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

{"title":"Gaps in person-centered abortion care in Italy: a cross-sectional study of women's experiences.","authors":"Anna Obwegs, Manuela Brioschi, Giorgia Rossato, Mirco Rizzi, Francesco Brigo, Gianni Turcato, Arian Zaboli","doi":"10.1080/13625187.2025.2558854","DOIUrl":"10.1080/13625187.2025.2558854","url":null,"abstract":"<p><strong>Background: </strong>Induced abortion (IA) is a key aspect of healthcare, yet women often face barriers related to access and quality of care. This study explored the care needs and perceptions of women who underwent non-therapeutic medical or surgical IA within 12 + 6 weeks of gestation in Italy.</p><p><strong>Methods: </strong>We conducted an observational, cross-sectional, descriptive study using an anonymous online questionnaire, available in Italian, German, and English. The survey, developed specifically for this study, was distributed between July and September 2024 and explored three phases of the abortion care pathway. Participants were voluntarily recruited via social media and institutional networks.</p><p><strong>Results: </strong>Among the 352 participants, 50.8% were over 35 years old, and 47.6% underwent surgical IA. Overall satisfaction with care was moderate (median = 7, IQR: 5-8), with considerable variation. While 33.9% reported that their needs were only partially met, 17.4% felt their needs were not met at all. The most commonly unmet needs were emotional support (27.9%) and access to information (13.4%). Notably, 44.2% did not receive information about available psychological support, despite expressing a need for it. Furthermore, 60.1% considered the continuous presence of a dedicated healthcare professional to be highly beneficial.</p><p><strong>Conclusions: </strong>The findings highlight systemic shortcomings in abortion care in Italy, particularly regarding communication, emotional support, and continuity of care. To improve experiences and promote equity, the adoption of person-centered care models and the integration of a dedicated midwife as a consistent point of contact are recommended. Further research should examine factors influencing these gaps.</p>","PeriodicalId":520795,"journal":{"name":"The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception","volume":" ","pages":"21-30"},"PeriodicalIF":2.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145310444","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":"Outcomes of medical abortion with an intrauterine device <i>in situ:</i> a retrospective review.","authors":"Kiara Marsh, Sharon T Cameron","doi":"10.1080/13625187.2025.2568759","DOIUrl":"10.1080/13625187.2025.2568759","url":null,"abstract":"<p><strong>Background: </strong>There is a lack of evidence on the outcomes of medical abortion with an intrauterine device (IUD) <i>in situ</i>. Guidelines recommend IUD removal prior to medical abortion, but retrieval is not always possible. This study examines the outcomes of medical abortion (< 12 weeks) in women where the IUD was removed prior to abortion and those where it remained <i>in situ</i>.</p><p><strong>Methods: </strong>A retrospective review of medical abortion outcomes < 12 weeks (complete abortion, incomplete abortion and ongoing pregnancy) at a single abortion service in Scotland over five years (2020-2024). Outcomes were compared for those with IUD removed pre abortion and those with the IUD left <i>in situ</i>.</p><p><strong>Results: </strong>Of 18,436 cases presenting for abortion, 98 (0.53%) reported that they had an IUD <i>in situ</i>. Of these, there were 61 cases (76%) who had a medical abortion (< 12 weeks) in whom the IUD was visible on a pre abortion ultrasound. In 46/61 (75%), the IUD was removed pre abortion and in 15/61 (25%) it was not retrievable. Complete abortion occurred in all cases where the IUD was removed and in 14/15 cases (93%) with the IUD left <i>in situ</i>. There was one ongoing pregnancy (IUD <i>in situ</i> group).</p><p><strong>Conclusion: </strong>Medical abortion with an IUD <i>in situ</i> appears safe and effective showing comparable success and low complication rates to cases where the IUD is removed pre abortion. This supports clinical practice of proceeding to medical abortion in cases where the IUD cannot be retrieved.</p>","PeriodicalId":520795,"journal":{"name":"The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception","volume":" ","pages":"43-47"},"PeriodicalIF":2.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145310480","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 impact of hormonal intrauterine device use on health-related quality of life in women with a history of venous thromboembolism: a systematic review.","authors":"Júnea Chagas, Juliana Almeida Oliveira, Elaine Cristina Fontes de Oliveira, Gabriella Braga Andrade Martins, Flávia Ribeiro de Oliveira, Daniel Dias Ribeiro, Ana Luiza Lunardi Rocha","doi":"10.1080/13625187.2025.2547063","DOIUrl":"10.1080/13625187.2025.2547063","url":null,"abstract":"<p><strong>Objective: </strong>To systematically review the available evidence on changes in health-related quality of life (HRQoL) associated with the levonorgestrel-releasing intrauterine system (LNG-IUS) for contraception or menstrual bleeding management in women with a history of venous thromboembolism (VTE), regardless of anticoagulant use.