That's right! Hormonal contraceptives are traditionally associated with two female sex hormones: estrogen and progestin. These are combined for an effective contraceptive, and also provide numerous other non-contraceptive benefits. Contraceptive protection is guaranteed by the sole presence of progestin. Did you know that? If you want more information on the progestin pill, go to the section “The progestin-only pill”.

The classic pill, as well as all other hormone-based contraceptives, works in several different ways. The main mechanism is to block ovulation, so an egg is not released every month. This effect is further amplified by making the environmental conditions unsuitable for both gametes (the egg from the woman and the sperm from the man). How does it do that? On one hand, it makes the mucus of the uterine cervix so thick that it becomes a hostile barrier for the ascent of the sperm to the egg. On the other hand, it thins the endometrium (the lining of the uterine cavity), making it unsuitable for implantation of the egg.

Hormonal contraceptives are the safest methods (with close to 100% efficacy), offering the best possible protection. This is especially true for long-acting reversible contraception (LARC), such as intrauterine devices and subdermal implants.

During the week-long break from taking the pill, the monthly blood flow is not the same as "natural" menstruation. The latter is a sign of reproductive health because it means that the uterus is able to prepare for a possible pregnancy each month. On the other hand, when female hormones are taken with hormonal contraceptives, the flow that occurs during the break from taking the pill is not a real menstruation (pseudo-menstruation), but rather a way to give the woman the appearance of a harmonic cycle that is similar to the physiological one. In theory, but also in practice, the contraceptive could be taken on an ongoing basis. In fact, there are pills that you take every day that do not include a pause during which a monthly cycle occurs. These are called extended regimen pills, and will be discussed in other answers.

This is good if you are happy with what you are taking! The pill is not a matter of fashion, but a method that protects against unwanted pregnancy, and it should make you feel both good and safe thanks to its effects/benefits/non-contraceptive advantages. The pills available are not all the same – there are a wide variety of them because there are many different women with many different needs. There is not one contraceptive that is better than the rest. Rather, there is one to suit each woman according to her needs. A new contraceptive is not necessarily better than an old one. The fact that a new pill has been developed does not mean you should stop taking the old one that has been working well for you.

What Claudia says is true for some women. Among the most common estrogen-related effects of the combined pill are headache (cephalea), nausea, vomiting and breast tenderness. The onset of these effects can lead to temporary or permanent issues if the problems don't diminish with continued use of the method. The advice of gynecologists in these cases is essential in order to offer the woman an equally valid contraceptive solution without the effects of estrogen.

The data is clear. Women who smoke more than 15 cigarettes daily (heavy smokers) have a three-times higher risk of infarction than women who do not smoke. This risk increases in proportion to the number of cigarettes smoked, not to mention that the risk of stroke as well as incidences of death from all causes doubles. These risks further increase if the habit of smoking is combined with the use of combined hormonal contraceptives (CHC). The risk of venous thromboembolism (VTE) doubles in women smokers using CHC after 35 years of age.

The extended regimen pill is a combined pill (estrogen-progestin) that is taken continuously (every day) for 3 months. Who is it suitable for? Professional female athletes, women who travel a lot or have busy or physically demanding jobs (policewomen, photographers, nurses, etc.) and who want a lower frequency of menstrual cycles. The amount of estrogen hormones that the woman takes is higher compared to that taken with other pills, the patch and especially the ring.
In the case of the extended regimen, the woman may not have any menstrual-like flow (amenorrhea). This is a situation that is well-accepted by some women, and sometimes even requested from the gynecologist, while for others it presents an anxiety factor or a "failure" of femininity.

The "extended regimen" of the combined pill has been especially designed to eliminate the discomfort associated with the monthly flow, which significantly affects the quality of life for many women. There are many situations in which this method of administration can provide an advantage, such as heavy menstruation, very painful cycles (dysmenorrhea), migraine attacks during the break from taking the pill, anemia, frequent forgetfulness of taking the pill and other situations.

