耽美大神 天涯:避孕药的问答：优势、风险及选择

避孕药问答：优势、风险及选择

How are pills that delay your period different from regular birth control pills? Does the pill cause weight gain? Here are the answers. 

与常规避孕药相比，推迟月经的避孕药有何不同？1

By Mayo Clinic staff

作者：Mayo医学中心

If you use the birth control pill — that is, an oral contraceptive — you're probably happy with its convenience and reliability. Still, you may have many questions about the potential effects of the birth control pill on your overall health. 

    如果你使用避孕药丸，也就是某种口服避孕药，你可能会其方便性和可靠性感到满意。然而，你可能对口服避孕药对整体健康的潜在影响仍有一些疑问。

How do pills that delay or eliminate your periods differ from other birth control pills?

推迟或者停止月经来潮的避孕药，与其他类型的药物存在哪些区别？

Traditional birth control pills mimic a regular 28-day monthly cycle. For the first 21 days, you take active pills containing reproductive hormones. For the last seven days, you take placebos. While you're taking the placebo pills, you bleed vaginally, as if you were having a regular menstrual period. By contrast, extended-cycle birth control pills contain active hormones for every day of the month. 

    传统的避孕药物模拟规律的28天月经周期。在前21天，服用含有生殖激素的活性药片。在其余7天内则服用安慰剂。当服用安慰剂时，开始出现阴道流血，相当于一次规律的月经来潮。同时，长周期避孕药则是在一个月内的每天均使用含有激素的药物。

The first extended-cycle pill regimens introduced provide active hormone pills every day for three months, then one week of placebo pills (Seasonale) or low-dose estrogen pills (Seasonique, LoSeasonique). You'll experience menstrual bleeding during that week. A newer extended-cycle regimen is designed to be taken continuously for one year (Lybrel). It's meant to suppress all menstrual bleeding. 

    第一种长周期避孕药，在前三个月每天口服含有激素活性的药片，然后给予一周安慰剂（商品名Seasonale）或者低剂量雌激素（商品名Seasonique,LoSeasonique）。在这一周内出现月经来潮。一种新的长周期避孕药设计为连续服用1年（商品名Lybrel）。该药物意味着抑制全部的月经来潮。

Some evidence suggests an advantage to this type of regimen. By continuously taking the pill, you prevent hormonal fluctuations that are responsible for bleeding, cramping, headaches and other discomforts associated with getting your period. Unscheduled bleeding and spotting often occur during the first few months. It typically goes away with continued use, but some women do continue to have unscheduled bleeding with continuous use of pills. 

    一些资料显示，长周期避孕药具备一定优势。通过连续服用药物，可以避免因为激素水平波动造成阴道出血、抽筋、头痛以及其他月经期间相关的不适症状。在使用的最初数周内，可能出现不规则阴道流血或点滴出血。此类现象在继续用药的过程中一般会消失，但仍有少部分女性有不规则阴道出血发生。

Can you use ordinary birth control pills continuously to prevent having a period?

能否通过连续服用普通口服避孕药来避免月经？

It's possible to prevent your period with continuous use of any birth control pill. This means skipping the placebo pills and starting right away on a new pack. Continuous use of your birth control pills works best if you're taking a monophasic pill — with the same hormone dose in the three weeks of active pills. 

    连续服用任何类型的口服避孕药来避免月经来潮是可行的。也就是不服用安慰剂，而是直接开始服用下一盒含有激素活性的药片。在使用单周期药物时连续服药的方法效果最好——连续服用3周含有同种激素的活性药片。

You may find continuous use of birth control pills a convenient way to avoid having your period during an important occasion or trip. Taking a monthly regimen birth control pill continuously is fine, but with continuous use of the pill you may develop breakthrough bleeding and then you should take the placebo pills so that you'll have a menstrual cycle. 

    在某些重要的场合或者旅途中，通过连续使用避孕药来避免月经是一种方便的方法。仅仅连续服用一个月的避孕药基本安全，但如果连续长时间服用，则可能出现突破性阴道出血，这时需要服用安慰剂药片从而发生一次月经来潮。

If you plan to have a baby, how soon after stopping the birth control pill can you conceive?

如果打算怀孕，那么停用避孕药后多长时间可以怀孕？

After you stop taking the pill, you may have only a two-week delay before you ovulate again. Your period would follow about four to six weeks after you take the last pill. Once ovulation resumes, you can become pregnant. If this happens during your first cycle off the pill, you may not have a period at all. 

    停用口服避孕药后，再次排卵可能延后二周左右。距离最后一次服药的大约四到六周可能出现月经来潮。一旦排卵恢复则有可能受孕。如果受孕发生在停药后的第一个排卵周期，那么可能不会发生月经来潮。

Is there an advantage to waiting a few months after stopping the pill before trying to conceive?

