Therefore, considering the frequency of their sexual intercourses and the short lasting of sexual partnerships, effective contraceptive counselling for adolescent should be an absolute necessity.
Nevertheless, the adherence to COCs is often poor; concerns about side-effects, especially those affecting the menstrual cycle and the body weight, are often given as reason for discontinuation.
Consequently, unwilling pregnancies in adolescents remain a widespread social problem in all developed countries; in fact, five million abortions carried out yearly worldwide concern girls aged 15-19 (11). Then, it is mandatory to provide for a safe method of birth control in this age-group and to avoid the method discontinuation.
Adverse Effects of Hormonal contraception
- Cardiovascular Effects
- - Myocardial Infarction
- - Stroke
- - Arterial Accidents
- - Venous Thromboembolism
- - Blood Hypertension
- Other Effects
- - Angioedema
- - Peliosis Hepatis
- - Severe Adverse Ocular Reactions
- - Vasculitis
- Moderate adverse effects
- Cancer Risks
- - Breast cancer risk
- - Ovarian cancer risk
- - Endometrial cancer risk
- - Cervical cancer risk
- - Colorectal cancer risk
- - Skin cancer risk
- - Liver cancer risk
- - Pancreatic cancer risk
- - Neurofibromas growth
- - Unclear cancer risks
- Hazardous prescription
- Hormonal contraception in female transplant recipients
- - Hormonal contraception in female kidney recipients
- - Hormonal contraception in female liver transplant recipients
- - Hormonal contraception in female heart transplant recipients
- - Contraception in women HIV infected
- Mild Adverse effects
- New Perspectives immunocontraception
- Contraceptive counseling
However, the contraception management of these young women may encounter serious problems among those unaware carriers of the “factor V Leiden mutation” or with other kind of diseases, especially affecting hemostatic system (12,13,14).
Furthermore, there is an emerging evidence for requiring contraception in women aged 40 and older in which the occurrence of unintended pregnancy represents a significant problem. Adverse effects in healthy women taking hormonal contraceptives, are never accepted and can lead to poor compliance.
In addition, clinical researches reported a statistically significant correlation between undesirable side-effects and impairment of sexual function resulting in a very high considerable aspect in this age-group. Although fertility naturally declines with advancing age, women in their forties wish to continue to be sexually active long beyond their desire for childbearing. Then contraception becomes a great consideration during the last reproductive years.
Current researches indicated the safety of extending the use of combined hormonal contraceptives (COCs) to healthy women beyond the age of 40 and up to menopause without the need for replacement (15).