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Progestin-only contraception: Injectables and implants

机译:仅孕激素避孕药:注射剂和植入物

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摘要

Progestin-only contraceptive injectables and implants are highly effective, longer-acting contraceptive methods that can be used by most women in most circumstances. Globally, 6% of women using modern contraception use injectables and 1% use implants. Injectables are the predominant contraceptive method used in sub-Saharan Africa, and account for 43% of modern contraceptive methods used. A lower-dose, subcutaneous formulation of the most widely used injectable, depot-medroxyprogesterone acetate, has been developed. Implants have the highest effectiveness of any contraceptive method. Commodity cost, which historically limited implant availability in low-resource countries, was markedly lowered between 2012 and 2013. Changes in menstrual bleeding patterns are extremely common with both methods, and a main cause of discontinuation. Advice from normative bodies differs on progestin-only contraceptive use by breastfeeding women 0-6 weeks postpartum. Whether these methods are associated with HIV acquisition is a controversial issue, with important implications for sub-Saharan Africa, which has a disproportionate burden of both human immunodeficiency virus (HIV) and maternal mortality.
机译:仅孕激素的避孕药和植入物是高效,长效的避孕方法,大多数妇女在大多数情况下都可以使用。在全球范围内,使用现代避孕方法的妇女中有6%使用注射剂,而有1%使用植入物。注射剂是撒哈拉以南非洲地区使用的主要避孕方法,占现代使用避孕方法的43%。已经开发出使用最广泛的可注射的醋酸甲羟孕酮的低剂量皮下制剂。植入物是所有避孕方法中功效最高的。从历史上讲,在资源匮乏的国家中,历史上限制植入物供应的商品成本在2012年至2013年间已显着降低。两种方法的月经出血模式变化极为普遍,这也是停药的主要原因。规范机构的建议在产后0-6周母乳喂养妇女仅使用孕激素避孕药方面有所不同。这些方法是否与艾滋病毒的获取有关,是一个有争议的问题,对撒哈拉以南非洲地区具有重要意义,因为撒哈拉以南非洲地区的人类免疫缺陷病毒(HIV)和孕产妇死亡率负担过重。

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