含孕激素宫内节育器

含孕激素宫内节育器
放入子宫的节育器
背景
生育控制種類宫内节育器
初次使用日期1990年(曼月乐)
1976年(黄体酮节育器,2001年停用)
失败比率 (第一年)
完美使用0.2%
一般使用0.2%
用法
持續期間5-7年(曼月乐)、3年(Skyla)
可逆性2-6个月
注意事項每月检查位置
醫師診斷一个月后复查,此后每年至少复查一次
優點及缺點
是否可以防止性傳播疾病
週期月经不调、经期缩短或停止
是否影響體重潜在副作用
好處无需每日采取避孕腊施
風險良性卵巢囊肿、盆腔炎、子宫穿孔(罕见)等

含孕激素宫内节育器(英語:Intrauterine device with progestogen),商品名为曼月乐Mirena)等,是一种可以释放左炔诺孕酮宫内节育器,其用途包括避孕、缓解月经过多、预防雌激素替代疗法英语Hormone replacement therapy可能产生的子宫内膜增生等。[1]这是最为有效的避孕方式之一,其年避孕失败率仅为0.2%左右。[2]该装置经由手术放入子宫中,有效期为三至五年。[3]取出之后,生育能力将很快得以恢复。[1]

其不良反应包括月经失调、良性卵巢囊肿骨盆疼痛、抑郁等。[1]个别情况下可能出现子宫穿孔英语Uterine perforation[1]妊娠时不推荐放入该装置,而哺乳期时则能安全使用。[1]

含孕激素宫内节育器是一种长效可逆避孕方法英语Long-acting reversible contraception[4]该装置通过孕激素以稠化宫颈黏液并让子宫内膜变薄,从而抑制精子通过宫颈并影响受精卵着床,以此起到避孕的作用。[1]

含左炔诺孕酮的宫内节育器最初于1990年在芬兰批准上市,2000年起开始在美国上市。[5]其被列入世界卫生组织基本药物标准清单,属于最有效、最安全的药物之一。[6]其在发展中国家的批发成本约为122.46美元。[7]在英国,国民保健署购买该装置的价格约为88英镑。[1]而在美国的售价则约为844美元。[8]已有120余个国家批准了含左炔诺孕酮的宫内节育器,并为超过1000万名女性所使用。[5][9]

参考文献

  1. ^ 1.0 1.1 1.2 1.3 1.4 1.5 1.6 British national formulary: BNF 69 69th. British Medical Association. 2015: 556. ISBN 9780857111562. 
  2. ^ Trussell, James. Contraceptive efficacy. Hatcher, Robert A.; Trussell, James; Nelson, Anita L.; Cates, Willard Jr.; Kowal, Deborah; Policar, Michael S. (eds.) (编). Contraceptive technology 20th revised. New York: Ardent Media. 2011: 779–863. ISBN 978-1-59708-004-0. ISSN 0091-9721. OCLC 781956734.  Table 26–1 = Table 3–2 Percentage of women experiencing an unintended pregnancy during the first year of typical use and the first year of perfect use of contraception, and the percentage continuing use at the end of the first year. United States.页面存档备份,存于互联网档案馆
  3. ^ Levonorgestrel intrauterine system medical facts from Drugs.com. www.drugs.com. [1 January 2017]. (原始内容存档于2017-01-01). 
  4. ^ Wipf, Joyce. Women's Health, An Issue of Medical Clinics of North America,. Elsevier Health Sciences. 2015: 507 [2017-09-26]. ISBN 9780323376082. (原始内容存档于2019-06-05). 
  5. ^ 5.0 5.1 Bradley, Linda D.; Falcone, Tommaso. Hysteroscopy: Office Evaluation and Management of the Uterine Cavity. Elsevier Health Sciences. 2008: 171 [2017-09-26]. ISBN 0323041019. (原始内容存档于2019-07-30). 
  6. ^ WHO Model List of Essential Medicines (19th List) (PDF). World Health Organization. April 2015 [8 December 2016]. (原始内容存档 (PDF)于2016-12-13). 
  7. ^ IUD (Levonorgestrel). International Drug Price Indicator Guide. [8 December 2016]. [永久失效連結]
  8. ^ Zieman, Mimi. Chapter 27. Managing Contraception 2012–2014. Managing Contraception. [2017-09-26]. ISBN 9781467536400. (原始内容存档于2020-08-03). 
  9. ^ Schäfer-Korting, Monika. Drug Delivery. Springer Science & Business Media. 2010: 290 [2017-09-26]. ISBN 9783642004773. (原始内容存档于2019-06-09). 

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