</p><p><strong>Methods: </strong>This systematic review was conducted following Cochrane Collaboration guidelines and the PRISMA statement. A comprehensive search was carried out in PubMed, Embase, Cochrane Central, Scopus, Web of Science, and the Virtual Health Library (VHL), without language or date restrictions.</p><p><strong>Results: </strong>Four observational studies met the inclusion criteria, encompassing 32 women from non-randomised cohorts and case series. Among these patients, 81% experienced a reduction in menstrual blood loss, and satisfaction rates were ≥70%. No significant adverse events were reported.</p><p><strong>Conclusion: </strong>The LNG-IUS appears to be a valuable option for improving HRQoL in women with a history of VTE, particularly through its effectiveness in reducing menstrual bleeding. It may be especially beneficial for those receiving anticoagulation therapy. To our knowledge, this is the first systematic review focused on HRQoL outcomes with LNG-IUS in this population, highlighting the importance of individualized contraceptive and menstrual management in women with increased thrombotic risk. Further high-quality studies are needed to strengthen these findings.</p>","PeriodicalId":520795,"journal":{"name":"The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception","volume":" ","pages":"4-10"},"PeriodicalIF":2.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145002699","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":"Emergency contraception in Swiss pharmacies - clients' experiences and needs.","authors":"Esther Spinatsch, Claudia Schwitter, Jasmin Kälin, Samuel S Allemann","doi":"10.1080/13625187.2025.2538534","DOIUrl":"10.1080/13625187.2025.2538534","url":null,"abstract":"<p><strong>Purpose: </strong>This study examines women's experiences and needs regarding oral emergency contraception (EC) counselling and dispensing in Swiss pharmacies, a key service to prevent unplanned pregnancies after unprotected sexual intercourse.</p><p><strong>Methods: </strong>We conducted an anonymous online survey among women who obtained EC from Swiss pharmacies and performed exploratory descriptive analyses on EC use patterns, expectations, and experiences.</p><p><strong>Results: </strong>Analysis of 316 questionnaires revealed high overall satisfaction with EC counselling, with 91% of participants understanding the need for consultation. Respondents had a mean age of 25 years; 65% had used EC before. First-time users reported the greatest increases in knowledge (+16%) and reassurance (+19%). Educational level also influenced these perceptions. Counselling content generally aligned well with expectations. Most common concerns before obtaining EC were lack of discretion (42%) and fear of judgement from pharmacy staff (37%), though these were rarely confirmed. Differences emerged between first-time and recurrent users, education levels, and language of respondents.</p><p><strong>Conclusion: </strong>The Swiss model of oral EC without prescription, combined with mandatory pharmacy counselling, appears practical and acceptable, increasing women's knowledge and confidence. New tools and strategies may help address concerns about privacy and fear of judgement to further improve the service and better meet individual needs.</p>","PeriodicalId":520795,"journal":{"name":"The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception","volume":" ","pages":"31-42"},"PeriodicalIF":2.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144986748","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":"Rejecting the contraceptive pill. Times are changing faster than physicians' minds: Gen Z's pledge to be listened to.","authors":"G E Cetera, M C Punzi, V Boero","doi":"10.1080/13625187.2025.2533949","DOIUrl":"10.1080/13625187.2025.2533949","url":null,"abstract":"<p><p>The conflict between Gen Zs and Baby Boomers is becoming evident also in the choice of contraception. In the last decades Western countries have witnessed a considerable drop in the number of women taking combined oral contraceptives and a simultaneous surge in the use of non-hormonal methods of contraception. Authors have attributed such trend to the dissatisfaction with side effects of hormonal contraceptives as well as to hormone hesitancy, which appears to be amplified by social media. However, blaming unscientific sources of information, as well as the supposed reduced literacy of those who resort to such polarised and incomplete evidence, may be a form of simplification. We believe there exists a number of literate young women who are far from 1) the recent far-right backlash against hormonal contraception; 2) online promoters of 'hormonophobia'; and 3) advocates of excessive 'healthism'; women who are no longer keen to endure the impact hormonal contraception has on their body for the sole sake of preventing pregnancy. Boomers' daughters are asking for a type of effective contraception which 1) is free of disturbing side effects on mental health and sexuality, which probably the previous generation was willing to endure in the name of self-determination; 2) has less of an impact on women's bodies' functioning. It is urgent physicians start taking into account the needs of this generation. Personalising treatment and empathising with their critical view may promote research towards forms of contraception that are perceived by women as less invasive and aligned with their values.