The progestin revolution 2: progestins are now a dominant player in the tight interlink between contraceptive protection and bleeding control-plus more.

IF 2.2 Q2 OBSTETRICS & GYNECOLOGY Contraception and reproductive medicine Pub Date : 2023-10-09 DOI:10.1186/s40834-023-00249-5
Donna Shoupe
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Abstract

The interlink between bleeding control and contraceptive development has always been an important factor. But after many years of advances in contraceptive technology, this interplay has resulted in development of safer and better contraceptive methods that often offer significantly less bleeding for women with both normal bleeding patterns as well as in those suffering from heavy menstrual bleeding (HMB). Recognition of the success of progestin-only methods, such as the hormonal IUDs, progestin dominant oral contraceptives, and the high dose progestin-only pill in substantially decreasing and controlling menstrual bleeding has led the way. This recognition also led to the development of many [non-contraceptive] protocols to stop acute heavy bleeding as well as manage long-term bleeding [using contraceptive methods as well; as non-contraceptive methods].But even better, there is a new PLUS. The distinct benefit and risk profiles of the many different progestins now available are intentionally being used either in combination contraceptive pills [COCPs] or alone, to add additional benefits, to decrease side effects and risks, and increase effectiveness and bleeding control.

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孕激素革命2:在避孕保护和出血控制之间的紧密联系中,孕激素现在占据了主导地位。
出血控制和避孕药具开发之间的相互联系一直是一个重要因素。但经过多年避孕技术的进步,这种相互作用导致了更安全、更好的避孕方法的发展,这些方法通常为出血模式正常的女性和月经大出血(HMB)的女性提供明显更少的出血。人们认识到仅使用孕激素的方法在显著减少和控制月经出血方面取得了成功,如激素宫内节育器、以孕激素为主的口服避孕药和高剂量仅使用孕激素药丸。这一认识也导致了许多[非避孕]方案的发展,以阻止急性大出血,并管理长期出血[也使用避孕方法;作为非避孕方法]。但更好的是,有一个新的PLUS。目前可用的许多不同孕激素的不同益处和风险特征被有意用于联合避孕药[COCP]或单独使用,以增加额外的益处,减少副作用和风险,提高有效性和出血控制。
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