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CC BY-NC-ND 4.0 · Rev Bras Ginecol Obstet 2017; 39(06): 294-308
DOI: 10.1055/s-0037-1603647
Review
Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Long-Acting Reversible Contraception[*]

Contracepção reversível de longa ação*
Rogerio Bonassi Machado
1   Tocogynecology Departament, Faculdade de Medicina de Jundiaí, Jundiaí, São Paulo, Brazil
,
Ilza Maria Urbano Monteiro
2   Tocogynecology Departament, Faculdade de Ciências Medicas, Universidade Estadual de Campinas, Campinas, São Paulo, Brazil
,
Jarbas Magalhães
3   Centro Personna de Ginecologia e Saúde da Mulher de Mogi Mirim (Center Personna for Gynecology na Woman's Health of Mogi Mirim), Mogi Mirim, São Paulo, Brazil
,
Cristina Aparecida Falbo Guazzelli
4   Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil
,
Milena Bastos Brito
5   Gynecology and Obstetrics Departament, Escola Bahiana de Medicina e Saúde Pública, Universidade Federal da Bahia, Salvador, Bahia, Brazil
,
Marta Franco Finotti
6   Gynecology and Obstetrics Departament, Faculdade de Medicina, Universidade Federal de Goiás, Goiás, Brazil
,
Jaqueline Neves Lubianca
7   Gynecology and Obstetrics Departament, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
,
Luis Carlos Sakamoto
8   Centro de Referência da Saúde da Mulher (Reference Center of Woman's Health), Hospital Perola Byington de São Paulo, São Paulo, São Paulo, Brazil
,
Silvio Antonio Franceschini
9   Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brazil
› Author Affiliations
Further Information

Publication History

04 December 2016

03 March 2017

Publication Date:
03 July 2017 (online)

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Abstract

Unwanted pregnancy is a major public health problem both in developed and developing countries. Although the reduction in the rates of these pregnancies requires multifactorial approaches, increasing access to long-acting contraceptive methods can contribute significantly to change this scenario. In Brazil, gynecologists and obstetricians play a key role in contraceptive counseling, being decisive in the choice of long-acting reversible methods, characterized by intrauterine devices (IUDs) and the contraceptive implant. The vast scope due to the reduced number of situations to indicate long-acting methods should be emphasized in routine contraceptive counseling. On the other hand, gynecologists and obstetricians should adapt the techniques of insertion of long-acting methods, and engage in facilitating conditions to access these contraceptives through public and private health systems in Brazil. This study is part of a project called Diretrizes e Recomendações FEBRASGO (Guidelines and Recommendations of the FEBRASGO – Brazilian Federation of Gynecology and Obstetrics Associations from the Portuguese acronym). It aims to review the main characteristics of long-acting contraceptives and critically consider the current situation and future prospects to improve access to these methods, proposing practical recommendations of interest in the routine of gynecologists and obstetricians.

Resumo

A gravidez não planejada representa importante problema de saúde pública tanto em países desenvolvidos quanto naqueles em desenvolvimento. Embora a redução das taxas dessas gestações requeira abordagens multifatoriais, o aumento no acesso aos métodos contraceptivos de longa ação pode contribuir de forma expressiva na mudança desse cenário. No Brasil, os ginecologistas e obstetras têm papel fundamental no aconselhamento contraceptivo, sendo decisivos na escolha dos métodos reversíveis de longa ação, caracterizados pelos dispositivos intrauterinos (DIUs) e pelo implante anticoncepcional. A grande abrangência decorrente do pequeno número de situações que contraindicam os métodos de longa ação deve ser enfatizada no aconselhamento contraceptivo de rotina. Por outro lado, os ginecologistas e obstetras devem se adaptar às técnicas de inserção dos métodos de longa ação, bem como se engajar na facilitação de condições para o acesso a esses contraceptivos por meio do sistema de saúde pública e privada no Brasil. Este estudo, parte do projeto denominado “Diretrizes e Recomendações FEBRASGO”, tem por objetivo revisar as principais características dos contraceptivos de longa ação, além de considerar de forma crítica o panorama atual e as perspectivas futuras, visando melhorar o acesso a esses métodos, com recomendações práticas de interesse na rotina do ginecologista e obstetra.

Keywords

contraception - contraceptive agents - contraceptive devices - intrauterine devices - progestins

Descritores

anticoncepção - anticoncepcionais - dispositivos anticoncepcionais - dispositivos intrauterinos - progestógenos

Note

This study is part of the Guidelines and Recommendations of the FEBRASGO, and its authors are members of the Brazilian National Specialized Commission in Contraception.


* This revision is part of the Project Series, Guidelines and Recommendations of the Federação das Associações de Ginecologia e Obstetrícia - FEBRASGO, elaborated by the Specialized National Committees in Contraception.


 

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