Contraception is the collection of methods used to protect against the risk of an unwanted pregnancy after sexual intercourse. 

Contraception is an important and delicate choice that should be made together, and it should fulfill the needs and resolve the doubts of both parties involved. You should ask for advice from a gynecologist, who is the most qualified person to help you select the contraceptive that is best suited to your needs.

Choosing the most appropriate method of contraception requires knowledge of all the methods available today. Each of the two partners must be able to choose freely within the couple dynamic, under serene, calm conditions. In this sense, casual relationships, as well as sudden or unexpected encounters, can cause emotional choices (or even no choice at all) to be made that could lead to undesirable situations that are often difficult to resolve.

Today there are many methods of contraception to choose from, which are more or less effective, easy to use and adapted to individual needs.

There are two male methods: coitus interruptus (pulling out), which is not very trustworthy, and the condom, a thin latex sheath that if put on correctly, prevents direct contact between the two partners, and thus protects against unwanted pregnancies but also - and this is the only method to do so - from sexually transmitted infections.

There are many more methods available to women. For simplicity, they are divided into three groups: hormonal methods, barrier methods and natural methods.

The pill, which contains female sex hormones in low doses, is the safest method. It works by preventing ovulation, and therefore fertilization. Other hormonal methods, which are suitable and popular amongst young girls, are the ring and the patch, which act in a manner similar to the pill, but do not require daily administration. There are also other hormonal methods, such as the pill and the progestin hormone implant, which are indicated when estrogen-progestin contraceptives are not tolerated, as well as in other situations.

An IUD (intrauterine device) is generally recommended after the first pregnancy. A diaphragm is not simple to put on, and has gone a bit out of use in favor of other barrier methods such as the female condom, cervical cap and sponge.  Even the so-called natural methods are very complicated to follow; many rules must be respected, and you must be very comfortable with your own body. These methods are more suitable for stable adult couples, and require the availability of the couple to accept a child in case of error. Natural methods are the only ones approved by the Catholic Church.

Finally, there is a product, sold in pharmacies, that has a small computer that can signal the time of ovulation by doing an analysis of morning urine, and thus indicate the fertile period during which sex is riskier. This can only be used by women who have a regular cycle. For a teenager, it is especially difficult to accurately determine the date of ovulation. During this age period, the cycles are still perfecting and are often irregular.

Even if you're just starting out, stay calm, because hormonal methods are the best choice for young women like you. Your gynecologist can confirm this. These methods give you the greatest possible security. Furthermore, if you think about it, they let you personally manage your sex life, and this is an important opportunity to be aware of from the very beginning. Hormonal contraception is the best tool you can use to have a healthy, peaceful and truly spontaneous sex life without fear or anxiety.

If you have a casual partner, do not forget to use condoms for dual protection. This way you can also steer clear of any sexually transmitted diseases.

These are four essential requirements that all hormonal contraceptive methods guarantee, with different combinations of active ingredients and methods of assumption. The choice of method assumes that you know, at least roughly, all the methods that are available, so it is important that you inform yourself. If in doubt, ask your gynecologist, either alone or together with your boyfriend or partner. Among the hormonal methods, the effectiveness of contraceptives is the highest (~ 100%); if you use them correctly, you are guaranteed to have no unintended pregnancies. Reversibility allows you to quickly return to preexisting conditions of fertility once you decide to stop your method. Safety is at its maximum to ensure no harmful effects during the period of use and in the future. Finally, acceptability means no interference with sexual spontaneity, and in this regard, hormonal contraception is also a winner.

Different hormonal contraceptive methods are available: the pill, ring, patch, implant and IUD. Such methods may include a combination of two female hormones (estrogen-progestin, combined or COC methods) or just the hormone progestin (methods without estrogen).

The estrogen and progestin contained in contraceptives are the same female sex hormones that your body produces, administered according to specific schemes and in certain quantities. These quantities are always very low compared to the first pills of the past, and are formulated to achieve the maximum contraceptive efficacy possible with a minimum dosage that is better tolerated.

Starting to use a hormonal contraceptive is an opportunity for every woman like you to adopt, in case you haven't already, a healthy way of life (balanced diet, no smoking, little alcohol, regular exercise, weight control, etc.).