This is one aspect – and it's best to point this out right away – that is harmless from a health point of view, but that the woman should be well-informed of. Regardless of the type of pill (monophasic, biphasic or triphasic), the extended regimen can more easily cause occurrences of spotting (the minor bleeding that Federica mentioned), particularly in the first few months of treatment when the body has to adapt to the new regimen. Not all women want to deal with this. To reduce the incidence of this unexpected spotting, all you have to do is stop taking the pill for 4-5 days to voluntarily cause a pseudo-menstrual flow. After the break, you can start taking the pill with the same regimen (even if the flow is not completely finished). Spotting does not in any way suggest a reduced effectiveness of the pill, unless the woman has forgotten to take one or more doses, and is not a contraindication to following the extended regimen. In any case, in regards to all these aspects, it is best to discuss things verbally with your gynecologist to assess risks and benefits together, taking into account sensitivity, lifestyle, culture, religion and any factors that can affect the choice of one method compared to another.

The irregular and sometimes very abundant menstruation (sometimes resembling an actual hemorrhage) of puberty, so defined by medical terms as menometrorrhagia, is most often due to the immaturity of the ovulatory "system." Given Ilaria's young age, once other organic causes have been excluded, the combined pill may be the ideal solution since it stabilizes hormone levels (and thus regulates menstrual flow), and could simultaneously return serenity to both the daughter and the apprehensive mother.

This is a myth that should be dispelled once and for all! Unfortunately, there are still many girls, either uninformed or ill-advised, who think that the contraceptive pill is not a suitable method for young girls going through their first sexual experiences. In reality, if you think about it, it's actually a great ally, because in addition to having high contraceptive efficacy, it also offers many additional benefits, such as helping with menstrual pain (dysmenorrhea), which is a frequent complaint and poorly tolerated by young girls like you.
If the woman is healthy, there are no restrictions for the combined pill from menarche (the first menstrual period) until 40 years of age.

The question that Anna has is not unusual. Even after 40 years, if the woman is healthy, the advantages provided by taking the combined pill usually outweigh the risks. In any case, a medical opinion is still necessary. Some studies have shown that in premenopausal women aged 40 years and older, hormonal contraceptives have not shown any significant effects on bone mass, while they seem to preserve it during the period of time that is closer to the end of menstruation (perimenopause).

The gynecologist can evaluate the cardiovascular risk and the possible impact on the metabolism of the individual woman on a case by case basis, taking into account that as the protective umbrella of estrogen decreases, this risk in women increases, eventually reaching the same levels as a man. You can always use a progestin-only contraceptive.

Do you, like Cynthia, also have this concern? We must say right away that it is unfounded. Perhaps the first pills on the market had such an effect, but the newer pills are not fattening because they contain hormone doses that are very low, but sufficient enough to be effective. Talk to your gynecologist. Today there are even pills that help combat water retention, and thus the resulting weight gain. In any case, don't pretend that you don't know how to keep fit – all you need to do is eat a diet of healthy, light food and maintain regular physical activity to stay beautiful and healthy! You don't need to become an Olympic champion - just a little perseverance and moderate activity will do the trick. Want a tip? Pick an activity that you like at a convenient time in order to keep yourself motivated, and maybe do it together with one or more friends to make it more fun. That way you can inspire each other. Want to try it?

This seems to be a concern for many women, including foreign ones. You can take the pill for as long as you want. Then, when you stop taking it, you can get pregnant without any problems. The truth is really the complete opposite – the pill protects your fertility, it does not compromise it. Your Fertility has great value and should be protected to the maximum. With the pill, you're sure to have a method that is one of the most secure, and that allows you to live your sex life spontaneously and without anxiety. You will have the security of being able to safely preserve your fertility "under lock and key," to be opened whenever you decide you are ready to have a baby.

There are a few things to consider. Above all, it is important to know that the most suitable pill to take during breastfeeding is the progestin-only pill, which has the advantage of not increasing the risk of thrombosis and not influencing the quality and quantity of milk.

If you decide to breastfeed, the combined pill, the ring or the patch can be used safely only after at least 6 months postpartum.

If you decide not to breastfeed, you can start taking the combined pill after a period of at least 3 weeks postpartum. This is because the risk of venous thromboembolism is high not only during pregnancy, but also during the first three weeks after birth, decreasing slowly after 3 weeks and returning to its baseline within 6 weeks. Alternatively, you can also choose the ring or the contraceptive patch.

In cases where after giving birth there is a risk of thromboembolism that is higher than normal (e.g. in the case of cesarean section, hemorrhage and/or postpartum transfusion, obesity, being a heavy smoker, a long period of immobility and other conditions), it is better to postpone taking estrogen-progestin contraception again for at least 6 weeks. In any case, it is important to consult your gynecologist.

