Contraception for adolescent and young women. A consensus conference results.

Abstract

Objective: This consensus aimed to establish a consensus on hormonal contraception for adolescents and young women by synthesising current evidence and expert opinions, ultimately forming an evidence-based framework to guide clinical decision-making for methods approved in Italy.

Methods: An expert panel convened by the Italian Society of Contraception conducted a systematic review of the literature regarding contraceptive efficacy, cycle control, hyperandrogenism, sexual function, mood, bone health, and vaginal health. Consensus statements were debated and refined iteratively during the Society's 15th National Congress. Approximately 150 clinicians cast anonymous electronic votes, requiring a consensus of at least 75% to finalise each statement.

Results: All statements exceeded the 75% consensus threshold. Recommendations emphasise the prioritisation of long-acting reversible contraceptives as primary choices for adolescents due to their enhanced efficacy and adherence rates. The panel highlighted the importance of anticipatory counselling regarding bleeding patterns and other side effects to reduce discontinuation rates. Combined hormonal methods have been proven effective for managing acne, with recommendations offered for selecting formulations that enhance sexual health, stabilise mood, and consider bone metabolism.

Conclusions: Selecting a hormonal contraceptive for young women requires a personalised evaluation that considers pregnancy prevention, tolerability, and additional non-contraceptive advantages. This consensus provides Italian clinicians with a structured, evidence-based framework to facilitate personalised counselling and encourage the sustained, safe use of contraceptives.