Contraceptive counseling

In adolescents, depot medroxyprogesterone may be an ideal option,  but its use is associated with poor continuation rates. Although the major problem is menstrual irregularity; the time, expense and inconvenience of a gynaecological visit also pose a barrier to use. Self-administration might make visit unnecessary. Adequate training and counselling regarding bleeding patterns may maximize success rates with self-administration (15)

Currently, the need for contraception in a period of life characterized by irregular menstrual cycles as the perimenopause,  represents a social event.

The introduction of new lower-dose contraceptives and progestin-only formulations as implants and IUD-releasing progestin has deeply changed the indications for hormonal contraception,  allowing its use in women in whom it was previously contraindicated (16.17,18,19,20)

Although,  gynecologist’s personal opinions and poor knowledges about this field, often lead to refuse contraception in older women.  Other important problems regard the contraceptive counselling post-abortion, post-partum and the contraceptive guidance for women at risk of sexually   transmitted   diseases   or   affected   by   HPV,  and/or   HIV   infections (21,22,23,24,25,26,27,28,29,30,31)

Although   many   studies   have   shown   a disappointing periabortion contraceptive uptake;  it was found that contraceptive counseling by a dedicate team, during pre-abortion visit, can dramatically improve post-abortion contraception uptake.  In addition,  according to the woman’s preference   it   is   possible   to   provide   immediate   post-abortal   IUD-insertion (32,33).

Preconception counselling is very important in adolescent sexually active with type 1-diabetes. In fact,early and unsafe sexual practices may increase their risk for unplanned pregnancy that could result in pregnancy-related complications.

Enhancing   knowledge   and   attitude   towards   preconception   counselling   and reproductive   health   education   may   reduce   these   risks   and   may   permit   a future, healthy reproductive life (34,35,36).

Expert counselling is necessary to plan birth control strategy in women affected by chronic serious diseases or transplant-recipients. In these women, sometimes there is difficulty to select a hormonal contraceptive risk-free,  but pregnancy may be even riskier (37,38,39,40,41,42).

Page 2 of 31 2 3 Next »

Provided by ArmMed Media