Rosenberg M J, Waugh M S
Health Decisions, Inc., Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill 27514, USA.
Am J Obstet Gynecol. 1998 Sep;179(3 Pt 1):577-82. doi: 10.1016/s0002-9378(98)70047-x.
Our purpose was to define the frequency and reasons for oral contraceptive discontinuation and subsequent contraceptive behavior.
A nationwide prospective study of 1657 women initiating or switching to the use of a new contraceptive from private practices, clinics, and a health maintenance organization was performed.
Six months after a new oral contraceptive prescription, 68% of new starts and 84% of switchers still used oral contraceptives. Of women who discontinued, 46% did so because of side effects, whereas 23% had no continuing need. More than four fifths of women who discontinued oral contraceptives but remained at risk of unintended pregnancy either failed to adopt another method or adopted a less effective method. Fifteen percent of women who discontinued oral contraceptives resumed their use within the 7-month follow-up period.
Counseling should emphasize the possibility of side effects, stressing the fact that most will be transient, and the need to identify a backup method. Follow-up visits should be scheduled for 1 to 2 months after a prescription is written.
我们的目的是确定口服避孕药停用的频率及原因，以及随后的避孕行为。
对1657名从私人诊所、门诊和健康维护组织开始使用或改用新避孕药具的女性进行了一项全国性前瞻性研究。
新开具口服避孕药处方6个月后，68%的新使用者和84%的改用者仍在使用口服避孕药。在停用口服避孕药的女性中，46%是因为副作用，而23%是不再有持续的需求。超过五分之四停用口服避孕药但仍有意外怀孕风险的女性要么未采用其他避孕方法，要么采用了效果较差的方法。15%停用口服避孕药的女性在7个月的随访期内恢复了用药。
咨询应强调出现副作用的可能性，强调大多数副作用是暂时的这一事实，以及确定备用避孕方法的必要性。在开具处方后1至2个月应安排随访。
