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Minerva Obstetrics and Gynecology 2021 October;73(5):614-20

DOI: 10.23736/S2724-606X.21.04897-1


lingua: Inglese

Current and future hormonal contraception in Italy: results from an Italian consensus expert meeting

Costantino DI CARLO 1, Massimo ABBONDANZA 2, 3, Antonella AGNELLO 4, Giovanni CAVALLI 5, Lorenza DRIUL 6, Massimo PETRIGLIA 7, Andrea TINELLI 8, Alessandra TIRELLI 9, Anna TUSEI 10, Giovanni GRANDI 11

1 Department of Neurosciences and Reproductive Sciences, Federico II University, Naples, Italy; 2 Unit of Gynecology, ASL Città di Torino, Turin, Italy; 3 ASL TO5, Turin, Italy; 4 Poliambulatorio Euganea Medica, SYNLAB, Padua, Italy; 5 Unit of Obstetrics and Gynecology, ASST Fatebenefratelli-Sacco, Milan, Italy; 6 Unit of Obstetrics and Gynecology, University of Udine, Udine, Italy; 7 Unit of Obstetrics and Gynecology, Velletri Hospital, Velletri, Rome, Italy; 8 Unit of Obstetrics and Gynecology, Veris delli Ponti Hospital, Scorrano, Lecce, Italy; 9 Gynepro Medical Center, Bologna, Italy; 10 Unit of Obstetrics and Gynecology, Valduce Hospital, Como, Italy; 11 Unit of Obstetrics and Gynecology, Department of Medical and Surgical Sciences for Mother, Child and Adult, University of Modena and Reggio Emilia, Modena, Italy

BACKGROUND: Hormonal pills are among the most widely contraceptive methods used by women, despite the possible onset of different adverse events. To minimize the risk of thrombosis-related adverse events, different formulations and doses have been investigated. Micronized estradiol (E2)/nomegestrol acetate (NOMAC) 24+4 is the first monophasic combined oral contraceptive pill containing natural E2, the same steroid produced by the granulosa cells of women ovaries. This combination presents an improved effect on hemostasis and metabolism compared to ethinyl-estradiol (EE)-based products and may be considered a good option to meet women’s needs in a more physiological way. Despite the benefits of E2, its use is still not so common among combined oral contraceptives (COC).
METHODS: Seventy-seven Italian gynecologists were involved and asked to answer a survey to investigate some aspects related to contraception. The results of the survey were discussed within the same gynecologists and a panel of experts during eight macro-regional meetings.
RESULTS: The survey demonstrated that clinicians dedicate 40-60% of their time to contraception and confirmed the importance of the choice of the contraceptive pill, which is mostly prescribed for contraceptive purposes. Moreover, COC containing E2 is considered as the first choice in oral contraception and meets the features of an ideal pill.
CONCLUSIONS: Italian gynecologists reported that E2-based pill presents benefits related to safety, good tolerability, and low adverse events, in particular, related to a reduced thromboembolic risk. Research market data highlight that the use of these types of COC should expand with respect to traditional compounds containing EE.

KEY WORDS: Hormonal contraception; Estrogens; Ethinyl estradiol

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