Segarra Ignacio, Menárguez Micaela, Roqué María Victoria
Department of Pharmacy, Faculty of Pharmacy and Nutrition, Catholic University of Murcia (UCAM), Murcia, Spain.
"Pharmacokinetics, Patient Care and Translational Bioethics" Research Group, Faculty of Pharmacy and Nutrition, Catholic University of Murcia (UCAM), Murcia, Spain.
Front Med (Lausanne). 2023 Jun 30;10:1167504. doi: 10.3389/fmed.2023.1167504. eCollection 2023.
Hormone-based contraception disrupts hormonal balance, creating artificial states of anovulation and threatening women's health. We reviewed its main adverse effects and mechanisms on accelerated ovarian aging, mental health (emotional disruptions, depression, and suicide), sexuality (reduced libido), cardiovascular (brain stroke, myocardial infarction, hypertension, and thrombosis), and oncological (breast, cervical, and endometrial cancers). Other "collateral damage" includes negative effects on communication, scientific mistrust, poor physician-patient relationships, increased patient burden, economic drain on the healthcare system, and environmental pollution. Hormone-sensitive tumors present a dilemma owing to their potential dual effects: preventing some cancers vs. higher risk for others remains controversial, with denial or dismissal as non-relevant adverse effects, information avoidance, and modification of scientific criteria. This lack of clinical assessment poses challenges to women's health and their right to autonomy. Overcoming these challenges requires an anthropological integration of sexuality, as the focus on genital bodily union alone fails to encompass the intimate relational expression of individuals, complete sexual satisfaction, and the intertwined feelings of trust, safety, tenderness, and endorsement of women's femininity.
基于激素的避孕方法会扰乱激素平衡,导致无排卵的人为状态,并威胁女性健康。我们回顾了其对加速卵巢衰老、心理健康(情绪紊乱、抑郁和自杀)、性功能(性欲降低)、心血管(中风、心肌梗死、高血压和血栓形成)以及肿瘤学(乳腺癌、宫颈癌和子宫内膜癌)方面的主要不良反应及机制。其他“附带损害”包括对沟通的负面影响、科学信任缺失、医患关系不佳、患者负担加重、医疗系统的经济消耗以及环境污染。激素敏感性肿瘤因其潜在的双重影响而带来两难困境:预防某些癌症与增加其他癌症风险仍存在争议,存在将其视为无关不良反应而予以否认或忽视、信息回避以及科学标准变更的情况。这种缺乏临床评估的状况对女性健康及其自主权利构成挑战。克服这些挑战需要从人类学角度整合性观念,因为仅关注生殖器的身体结合无法涵盖个体亲密的关系表达、完全的性满足以及信任、安全、温柔和对女性女性气质认可等交织的情感。