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エビデンスに基づくEP配合剤のベネフィットとリスク
EP配合剤とは

EP配合剤は、医療従事者による適切な情報提供により、避妊・月経困難症など様々な目的に使用することができます。

エストロゲン(卵胞ホルモン)とプロゲスチン(黄体ホルモン)の配合剤(EP配合剤)は、避妊や月経困難症など様々な目的で使用されています。(一部、ホルモン補充療法(HRT)や骨粗鬆症の治療に用いられるEP配合剤もありますが、本稿ではそれらの薬剤は含みません。)

EP配合剤は、健康女性も使用すると考えられるため、薬剤による健康被害は極力避けなければなりません。エストロゲンとプロゲスチンのうち、特にエストロゲンの含有量を減らすことにより副作用の発生率が低下するとの報告がなされたことから、エストロゲンの低用量化が進められ、1973年にアメリカでエストロゲンの含有量が50㎍未満のEP配合剤が低用量経口避妊薬として承認されました。

日本国内では、1999年に低用量経口避妊薬が避妊を目的として発売されました。また、エストロゲンの含有量が20㎍にまで低用量化された製剤などが月経困難症治療薬として発売されています。

2010年のデータによると、世界で約5800万人を越える女性がEP配合剤を使用しています1)。EP配合剤には様々なベネフィットを有する反面、副作用などのリスクも伴いますが、多くの女性はこれらのベネフィットとリスクについて、必ずしも理解しながらEP配合剤を使用しているわけではありません2)。またEP配合剤の使用で、体重や妊孕性、がんのリスクなど、どのような影響を及ぼすのか、あるいはどのように関わっているのかを詳細に知りたいと思っています。

EP配合剤のベネフィットとリスクに関して、包括的な情報を女性に提供することで、医療従事者は関連疾患に対する最も適した治療法または避妊法を提供することができます。

略語一覧を見る

略語一覧

AIDS:
後天性免疫不全症候群
ATE:
動脈血栓塞栓症
BMI:
ボディマス指数
DSG:
デソゲストレル
DVT:
深部静脈血栓症
EP配合剤:
エストロゲンとプロゲスチンの配合剤
HIV:
ヒト免疫不全ウイルス
HPV:
ヒトパピローマウイルス
HRT:
ホルモン補充療法
IUD:
子宮内避妊器具
LNG-IUS:
レボノルゲストレル放出子宮内システム
MI:
心筋梗塞
OCs:
経口避妊薬。ただし配合型経口避妊薬とプロゲスチン単独経口避妊薬を含む
PE:
肺塞栓症
PI:
パールインデックス。低用量経口避妊薬の1年間の避妊失敗率
PID:
骨盤内炎症性疾患
PMDD:
月経前不快気分障害
STI:
性感染症
VTE:
静脈血栓塞栓症

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参考文献を見る

参考文献

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Last Updated:2018/08/21 L.JP.MKT.WH.02.2017.0860