Gynäkologische Endokrinologie

, Volume 15, Issue 2, pp 139–152 | Cite as

Hormonelle Kontrazeption in Risiko- und Spezialsituationen

CME
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Zusammenfassung

Schwerwiegende Komplikationen unter hormoneller Kontrazeption, z. B. venöse Thrombembolien oder ein Myokardinfarkt, betreffen überwiegend Frauen mit Risikofaktoren oder genetischer Prädisposition. Wichtig bei der Auswahl eines geeigneten Kontrazeptivums für Risikopatientinnen sind daher eine gezielte Eigen- und Familienanamnese bei Erstverordnung sowie eine allgemeine und gynäkologische Untersuchung, um mögliche Fallstricke vorab zu identifizieren. Wichtige kardiovaskuläre Risikofaktoren sind arterieller Hypertonus, Adipositas, Dyslipidämien, Rauchen und Diabetes mellitus. Bei Thrombophilien und im Falle von Systemerkrankungen wie Lupus erythematodes sollte ebenfalls ein erhöhtes Thromboserisiko berücksichtigt werden. Hilfreich bei der Entscheidung sind in der Praxis die Empfehlungen der World Health Organization, die auch die Kontrazeption in Sondersituationen abdecken. In einigen Fällen sind jedoch Einzelfallentscheidungen notwendig, ggf. auch in einem interdisziplinären Rahmen.

Schlüsselwörter

Kardiovaskuläres Risiko Autoimmunerkrankungen Meningeom Stillen Thrombophilie 

Special issues in hormonal contraception

Abstract

Severe adverse effects using hormonal contraception (e. g. venous thromboembolism, myocardial infarction, ischemic stroke) are increasingly found in women with cardiovascular or genetic risk factors. Therefore, a thorough evaluation of personal and family history as well as a physical and gynecologic examination are essential before prescribing a contraceptive method. Important cardiovascular risk factors are hypertension, obesity, dyslipidemia, smoking and diabetes. In case of thrombophilia or preexisting systemic diseases (e. g. systemic lupus erythematosus) it is necessary to consider a concomitant risk of venous thromboembolism. The medical eligibility criteria for contraceptive use recommendations of the World Health Organization provide substantial help for choosing a suitable contraceptive method even in case of comorbidities. In some cases a special interdisciplinary approach is required.

Keywords

Risk, cardiovascular Autoimmune diseases Meningeoma Breast feeding Thrombophilia 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

S. Segerer gibt an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von dem Autor durchgeführten Studien an Menschen oder Tieren.

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Copyright information

© Springer Medizin Verlag Berlin 2017

Authors and Affiliations

  1. 1.Facharzt-Zentrum für Kinderwunsch, Pränatale Medizin, Endokrinologie und Osteologie Hamburg GmbHamedes expertsHamburgDeutschland

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