The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception最新文献

{"title":"Re-evaluating desogestrel: hormonal contraception, early-onset breast cancer, and the postpartum period.","authors":"Ambrogio P Londero, Serena Bertozzi, Anjeza Xholli, Kerstin Sandelin, Angelo Cagnacci","doi":"10.1080/13625187.2026.2656682","DOIUrl":"10.1080/13625187.2026.2656682","url":null,"abstract":"<p><p>This clinical perspective evaluates the implications of recent registry-based findings that associate desogestrel-containing hormonal contraceptives with early-onset breast cancer, considering potential modifications to clinical practice. The analysis focused on cancers diagnosed before age 50 that are significantly shaped by the epidemiology of early-onset breast cancer, the transient postpartum increased risk of breast cancer, genetic susceptibility, and the clinical selection of progestin-only methods for women with cardiometabolic risk. Associations observed with desogestrel may reflect residual confounding from postpartum timing, breastfeeding duration, and metabolic factors, rather than drug-specific carcinogenicity. Due to the many drawbacks of the registry study, the current evidence does not support discouraging the use of desogestrel during lactation or in patients contraindicated for oestrogen, de facto depriving many women of the possibility to perform an appropriate hormonal contraception. This paper delineates methodological priorities for future research to effectively distinguish biological effects from reproductive and metabolic confounding factors.</p>","PeriodicalId":520795,"journal":{"name":"The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception","volume":" ","pages":"257-260"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147701793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The missing half: a historical meta-narrative review of gendered responsibility in the history of contraception.","authors":"Heidi Stelling, Megan E L Brown, Amiee Trinder, Sophia Nahid, Bryan Burford","doi":"10.1080/13625187.2026.2707139","DOIUrl":"https://doi.org/10.1080/13625187.2026.2707139","url":null,"abstract":"<p><strong>Introduction: </strong>The history of contraception is largely the history of women's contraception. Twentieth-century innovations and expanding sexual freedoms promised women greater reproductive control, yet male methods remained limited and unchanged. Contemporary contraceptive discourse continues to centre women's bodies, assuming women will manage fertility, tolerate side-effects, and bear the consequences of contraceptive failure. Drawing on feminist theory, this review examines how social, political, and medical developments attached responsibility for contraception to women, and how these historical patterns continue to shape contemporary attitudes towards male contraception, trust, and reproductive responsibility.</p><p><strong>Method: </strong>A meta-narrative review was conducted using an adapted version of Greenhalgh's six-step framework. An interprofessional team of researchers worked reflexively across all stages, drawing on their varied expertise to guide interpretation and decision-making.</p><p><strong>Findings: </strong>61 papers present findings across seven historical periods, tracing major social, political, and medical shifts influencing contraceptive development from pre-18th-century practices to the modern public health era. Across the historical record, male contraception remained comparatively peripheral, commonly associated with disease prevention, family completion, or exceptional responsibility rather than routine reproductive labour.</p><p><strong>Conclusion: </strong>The historical record suggests that contemporary inequalities in contraceptive responsibility reflect longstanding social and medical structures that positioned reproduction as women's work. Expanding women's contraceptive control often increased expectations that women should manage fertility, while male responsibility remained comparatively limited or voluntary. New male contraceptive technologies may alter available methods, but tensions surrounding trust, control, and responsibility are likely to persist while the physical and social consequences of pregnancy continue to fall disproportionately on women.</p>","PeriodicalId":520795,"journal":{"name":"The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception","volume":" ","pages":"1-19"},"PeriodicalIF":2.0,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148612263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genital cosmetic surgery intention and its association with genital self-image and body exposure during sexual activity: a cross-sectional study.","authors":"Hülya Özberk, Merlinda Aluş Tokat, Onur Yavuz, Melike Coşkun","doi":"10.1080/13625187.2026.2704114","DOIUrl":"https://doi.org/10.1080/13625187.2026.2704114","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this study is to examine the relationship between genital self-image and body perception during sexual intercourse by determining women's intentions to undergo genital cosmetic surgery and their preferences for genital cosmetic surgery.