女性 40 岁以上避孕：综合指南。

Contraception for women over 40: A comprehensive guide.

机构信息

BMedSci, MBBS, Reproductive Biology Fellow, Reproductive Services Unit, The Royal Women@s Hospital, Melbourne, Vic.

MBBS, FRANZCOG, MClinEpid, MReproMed, MHealth@MedLaw, GradCertEBM, Associate Professor, Faculty of Medicine and Health Sciences, University of Melbourne, Parkville, Vic; Clinical Director, Melbourne IVF, East Melbourne, Vic.

出版信息

Aust J Gen Pract. 2024 Oct;53(10):746-750. doi: 10.31128/AJGP-04-23-6803.

DOI:10.31128/AJGP-04-23-6803

PMID:39370161

Abstract

BACKGROUND

Women in their 40s experience significant reproductive health changes, requiring personalised contraception to avoid unintended high-risk pregnancies and adapt to changing health conditions.

OBJECTIVE

This article examines optimal contraceptive choices for women in their 40s, considering effectiveness, ease of use, non-contraceptive benefits, side effects, contraindications and re-evaluation or discontinuation timings.

DISCUSSION

Contraceptive choices for women in their 40s vary depending on their family planning status, underlying health conditions and risk factors. Long-acting reversible contraceptives, permanent sterilisation and progestogen-only methods (excluding depot medroxyprogesterone acetate) are preferred options for women who have completed their families. Hormonal contraceptives can help manage menstrual disorders and bone health issues while providing endometrial protection during menopause. Regular contraceptive reviews should be conducted, and options adapted as needed.

摘要

背景

40 多岁的女性经历着显著的生殖健康变化，需要个性化的避孕措施来避免意外的高风险怀孕，并适应不断变化的健康状况。

目的

本文探讨了 40 多岁女性的最佳避孕选择，考虑了有效性、易用性、非避孕益处、副作用、禁忌症以及重新评估或停药时间。

讨论

40 多岁女性的避孕选择因计划生育状况、潜在健康状况和风险因素而异。对于已经完成家庭生育的女性，长效可逆避孕措施、永久性绝育和单纯孕激素方法（不包括醋酸甲羟孕酮长效避孕针）是首选。激素避孕措施可以帮助管理月经紊乱和骨骼健康问题，同时在绝经期间提供子宫内膜保护。应定期进行避孕措施复查，并根据需要调整选择。