口服避孕药的发展和使用现状

复方口服避孕药(COC)上市近五十年来的主要进展表现在降低雌激素剂量、开发新型孕激素、发展多相型COC及改进包装和服用方法等。在保证避孕效果的基础上,减少COC的不良反应并提高安全性,且为使用者提供更多的健康益处。已在中国上市的COC有十几种,对COC的了解不足或存在偏见,是中国COC使用率甚低的主要原因之一,可通过加强宣传和咨询,促进COC的推广应用。     

口服避孕药的发展和使用现状

复方口服避孕药(COC)上市近五十年来的主要进展表现在降低雌激素剂量、开发新型孕激素、发展多相型COC及改进包装和服用方法等.在保证避孕效果的基础上,减少COC的不良反应并提高安全性,且为使用者提供更多的健康益处.已在中国上市的COC有十几种,对COC的了解不足或存在偏见,是中国COC使用率甚低的主要原因之一,可通过加强宣传和咨询,促进COC的推广应用.     

女性医务工作者避孕方式的选择及对口服避孕药的认知

目的:了解中国女性医务工作者自身避孕方式的选择及对口服避孕药(COC)的认知和使用状态。方法:选取2012年10月~2013年4月参加健康讲座的女医务人员共3500位,以问卷的形式调查其一般情况、COC非避孕作用的益处及风险、非意愿妊娠流产的情况、自身避孕方式的选择。结果:1本次回收有效问卷3216份,年龄35.3±9.4岁。调查对象妇产科医护人员占27.5%,其他临床科室医护人员占40.4%,医疗辅助科室人员占23.6%,行政管理人员占8.5%。2关于COC避孕以外益处的认知,治疗痛经和经前期紧张综合征42.6%,治疗痤疮、改善皮脂分泌33.4%;3关于COC使用的误区,认为现代低剂量COC,需停药3~6个月后再妊娠占43.5%,长期服用COC对身体有害、应间断服用占30.8%;4在有性生活的3136名人员中,已完成生育的比率为59.6%,有35.3%的医护人员因意外妊娠做过人工流产术,其主要原因为未采取任何可靠避孕措施(49.4%);5已生育医护人员中避孕方式选择的比例为IUD 34.7%、曼月乐(LNG-IUS)4.8%、避孕套19.9%,未完成生育的女性选择COC 2.2%。结论:女性医务人员选择COC避孕的比率很低,对COC认知错误率较高,需要加强相关知识的学习。     

吃避孕药治疗青春痘容易导致不孕

哈尔滨小微我是一名22岁的女大学生,听同学说吃避孕药能治疗青春痘,就连着服用了一段时间。最近经常感到头晕、恶心,到医院就诊后方才得知是由于自己服用避孕药后产生的副作用。请问服用避孕药治疗青春痘到底有没有作用?     

抗生素临床研究的一些进展(上)

一、临床药理学的进展及其在抗生素临床研究中的重要性临床医务人员往往对药物的作用比较重视,而对其副作用则注意不够。估计约5～6％的病人因药物的过量或药物的副作用而住院。对住院病人严加观察,服用或注射药物后约30～40％可出现一些副作用,女比男为多;胃肠道反应和过敏反应多见于女性,而男性以电解质平衡失调为多见。药物反应的个体差异很大,乃与遗传因素如遗传缺陷、遗传变异等有关。婴儿、老人、孕妇等的药物反应也与一般青少年不同,怀孕最初3个月为胚胎发育期,在此期内应用某些药物有导致畸胎的可能。很多药物间存在着配伍禁忌和交互作用,烟、酒、食物、疾病等均可影响药效。     

常用抗癫痫药物对小儿癫痫血同型半胱氨酸水平的影响

[目的]探讨常用抗癫痫药物(AEDs)对小儿癫痫血同型半胱氨酸(Hcy)水平的影响,寻找降低抗癫痫药物副作用的有效途径。[方法]采用循环酶法分别测定92例服用单一药物治疗的癫痫患儿(服用丙戊酸钠35例、卡马西平31例、苯巴比妥26例)和30例未服用AEDs的癫痫对照者及36例健康对照者血Hcy水平,比较各组间差异。[结果]药物观察组中服用丙戊酸钠、卡马西平和苯巴比妥的患儿血中Hcy水平均高于癫痫对照组和正常对照组(P﹤0.001),且丙戊酸钠组、卡马西平组和苯巴比妥组间Hcy水平差异无统计学意义(P﹥0.05);癫痫对照组患儿的Hcy水平略高于正常对照组,但差异无统计学意义(P﹥0.05)。[结论]对长期使用抗癫痫药物的患儿应定期检测血Hcy水平,及早发现血Hcy水平升高并早期采取干预措施,有利于防止抗癫痫药物的副作用并提高疗效。     

你的服药方法科学吗?