If you feel like you're stumbling around in the dark, the best thing to do is to go to a women's health center or a doctor's office, perhaps accompanied by a trusted adult (your mother, if you feel comfortable, or an aunt or other person with whom you can speak freely).

When choosing the type of contraception, or the mode of administration, you must first take into account your individual needs, and at the same time ensure their safety. This way, once you have made a decision, you will be more motivated to follow the method over time, and will have greater satisfaction. In a woman's health center, there are doctors who are prepared and trained to identify and meet the various contraceptive requirements for women or for couples based on specific needs. There are methods that are suitable for infrequent or temporary sexual activity, while others are better suited for frequent or regular sexual activity. Both approaches are valid because they respond to different needs.

Let's debunk this myth right away! You can get pregnant the first time, and it doesn't get more true than that. So the best way to live this experience spontaneously and with passion is to avoid unnecessary risks by choosing a protective method of contraception that enables you to live this unique life experience to the fullest. Knowing that you run no risk of unwanted pregnancy, and at the same time being able to protect your "gift" of fertility gives you a real chance to experience sex spontaneously, safely and calmly. It also creates trust and complicity with your boyfriend, which are important values to begin your sex life with.

This is the testimony of Paola, a twenty-year-old girl who said she was happy with her choice. Her comment shows how the choice of contraception can significantly influence a woman's approach to life, and also her romantic relationship. But the reverse is also true. The way in which a woman is living her sex life and her romantic relationship at a given moment is crucial in her contraceptive choices. Fortunately, there are many different hormonal methods that exist for every need related to health, well-being, age and... your wallet! These provide a wide range of feminine protection, so it is important to be informed in order to make your choice with conviction and awareness, and to be able to fully understand the advice of your gynecologist. Would you ever have thought that your gynecologist would play a key role in the major stages of your life as a woman? It is important to establish a sincere and open dialogue with him/her from the very beginning.

Today, more than yesterday, a couple's social life is affected by external factors (stress, financial problems, job insecurity, etc.) that make the fragile balance of life as a couple more delicate. A gratifying sexual life, without the anxiety of an unwanted pregnancy, helps strengthen the love life of a couple and make it more harmonious. When choosing the best time to have a child, you must take into account the psychological, physical and future financial state of the family. Nothing should be left to chance when it comes to avoiding pregnancy and/or passively accepting it. Therefore, the choice of a contraceptive method, especially within a stable couple, should be agreed upon by both partners. Have you and your partner talked to each other regarding this matter?

So says Anna Paola, and hers is just one of the many testimonials received. Feeling sure that you don't risk an unwanted pregnancy allows you to live your sexuality in a more spontaneous, calm and healthy way, particularly for young women during their first sexual experiences. An approach without the anxiety of getting pregnant is what it takes to start building an understanding of sexual confidence and complicity.

This is the experience of Beatrice! "A good relationship with my "gyno" is essential," she wrote to us, and she's right.  Numerous studies have shown that a good relationship with your gynecologist has a significant impact on your choice of contraception, and on the ability to gain greater confidence with the method itself. Establishing a relationship of empathy with your doctor is also important considering that he/she is the standard specialist for every woman in the primary stages of her life, both for health but also for the emotional load connected to everything regarding intimacy and her sex life, or that of the couple.

Silvia's experience made a mark on her, and gave her the necessary determination to make a more informed choice for herself and her sexuality. Also in this situation it is important to be supported and guided by sound advice and a relationship of trust with your gynecologist, who should know how to listen to you without judging, but rather by offering support, understanding and clear and correct information on the best choice to make.

Having a baby is a choice that is so important that it should be done at the right time, in a conscious way, when you are ready and mature enough to calmly face all the responsibilities that it entails. This can become, when desired and wanted, one of the happiest and most beautiful moments in the life of a couple.