</p>","PeriodicalId":520795,"journal":{"name":"The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception","volume":" ","pages":"319-323"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144755671","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":"Exploring the dual potential of Novel vaginal contraceptive pH regulator spermicide for STI prevention.","authors":"Berna Dilbaz, Cağlayan Ates","doi":"10.1080/13625187.2025.2540397","DOIUrl":"10.1080/13625187.2025.2540397","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":"301-303"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144986791","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":"Conservative management of enhanced myometrial vascularity (EMV) after a first trimester miscarriage or termination of pregnancy: a retrospective cohort study.","authors":"Emma Bertucci, Filomena Giulia Sileo, Anna Luna Tramontano, Federico Varliero, Alessandra Danieli, Giovanni Grandi, Carlo Alboni, Antonio La Marca, Luca Savelli","doi":"10.1080/13625187.2025.2535400","DOIUrl":"10.1080/13625187.2025.2535400","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the spontaneous resolution time, need for rehospitalization or surgical management during conservative management in women diagnosed with Enhanced Myometrial Vascularity (EMV) after first-trimester miscarriage or termination of pregnancy (TOP) and to evaluate the different evolution between women with or without associated retained products of conception (RPOC).</p><p><strong>Methods: </strong>Retrospective cohort study conducted at Azienda Ospedaliero-Universitaria di Modena and including all women with a sonographic diagnosis of EMV (with/without RPOC) between January 2021 and August 2024. All patients were managed conservatively with serial follow-up ultrasound (US) scans till the sonographic resolution of the EMV. Some women were immediately prescribed with different oral hormonal therapies (HT) during follow-up. Chi-squared test and Fisher's exact test were used as appropriate adopting a p-value less than 0.05 for significance.</p><p><strong>Results: </strong>31 women with EMV were included; overall, 29/31(93.5%) were followed up by US only until spontaneous disappearance of the EMV. Two women required additional procedures. No differences were found in terms of: mean time of resolution (97.6 vs. 66.2 days, <i>p</i> = 0.20), re-admission for bleeding (37.5% vs. 20.8%, <i>p</i> = 0.35), need for transfusion (12.5% vs. 4.2%, <i>p</i> = 0.40) and Emergency-Room access for bleeding (25% vs. 20.8%, <i>p</i> = 0.81) during follow-up between patients with RPOC associated with EMV vs. isolated EMV. Results were similar comparing women who had an immediate prescription of HT vs. women not receiving HT.</p><p><strong>Conclusions: </strong>Hemodynamically stable patients with US diagnosis of EMV can be managed conservatively with serial US follow-ups; HT can be prescribed immediately without increasing the risk of complications in these 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":"359-367"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144755670","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":"Consensus conference results on contraception in women beyond 40 years of age.","authors":"Angelo Cagnacci, Franca Fruzzetti, Vincenzina Bruni, Alessandro Gambera, Maurizio Guida, Gloria Bonaccorsi, Ambrogio Pietro Londero","doi":"10.1080/13625187.2025.2544754","DOIUrl":"10.1080/13625187.2025.2544754","url":null,"abstract":"<p><p><b>Objective:</b> The objective is to develop expert consensus to inform clinical decision-making in the use of hormonal contraceptives in women over 40 years of age. <b>Methods:</b> A multidisciplinary panel organised by the Italian Society of Contraception performed a systematic literature review up to October 2024, defining the priorities in the choice of a contraceptive and its effects on cardiovascular risk, menstrual bleeding, bone health, and sexual function associated with hormonal contraception in women over 40. Statements summarising the findings were discussed and refined in a dedicated expert meeting. Final statements were presented and subjected to anonymous voting at a national congress, where consensus was defined as a minimum of 75% agreement. <b>Results:</b> Ninety-five to ninety-nine percent of participants endorsed seven consensus statements. Cardiovascular safety is recognised as the primary factor in the selection of contraceptives. The use of progestogen-only methods is considered safe for cardiovascular risk. Combined hormonal contraceptives utilising natural oestrogens or 20 mcg ethynylestradiol in conjunction with non-androgenic progestins are considered more advantageous for the cardiovascular risk profile. The levonorgestrel intrauterine device, oestradiol valerate/dienogest, and the combined contraceptive vaginal ring are identified as the most effective options for menstrual management. The type of hormone and its route of administration can influence sexual function, with implants and vaginal rings showing positive effects. Combined hormonal contraceptives demonstrate protective effects on bone density, whereas progestogen-only methods exhibit a neutral impact. <b>Conclusions:</b> This Italian consensus provides evidence-based guidance on hormonal contraceptive choices for women over 40, incorporating non-contraceptive effects to support individualised care during perimenopause.