Interní Med. 2002; 4(8): 10-13

Kombinovaná hormonální antikoncepce - základní informace o rizicích a výhodách

MUDr. Martina Novotná
Gynekologicko-porodnické oddělení Nemocnice Milosrdných bratří, Brno

Keywords: combinated oral contraception, benefits and risks, therapeutic indications.

Published: December 31, 2002  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Novotná M. Kombinovaná hormonální antikoncepce - základní informace o rizicích a výhodách. Interní Med. 2002;4(8):10-13.

COC (combined oral contraception) přináší uživatelkám nejen spolehlivou kontrolu jejich fertility, ale řadu významných zdravotních profitů. Až v 50 % případů zmírňuje dysmenoreu, snižuje menstruační krvácení a tím riziko sideropenické ane-mie, redukuje výskyt myomů a příznivě ovlivňuje kvalitu pleti. Zaujímá prakticky nezastupitelné místo mezi terapeutiky v gynekologické endokrinologii. S velkou pravděpodobností při premenopauzálním užívání zvyšuje kostní denzitu, snižuje riziko fraktury kyčle a hraje roli v primární prevenci presenilní demence. Snižuje riziko karcinomu ovaria a endometria. Neovlivňuje výskyt karcinomu děložního čípku. Mírně zřejmě zvyšuje riziko karcinomu prsu u mladých nulipar užívajících COC déle než osm let před prvním porodem. Velmi mírně zvyšuje riziko hepatocelulárního karcinomu u uživatelek bez anamnézy hepatitidy B. Nezvyšuje riziko arteriálních cévních onemocnění u nerizikových uživatelek a riziko venózních cévních onemocnění zvyšuje jen nepatrně. Většina pozitivních účinků se zvýrazňuje při dlouhodobém užívání COC.

Odbornou lékařskou péčí je možné zajistit bezpečné užívání COC pro většinu žen a umožnit jim tak profitovat i z nekontra-cepčních účinků COC.

COMBINATED ORAL CONTRACEPTION - BASIC INFORMATIONS ABOUT RISKS AND BENEFIS

Besides reliable control of fertility COC brings a lot of another health profits. COC reduces dysmenorhea by 50 %, lowers menstrual bleeding and the risk of sideropenic anemia, reduces occurence of uterine fibroids and has positive influence on skin´s quality. COC plays almost irreplaceable role in gynecologic endocrinology. Premenopausal using of COC could help preserve bone mineral density and reduce the risk of hip fracture, probably plays important role in primary prevention of Alzheimer´s disease. Very important feature is protective effect against endometrial and ovarian cancer. Association of COC use and increased risk of cervical cancer has not been confirmed. The risk of breast cancer is probably slightly increased among young nulliparas using COC longer than 8 years before their first labor. The risk of hepatocelullar cancer among COC users is very slightly increased. The risk of arterial cardiovascular diseases seems not to be increased at no-risk users and the risk of venus ones is only very slightly incraesed. Most of profits of COC increases with duration of use. The using of COC is safe for most of women upon skilled medicine care, which make them possible to take an advantage of non-con-traceptive effect of COC.