停用避孕药后等待几个月，是否对怀孕有益处？

If you have at least one normal period before conceiving, it will be somewhat easier to estimate when you ovulated and when your baby is due. 

    如果在妊娠前至少出现一次正常月经来潮，那么某种程度上可以更容易判断排卵时间和胎儿足月的时间。

In the past, doctors had concerns that if you conceived immediately after stopping the pill, you had a higher risk of miscarriage. However, these concerns have proved to be largely unfounded. 

    过去，医生对停用避孕药后立即受孕者是否增加流产风险存在顾虑。然而目前这种顾虑被证实缺乏根据。

If you plan to wait a few months, use a backup form of birth control while your menstrual cycles get back to normal. 

    如果计划停药后等待数月，那么在月经恢复后请使用屏障避孕。

What happens if you stop taking the birth control pill but your period doesn't resume?

如果停药后月经周期没有恢复是怎么回事呢？

If don't get a period for several months, you may have what's known as post-pill amenorrhea. The pill prevents your body from making hormones involved in ovulation and menstruation. When you stop taking the pill, it can take some time for your body to return to normal production of these hormones. 

    如果数月仍未恢复月经，有可能出现停药后闭经。避孕药使机体不产生排卵和月经来潮相关的激素。停药后身体需要一定时间恢复正常产生激素。

Typically, your period should start again within three months after you stop taking the pill. But some women, especially those who took the pill to regulate their menstrual cycles, may not have a period for many months. 

    一般来说，停药后三个月应该会恢复正常月经来潮。但仍有部分女性，尤其是服药调整月经周期者，可能在停药后较长时间不能恢复正常月经。

If you don't have a period within three months, take a pregnancy test to make sure you're not pregnant and then see your doctor. 

    如果在三月内未能恢复月经来潮，建议进行早孕测试检验是否怀孕并看医生。

Will a pregnancy test be accurate if you're taking the birth control pill?

如果正在口服避孕药，早孕测试是否准确？

You can get accurate results from a pregnancy test while you're on the pill. Pregnancy tests work by measuring a specific pregnancy-related hormone — human chorionic gonadotropin (HCG) — in your blood or urine. The active ingredients in birth control pills don't affect how a pregnancy test measures the level of HCG in your system. 

    在口服避孕药期间，早孕测试仍然是准确的。早孕测试通过检测一种妊娠相关激素——人绒毛膜促性腺激素（HCG）——在血液或尿液中的浓度来判断是否妊娠。避孕药中的有效成分并不影响早孕测试对HCG的检测。

What happens if you take birth control pills while you're pregnant?

如果已经怀孕却口服了避孕药该怎么办？

If you continued taking your birth control pill because you didn't realize you were pregnant, don't be alarmed. Despite years of this accident happening, there's very little evidence that exposure to the hormones in birth control pills causes birth defects. Once you learn that you're pregnant, stop taking the birth control pill. 

    如果没有发现怀孕却不慎口服了避孕药，请不必惊慌。这种情况时有发生，目前还没有证据显示暴露于避孕药中所含的激素会导致妊娠不良反应。一旦发现怀孕，请立即停用避孕药。

Can you use several birth control pills at once for emergency contraception?

是否能同时一次服用多种避孕药来作为紧急避孕？

It's possible to use standard estrogen-progestin birth control pills for emergency contraception, but check with your doctor for the proper dose and timing of the pills. 

    服用标准的雌激素-孕激素避孕药进行紧急避孕是可行的，但须与医生讨论适当的服药剂量和时间。

There are two types of pills specifically designed to keep you from becoming pregnant if you've had unprotected vaginal intercourse. These medications are sometimes referred to as the "morning-after pill." Levonorgestrel (Plan B One-Step, Next Choice) is available over-the-counter for women age 17 and older. It's available at drugstores, as well as health clinics and Planned Parenthood. Ulipristal acetate (Ella) also is approved for emergency contraception. It's available only by prescription. 

    有两种类型的药物特别用于非意愿性交后的避孕。此类药物通常被称为“事后避孕药”。左炔诺孕酮（商品名Plan B One-Step, Next Choice）可以为17岁及以上的女性方便购买。该药物可以在药房、诊所和计划生育单位购得。Ulipristal acetate(Ella)也用于紧急避孕，但它必须经医师处方购买。

如果已经多年服用避孕药，此时决定停药，那么是否可以随时停药还是必须把目前这个周期服完？

In terms of your overall health, it makes little difference when you stop taking the pill. When you finally do stop the pill, you can expect some bleeding, which may change the rhythm of your menstrual cycle. But you can stop at any time. 

    对整体健康而言，在何时停药无明显差别。当最终停药后，可能出现少量阴道流血从而改变月经周期。但是，您可以选择在任何时间停药。

Can you get pregnant during the week that you take the nonactive (placebo) pills?

