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Hormonale Kontrazeption in der Perimenopause

Hormonal contraception in perimenopause

  • Leitthema
  • Published:
Gynäkologische Endokrinologie Aims and scope

Zusammenfassung

Die Perimenopause ist gekennzeichnet durch eine Variabilität der Zykluslänge und endokrine Veränderungen. Es besteht jedoch weiterhin die Möglichkeit der Konzeption. Es stehen verschiedene kontrazeptive Möglichkeiten wie orale Kontrazeptiva (OC), Tubensterilisation, Intrauterinpessar, Barrieremethoden sowie hormonale injizierbare Kontrazeptiva und Implantate zur Verfügung. Neuere Kontrazeptiva wie der Vaginalring und transdermale Systeme bedürfen weiterer Studien zum Nachweis der Sicherheit und Effizienz in der Perimenopause. Gesunde Frauen ohne Nikotinabusus können bis in das 6. Lebensjahrzehnt OC erhalten. Hierdurch können Blutungsstörungen, vasomotorische Symptome, das Ovarial-, Endometrium- und Kolorektumkarzinomrisiko reduziert sowie eine Osteoporoseprävention bewirkt werden.

Abstract

Perimenopause marks the transition from normal ovulation to anovulation. However, perimenopausal women may still be at risk for unintended pregnancy. Various contraceptive methods may be offered including oral contraceptives (OC), tubal ligation, intrauterine devices, barrier methods, hormonal injectables and implants. Furthermore, the contraceptive vaginal ring and the transdermal contraceptive system have been introduced recently. However, these new options have to be further investigated in perimenopausal women. Women should be informed that OC use until menopause or the mid-50s is both safe for healthy, non-smoking women and effective in easing perimenopausal symptoms. OC use during perimenopause can also help reduce risks of bone density loss, as well as endometrial, ovarian and colorectal cancer later in life.

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Literatur

  1. Association of Reproductive Health Professionals 2004;http://www.arhp.org

  2. Casper RF, Dodin S, Reid RL et al. (1997) The effect of 20 µg ethinyl estradiol/1 mg norethindrone acetate (Minestrin), a low-dose oral contraceptive, on vaginal bleeding patterns, hot flashes, and quality of lifein symptomatic perimenopausal wome. Menopause 4: 139–147

    Google Scholar 

  3. Centers for Disease Control and the National Institute of Child Health and Human Development (1987) The reduction in risk of ovarian cancer associated with oral-contraceptive use. The Cancer and Steroid Hormone Study of the Centers for Disease Control and the National Institute of Child Health and Human Development. N Engl J Med 316(11): 650–655

    PubMed  Google Scholar 

  4. Centers for Disease Control and the National Institute of Child Health and Human Development (1987) Combination oral contraceptive use and the risk of endometrial cancer. The Cancer and Steroid Hormone Study of the Centers for Disease Control and the National Institute of Child Health and Human Development. JAMA 257(6): 796–800

    Article  PubMed  Google Scholar 

  5. Collaborative Group on Hormonal Factors in Breast Cancer (1996) Breast cancer and hormonal contraceptives: collaborative reanalysis of individual data on 53 297 women with breast cancer and 100239 women without breast cancer from 54 epidemiological studies. Lancet 347(9017): 1713–1727

    Article  PubMed  Google Scholar 

  6. Consensus conference on combination oral contraceptives and cardiovascular disease. Fertil Steril 71 [6 Suppl 3]: 1S–6S. Review

  7. Davis A, Godwin A, Lippman J et al. (2000) Triphasic norgestimate-ethinyl estradiol for treating dysfunctional uterine bleeding. Obstet Gynecol 96(6): 913–920

    Article  PubMed  Google Scholar 

  8. DeCherney A (1996) Bone-sparing properties of oral contraceptives. Am J Obstet Gynecol 174(1 Pt 1): 15–20. Review

    Article  PubMed  Google Scholar 

  9. European Menopause and Andropause Society: The transitional management: The use of oral contraceptives in Perimenopause. European Menopause and Andropause Society online

  10. Farmer RDT, Preston TD (1995) The risk of venous thromboembolism associated ith low oestrogen oral contraceptives. J Obstet Gynecol 15:195–200

    Google Scholar 

  11. Fernandez E, La Vecchia C, Balducci A et al. (2001) Oral contraceptives and colorectal cancer risk: a meta-analysis. Br J Cancer 84(5): 722–727

