Stubblefield P G
J Reprod Med. 1986 Sep;31(9 Suppl):922-8.
Low-dose oral contraceptives differ in the specific progestin component. Our review of available animal and human data revealed differences between the progestins as to their potencies for estrogenic, anti-estrogenic, androgenic and progesterone effects. Ideally, oral contraceptive formulations should have the minimal effective dose, sufficient to prevent pregnancy but with the fewest metabolic changes. The risk of cardiovascular disease may be predicted by changes in the composition and amount of circulating lipoproteins. Progestins with significant androgenic potency can lower high-density lipoprotein2; that is a possible adverse effect. Randomized, blind, comparative trials of the new multiphasic preparations are needed to determine which ones truly cause the fewest metabolic changes that might be of clinical significance.
低剂量口服避孕药的特定孕激素成分有所不同。我们对现有动物和人体数据的综述显示，不同孕激素在雌激素、抗雌激素、雄激素和孕激素作用的效力方面存在差异。理想情况下，口服避孕药配方应具有最低有效剂量，足以预防怀孕但代谢变化最少。心血管疾病风险可通过循环脂蛋白的组成和数量变化来预测。具有显著雄激素效力的孕激素会降低高密度脂蛋白2；这是一种可能的不良反应。需要对新型多相制剂进行随机、盲法、对照试验，以确定哪些制剂真正引起的可能具有临床意义的代谢变化最少。
