contraceptive methods; risks and benefits; hormonal and non-hormonal options
Abstract :
[en] Introduction: The Pill and and other forms of hormonal contraception, if taken correctly, are very effective and safe for millions of women, but since a few years, due to debates and controversies about third- and fourth-generation pills, other options have gained in popularity. Objectives: to provide a review of oestroprogestative contraception (OP), progestative contraception, IUDs with a focus on their advantages and side-effects according to the specific needs of women.Methods: Literature review and lessons learned from clinical practice.Results: the importance of family and individual history, the life-style and socio-economic conditions are critical factors for advising women of the 15 contraceptive choices available to them. The risk/benefit ratio of OP contraception needs a yearly follow-up. The progestative contraception is the preferred option for women who have contraindication for estrogen, are older than forty, and/or have risk factors such as a history of venous thromboembolism, overweight and smoking. The IUD is well tolerated and causes few side effects. Among the other contraceptive methods, sterilization and diaphragms are briefly discussed. Conclusions: Among the many safe and effective contraceptive methods, it is important for general practitioners to know the advantages and the side effects of each method, as well as the specific conditions of the woman, to propose the best options available. In case of difficulties of follow up or adherence to daily uptake, in particular among adolescents, long-acting methods such as IUD or implants are preferable. [fr] Introduction: Longtemps préférée des femmes, les pilules sont en recul en Belgique depuis les polémiques sur les pilules de 3° et 4° génération. Si le recours à la contraception orale a diminué, d'autres pratiques contraceptives se sont renforcées. Objectifs: Fournir une description détaillée des contraceptifs oestroprogestatifs (OP), des contraceptifs à base de progestatifs seuls et des dispositifs intra-utérins, en soulignant leur intérêt mais aussi les risques de leur utilisation. Méthode: Revue de la littérature et expérience clinique. Résultats: L'importance des antécédents personnels, familiaux, et du style de vie est déterminante pour évaluer les indications des différentes méthodes. En ce qui concerne les contraceptifs OP, le rapport risque/bénéfice nécessite un suivi annuel. La contraception progestative est une option choisie par de nombreuses femmes, particulièrement celles qui ont plus de 40 ans, et/ou des facteurs de risque comme le tabac, le surpoids ou des antécédents de TEV. Le dispositif intra-utérin est généralement bien toléré comme méthode contraceptive car il présente peu d'effets secondaires ou de complications. Parmi les autres méthodes contraceptives, la stérilisation féminine et le diaphragme sont brièvement discutés. Conclusion: Parmi les nombreuses possibilités de choix contraceptifs, il est important de faire connaître les indications et contre-indications en tenant compte de la situation de la personne. En cas de difficulté de suivi et d'observance, en particulier chez les adolescentes, la prescription des méthodes à longue durée d'action est préférable.
Disciplines :
Reproductive medicine (gynecology, andrology, obstetrics)
Author, co-author :
Manigart, Yannick; Université Libre de Bruxelles - ULB > Gynécologie-Obstétrique
BELIARD, Aude ; Centre Hospitalier Universitaire de Liège - CHU > Service de gynécologie, sénologie, obstétrique (CHBAH)
Rozenberg, Serge; Université Libre de Bruxelles - ULB > Gynécologie-Obstétrique
Gilles, Christine; Université Libre de Bruxelles - ULB > Gynécologie-Obstétrique
Language :
English
Title :
Etat de la contraception en 2016
Alternative titles :
[en] State of contraception in 2016
Publication date :
September 2016
Journal title :
Revue Médicale de Bruxelles
ISSN :
0035-3639
eISSN :
2795-8558
Publisher :
Association des Médecins Anciens Étudiants de l'Université Libre Bruxelles, Belgium
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