在服用无活性药物（安慰剂）的一周内是否可能怀孕？

Taking the nonactive pills doesn't put you at higher risk of unintended pregnancy. If you're taking your birth control pills exactly as directed, they're 98 to 99 percent effective at preventing pregnancy. 

    口服无活性药物并不增加非医源性妊娠的风险。如果严格按照方法服用，避孕有效率可达到98-99%。

If, however, you've missed a dose — or several doses — during a cycle, you might be at higher risk of unintended pregnancy during that cycle. To be safe, use a backup form of contraception, such as a condom. 

    如果漏服了一个周期内的一片或者数片药物，那么该周期内非意愿性妊娠的风险将增加。为了安全起见，可以采用屏障避孕，例如安全套。

Do birth control pills cause weight gain?

口服避孕药是否导致体重增加？

    很多女性认为避孕药会导致肥胖。但研究显示。口服避孕药对体重的影响很小，如果确实存在的话。但同时，身体可能在乳房、臀部和大腿等部位潴留更多的液体，使人感觉似乎体重有所增加。避孕药中的雌激素成分可以影响脂肪细胞，造成脂肪细胞体积增大但其数目并不增多。

How do birth control pills affect your risk of cancer?

避孕药是否与癌症风险相关？

Scientific evidence suggests using birth control pills for longer periods of time increases your risk of some cancers, such as cervical cancer and liver cancer, but it also decreases your risk of other types of cancer, including ovarian cancer and endometrial cancer. 

    科研资料显示，长期使用口服避孕药可能增加某些癌症的风险，例如宫颈癌和肝癌，但也同时降低一些癌症的风险，包括卵巢癌和子宫内膜癌。

The effect of birth control pills on breast cancer risk isn't quite clear. However, some studies do show a link between pill use and breast cancer. Key factors seem to be how many years you take the pill and how recently you last used the pill. In one study, use of birth control pills led to a higher risk of premenopausal breast cancer in women who took the pill for four or more years before having a baby. Other evidence suggests that 10 or more years after you stop taking the pill, your breast cancer risk returns to the same level as if you had never taken birth control pills. 

    口服避孕药对乳腺癌的影响尚不清楚。一些研究确实显示避孕药和乳腺癌存在联系。重点是服药的年数和距离上次用药的时间。一项研究显示，在生育前使用口服避孕药达10年或以上，可导致绝经前乳腺癌风险增加。其他资料显示，停药10年及以上，乳腺癌风险可降低至从未服用避孕药的女性的水平。1

Do birth control pills affect cholesterol levels?

避孕药是否影响胆固醇水平？

Birth control pills can affect cholesterol levels. How much of an effect depends on the type of pill you're taking and what concentration of estrogen or progestin it contains. Birth control pills with more estrogen can have a slightly beneficial overall effect on your blood lipid levels. In general, though, the changes aren't significant and don't affect your overall health. 

    避孕药可以影响胆固醇水平。其影响程度取决于药物类型以及雌激素和孕激素的成分比例。含有更高雌激素成分的避孕药对整体血脂水平具有一定程度的好处。一般而言，避孕药对血脂造成的影响并不明显，而且不影响整体健康。

Do birth control pills affect blood pressure?

避孕药是否影响血压？

Birth control pills may slightly increase blood pressure. If you take birth control pills, have your blood pressure checked regularly. If you already have high blood pressure, talk with your doctor about whether you should consider an alternative form of birth control. 

    避孕药可能轻微地升高血压。在用药期间需定期监测血压。如果已经患有高血压，与医生商议是否需换用其他避孕方式。

Can women over age 35 continue taking birth control pills?

超过35岁的女性是否可以使用口服避孕药？

Although women over age 35 used to be told to stop taking birth control pills, these limits no longer apply to healthy, nonsmoking women. However, birth control pills aren't recommended for women over age 35 who smoke because of the risk of cardiovascular disease. If you're 35 or older and you smoke, you need to quit smoking before you can safely continue using birth control pills. 

    尽管35岁以上的女性曾经被告知停止使用口服避孕药，但该限制并不适用于健康、不吸烟的女性。口服避孕药不推荐35岁以上的吸烟妇女使用，因为心血管疾病的风险可能增加。如果您年龄超过35岁并且吸烟，则需要戒烟，才能安全地继续服用避孕药。

Can antibiotics decrease the effectiveness of birth control pills?

是否抗生素会降低口服避孕药的功效？

The effects of antibiotics on birth control pills may be overstated — except in the case of one antibiotic, rifampin (Rimactane). Studies clearly show that rifampin decreases the effectiveness of birth control pills in preventing ovulation. However, rifampin isn't used widely today.

    抗生素对避孕药的影响有可能存在，除抗生素利福平（商品名Rimactane）确实存在外。研究清楚显示，利福平会降低避孕药抑制排卵的效力。目前利福平已不广泛应用。