为了使药物服用后获得满意的疗效,并且减少副作用的发生,要根据医嘱或药品说明书的规定服药,切忌随意服药。一般来讲,大多数药物是一日3次(一日按24小时计)服用。在体内消除快的药物则按每日4次(每隔6小时1次);在体内消除慢的药物可每日2次、甚至1次服用(如某些长效制剂如康泰克、茶碱控释片等)。还有些特殊药物如镇静催眠药及导泻药,也要求在睡前30分钟或1小时1次服用。此外某些止痛和解痉药物如去痛片、氨酚待因片、阿托品片、莨菪片等只在需要时服用即可,如症状不缓解才     

2021-2022年妇产科医生复方短效口服避孕药处方知信行网络调查

目的：了解妇产科医生对复方短效口服避孕药(COC)的认知、态度和行为，为我国COC的应用和推广提供参考。方法：2021年6月-2022年4月，经全国计划生育工作网络招募调查对象，在全国21个省份招募自愿参加的妇产科医生为研究对象，用自制问卷进行线上调查。问卷内容主要包括调查对象基本信息和COC知信行情况。采用潜在类别分析、Cochran-Mantel-Haenszel检验、两水平二分类logistic回归分析等方法对数据进行统计分析。结果：共发出1600份调查问卷，回收有效问卷1450份，回收率90.63%。调查对象的COC总体认知得分集中趋势为[73.2(60.6,80.3),COC优缺点、作用机制、禁忌证和非避孕应用的认知得分依次为[72.9(52.1,77.1)]、[80.0(80.0,100.0)]、[77.8(66.7,88.9)]、[88.9(77.8,100.0)]。针对COC应用的态度，阻碍因素中“老百姓对COC不了解”(85.2%)和“增加静脉血栓等心血管疾病风险”(75.5%)占比较高，促进因素中“对象有避孕需求且无禁忌证”(89.9%)、“对象有治疗需求且无禁忌证...     

选好服法疗效佳

某些西药和中成药,在使用时如果能够选用合适的服药方法,是可以提高药效和减少副作用的,以下就给您简要的介绍一下。空腹空腹服用抗胃溃疡药如西咪替丁、胃仙V等药品,可以使药更好地分布在胃粘膜表面,提高药效。饭后在饭后服用阿司匹林和糖皮质激素类药(如地塞米松、强的松)等对胃有刺激作用的药物,可减少对胃肠道的刺激。四环素类抗生素,在饭后服用可以提高药物的利用率。     

维生素C过量服用有害

非典流行期间,卫生部公布了“快速提高免疫力”的药物,其中之一为维生素C。它价格低廉,购买方便(在OTC药店中可买到),服用方便……故许多人为防非典,提高免疫力,长期服用维生素C,最大剂量达到一天几十片,结果出现血尿、腹痛和腹泻等副作用。笔者在“药物咨询”时,也常有人问:过量服用维生素C有否副作用?     

Preliminary examination of oral contraceptive use among university-aged females

The etymology and use of oral contraceptives (OCs) has greatly influenced the sexual practices and social lives (e.g., decisions concerning childbearing, careers) of adolescent and adult women. In addition, OCs have the potential to benefit or harm its users depending upon the utilization practices and characteristics/lifestyle habits of the women consuming them. A 28-item questionnaire was distributed to female students at a university in Central Ontario and examined: (1) socio-demographic information; (2) background information concerning oral contraceptive use (e.g., length of time taking the pill, concerns about pill use, side effects while on the pill); and (3) procedure for taking the pill (e.g. maximizing effectiveness and safety). Preliminary analysis indicated that females may not be equipped with adequate knowledge or receiving the necessary support to practice the most efficacious behaviours surrounding pill use.     

Are affluent, well-educated, career-orientated women knowledgeable users of the oral contraceptive pill?

OBJECTIVE: Studies have shown poor knowledge of oral contraceptives among women attending government health clinics and women in rural areas. Little is known about the level of contraceptive knowledge in educated, affluent, career-orientated women, although it could be expected that access to information would be greater. The study objective was to describe the profile, knowledge and understanding of oral contraceptive users in a private general practice in Johannesburg, South Africa. METHODS: Over a period of 3 months, all women attending a private general practice who were using an oral contraceptive were asked to complete an anonymous questionnaire. Informed written consent was obtained in all cases. RESULTS: Fifty-one women participated in the study. Most women were nulliparous (71%), held a tertiary educational qualification (80%), were employed (84%) and were not concerned about the cost of their pill (65%). Most respondents (86%) obtained their information from a doctor. However, only 12% of women were aware of the danger of extending the active pill-free interval. Less than half (49%) were aware that their pill was less effective if taken more than 12 hours late and only 31% of women knew that their pill was effective again after taking seven active tablets. CONCLUSIONS: Educated, affluent women attending a private general practice lacked basic knowledge of the oral contraceptive pill. Consultations by practitioners need to be improved.     