</p><p><strong>Methods: </strong>This cross-sectional study included 410 women between January and December 2025. Women were evaluated based on their intentions to undergo genital cosmetic surgery and were divided into two groups accordingly. Data were collected using the Descriptive Characteristics Assessment Form, Female Genital Self-Image Scale (FGSIS), and Body Exposure During Sexual Activity Questionnaire (BESAQ).</p><p><strong>Results: </strong>Among all women, 46.3% of women stated that they had considered undergoing genital cosmetic surgery. The most frequently preferred procedures were genital whitening (31.1%), laser vaginal rejuvenation (20.0%), and vaginoplasty combined with genital whitening (15.8%). The most important motivation for requesting surgery was sexual pleasure (32.6%), followed by social media (21.1%) and partner request (21.1%). BESAQ scores were found to be significantly higher among women considering genital cosmetic surgery (<i>p</i> = 0.015), but no significant difference was found in terms of FGSIS scores (<i>p</i> = 0.177). A moderate negative correlation was found between BESAQ and FGSIS in the group considering surgery (r= -0.387; <i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>The intention for genital cosmetic surgery appears to be more closely related to increased body-focused cognitive processes during sexual intercourse than to genital self-image. This highlights the importance of psychosexual evaluation and comprehensive counselling processes in genital cosmetic surgery requests.</p><p><strong>Short condensation: </strong>Approximately half of women consider genital cosmetic surgery. Women who consider genital cosmetic surgery have a higher body focus during sexual intercourse. Social media and partner influence are important motivators.</p>","PeriodicalId":520795,"journal":{"name":"The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception","volume":" ","pages":"1-9"},"PeriodicalIF":2.0,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148521867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dienogest as a progestin in contraception and non-contraceptive clinical entities (heavy menstrual bleeding, acne and hirsutism). Narrative review of the literature and recent developments.","authors":"Giovanni Grandi, Rossella E Nappi, Angelo Cagnacci, Vincenzina Bruni, Vincenzo Bettoli, Alessandro Gambera, Filippo Favalli, Enrico Colli, Pedro-Antonio Regidor","doi":"10.1080/13625187.2026.2695185","DOIUrl":"10.1080/13625187.2026.2695185","url":null,"abstract":"<p><strong>Background: </strong>Combined oral contraceptives (COC)s, besides offering a reliable and safe contraception, offer a variety of non-contraceptive health benefits and therapeutic positive aspects.</p><p><strong>Methods: </strong>While contraceptive use is the primary indication for COC use, a variety of medical conditions have been added in the summary of product characteristics (SmPC) of these formulations.</p><p><strong>Results: </strong>Dienogest, a 17a-cyanomethyl-17ß-hydroxy-4,9-estradien-3-one progestin is used in different dosage regimes with different oestrogens and with different release forms in contraception and has, depending on the type of COC additional medical treatment indications.</p><p><strong>Conclusions: </strong>This narrative review will focus on the effects, apart from contraception, of these COCs on female target organs like the uterus and the skin and clinical entities as the polycystic ovarian syndrome (PCOS).</p>","PeriodicalId":520795,"journal":{"name":"The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception","volume":" ","pages":"1-13"},"PeriodicalIF":2.0,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148407792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Critical assessment of a prolonged-release EE/DNG contraceptive safety analysis.","authors":"Jonathan Douxfils, Nathalie Chabbert-Buffet, Mitchell D Creinin, Marie Didembourg, Jean-Michel Dogné, Jean-Michel Foidart, Ulysse Gaspard, Oskari Heikinheimo, Øjvind Lidegaard, Médéa Locquet, Laure Morimont, Lucie Raskin, Kristina Gemzell Danielsson, Helena Kopp-Kallner","doi":"10.1080/13625187.2026.2627482","DOIUrl":"10.1080/13625187.2026.2627482","url":null,"abstract":"","PeriodicalId":520795,"journal":{"name":"The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception","volume":" ","pages":"197-200"},"PeriodicalIF":2.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146215507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Isthmocele: prevalence and clinical impact on menstrual bleeding patterns.","authors":"Montas Laporte, Ana C Marcelino, Paula da Cunha Pereira, Kleber Cursino, Luis Bahamondes","doi":"10.1080/13625187.2026.2616361","DOIUrl":"10.1080/13625187.2026.2616361","url":null,"abstract":"<p><strong>Objective: </strong>To determine the prevalence of isthmocele and its clinical impact on menstrual bleeding patterns.