</p>","PeriodicalId":520795,"journal":{"name":"The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception","volume":" ","pages":"304-318"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144986723","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":"Young women's experiences with their first contraceptive consultation in general practice: a Dutch mixed methods study.","authors":"Sanne Olofsen, Roos Knibbeler, Pieter C Barnhoorn, Ineke van der Vlugt, Jenneke van Ditzhuijzen","doi":"10.1080/13625187.2025.2541781","DOIUrl":"10.1080/13625187.2025.2541781","url":null,"abstract":"<p><strong>Purpose: </strong>This mixed-methods study investigated young women's experiences with the first contraception consultation with their general practitioners (GPs), including their expectations beforehand.</p><p><strong>Materials and methods: </strong>First, a questionnaire was completed by 516 young women (aged 16-25) who recently had their first contraception consultation (up until 2 years before). A linear multiple regression analysis was used to analyse which predictors were significantly associated with satisfaction with the consultation. Second, a subsample of 14 participants was interviewed, to gain insight into factors shaping experiences with the first contraception consultation.</p><p><strong>Results: </strong>Overall, women were quite content with their first contraception consultation with the GP and rated it with a 7.1 (SD = 1.56) on a scale from 1-10. However, their experience was negatively affected when women did not feel at ease or respected, if they experienced a lack of time, or missed the opportunity to ask questions. 58.2% of the women wanted shared decision making, but only 18.7% actually experienced this (X2(1)=30.91, <i>p</i> < 0.001). Despite a strong need for information, not all young women were open to information during the initial contraception consultation. Women's expectations, feelings of uncomfortableness, and their preoccupations with starting contraception, shaped the openness to clinical information from the GP.</p><p><strong>Conclusions: </strong>Expectations of the consultation should be made explicit during the consultation to improve young women's experiences. A standard follow-up evaluation consultation for women starting contraception may increase the likelihood of satisfaction with the chosen contraceptive method and thus contribute to quality of care.</p>","PeriodicalId":520795,"journal":{"name":"The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception","volume":" ","pages":"324-334"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144986746","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 use of hormonal contraceptives in a cohort of healthy women with BRCA mutations under surveillance in an Italian Family Cancer Clinic.","authors":"Giovanni Grandi, Alice Sgandurra, Lia Feliciello, Valeria Pedrini, Gloria Guariglia, Nicoletta Del Duca, Angela Toss, Laura Cortesi, Lorenzo Aguzzoli, Antonio La Marca","doi":"10.1080/13625187.2025.2533924","DOIUrl":"10.1080/13625187.2025.2533924","url":null,"abstract":"<p><strong>Purpose: </strong>The use of hormonal contraceptives (HC) in women with BRCA mutation is controversial. We describe the real-world application of HC in a cohort of healthy women with confirmed mutation under surveillance, in relation to the specific genetic mutations (BRCA1 vs. BRCA2), in comparison to similar women of the same cohort who were not using HC or had recently undergone risk-reducing surgery (RRSO).</p><p><strong>Materials and methods: </strong>All premenopausal women with BRCA mutation with no previous breast cancer evaluated in a semestral period were included.</p><p><strong>Results: </strong>Of a total of 158 women, 52 were excluded due to a history of breast cancer. Among the remaining 106 women, the majority (45.2%) were HC users; among them, most were BRCA1 carriers (<i>p</i> < 0.05). In addition, women using HC were younger and nulliparous in comparison to women who were not using HC or had recently undergone RRSO (<i>p</i> < 0.05). Finally, the trend of CA125 was not impacted by HC use, but CA125 values in women who had undergone RRSO were the lowest (<i>p</i> < 0.05).</p><p><strong>Conclusions: </strong>The use of HC in women with BRCA mutations is a well-established clinical practice in our Family Cancer Clinic, especially in young, nulliparous and BRCA1 mutation carriers.</p>","PeriodicalId":520795,"journal":{"name":"The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception","volume":" ","pages":"356-358"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144693152","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}