraindications.
An oestrogen-free ovulation inhibitor POP has been authorised in the USA and the EU. It contains 4 mg of drospirenone (DRSP). The hormone administration regimen of 24 days followed by a 4-day hormone-free period was chosen to improve bleeding control and to maintain oestradiol concentrations at early follicular- phase levels, preventing oestrogen deficiency.
Clinical trials have demonstrated high contraceptive effectiveness, a very low risk of cardiovascular risk events and a favourable bleeding pattern. Due to the long half-life of DRSP (30-34 h), the effectiveness is maintained even in case of a forgotten pill on a single occasion. Studies involving deliberate 4 days in one cycle 24-hour delays in taking a pill have demonstrated that ovulation inhibition is maintained if a single pill is missed.
This review article will describe the clinical impact in the daily use of the 4 mg DRSP only pill and the resulting data on the effectiveness and safety of this hormonal contraceptive.
用于避孕的孕激素要么是复方激素避孕药的成分，要么作为单一活性成分使用。孕激素在长期避孕方面非常有效，安全性良好，禁忌证极少。
一种不含雌激素的排卵抑制性短效口服避孕药已在美国和欧盟获得批准。它含有4毫克屈螺酮（DRSP）。选择24天激素给药方案，随后是4天无激素期，以改善出血控制，并将雌二醇浓度维持在卵泡早期水平，预防雌激素缺乏。
临床试验已证明其避孕效果高、心血管风险事件风险极低且出血模式良好。由于屈螺酮的半衰期长（30 - 34小时），即使偶尔漏服一片药，避孕效果仍能维持。涉及在一个周期内故意延迟4天服药24小时的研究表明，如果漏服一片药，排卵抑制仍能维持。
这篇综述文章将描述每日使用4毫克屈螺酮单方制剂的临床影响以及该激素避孕药有效性和安全性的相关数据。
