Combined oral contraceptives: update recommendations of the Latin American contraceptive association

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art_PALACIOS_Combined_oral_contraceptives_update_recommendations_of_the_Latin_2023.PDF (1.17 MB)
Citações na Scopus
0
Tipo de produção
article
Data de publicação
2023
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
TAYLOR & FRANCIS LTD
Autores
PALACIOS, Santiago
AYALA, Gabriela
GONZALEZ, Gemarilis
BADILLA-APUY, Can L.
MARCHENA, Jeannette
MARTINEZ, Katia
MOSTAJO, Desiree
VERNAZA, Maria S.
PARADAS, Alejandro
HERNANDEZ, Luis
Citação
GYNECOLOGICAL ENDOCRINOLOGY, v.39, n.1, article ID 2271072, 6p, 2023
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Background: In recent years, new combined oral contraceptives (COCs) have become available, representing an advance in terms of individualization and compliance by users.Objective: To provide recommendations regarding COCs: formulations, use, efficacy, benefits and safety.Method: For these recommendations, we have used the modified Delphi methodology and carried out a systematic review of studies found in the literature and reviews performed in humans, published in English and Spanish in Pubmed, Medline and advanced medicine and computer networks until the year 2021, using the combination of terms: 'oral contraceptives', 'estroprogestins' and 'combined oral contraceptives'.Results: Regarding the estrogen component, initially switching from mestranol (the pro-drug of ethinylestradiol) to ethinylestradiol (EE) and then reducing the EE dose helped reduce side effects and associated adverse events. Natural estradiol and estradiol valerate are already available and represent a valid alternative to EE. The use of more potent 19-nortestosterone-derived progestins, in order to lower the dose and then the appearance of non-androgenic progestins with different endocrine and metabolic characteristics, has made it possible to individualize the prescription of COC according to the profile of each woman.Conclusion: Advances in the provision of new COCs have improved the risk/benefit ratio by increasing benefits and reducing risks. Currently, the challenge is to tailor contraceptives to individual needs in terms of safety, efficacy, and protection of female reproductive health.
Palavras-chave
Combined oral contraception, hormonal, estrogens, progestogens, benefits, risks, individualization
URI
https://observatorio.fm.usp.br/handle/OPI/57477
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Coleções
Artigos e Materiais de Revistas Científicas - FM/MOG
Artigos e Materiais de Revistas Científicas - ODS/03