Every gynecologist, whether private or from a women's health center, is accustomed to interacting with women from different walks of life, be it social, cultural or religious, who do not necessarily have the same characteristics or needs based only on age group. Cultural and religious traditions should not be a barrier between a woman and her gynecologist. A doctor respects, and does not judge, the cultural traditions of all women, their religious beliefs, sexual choices and resulting behaviors. It is his/her task to provide information and give the woman support and competent advice regarding her health, and provide an informed risk assessment for her sexual and reproductive life.

The best thing to do is to contact your local women's health center and/or hospital gynecology department. The relevant ASL will definitely be able to tell you where to find the closest location. You can also look online to find the most convenient location, or if you prefer to remain unnoticed, you can go to a different area from where you live, far away from prying eyes. You can request the presence of a linguistic-cultural mediator during your visit in a women's health center, as well as in many hospital gynecology departments. This person can be instrumental in allowing a foreign woman and/or immigrant to speak about intimate and sensitive issues with greater ease, and to feel understood. In many cases, it's even better that the woman is able to talk alone, without the presence of her husband or family, who can unknowingly translate distorted information on intimate and reproductive health, of which the woman, of any culture, must be fully aware.  Additionally, in women's health centers and in doctors' offices there are often illustrated materials that are translated into major languages ​​that can be taken home to read calmly, after which you can return to ask for additional information or explanations. Often there are also specific times dedicated to girls and boys, even those who are underage, to talk with people who have a lot of experience communicating with adolescents, including on issues that are particularly sensitive and maybe embarrassing.

In our experience as gynecologists, sometimes there is no alternative, even if the best solution would be for the woman to be alone during her visit or with both a cultural mediator and the doctor. If the interpreter is a family member, this can create problems both for the woman (who must reveal confidential information regarding her intimate life) and for the doctor, who has no assurance that his/her messages are being properly translated. It often happens that the interpreter husband/family member/friend talks about what he/she believes to be more correct in his/her culture in regards to the woman, instead of actually transmitting the doctor's questions and the woman's answers. It is very easy to create communication errors this way, resulting in errors in the use of contraception and in adherence to method of contraception over time. 

What is the role of an interpreter/cultural mediator in a women's health center? The roles are many, and are aimed at helping both the woman and the doctor.

For a foreign women like you, he/she is a key figure for providing easier access to service. He/she welcomes women and reassures them, and understands their questions and their needs, even for delicate, personal matters such as fertility, sex life and contraception, topics that in some cultures are not talked about very much, and of which even less is known, which are often experienced with different mindsets by Italian women. The cultural mediator translates information, documents, instructions, exam notes and treatment methods. He/she accompanies them when necessary to other services provided by the women's health center, etc.

Even for doctors and other health professionals, they are very important figures that facilitate effective communication between the parties through translation of information and requests. They are able to pass on knowledge relative to different cultural contexts and practices. They make the responses from both parties directed and efficient. They avoid and prevent misunderstandings and misconceptions, and "streamline" visits and the passage of information. They introduce elements of organizational change and adaptation of protocols and procedures based on the characteristics of the woman.

"At first I was very suspicious and reluctant, but after a few meetings it has become a welcoming place for me, where I know I am understood and welcome without prejudice.  The cultural mediator I met there helped me to understand the instructions and advice of the gynecologist. She is sensitive and has never made me feel different or judged. She always has a kind word, listens to what I say and makes a lot of effort to make sure I understand the doctor's explanation on reproduction and on the various contraceptive methods available, which promotes better understanding and decision-making. I understood, even if not immediately, that her mediation is valuable because it encourages communication between me and the gynecologist, and the other doctors as well. If she were not there, I wouldn't understand anything, and perhaps I wouldn't come either since I would feel embarrassed. At first, I would come with one or two family members. Now I even come alone. I trust her and I feel welcomed and assisted. She is a point of reference for me and for my friends, who came after me."
This is one of the many testimonies of immigrant women who come to the women's health center. Let us remember that the role and the sensitivity of the intercultural mediator is also of paramount importance in cases, which are unfortunately too frequent, of violence or exploitation of women, whether physically, psychologically or financially. Unfortunately, we read stories about this every day, and the women's health center has a dedicated welcoming service which offers a shoulder to lean on and which can be fully trusted. It's a good thing they're there!

