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DOI: 10.1055/s-0037-1603647
Long-Acting Reversible Contraception[*]
Contracepção reversível de longa ação*Publikationsverlauf
04. Dezember 2016
03. März 2017
Publikationsdatum:
03. Juli 2017 (online)
![](https://www.thieme-connect.de/media/10.1055-s-00030576/201706/lookinside/thumbnails/10-1055-s-0037-1603647_3003cne-1.jpg)
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 - progestinsDescritores
anticoncepção - anticoncepcionais - dispositivos anticoncepcionais - dispositivos intrauterinos - progestógenosNote
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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