</p><p><strong>Materials and methods: </strong>A cross-sectional study was conducted from June 2023 to May 2025 at the Department of Obstetrics and Gynaecology, University of Campinas Medical School, Campinas, Brazil. Non-pregnant women aged 18-43 years with at least one caesarean delivery performed ≥6 months before enrolment and who were not using hormonal contraceptives or any kind of intrauterine devices were included. Participants completed a sociodemographic questionnaire, including caesarean-birth exposure collected retrospectively and a 90-day bleeding diary recording cycle interval, bleeding days, and flow intensity. All women underwent transvaginal ultrasound to assess the presence of isthmocele. Factors associated with isthmocele were examined using bivariate and multivariate logistic regression analyses.</p><p><strong>Results: </strong>Of 301 participants, 126 (41.9%) had an isthmocele and 82.5% (104/126) of them were symptomatic. Compared with women without the defect, those with isthmocele, were older (<i>p</i> = 0.005) had a higher number of pregnancies (<i>p</i> = 0.044), previous caesarean deliveries (<i>p</i> = 0.026), ≥8 days of menstrual bleeding (<i>p</i> = 0.002), chronic pelvic pain (<i>p</i> = 0.024), uterine volume of 90-109 cm³ (<i>p</i> = 0.021), anteroposterior diameter ≥40 mm (<i>p</i> = 0.018) and endometrial thickness ≥4.7 mm (<i>p</i> = 0.021). Women with symptomatic isthmocele exhibited defects with greater length, depth and width, as well as a thinner residual myometrium <i>(p</i> < 0.001), when compared to asymptomatic women.</p><p><strong>Conclusion: </strong>Isthmocele was associated with advanced maternal age, multiple caesarean deliveries, and larger uterine and isthmocele dimensions. Symptomatic cases were more likely in women with larger defects, whereas greater residual myometrial thickness was associated with fewer symptoms.</p><p><strong>Short condensation: </strong>Advanced age, multiple caesarean deliveries, chronic pelvic pain, and prolonged menstrual bleeding appear to be associated with the presence of isthmocele.</p>","PeriodicalId":520795,"journal":{"name":"The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception","volume":" ","pages":"166-174"},"PeriodicalIF":2.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145992993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is the contraindication to combined hormonal contraceptive use in asymptomatic women carrying mild thrombophilia still justified?","authors":"Marco Marietta, Valeria Coluccio, Stefano Cordella, Jacques Bertold Evens Versailles, Marta Barretta, Giovanni Grandi","doi":"10.1080/13625187.2025.2608037","DOIUrl":"10.1080/13625187.2025.2608037","url":null,"abstract":"","PeriodicalId":520795,"journal":{"name":"The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception","volume":" ","pages":"163-165"},"PeriodicalIF":2.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145902221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Polished but pointless? Assessing the potential of gold and silver-alloy IUDs versus copper-only devices in a large multinational cohort (EURAS-LCS12).","authors":"T Boehnke, L Eggebrecht, M Rizzo, M Klinghardt, K Heinemann","doi":"10.1080/13625187.2026.2616357","DOIUrl":"10.1080/13625187.2026.2616357","url":null,"abstract":"<p><strong>Background: </strong>Some copper intrauterine devices (IUDs) contain gold or silver to enhance durability, ultrasound visibility, and reduce infection risk, though evidence thereof is limited.</p><p><strong>Objective: </strong>To evaluate potential benefits of copper-gold and copper-silver alloys over copper-only IUDs regarding the occurrence of product technical complaints (PTC), pelvic inflammatory disease (PID), and unintended pregnancy.</p><p><strong>Methods: </strong>This exploratory analysis used data from the ongoing EURAS-LCS12 study, comparing outcomes across IUD types using descriptive statistics and incidence rates with 95% confidence intervals (CI).</p><p><strong>Results: </strong>Among 28,280 copper IUD users, copper-only IUDs were most common (63.4%) followed by copper-silver (32.4%) and copper-gold IUDs (4.2%). Overall, 114 PTC were reported within a follow-up time up to 113 months. The incidence of PTC was highest in copper-gold IUD users (copper-gold: 1.20 [95% CI, 0.86-1.70]; copper-silver: 0.21 [95% CI, 0.15-0.29]; copper-only: 0.09 [95% CI, 0.07-0.13] per 100 women-years [WY]). In total, we observed 28 events of PID with no substantial differences between groups (copper-only: 0.48 [95% CI, 0.29-0.75]; copper-silver: 0.40 [95% CI, 0.17-0.79]; copper-gold: 0.35 [95% CI, 0.01-2.00] per 1,000 WY). The incidence of unintended pregnancy was similar across groups (copper-gold: 0.46 [95% CI, 0.24-0.78]; copper-only: 0.43 [95% CI, 0.37-0.50]; copper-silver: 0.35 [95% CI, 0.27-0.45] per 100 WY).</p><p><strong>Conclusion: </strong>We did not observe any differences in the clinical outcomes PID and unintended pregnancy between copper-only, copper-silver and copper-gold IUDs. However, copper-gold IUD users experienced more PTC.