Hormonal contraception has been an available method of birth control for over four decades Despite this, women’s knowledge often moves between myth and   reality,  and   never   has   another   medical   finding   aroused   over   similar controversial opinions.

Misperceptions, previous personal experience, suggestion by poor experience from other women and influence of mass media, sometimes contribute to noncompliance or drop-out of the used hormonal contraceptive method because of the user’s rational or irrational anxieties ⁽¹⁾.

In fact, this flash-information may lead to a clearcut relationship between negative suggestion and the incidence of emotional refusal ⁽²⁾.

Particularly,  the mass media continue to show an ambiguous behaviour enhancing the health risks of COCs use with a generic and uncritical manner or emphasizing the good effects of the hormonal contraceptives without informing about their risks.  In addition,  the current international influence by pharmaceutical companies on one part of the research can contribute to minimize many adverse outcomes of the sexual steroids and to limit a widespread scientific information.

It is known that biological and psychological changes are linked to hormonal contraception,and their adverse effects   can   play   an   important   role in   determining   acceptability ⁽³⁾.

Actually, hormonal contraceptives (COCs) contain both estrogen and progestin or progestin alone.  In 1964,  ethinyl estradiol (EE)  a better tolerated synthetic estrogen, replaced mestranol and, at the moment, is still used.

Oral EE, 200 times more potent than estradiol, exerts its action,  primarily dose-dependent,  on the estrogen-target   organs   and   tissues   (endometrium,  mammary   epithelium, liver, haemostasis and lipid levels).

Furthermore,  the estrogen primarily controls the menstrual bleeding.  Estrogen and progestin work synergically to inhibit ovulation. 

The androgenic action of progestins,  reflected in reduction of HDL cholesterol,  is an important factor in occurrence of arterial accidents ⁽⁴⁾.