    Article  PubMed  Google Scholar 

  12. Gallo MF, Grimes DA, Schulz KF (2006) Skin patch and vaginal ring versus combined oral contraceptives for contraception. Cochrane Review 2006

  13. Gallo MF, Lopez LM, Grimes DA, Schuly KF (2006) Helmerhorst FM.Combination contraceptives: effects on weight. Cochrane Review 2006

    Google Scholar 

  14. Kailas NA, Sifakis S, Koumantakis E (2005) Contraception during perimenopause. Eur J Contracept Reprod Health Care 10(1): 19–25. Review

    Google Scholar 

  15. Kaunitz AM (2001) Lunelle monthly injectable contraceptive. An effective, safe, and convenient new birth control option. Arch Gynecol Obstet 265(3): 119–23. Review

    Article  PubMed  Google Scholar 

  16. Kaunitz AM (2002) Current concepts regarding use of DMPA. J Reprod Med 47 [9 Suppl]: 785–789. Review

  17. Lewis MA, Heinemann LA, Spitzer WO et al. (1997) The use of oral contraceptives and the occurrence of acute myocardial infarction in young women. Results from the Transnational Study on Oral Contraceptives and the Health of Young Women. Contraception 56(3): 129–140

    Article  PubMed  Google Scholar 

  18. NAMS guidelines;http://www.menopause.org

  19. Onyeka BA (2001) Levonorgestrel-releasing (20mcg/day) intrauterine systems (Mirena) compared with other methods of reversible contraceptives. BJOG 108(7): 770–771

    Article  PubMed  Google Scholar 

  20. Petitti DB, Sidney S, Bernstein A et al. (1996) Stroke in users of low-dose oral contraceptives. N Engl J Med 335(1): 8–15

    Article  PubMed  Google Scholar 

  21. PHSKC; Family Planning program, Clinical practice Guidelines update 2004

  22. Schlesselman JJ (1991) Oral contraceptives and neoplasia of the uterine corpus. Contraception 43(6): 557–579. Review

    Article  PubMed  Google Scholar 

  23. Sidney S, Petitti DB, Quesenberry CP Jr et al. (1996) Myocardial infarction in users of low-dose oral contraceptives. Obstet Gynecol 88(6): 939–944

    Article  PubMed  Google Scholar 

  24. Siskind V, Green A, Bain C, Purdie D (2000) Beyond ovulation: oral contraceptives and epithelial ovarian cancer. Epidemiology 11(2): 106–110

    Article  PubMed  Google Scholar 

  25. Smith JS, Green J, Berrington de Gonzalez A et al. (2003) Cervical cancer and use of hormonal contraceptives: a systematic review. Lancet 361(9364): 1159–1167. Review

    Article  PubMed  Google Scholar 

  26. Weiderpass E, Adami HO, Baron JA et al. (1999) Use of oral contraceptives and endometrial cancer risk (Sweden). Cancer Causes Control 10(4): 277–284

    Article  PubMed  Google Scholar 

  27. WHO Scientific Group (1998) Cardiovascular disease and steroid hormone contraception. Report of a WHO Scientific Group. World Health Organ Tech Rep Ser 877: i–vii, 1–89. Review

    PubMed  Google Scholar 

  28. Wildemeersch D, Schacht E, Wildemeersch P (2003) Performance and acceptability of intrauterine release of levonorgestrel with a miniature delivery system for hormonal substitution therapy, contraception and treatment in peri and postmenopausal women. Maturitas 44(3): 237–245

    Article  PubMed  Google Scholar 

  29. Zieman M, Guillebaud J, Weisberg E et al. (2002) Contraceptive efficacy and cycle control with the Ortho Evra/Evra transdermal system: the analysis of pooled data. Fertil Steril 77 [2 Suppl 2]:S13–18

    Google Scholar 

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  1. Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum Münster, Albert-Schweitzer-Straße 33, 48149 , Münster

    P. Stute & L. Kiesel

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  1. P. Stute
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  2. L. Kiesel
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Correspondence to P. Stute.

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Stute, P., Kiesel, L. Hormonale Kontrazeption in der Perimenopause. Gynäkologische Endokrinologie 4, 84–88 (2006). https://doi.org/10.1007/s10304-006-0144-y

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  • DOI: https://doi.org/10.1007/s10304-006-0144-y

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