Bagshaw S
Manager Medical Services, New Zealand Family Planning Association, Christchurch.
Drug Saf. 1995 Feb;12(2):91-6. doi: 10.2165/00002018-199512020-00002.
The risks and adverse effects of the low dose, new generation progestogen combined oral contraceptives (COCs) are much lower than original studies involving pills containing 50 micrograms estrogen. The main effects are those on the cardiovascular system, lipid and glucose metabolism and cancer. Any effect of the COC on myocardial infarction is probably minimal if the woman has no other risk factors especially smoking. The third generation progestogen, low dose COCs have very little effect on lipid or glucose metabolism. There may be a slight increase in breast cancer if COCs are used under the age of 25 years and for more than 4 to 8 years, and in the risk of cervical cancer. It is too early to estimate long term cancer effects of the newer COCs. Adverse effects such as nausea and breast tenderness can be managed by changing the estrogen dose or the type of progestogen. Overall, the clinical benefits of the COC probably outweight the risks and adverse effects.
低剂量新一代孕激素复方口服避孕药（COCs）的风险和不良反应远低于早期涉及含50微克雌激素药丸的研究。主要影响涉及心血管系统、脂质和葡萄糖代谢以及癌症。如果女性没有其他风险因素，尤其是吸烟，COC对心肌梗死的任何影响可能微乎其微。第三代孕激素低剂量COCs对脂质或葡萄糖代谢影响很小。如果在25岁以下使用COCs超过4至8年，乳腺癌风险可能会略有增加，宫颈癌风险也会增加。评估新型COCs对癌症的长期影响还为时过早。恶心和乳房压痛等不良反应可通过改变雌激素剂量或孕激素类型来处理。总体而言，COC的临床益处可能超过风险和不良反应。