A few things need to be taken into consideration. Hypericum, or St. John's wort, which is used as an antidepressant, interacts with many drugs. When taken together with the pill, even when spaced out, it may cause a reduction in contraceptive effectiveness due to a decrease in the plasma concentration of estrogen (ethinyl estradiol). 

It's true. Generally, in these situations, your gynecologist will recommend double protection. Continue taking the pill but also use condoms for the duration of the antibiotic therapy. Remember that the condom is the only method that also protects you from sexually transmitted infections. This is especially important if you have relations with casual partners or multiple partners – don’t risk it!

This is the testimony of Sara but also Federica, Silvia and many other girls and women who have seen their cycle become regular with the use of the pill. The combined pill, in addition to its contraceptive efficacy, offers many non-contraceptive benefits, especially for those who have cycle disorders. It regulates the flow and rhythm of the menstrual cycle; many women who have had irregular cycles or heavy menstruation and other ailments feel much better after taking it. The combined pill also reduces the risk of anemia, often caused by heavy blood loss and ovarian cysts. In women who are particularly predisposed, the combination pill can significantly change the quality of life while also offering an umbrella of contraception and protecting your fertility, which is preserved intact for whenever you decide to get pregnant.

All combined hormonal methods are comparable in terms of contraceptive efficacy; they all have the same optimal safety features, reversibility and ease of use. What changes is the method of intake, which can be more or less convenient depending on the needs and perception of each individual woman. The patch should be applied to the skin and replaced every week. The ring should be placed in the vagina, where it remains for three weeks. This latter requires more familiarity with your own body, and requires less manual work. The combined pill has the advantage of existing in many combinations and different dosage regimens so that you can find the one that best fits your needs, as if it were designed especially for you!

In this regard, the combined pill has many followers such as Sandra, for whom it has significantly improved the quality of life. In addition to its contraceptive efficacy, it reduces menstrual pain and all the countless symptoms and discomforts that are typical during the days before menstruation – the so-called premenstrual syndrome that occurs in almost all women, causing both physical and psychological symptoms that are different from woman to woman (there are over a hundred different kinds of symptoms!).

The pill also reduces menstrual pain (dysmenorrhea), allowing even those women who suffer from it to have a better quality of life, avoiding absences from school or work and other daily inconveniences.

You're not alone Fabiola, even if that doesn't provide a lot of consolation! Pain during menstruation (dysmenorrhea) is unfortunately a frequent symptom that happens often for teenagers, but also for younger and adult women. The pill and estrogen-progestin contraceptives (CHCs) can be a solution to this problem. Extended use pills are particularly recommended. These are taken every day of the year, continuously, eliminating the monthly pause during which withdrawal bleeding (menstrual flow while taking the pill) occurs. This allows women to remain without menstrual flow for four months, thus having only three periods per year. The total absence of flow (amenorrhea) should not be cause for concern. The "extended regimen" of estrogen-progestin has been especially designed to eliminate the discomfort associated with the monthly flow, which is painful for many women and significantly affects their quality of personal, social and work life.

Can you relate to what Desirée has written? The estrogen-progestin contraceptive pill, in addition to its contraceptive action, is often used to treat acne, as you know.

The estrogen contained in the pill has a beneficial effect on forms of excess androgens (hyperandrogenism). Androgens are male hormones, but they are present in small amounts in women. If these are in excess, they can cause disorders such as acne. The pills that are used for these problems contain a progestin (the female hormone from the 2nd half of the cycle) with specific anti-androgen action.

It's true. According to the latest guidelines from the World Health Organization, routine examinations are not necessary to start taking the pill unless it is for the use of an IUD (progestin-medicated coil) or a diaphragm. The only recommended test is a simple blood pressure measurement, which is done during the visit. In order to know what your blood pressure is and keep it under control, you can measure it regularly at the pharmacy or by yourself if you have a sphygmomanometer.

Exams are recommended by the gynecologist only if risk factors emerge during your visit, such as high blood pressure, obesity or a history of venous thrombosis.

This is another misconception that needs to be dispelled! The combined pill does not cause breast cancer, especially the low-dose pills that exist today. The pill can actually protect against some cancers, such as ovarian and colon cancer, and can even maintain this protection for several years after stopping. If you want to be even more reassured, ask your gynecologist to show you the results of some of the largest studies so you can check for yourself.