Download citation

References

  1. Beral V, Hermon C, Kay C, Hannaford P, Darby S, Reeves G. Mortality associated with oral contraceptive use: 25 year follow up of cohort of 46 000 women from Royal College of General Practitioners' oral contraception study. BMJ 1999; 318: 96-100. Go to original source... Go to PubMed...
  2. Beral V, Hannaford P, Kay C. Oral contraceptive use and malignancies of the genital tract. Results from the Royal College of General Practitioners' Oral Contraception Study. Lancet 1988; 10: 1331-1335. Go to original source... Go to PubMed...
  3. Cibula D, Cífková R, Fanta M, Poledne R, Živný J, Skibová J. Increased risk of non-insulin dependent diabetes, arterial hypertension and coronary artery disease in perimenopausal and coronary artery disease in perimenopausal women with history of the polycystic ovary syndrome. Hum Reprod 2000; 15: 785-789. Go to original source... Go to PubMed...
  4. Corson SL. Oral contraceptives for the prevention of osteoporosis. J Reprod Med 1993; 38 (12 Suppl): 1015-1020. Go to PubMed...
  5. Davis AR, Westhoff CL. Primary dysmenorrhea in adolescent girls and treatment with oral contraceptives. J Pediatr Adolesc Gynecol 2001; 14 (1): 3-8. Go to original source... Go to PubMed...
  6. Drife JO. The benefits of combined oral contraceptives. Br J Ostet Gynecol 1989; 96: 1225-1228. Go to original source... Go to PubMed...
  7. Gilliam M, Elam G, Maloney JM, Flack MR, Sevilla CL, McLaughlin-Miley CJ, Derman R. Acne treatment with a low-dose oral contraceptive. Obstet Gynecol 2001; 97 (4 Suppl): 9. Go to original source...
  8. Guillebaud J. Contraception Today. Martin Dunitz 2000.
  9. Hannaford PC. Cardiovascular events associated with different combined oral contraceptives: a review of current data. Drug Saf 2000; 22: 361-371. Go to original source... Go to PubMed...
  10. Hannaford PC, Villard-Mackintosh L, Vessey MP, Kay CR. Oral contraceptives and malignant melanoma. Br J Cancer 1991; 63 (3): 430-433. Go to original source... Go to PubMed...
  11. Michaelsson K, Baron JA, Farahmand BY, Persson I, Ljunghall S. Oral-contraceptive use and risk of hip fracture: a case-control study. Lancet 353 (9163): 1481-1484. Go to original source... Go to PubMed...
  12. Chapdelaine A, Desmarais J, Derman RJ. Clinical Evidence of the Minimal Androgenic Activity of Norgestimate. Int J Fertil 1989; 34: 347-352. Go to PubMed...
  13. Chiaffarino F, Parazzini F, La Vecchia C, Marsico S, Surace M, Ricci E. Use of oral contraceptives and uterine fibroids: results from a case-control study. Br J Obstet Gynaecol 1999; 106 (8): 857-860. Go to original source... Go to PubMed...
  14. Kaunitz AM. Oral contraceptive health benefits: perception versus reality. Contraception 1999; 59 (1 Suppl): 29-33. Go to original source... Go to PubMed...
  15. La Vecchia C, Altieri A, Franceschi S, Tavani A. Oral contraceptives and cancer: an update. Drug Saf 2001; 24 (10): 741-754. Go to original source... Go to PubMed...
  16. Marshall LM, Spiegelman D, Goldman MB, Manson JE, Colditz GA, Barbieri RL, Stampfer MJ, Hunter DJ. A prospective study of reproductive factors and oral contraceptive use in relation to the risk of uterine leiomyomata. Fertil Steril 1998; 70 (3): 432-439. Go to original source... Go to PubMed...
  17. Ross RK, Pike MC, Vessey MP, Bull D, Yeates D, Casagrande JT. Risk factors for uterine fibroids: reduced risk associated with oral contraceptives. Br Med J 1986; 293 (6543): 359-362. Go to original source... Go to PubMed...
  18. Strnad P, Daneš J. Nemoci prsu pro gynekology. Grada Publishing 2001.
  19. Vessey MP, Painter R. Endometrial and ovarian cancer and oral contraceptives-findings in a large cohort study. Br J Cancer 1995; 71 (6): 1340-1342. Go to original source... Go to PubMed...




Internal Medicine for Practice

Madam, Sir,
please be aware that the website on which you intend to enter, not the general public because it contains technical information about medicines, including advertisements relating to medicinal products. This information and communication professionals are solely under §2 of the Act n.40/1995 Coll. Is active persons authorized to prescribe or supply (hereinafter expert).
Take note that if you are not an expert, you run the risk of danger to their health or the health of other persons, if you the obtained information improperly understood or interpreted, and especially advertising which may be part of this site, or whether you used it for self-diagnosis or medical treatment, whether in relation to each other in person or in relation to others.

I declare:

  1. that I have met the above instruction
  2. I'm an expert within the meaning of the Act n.40/1995 Coll. the regulation of advertising, as amended, and I am aware of the risks that would be a person other than the expert input to these sites exhibited


No

Yes

If your statement is not true, please be aware
that brings the risk of danger to their health or the health of others.