Division of Adolescent Medicine, Department of Pediatrics, University of Michigan.
Departments of Family Medicine and Pediatrics, Uniformed Services University, Bethesda, Maryland.
Curr Opin Pediatr. 2024 Aug 1;36(4):382-388. doi: 10.1097/MOP.0000000000001346. Epub 2024 Mar 20.
Oral contraceptive pills are among the most popular contraceptives worldwide, including among adolescents, and are available over the counter in over 100 countries. However, when a prescription is required, oral contraceptives may be difficult to obtain, particularly for adolescents. Recent approvals of over-the-counter progestin-only pills in the United Kingdom and United States have brought widespread attention to this topic.
Progestin-only pills, including the norgestrel pill recently approved for over-the-counter use in the United States, are highly effective and may be used safely without a prescription or medical monitoring, including by adolescents. These pills are associated with relatively high user satisfaction. Although over-the-counter availability may improve contraceptive access overall, issues related to insurance coverage and out-of-pocket cost may continue to pose practical barriers to access for many individuals.
Over-the-counter oral contraceptives are an appropriate and important contraceptive option for many adolescents. Over-the-counter availability has the potential to increase access to safe and effective contraception in the United States, United Kingdom, and other countries where a prescription is currently required. Future research on use patterns among adolescents is needed, as are advocacy efforts and policies to ensure access and affordability.
目的综述：口服避孕药是全球范围内最受欢迎的避孕方法之一，包括在青少年中，并且在 100 多个国家都可以在柜台上购买。然而，当需要处方时，口服避孕药可能难以获得，尤其是对于青少年而言。最近在英国和美国批准非处方孕激素避孕药引起了广泛关注。
最新发现：孕激素避孕药，包括最近在美国获准非处方使用的去氧孕烯片，非常有效，无需处方或医疗监测即可安全使用，包括青少年。这些药物与较高的用户满意度相关。虽然非处方供应可能总体上改善避孕措施的可及性，但与保险覆盖范围和自付费用相关的问题可能继续对许多人获得药物造成实际障碍。
总结：非处方口服避孕药是许多青少年的合适且重要的避孕选择。在美国、英国和其他目前需要处方的国家，非处方供应有可能增加安全有效的避孕措施的可及性。需要对青少年的使用模式进行未来研究，以及进行宣传和政策工作，以确保可及性和可负担性。