So writes the "forgetful" Monica! For some women, especially (but not only) very young ones, remembering to take the combined pill each day at the same time can be a real problem, with the risk of further instances of forgetting and problems in the schedule that should be followed each month.

If you are one of these women, the vaginal ring or the patch may be more suitable methods of contraception for you, because they do not require daily intake. Ask your gynecologist to talk to you about it. These are both very effective methods, although the ring requires greater familiarity with your body compared to the patch, which is simply applied to the skin.

In fact, Stefania's advice is good advice. In order not to forget to take pill daily, make it a habit, like reading a good book before falling asleep. Each person can find the method that works best for her. Many girls put a memo or an alert on their mobile phone at the same hour each day. Once you have determined the best time to avoid forgetting to take it, it's best to always keep it the same. Make it a habit throughout your day. Stop and think about yourself for a moment.

For some women, such as Rachida, for religious but also cultural reasons (work or family environment, or surrounding circumstances), the pill is still associated with many taboos. It would be important in these cases to talk to a gynecologist, for example from the Family Planning Clinic, where there are often interpreters/cultural mediators who can provide all the necessary information to make informed choices based on the large amount of evidence that has been obtained over the years. In the Family Planning Clinic, women can also easily come into contact with other women and hear their testimonials.

Typically, gynecologists have no reason not to favor the woman's preferred choice, especially if it worked well for her before her pregnancy and she already feels confident with the method. Clearly, this should still entail a thorough examination during which the doctor will ensure that it is the most appropriate method. This is because recent studies have shown that some ethnic groups are more susceptible to specific metabolic effects. For example, African American women have been found to have a greater sensitivity to hypertension, while Asian women are more prone to diabetes. If the visit shows that everything is all right, the specialist will have no problem recommending a pill with the same method of intake that the woman was accustomed to (in many countries, for example, there are 28 pills packs, which does not provide for the 7-day break, and facilitates the adherence of the woman to the chosen method).

The pill offers the greatest possible protection for a woman's reproductive health.

The "fertility" value in certain ethnic groups and cultures is often considered the founding value for the identity of the woman herself. It is practically "locked up" along with the pill, and in general, all hormonal contraceptive methods. These are the most effective methods for protecting the fertility potential of every woman while she waits for the desired and/or best-suited time to have a baby. In Family Planning Clinics, you can meet specialists and talk with interpreters/cultural mediators who speak the same language, and who know the needs of religions and cultures that are different from Italian and European ones. This enables more efficient and empathetic communication with women from South America, China, India or the Middle East, that for reasons of culture, religion, family or ethnic origin may feel even more alienated in a country that is not their own, especially in regards to such delicate and intimate topics that are critical for their future health.

Simonetta writes this comment, summing up the experience of many girls and young women. Also in this case, it is important to be well informed in order to go beyond the clichés. Today there is such a wide variety of birth control pills providing the same contraceptive efficacy, that there is certain to be one that can meet the economic needs of each woman, of any age. It's always a good idea to ask your gynecologist, who can recommend a pill with controlled prices that might be more advantageous from an economic point of view. This way, even those who are young, and who maybe have less availability each month to buy the pill, can afford a safe method without the risk of having to abandon it after a few months. Starting with the right method is crucial to protecting fertility.

Who knows why many women, such as Giulia, continue to be convinced that the pill should be suspended once in a while due to health issues! Let's clear this up right away – they are poorly informed!

"But right now I'm not in a relationship...I only have sex once in a while... Maybe it would be better to take a break given that I've been taking it for 10 years..." Maura, 30 years old, could argue. In reality, also in this case, it is not necessary to suspend the pill, especially if the concern is that of damage to the health or fertility. Rather, if you have frequent "adventures," it is better to take precautions to also protect yourselves from sexually transmitted diseases, or even to also use a condom during intercourse. Safe sex is better, at any age.

Actually, you can still get pregnant, and thus you can continue taking the same combined pill unless the gynecologist does not recommend it for specific reasons. The latest studies show that it is safe to use even up to 50 years of age. In practice, you can even take it during premenopause if you do not smoke and if you are not hypertensive (of course, regular pressure checkups are necessary in order to be sure).

Claudia's comment enables us to talk about headaches (cephalia), a relatively common disorder in women of childbearing age. There are different types of headaches, and before taking the pill, you should discuss this with your gynecologist because the combined pill is not recommended for everyone.

