RESUMO
Los anticonceptivos orales combinados han evolucionado aceleradamente durante las últimas décadas reduciendo los efectos adversos sin afectar la eficacia y ajustándose a las preferencias de las mujeres. Es importante conocer las percepciones y expectativas de las usuarias para mejorar la adherencia y disminuir los fallos de la anticoncepción. Para tal fin se realizó un estudio encuestal con una muestra de 389 usuarias entre los 18 y 45 años de edad en las 4 ciudades principales de Colombia, evaluando además de las variables sociodemográficas el conocimiento y las preferencias de las usuarias relacionadas con los beneficios adicionales de esta terapia anticonceptiva. La muestra estuvo integrada en su mayoría por mujeres pertenecientes a los estratos socio-económicos medio (62,7%) y alto (37,3%). El 40,9% de las participantes se encontraban en el grupo de 18 a 25 años, 43,0% en el de 26 a 35 años y 16,1% en el de 36 a 45 años. 58,4% de las participantes refirieron conocer al menos un beneficio adicional de los anticonceptivos orales y cuando se les pidió que ordenaran por importancia cinco atributos propuestos por el encuestador como potenciales efectos beneficiosos, se obtuvo para todos los grupos de edad el siguiente orden: 1) que no afecte el peso corporal (35,2%), 2) disminución de la dismenorrea (26,6%), 3) mejorar la calidad de la piel (20,1%), 4) disminución en duración y volumen del sangrado menstrual (13,3%) y 5) reducir las fluctuaciones del estado anímico (5%). Una asesoría anticonceptiva individualizada y completa, donde se evalúen el conocimiento previo de los potenciales efectos beneficiosos de los anticonceptivos orales, las expectativas y preferencias de usuarias contribuirán a disminuir las tasas de embarazos no planificados relacionados con el uso incorrecto o con la suspensión de la terapia (AU)
Combined oral contraceptives have evolved rapidly in recent decades to reduce side effects without affecting the efficacy and according to the preferences of women. It is important to understand the perceptions and expectations of users to improve adherence and reduce the failure of contraception. To this end we conducted a survey-based study within a sample of 389 users aged 18 and 45 years of age in 4 major cities of Colombia, to assess sociodemographic variables in addition to knowledge and preferences of users related to the additional benefits of this contraceptive therapy. The sample consisted mostly of women belonging to middle (62.7%) and high (37.3%) socioeconomic groups. 40.9% of participants were in the group of 18 to 25 years, 43.0% in the group of 26 to 35 years and 16.1% in the group of 36 to 45 years. 58.4% of participants reported knowing at least one additional benefit of oral contraceptives, and when they were asked to rank by importance five attributes proposed by the interviewer as potential beneficial effects was obtained for all age groups the following order: 1) that it does not affect body weight (35.2%), 2) reduction of dysmenorrhea (26.6%), 3) improve the quality of the skin (20.1%), 4) decrease in duration and volume of menstrual bleeding (13.3%) and 5) reduce mood fluctuations (5%). An individualized and comprehensive contraceptive counseling, which assesses the prior knowledge of the potential beneficial effects of oral contraceptives, expectations and preferences of users will contribute to reducing unplanned pregnancy rates associated with incorrect use or with early discontinuation of therapy (AU)
Assuntos
Humanos , Feminino , Comportamento Contraceptivo/tendências , Anticoncepcionais Femininos/uso terapêutico , Anticoncepcionais Orais/uso terapêutico , Colômbia , Comportamento do Consumidor , Preferência do PacienteRESUMO
The low-dose combined oral contraceptive of ethinylestradiol 30 microg and dienogest 2 mg was launched in Germany in 1995, and is now the most commonly prescribed oral contraceptive in this country. Dienogest is a novel 19-nortestosterone-derived progestin with a unique pharmacokinetic and pharmacological profile, including antiandrogenic properties. Clinical studies have demonstrated that ethinylestradiol/dienogest is a reliable ovulation inhibitor with high contraceptive efficacy that is comparable with other combined oral contraceptives. It also provides effective cycle control, with reduced intensity and duration of menstrual bleeding, and improves dysmenorrhoea. The combination of ethinylestradiol and dienogest reduces serum androgen levels, and increases the levels of thyroid hormones; however, although thyroid hormone levels increase, there is no increased activity due to increases in transporter protein. Like other low-dose oral contraceptives, ethinylestradiol/dienogest has only minor influences on lipid and carbohydrate metabolism, adrenal hormones and blood pressure parameters, and appears to have a balanced effect on the haemostatic system. Ethinylestradiol/dienogest also has beneficial effects on hair and skin; a number of studies have reported decreased hair and skin greasiness, and improvements in acne vulgaris following treatment with ethinylestradiol/dienogest. After discontinuation of ethinylestradiol/dienogest, there may be a small delay in conception during the first three cycles, but there is no subsequent impairment of fertility. Furthermore, the duration of use of ethinylestradiol/dienogest does not seem to influence the rate of conception or time to conception. Ethinylestradiol/dienogest is well tolerated; adverse reactions associated with treatment include breast pain, headache and nausea/vomiting. These adverse reactions are rare and decrease in incidence over time.
