Chi I
Family Health International, Research Triangle Park, North Carolina 27709.
Contraception. 1993 Jan;47(1):1-21. doi: 10.1016/0010-7824(93)90105-g.
Progestogen-only oral contraceptives (POCs) are generally considered a good contraceptive choice for brestfeeding women and for women who want to use an oral form of contraception, but are not suited for, or cannot tolerate the side effects of, estrogen-containing preparations. However, a number of POCs' safety, efficacy and other related issues remain to be addressed. This paper reviews recent literature and evaluates these issues from an epidemiologic perspective. The small number of users imposes severe limitations in designing epidemiologic studies to address POCs' long-term safety issues, but available information suggests POCs are at least as safe as, if not safer than, COCs. Compared to COCs, POCs are more likely to cause menstrual disturbances which, in turn, could affect their acceptability and lead to poor compliance and hence higher pregnancy rates. POCs' efficacy has been estimated to be between 1.4 and 4.3 pregnancies per 100 woman-years of use. Lower pregnancy rates approaching those of COCs have been reported in centers with good counseling. POCs' benefits outweigh their risks. However, more studies are needed to further address POCs' safety and efficacy issues.
仅含孕激素的口服避孕药（POCs）通常被认为是哺乳期女性以及希望采用口服避孕方式但不适合或无法耐受含雌激素制剂副作用的女性的良好避孕选择。然而，一些POCs的安全性、有效性及其他相关问题仍有待解决。本文回顾了近期文献，并从流行病学角度评估了这些问题。使用者数量较少给设计解决POCs长期安全性问题的流行病学研究带来了严重限制，但现有信息表明POCs至少与复方口服避孕药（COCs）一样安全，甚至可能更安全。与COCs相比，POCs更易引起月经紊乱，这反过来可能影响其可接受性，并导致依从性差，从而使妊娠率升高。据估计，POCs的有效性为每100名女性每年有1.4至4.3次妊娠。在提供良好咨询服务的中心，已报告妊娠率较低，接近COCs的妊娠率。POCs的益处大于风险。然而，需要更多研究来进一步解决POCs的安全性和有效性问题。
