口服避孕药含屈螺经前综合症。

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洛佩兹LM, Kaptein AA, Helmerhorst调频

口服避孕药含屈螺经前综合症。

科克伦数据库系统启2012 2月15;(2):CD006586。cd006586.pub4 doi: 10.1002/14651858.。

PubMed ID

22336820 (在PubMed

]

文摘

背景:经前期综合征(PMS)是一个常见的问题。经前焦虑障碍(PMDD)是一种严重的经前综合症。联合口服避孕药,它提供黄体酮和雌激素,已经检查了他们的能力来缓解经前症状。一个包含屈和低雌激素剂量的口服避孕药已经批准用于治疗经前不悦症的女性选择口服避孕药避孕。目的:审查所有随机对照试验比较联合口服避孕药含有屈安慰剂或影响的另一个联合口服避孕药经前症状。搜索方法:我们寻找屈和经前综合症的研究在以下数据库:科克伦中心注册的对照试验(中央)(Cochrane图书馆),MEDLINE,和POPLINE(2011年12月20日);EMBASE,紫丁香,PsycINFO ClinicalTrials.gov,国际临床试验注册平台(ICTRP)世界卫生组织2011年3月(02)。我们还研究了引用列表相关的文章和写信给被调查人员找到其他试验。选择标准:我们在任何语言,包括随机对照试验相比,联合口服避孕药(COC)含屈螺与安慰剂或影响的另一个COC经前症状。主要结果包括情感和身体上的前瞻性记录的经前症状。 Adverse events related to combined oral contraceptive use were examined. DATA COLLECTION AND ANALYSIS: Two review authors independently extracted data and assessed study quality. For continuous variables, the mean difference (MD) was computed with 95% confidence interval (CI). For dichotomous outcomes, the Peto odds ratio (OR) with 95% CI was calculated. MAIN RESULTS: We included five trials with a total of 1920 women. Two placebo-controlled trials of women with PMDD showed less severe premenstrual symptoms after three months with drospirenone 3 mg plus ethinyl estradiol 20 mug than with placebo (MD -7.92; 95% CI -11.16 to -4.67). The drospirenone group had greater mean decreases in impairment of productivity (MD -0.31; 95% CI -0.55 to -0.08), social activities (MD -0.29; 95% CI -0.54 to -0.04), and relationships (MD -0.30; 95% CI -0.54 to -0.06). Side effects more common with the use of the drospirenone COC contraceptive were nausea, intermenstrual bleeding, and breast pain. The respective odds ratios were 3.15 (95% CI 1.90 to 5.22), 4.92 (95% CI 3.03 to 7.96), and 2.67 (95% CI 1.50 to 4.78). Total adverse events related to the study drug were more likely for the drospirenone COC group (OR 2.36; 95% CI 1.62 to 3.44). Three trials studied the effect of drospirenone 3 mg plus ethinyl estradiol 30 mug on less severe symptoms. A placebo-controlled six-month trial had insufficient data for primary outcome analysis. Another six-month study used levonorgestrel 150 microg plus ethinyl estradiol 30 microg for the comparison group but did not provide enough data on premenstrual symptoms. In a two-year trial, the drospirenone COC group had similar premenstrual symptoms to the comparison group given desogestrel 150 microg plus ethinyl estradiol 30 microg (OR 0.87; 95% CI 0.63 to 1.22). The groups were also similar for adverse events related to treatment (OR 1.02; 95% CI 0.78 to 1.33). AUTHORS' CONCLUSIONS: Drospirenone 3 mg plus ethinyl estradiol 20 mug may help treat premenstrual symptoms in women with severe symptoms, that is, premenstrual dysphoric disorder. The placebo also had a large effect. We do not know whether the combined oral contraceptive works after three cycles, helps women with less severe symptoms, or is better than other oral contraceptives. Larger and longer trials of higher quality are needed to address these issues. Trials should follow CONSORT guidelines.

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