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左炔诺孕酮用于性交后避孕的经验

[Experiences with levonorgestrel in postcoital contraception].

作者信息

Canzler E, Ahrendt H J, Ahrendt S

出版信息

Zentralbl Gynakol. 1984;106(17):1182-91.

PMID:6437102
Abstract

To examine levonorgestrel as a postcoital contraceptive, 77 women received an oral dose of 0.4 mg per coitus for 1011 cycles and 27 women were administered 0.75 mg per coitus for 226 cycles. In the first dose group seven women became pregnant (Pearl's index 8.3), while two pregnancies resulted in the second group, one of the latter because of faulty drug intake (uncorrected Pearl's index 10.6; corrected Pearl's index 5.3). Menstrual irregularities (chiefly break-through bleedings and oligomenorrhea) were observed in 84.4% and 88.9% of the women, respectively. The number of cycle disorders increased with increasing intake rate and diminished when the drug was applied in excess of six months. The experiments undertaken to test the mechanisms of action indicated an influence on both cervical factor and endometrium, whereas the occurrence of LH-peaks and biphasic basal body temperature patterns suggested the presence of ovulations. Application of levonorgestrel for postcoital contraception failed to be a reliable routine method of hormonal contraception because of insufficient efficacy and considerable menstrual irregularities. The drug should be administered only after unprotected sexual intercourse as might happen, to women with very low frequency of intercourse, or in periods of reduced fertility.

摘要

为研究左炔诺孕酮作为性交后避孕药的效果,77名女性在1011个周期中每次性交后口服0.4毫克,27名女性在226个周期中每次性交后服用0.75毫克。在第一剂量组中,7名女性怀孕(Pearl指数为8.3),而在第二组中有2例怀孕,其中1例是由于服药不当(未校正的Pearl指数为10.6;校正后的Pearl指数为5.3)。分别有84.4%和88.9%的女性出现月经不规律(主要是突破性出血和月经过少)。周期紊乱的数量随着服药率的增加而增加,当用药超过6个月时则减少。为测试作用机制所进行的实验表明,该药对宫颈因素和子宫内膜均有影响,而促黄体生成素峰值和双相基础体温模式的出现提示有排卵发生。由于效果不佳和明显的月经不规律,左炔诺孕酮用于性交后避孕未能成为一种可靠的常规激素避孕方法。该药仅应在无保护性交后(如可能发生的情况)、性交频率极低的女性或生育能力下降期间使用。

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