目的:为印度多囊卵巢综合征(PCOS)妇女使用口服避孕药(OCPs)的卫生保健提供者提供共识建议。
方法:广泛讨论,讨论,头脑风暴是在不同的兄弟会(专家)参与的情况下进行的。这些包括内分泌学家,妇科医生,生殖内分泌学家,皮肤科医生,公共卫生专家,研究人员,和一个项目经理与一个团队来制定指导方针。
方法:从2003年1月至2017年12月,通过使用适当控制的词汇对Medline和Cochrane数据库进行搜索来检索已发表的文献(例如,口服避孕药,多囊卵巢综合征,长期结果,不孕症)。临床实践指南收集,临床试验登记处,以及国家和国际医学专业协会的出版物和数据也进行了审查,以提出建议。
方法:指南委员会工作组包括来自PCOS协会(印度)的成员,印度辅助生殖协会,孟买妇产科学会,印度内分泌学会,印度皮肤科医师协会,性学家和性学家,化妆品皮肤病学会(印度),医学院的院士们,国家生殖健康研究所,和研究助理。核心团队包括五名生殖内分泌学家,五位妇科医生,五位皮肤科医生,三位内分泌学家,两名公共卫生专家和一名研究助理。
结论:这一共识声明为印度医生提供了关于在PCOS女性患者中使用OCP的指导/建议。PCOS是妇科/内分泌实践中常见的内分泌疾病之一。这种疾病的范围可能包括青春期前早熟的女孩,有多毛症的年轻女孩,痤疮和无排卵周期,已婚妇女不孕症,和老年妇女。尽管肥胖是大多数PCOS患者的共同特征,“精益PCOS”也存在。几年来,OCPs在PCOS妇女的症状管理中发挥了重要作用。这是由于OCPs减少黄体生成素,减少雄激素的产生,增加性激素结合球蛋白,结合雄激素。已经开发了几种新的OCP配方来减少副作用。这包括使用较少的雄激素孕激素和较低剂量的乙炔雌二醇。这些共识建议有助于卫生提供者选择正确的OCPs类型,这将缓解症状,副作用最小。它还可以深入了解适应症,禁忌症,以及对其短暂的担忧,中期和长期使用。
OBJECTIVE: To provide
consensus recommendations for health-care providers on the use of oral contraceptive pills (OCPs) in polycystic ovarian syndrome (PCOS) women in India.
METHODS: Extensive deliberations, discussions, and brainstorming were done with different fraternities (specialists) being involved. These included endocrinologists, gynecologists, reproductive endocrinologists, dermatologists, public health experts, researchers, and a project manager with a team to develop the
guideline.
METHODS: Published literature was retrieved through searches of Medline and The Cochrane Database from January 2003 to December 2017 using appropriate-controlled vocabulary (e.g., oral contraceptive pills, polycystic ovarian syndrome, long term outcomes, infertility). Clinical practice
guideline collections, clinical trial registries, and national and international medical specialty societies\' publications and data were also reviewed to suggest the recommendations.
METHODS: The working group for
guideline committee included members from the PCOS Society (India), Indian Society for Assisted Reproduction, The Mumbai Obstetric and Gynecological Society, The Endocrine Society of India, Indian Association of Dermatologists, Venereologists and Leprologists, Cosmetic Dermatology Society (India), Academicians from Medical Colleges, National Institute for Research in Reproductive Health, and a Research Associate. The core team included five reproductive endocrinologists, five gynecologists, five dermatologists, three endocrinologists, two public health experts and one research associate.
CONCLUSIONS: This consensus statement provides the guidance/recommendations for Indian practitioners regarding the use of OCP in women with PCOS. PCOS is one of the common endocrinopathies encountered in gynecological/endocrine practice. The spectrum of this disorder may range from prepubertal girls with premature pubarche, young girls with hirsutism, acne and anovulatory cycles, married women with infertility, and elderly women. Although obesity is a common feature for most PCOS patients, \'lean PCOS\' also exists. For several years, OCPs have played an important role in the symptom management of PCOS women. This is due to the fact that OCPs decrease the luteinizing hormone, reduce androgen production, and increase sex hormone-binding globulin, which binds androgens. Several new formulations of OCPs have been developed to decrease the side effects. This includes use of less androgenic progestins and lower doses of ethinyl estradiol. These
consensus recommendations help the health provider to choose the right type of OCPs, which will alleviate the symptoms with least side effects. It also gives insight into the indications, contraindications, and concerns regarding its short, intermediate and long-term use.