Comparative study and evaluation of side effects of low-dose contraceptive pills administered by the oral and vaginal route

This was a comparative study of side effects and acceptability of low-dose pills administered by the oral and vaginal rout. In an experimental clinical trial study, undesirable side effects of nausea, dysmenorrhea, breast tenderness, gastrointestinal disorders, vertigo, headache, and breakthrough bleeding (BTB) were studied. The participants of the case and the control groups were the same women. The side effects were compared in 143 women using contraceptive pill containing 150 microg levonorgestrel and 30 microg ethinyl estradiol by vaginal and oral route. The efficacy and acceptability were evaluated. The side effects among the patients who used the contraceptive pills orally were significantly higher than among those who used the vaginal route (p < 0.0001). BTB occurred more often with the oral route, but there was no significant difference between their incidences (p = 0.267). Most participants in this study expressed a high level of acceptability with the vaginal route. There was only one unwanted pregnancy, which occurred when the participant used the contraceptive pill vaginally, but used it incorrectly. Using the contraceptive pill administered by vaginal route is a safe method with fewer side effects and more acceptability when compared with the oral route.     

Study on the factors associated with contraceptive discontinuations in Bangkok

Detailed information was collected from 666 cohorts of pill, injectable-DMPA and IUD acceptors at 14 Bangkok Metropolis Health Clinics (MHCs). The contraceptive status at 12-month follow-up home interview shows that 47% of pill acceptors, 39% of DMPA acceptors and 55% of IUD acceptors were still using the same contraceptive method and receiving them from the original source. The women who initially adopted the pill could seek the oral contraceptive from other sources with a higher significant percentage (14%) than was found in the DMPA and IUD group. The DMPA group revealed the lowest percent of using same method and same source but higher rate of clinic switch (15%), including method and clinic switch (18%), than the pill and IUD acceptors. The women who adopted the pill had stopped using any contraceptive method with the highest percentage (31%). The main reason for method switch among the three contraceptive acceptors was disagreeable health effects; 50% of pill acceptors, 75% for DMPA acceptors and 49% for IUD acceptors. Another important reason for IUD switch was a 32% expulsion of IUD. Those who switched clinic gave the three important reasons of distance inconvenience, opening hour inconvenience and disagreeable health effects. Service-related factors are likely to play a less important role in determining discontinuation of the pill and DMPA, while the reasons on doctors objecting to removing the IUD appear to be the major service-related factor in discontinuation of IUD (19%). The decision to stop using any contraceptive appeared to be related to dissatisfaction with the method and side effects was the primary reason and the secondary reason was that they wanted another child.(ABSTRACT TRUNCATED AT 250 WORDS)     

Biphasic versus triphasic oral contraceptives for contraception

Side effects caused by oral contraceptives discourage compliance with and continuation of oral contraceptives. A suggested disadvantage of biphasic oral contraceptive pills compared to triphasic oral contraceptive pills is an increase in breakthrough bleeding. We examined this potential disadvantage by conducting a systematic review comparing biphasic oral contraceptives with triphasic oral contraceptives in terms of efficacy, cycle control, and discontinuation because of side effects.We included randomized, controlled trials comparing any biphasic oral contraceptive with any triphasic oral contraceptive when used to prevent pregnancy. Only two trials of limited quality met our inclusion criteria. Larranaga compared two biphasic and one triphasic pills, each containing levonorgestrel and ethinyl estradiol. No important differences emerged, and the frequency of discontinuation because of medical problems was similar with all three pills. Percival-Smith compared a biphasic pill containing norethindrone (Ortho 10/11) with a triphasic pill containing levonorgestrel (Triphasil) and another triphasic pill containing norethindrone (Ortho 7/7/7). The biphasic pill had inferior cycle control compared with the levonorgestrel triphasic pill.The available evidence is limited and of poor quality; the internal validity of these trials is questionable. Given that caveat, the biphasic pill containing norethindrone was associated with inferior cycle control compared with the triphasic pill containing levonorgestrel. This suggests that the choice of progestin may be more important that the phasic regimen in determining bleeding patterns.     

Does low iron status influence psychological functioning?

