자궁내피임장치의 최신 지견
Current opinion on intrauterine device (IUD)
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초록
자궁내피임장치는 난관결찰술과 비교할 정도의 높은 피임효과를 나타내며, 작용기전은 수정 후 유산의 촉진기전이 아니라, 자궁내 정자사멸의 환경을 발생시켜 피임을 유발한다, 자궁내피임장치는 골반염, 자궁외임신, 속발성 불임을 증가시키지 않 는다. 미산부, 미혼여성에서도 금기증은 아니다. 자궁내피임장치는 상부 여성생식기로 골반내 감염의 증가 없는 효과적인 피임방법이다. 추가적인 내과적 효과로 자궁내피임장치는 자궁내막암의 위험도를 낮추며, 호르몬함유 (levonogestrel) 자궁내 피임장치는 월경량 및 월경통을 경감시키고, 구리 (copper)함유 자궁내피임장치는 응급피임방법으로 사용할 수 있다, 적합한 환자선택과 삽입 전 환자와의 사전 상담이 자궁내피임장치의 성공의 관건이 될 것으로 사료되며 과거 수십 년 동안 새로운 피임방법의 발달과 근거중심의 연구결과가 있어 자궁내피임장치 사용의 새로운 기준이 적용되어야 할 것으로 사료된다.
Abstract
Intrauterine device (IUD) is a safe and efficient method of contraception in comparison with the efficacy of tubal sterilization, yet remains underutilized due to biased or outdated information about IUD. It is currently believed that the mechanism of action for IUDs is the production of an intrauterine environment that is spermicidal. IUD does not increase a woman's risk for pelvic infection, ectopic pregnancy, or subsequent infertility. IUD insertion in nulliparous or unmarried women is not contra-indicated. IUD is also a useful contraceptive method for those women without increasing the risk of ascending pelvic infection. The other benefit of IUD beyond contraception includes lowering the risk of endometrial cancer. The levonorgestrel-releasing intrauterine system reduces massive menstrual bleeding and dysmenorrhea. The copper IUD is the most effective method for emergency contraception. The careful patient selection and pre-insertion counseling are crucial to the success of IUD.
참고문헌 (25)
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