Hormonal contraception without estrogens The ESHRE Capri Workshop Group Human Reproduction Update, Vol.9, No.4 pp. 373-386, 29 |
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A
meeting was organized by ESHRE (Capri, Augusi 29-30, 2002) with
financial support from Schering S.p.A. to discuss hormonal contraception
wilhout estrogens. The long-term clinical effects of ethinyl estradiol
and the impact on environmental safety of the alkylated estrogen
components used in combined contraceptive pills remain the subject
of debate. The development of improved methods for the use of
progestogen-only contraception would represent a viabie and desirable
option. Several progestogen compounds are not alkylated, and these
can be delivered through a variety of routes. Some of the progestogen-only
methods are wel established in clinical use. Estimates for both
perfect and typical effectiveness are less than one pregnancy
per 100 woman-years with oral, injectable, implantable and intrauterine
methods. In practice, with the oral progestogen-only method, perfect
and typical effectiveness range from three to five pregnancies
per 100 woman-years. The main side effect with all progestogen-only
methods is unpredictable vaginal bleeding during the first months
of use, and this may lead to discontinuation. Nevertheless, continuation
of use is more frequent lf patients are well informed of this
side effect before treatment begins. No cardiovascular- and cancer-related
side effects have been proven. |