</p>","PeriodicalId":520795,"journal":{"name":"The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception","volume":" ","pages":"225-229"},"PeriodicalIF":2.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146055879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sexual function in perimenopausal women treated with relugolix and add back therapy for uterine fibroids: an observational study.","authors":"Matteo Mancarella, Lorenzo Novara, Silvia Carignano, Sara Hussein Aly, Marco D'Amore, Stefano Pautasso, Francesco Testa, Valentina Elisabetta Bounous, Annamaria Ferrero, Luca Giuseppe Sgro","doi":"10.1080/13625187.2026.2615974","DOIUrl":"10.1080/13625187.2026.2615974","url":null,"abstract":"<p><strong>Objectives: </strong>Uterine leiomyomas may cause disorders such as bleeding and bulky symptoms impacting on quality of life; a recent therapeutic option is relugolix, a GnRH antagonist effective in controlling bleeding and reducing the size of fibroids, administered in combination with low-dose oestrogens and progestins (add back therapy, ABT) to prevent related side effects of drug-induced menopause. Sexual function can be affected by leiomyomas, while the effect of such treatments on this issue is uncertain, considering both potential benefits from fibroid size reduction and concerns about hypoestrogenism. The aim of the present study is to evaluate the effect of relugolix-ABT on sexual function in premenopausal women treated for symptomatic uterine leiomyomas.</p><p><strong>Methods: </strong>The study included 21 premenopausal women affected by uterine fibroids with moderate-to-severe symptoms, treated with oral combination of relugolix 40 mg with ABT (oestradiol hemihydrate 1 mg + norethisterone acetate 0.5 mg). Sexual function was evaluated using the FSFI (Female Sexual Function Index) questionnaire at baseline and after 6 months of treatment; primary endpoint was the change in FSFI, along with secondary outcomes relating to treatment efficacy.</p><p><strong>Results: </strong>At 6 months no statistically significant changes in total FSFI scores were detected (23.0 +/- 8.0 vs 23.1 +/- 7.1, p 0.70); treatment resulted in a significant reduction in total volume (p 0.019) and mean diameter of fibroids (<i>p</i> 0.011) and in 87.5% of cases bleeding was effectively controlled.</p><p><strong>Conclusion: </strong>Treatment with relugolix-ABT was not associated with statistically significant changes in sexual function, with a good tolerability profile, while effectively reducing the fibroid size and controlling bleeding in most cases.</p>","PeriodicalId":520795,"journal":{"name":"The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception","volume":" ","pages":"214-224"},"PeriodicalIF":2.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145968292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimising contraceptive counselling: insights for obesity and bariatric surgery patients.","authors":"Julia C Coronado-Arroyo, Jenyfer María Fuentes-Mendoza, Marcio Concepción-Zavaleta, Fernanda Ginebra Castillo-Velásquez, Diego Velarde-García, Juan Eduardo Quiroz-Aldave, Luis Concepción-Urteaga, José Paz-Ibarra","doi":"10.1080/13625187.2025.2609771","DOIUrl":"10.1080/13625187.2025.2609771","url":null,"abstract":"<p><strong>Purpose: </strong>Women with obesity and those undergoing bariatric surgery face unique challenges when selecting contraceptive methods due to metabolic alterations, surgical malabsorption, and increased thromboembolic risk. This narrative review aims to summarise current evidence and provide practical guidance for safe and effective contraceptive counselling in these populations.</p><p><strong>Materials and methods: </strong>A comprehensive narrative search was conducted in PubMed, Scopus and Google Scholar up to May 2025 using terms related to 'contraception', 'obesity', and 'bariatric surgery'. Recent international guidelines and clinical studies were synthesised to identify evidence-based recommendations and knowledge gaps.</p><p><strong>Results: </strong>Combined hormonal contraceptives are relatively contraindicated in women with obesity, particularly in those with additional cardiovascular risk factors. Long-acting reversible contraception (LARC) methods, including intrauterine devices and subdermal implants, demonstrate the highest safety and effectiveness. Progestogen-only methods may be appropriate alternatives, while oral routes are less reliable after malabsorptive procedures.</p><p><strong>Conclusions: </strong>Tailored contraceptive counselling is essential for women with obesity and post-bariatric surgery. Prioritising LARC options, assessing individual thrombotic and metabolic risk, and providing multidisciplinary follow-up can optimise reproductive health outcomes in this growing population.</p>","PeriodicalId":520795,"journal":{"name":"The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception","volume":" ","pages":"175-191"},"PeriodicalIF":2.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145902215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}