To examine the possibility that low iron status has functional consequences, 297 young adults were distinguished in terms of serum ferritin levels and were compared using measures of psychological functioning: digit span, reaction times, a measure of sustained attention and a questionnaire measure of mental health. Of the 297 young adults tested 51.6% of females and 11.5% of males had serum ferritin levels below 20 ng/1. In males being vegetarian, and in females dieting, was associated with lower ferritin values. In males, and females not taking the oral contraceptive pill, there was no association between low ferritin status and poor performance on various cognitive tests. In females taking the oral contraceptive pill, those with ferritin values below 5 ng/ml were significantly more likely to report being depressed. It was concluded that for most of this population there was little evidence that low iron status was associated with changes in psychological status.     

Self-described impact of noncompliance among users of a combined hormonal contraceptive method

BACKGROUND: A number of factors related to the user and the method affect contraceptive compliance. STUDY DESIGN: This cross-sectional multicenter study was designed to assess self-described impact of noncompliant behavior among 26,250 typical users of a combined hormonal contraceptive method who consulted their physicians for control visits. A self-administered questionnaire was completed. RESULTS: Sixty-five percent of women used the pill, 23% the vaginal ring and 12% the transdermal patch. Noncompliant behavior (missing/delays in taking/application, insertion or removal of the pill/skin patch/vaginal ring) was recorded in 71% of pill users, 32% of patch users and 21.6% of vaginal ring users (p<.0001). Emergency contraception was requested by 14% of pill users, 11% of patch users and 6.3% of ring users. About 40% of women in all groups called or visited a physician. Seventy percent of women continued to have active sex life, and 60% used an additional contraceptive method. Noncompliant behavior negatively affected work activities and/or couple relationships in 10-20% of cases. More than 50% of women reported they were worried and about 20% were scared due to inconsistent use of the contraceptive method. After filling out the questionnaire, 64.7% of pill users continued to prefer the pill, 61.7% of patch users preferred the patch and 96.6% of women using the vaginal ring preferred the ring. CONCLUSIONS: Noncompliant behavior had noticeable effects on emotional well-being, prompted request for physicians' advice, and use of emergency contraception. Despite recognition of problems associated with inconsistent use, women tended to prefer the currently used contraceptive method.     

复方口服避孕药治疗经前期综合征的临床疗效和安全性评价

目的:研究复方口服避孕药物治疗经前期综合征的疗效和安全性。方法:经前期综合征患者86例,随机分为治疗组(45例)和对照组(41例),治疗组给予复方口服避孕药,对照组给予维生素B6。分别用经期不适问卷(MDQ)和证候评分评估服药前和服药1、3、6个周期后经期不适的程度。结果:试验结束后,治疗组的MDQ评分、证候评分较对照组有显著性差异(P<0.05);治疗组和对照组的临床疗效总有效率分别81.1%和48.7%,有明显显著性差异(P<0.01);结论:复方口服避孕药对经前期综合征有较好的疗效和安全性。     

The classical and alternate pathways of complement in oral contraceptive users

Whole complement (CH50), C3, C4, the alternate pathway activity of complement (APH50) and factor B were measured in 159 women currently taking oral contraceptives and in 186 women who were not taking the pill. The mean levels of all components of the complement, except APH50, were found to be elevated in current users compared to non-users. The elevation in serum levels was seen in the first year after initiation of oral contraceptive use. Thereafter, levels changed little with duration of use. Among women who stopped using oral contraceptives, complement levels were similar to those of women who had never used the pill. Results appeared to be similar irrespective of the type of progestagen included in the oral contraceptive. These data provide support for the view that oral contraceptives have no adverse effect on the classical and the alternate pathways of complement.     

Side effects and compliance with low- and conventional-dose oral contraceptives among adolescents

Oral contraceptives are the most popular birth control method for teenagers, yet many teens discontinue use of these contraceptives prematurely. The need to minimize any potential long-term medical complications from the use of contraceptive hormones must be balanced with the desirability of increasing acceptance of contraceptives by adolescents. There has been concern that the use of socalled “low-dose” estrogen preparations, although decreasing the likelihood of complications, may lead to side effects that make compliance less certain. The present study comparing two commonly used oral contraceptive preparations, one low dose, one conventional dose, tests the hypothesis that among adolescents an association exists between oral contraceptive side effects and compliance. Using a double-blind crossover method, 55 sexually active adolescent females received two months each of a preparation containing 35 μg ethinyl estradiol and 0.5 mg norethindrone and another containing 50 μg mestranol and 1.0 mg norethindrone. The 50-μg preparation was associated with fewer side effects when administered during the first two months. No differences in side effects were noted in the latter two months, but there was a slight increase in weight gain when compared with the 35-μg preparation. The most common side effect was intermenstrual bleeding with the 35-μg pill. There was no documented relationship between the occurrence of side effects and compliance.