Contraception and Family Planning: New Aspects Related to the Therapeutic Possibilities

The therapeutic use of CHC (combined hormonal contraception) is examined in healthy patients who accept this contraceptive method and in patients with specific problems (abundant menstrual flows, hyperandrogenism, chronic pelvic pain, PMS, disability, different lifestyles, etc.) who require contraception. Rational motivation for the non-only contraceptive use of this device is represented by their mechanism of action: antigonadotropic action with ovulatory block and reduced production of sex steroids, endometrial response with changes in menstrual bleeding, action on the progesterone receptor, downregulation of estrogen receptors, and anti-inflammatory action. The dosing regimen (continuous regimen) can also modulate the therapeutic response in relation to the utilization in pathologies with catamenial exacerbation. The metabolic response varies in relation to the characteristics of the association (synthetic or natural estrogen, progestin component) with possible hepatocellular action, characteristic for associations with EE. Numerous data on associations with EE, few data with natural estrogens are available; the assumptions of use in relation to particular therapeutic lines are examined

Satisfaction and compliance in hormonal contraception: the result of a multicentre clinical study on women's experience with the ethinylestradiol/norelgestromin contraceptive patch in Italy

<p>Abstract</p> <p>Background</p> <p>For many women finding the right contraceptive method can be challenging and consistent and correct use over a lifetime is difficult. Even remembering to take a birth control pill every day can be a challenge. The primary objective of this study was to evaluate women's experience with a weekly ethinylestradiol/norelgestromin contraceptive patch (EE/NGMN patch), given new technologies recently developed in hormonal contraception to increase women's options in avoiding daily dosing.</p> <p>Methods</p> <p>In 24 Italian sites, 207 women received the EE/NGMN patch for up to 6 cycles. At study end, overall satisfaction and preference, as well as compliance, efficacy and safety, were evaluated.</p> <p>Results</p> <p>175 women (84.5%) completed the study. The overall satisfaction rate was 88%; convenience and once-a-week frequency of the patch were especially appreciated. At baseline, 82 women (39.4%) were using a contraceptive method, mainly oral contraceptives and barrier methods, but only 45.1% were very satisfied/satisfied; after 6 months with the patch, 86.3% of this subset was very satisfied/satisfied. Considering the method used in the 3 months before the study entry, 78.1% strongly preferred/preferred the patch, for convenience (53.9%), ease of use/simplicity (28.9%), fewer (9.2%) and less severe (2.6%) side effects. Compliance was very high: 1034/1110 cycles (93.2%) were completed with perfect compliance and the mean subject's compliance score was 90%. One on-therapy pregnancy occurred. The patch was safe and well tolerated: adverse events frequency was low, with predominantly single reports of each event. Most of them started and subsided during cycle 1.</p> <p>Conclusion</p> <p>This study demonstrated that the EE/NGMN patch is associated with high satisfaction levels and excellent compliance. At study end, the majority of women indicated that they would continue using the patch.</p

Counseling ed esame obiettivo nell’adolescente: indicazioni per una valutazione rispettosa della sessualità

Dubbi o paure relative alla sessualità sono spesso presenti nei bisogni di salute degli adolescenti sia che restino impliciti dietro una richiesta di visita o di prescrizione contraccettiva sia che vengano espressi. Partendo dalle richieste o dai sintomi sessuali, spesso correlati ad una fase ancora di conoscenza di sé e dell?altro, è possibile offrire un counseling ed un esame ginecologico orientato, che chiarisca almeno in parte la dimensione del problema. Infine non dimentichiamo che, proprio per la sua specificità nel percorso di crescita adolescenziale, può essere indispensabile per una corretta presa in carico di alcune situazioni cliniche, proporre il tema della sessualità come argomento privilegiato di consulenza