• The common tension headache (non-migraine headache), is not a contraindication for using the combined pill, or for continuing to use it if the headache occurs during intake.
• A migraine without an aura does not constitute a contraindication to the use of combination hormonal contraceptives (CHCs) according to the latest World Health Organization guidelines.
• In the case of migraines with an aura, this risk increases further such that all international guidelines absolutely contraindicate the use of CHCs in women who suffer from it.

If you recognize yourself in any of these cases, your gynecologist's advice will be invaluable in order to have a competent opinion on alternative solutions. Some papers have documented that progestin-only contraception may be a better option for women who get migraines, but the assessment must be conducted on a case-by-case basis.

Thanks Francesca, this allows us to speak about this issue as it relates to the pill in order to give you all the information that you need. If you have normal blood pressure, the use of the pill, as well as other combined hormonal contraceptives (CHCs), has a minimal effect on blood pressure (BP). The primary International Guidelines contraindicate the use of all CHCs, including the combined pill, in women with high blood pressure, even if controlled properly, because hypertension is in itself a factor that increases the risk for the heart and blood vessels (cardiovascular risk). If you have concerns or questions, talk calmly with your gynecologist to get knowledgeable and personalized advice. Together you can choose the most appropriate method that makes you feel at ease.

Today, pregnancy for a woman with diabetes is no longer as precarious a condition as it was considered to be a few years ago. Nevertheless, it remains an event that requires greater attention for those who suffer from it with respect to women who don't have diabetes. For this reason, it is important to plan the pregnancy for a time in which the metabolic control of diabetes is optimal. If you recognize yourself in Silvana's comment, the best thing to do is consult your gynecologist. It is also good to know that the most recent international guidelines recommend that a hormonal contraceptive be chosen on the basis of the general conditions of a woman's health, the type of diabetes, the age of the disease (how many years she has had diabetes) and the presence of complications and/or associated diseases (obesity, hypertension etc.).

If your diabetes is without vascular complications, you can take the pill (or another combined hormonal contraceptive) after consulting your gynecologist. The same is true in the case where you got diabetes during a previous pregnancy

(Gestational diabetes) which then disappeared after giving birth.

In this case, the situation is more delicate because Adele has told us that she already has complications from diabetes. In women with diabetes complicated by neuropathy, nephropathy or retinopathy, the use of combined oral contraceptives is not recommended unless their personal situation, based on the opinion of their gynecologist, does not make them more susceptible to real or perceived risks. Recommended instead is the progestin-only pill and the IUD that releases levonogestrel (LNG), a type of progestin, as well as the subdermal implant that releases etonogestrel.

Other important factors that may increase risks include age greater than 35 years, the habit of smoking, the presence of hypertension (high blood pressure) and the presence of other diseases with cardiovascular risk that are associated with type 2 diabetes. In these cases, guidelines do not recommend the use of the classic pill with the estrogen-progestin combination, but rather progestin-only contraception.

Cecilia's question is one that I often receive. The risk factors for varicose veins and other superficial venous problems (DVT) include older age, family history, obesity, numerous childbirths and occupations requiring long periods of standing. The studies carried out have shown that the presence of varicose veins in the lower limbs, or other superficial venous problems, does not increase the risk of deep vein thrombosis (DVT). Similarly, this risk does not increase in women with varicose veins that take the estrogen-progestin pill or other combined hormonal contraceptives (CHCs) with respect to women without varicose veins.

It's important to discuss this comment by Sonia in greater detail. Combined contraceptives, such as the estrogen-progestin pill that combines both estrogen and progestin hormones, cause a very small increase in the risk of thrombosis. This is estimated to be 0.04 to 0.06 cases/year in 10,000 exposed women compared to a baseline risk of around 2 cases/10,000 in women of childbearing age and the risk during pregnancy of 6/10,000 pregnancies. In this case, the numbers really help to underline the fact that the chance is very low, even more so if there is no familial predisposition, such as in the case of Sara. You should also know that the risk is greater during the first year of taking contraception, and depends on many factors. Some of these factors cannot be influenced, such as age and family history (mother or sisters with a predisposition to thrombosis or with a history of it), while others can be influenced in terms of prevention, such as lifestyle (smoking, unhealthy diet, physical inactivity), trauma, surgery, prolonged immobilization, pregnancy and puerperium. The factors to consider are many, and it is the gynecologist's job to evaluate each individual case. Trust him/her with confidence to resolve any doubts you may have.

In Ivana's case, there is a family predisposition to thrombotic risk. According to the most recent guidelines, also in this case specific tests are not recommended. The reasons are different, and certainly the gynecologist has explained them extensively to Ivana.

Compared to the most common blood chemistry tests (the classic blood test, for instance), specific tests for thrombophilia are highly complicated and varied, and have a high diagnostic error rate. Furthermore, they have little predictive value, and thus they are not recommended for routine use. Medically, this results in the risk of over-diagnosis and excessive medicalization, as well as unnecessary high costs. Experts in this matter believe that a negative result may be falsely reassuring, while a false positive may unnecessarily discourage the use of contraception. The gynecologist should evaluate each person on a case-by-case basis.

Studies on the impact of CHCs on obesity are limited, as excessive weight is often an exclusion criterion in clinical studies. Therefore, it is important to discuss what the best method is together with your gynecologist. Each woman is different, and the method that might work well for you may not be recommended for your sister, cousin or a friend. Among the various hormonal contraceptives that exist, perhaps those that are most suitable for women with excessive weight are the reversible, long-acting ones, such as the subdermal implant, the hormonal intrauterine device (IUD) or the copper coil. All three of these methods are reversible. In fact, they can be removed at any time if you wish to get pregnant, or for any other reason.

In obese women, both cardiovascular risk and thrombotic risk are kept low in an absolute sense, but are higher than in women of normal weight.

If you are reading this response, maybe you or someone you love also feels depressed like Elena. Many women of childbearing age have depressive symptoms such as sudden mood swings, irritability, nervousness, excitability and anxiety, many of which can worsen during menstruation. The interaction that sex hormones have with the central nervous system (CNS) has been known for a long time; the appearance of these symptoms while taking the classic pill or other combined hormonal contraceptives (CHC) may be a reason for discontinuing treatment. Nevertheless, according to the supporting scientific literature, there is no evidence that the use of CHCs increases these symptoms in women with depression compared to their level of appearance prior to intake, or compared to depressed women who don't use the pill or other combined hormonal contraceptives. In fact, in some women, the use of CHCs resulted in a reduction in depressive symptoms compared with the situation prior to intake.

The case of Valeria permits us to state that there are no specific contraindications. If you find yourself in this situation, it is best to consult with your gynecologist in order to get competent, personalized advice on your real needs. According to studies, the use of the estrogen-progestin pill or other combined hormonal contraceptives (CHCs) is associated with increased levels of the thyroid hormones thyroxine (T4), triiodothyronine (T3) and cortisol, which are induced by the increased activity of the globulin protein that binds the hormone thyroxine, (TBG), and the globulin protein that binds the corticosteroid hormones, (CBG). According to various studies, the amount of thyroid hormones T3, T4 and free cortisol in the circulation, as well as the function of the thyroid and adrenal glands, remain unchanged while taking the pill or other combined hormonal contraceptives.

In reality there are no contraindications for using the pill or other combined hormonal contraceptives in women with multiple sclerosis. In fact, some authors have even shown a benefit in terms of delay of onset of first attack of the disease. Further studies are in progress.

Do you also suffer from endometriosis like Lucia? In the case of endometriosis, there are no particular contraindications to the classic pill or other combined hormonal contraceptives, although the latest studies consider the use of contraceptives with only progestin to be more favorable, such as the progestin-only pill or the subdermal implant. Both of these methods, in fact, have a more beneficial effect on the lining of the uterus (endometrium), and thus provide a more substantial improvement in the pain that accompanies endometriosis, which can negatively influence the life of a woman who suffers from it.

In fact, taking the combined pill in the presence of an HPV (Human Papilloma Virus) infection increases the chance of developing cervical cancer. This is not an absolute contraindication – the woman can take it – but she must strictly adhere to preventative checkups, as recommended by her doctor.

In the case of persistent HPV infection, or of verified lesions related to the Papilloma virus, it is essential that the woman undergo an adequate follow-up that includes an HPV test, Pap smear and colposcopy after treatment.

The long-term use (≥ 5 years) of the combined pill could promote the worsening of at-risk lesions associated with a persistent HPV infection. If you are in this situation, it is important that you are well-informed in order to be able to make the right decision after consulting with your gynecologist. Together you can decide what the best solution is to meet your needs.