At first, the requirement for a medical prescription may seem counterproductive, but if after the first 3 months the contraceptive method chosen is found to be the most suitable, the gynecologist can write you a prescription that covers a longer period of time (6 months or more). The availability of a renewable, long-term prescription and lasting supplies reduces the possibility of suspension for lack of preparation or for inability to renew the prescription, for example for a woman who moves frequently, travels or does professional sports.

Let's debunk once and for all this unfounded misconception! Precisely because of this false belief, many girls, and also many adult women, refuse to use it, putting themselves at risk of an unwanted pregnancy which would be a much more critical issue to manage. Previously, the first pills made contained a high dose of estrogen, and this could actually result in a slight increase in weight (always mild, we're talking about a maximum of 2 pounds in the 1st year), mainly due to water retention. Today, however, the problem is completely solved. Both the pill and the other combined oral contraceptives (COCs) are all low in estrogen (≤30 mcg) and do not cause weight gain.

It's important to remember that the first rule for maintaining normal weight is always a healthy lifestyle, which means a complete and balanced diet combined with regular physical activity that is commensurate with age. In this sense, it might be useful for you to keep a food diary for a couple of months, recording everything you eat, including snacks. You would not be the first to find out that you eat more than you think you do without realizing it.

If the feeling of weight gain or "...being swollen" persists, you can ask your gynecologist to switch to a pill that contains only progestin, which helps to counteract water retention. 

First of all, it is important to understand that cancer is caused by multiple mechanisms, not all of which are fully known yet, but above all, that not all cancers are the same.

As for the use of combined oral contraceptives (COCs), the opposite is true - not only do they not cause cancer, but they actually reduce the risk of some cancers, such as ovarian cancer, colon cancer and endometrial cancer, and they maintain this protective effect even several years after discontinuation of contraception.

In particular, in regards to ovarian cancer, which is actually very aggressive, the reduction in cancer risk that is obtained with taking a combined oral contraceptive (COC: pill, ring or patch) it is very advantageous. This happens because COCs do not cause a "blockage" of the ovaries, but keep them "at rest," that is, you are not ovulating. This rest is beneficial for women who do not have pregnancies, since it is known that ovarian cancer is related to ovulations. Uninterrupted ovulation is one of the causes of ovarian cancer. COCs prevent ovulation, and thus exact a protective effect, especially with prolonged use (> 10 years). It has been shown that one can reduce the relative risk of ovarian cancer by 20% for every 5 years of use of the combined pill or another COC.

For other types of cancer (such as breast), the effects of COCs are not significant. It's true that there may be personal risk factors, or tumors in place, in which case it's better to avoid taking them, but in this case you will have already been well informed by your gynecologist and together you will have made the right decision for you.

In theory, being only 30 years old, you still have a window of relative safety for another five years, but then the risk of thromboembolic events such as heart attacks or strokes increases. You should take some time to seriously consider this point - why not take the opportunity to stop smoking immediately, without waiting five years? After this period, it may be more difficult, and the number of cigarettes may have increased. Think about it! Now you know.

It's true. After 35 years, smoking - especially more than 15 cigarettes per day - is a serious health risk for all women in general. The substances that are inhaled along with the tobacco smoke can damage cell repair mechanisms, opening up the possibility of pro-inflammatory changes that can cause serious diseases. Additionally, smoking causes premature aging of the skin, which loses its elasticity and looks dull and dehydrated.

All COCs are not recommended in women smokers who are over 35 years of age due to the increased risk of thromboembolism. Alternatively you can use hormonal contraceptives without estrogen (progestogen-only pill, implant and IUD) if you limit smoking. If you really don't want to give it up, then it's better to think about a non-hormonal method.

If you found out you were pregnant while you were still taking the estrogen-progestin pill or another combined oral contraceptive (COC), contact your gynecologist or someone from the women's health center right away, who will probably give you an ultrasound. Afterwards, you can discuss together all the aspects of the case, and decide what to do, obviously in accordance with your partner as well.  The hormones contained in a COC are not usually a problem for the fetus. More than anything else it will be important to remember if you took any other medicines or got any X-rays when you didn't know that you were pregnant.

The use of COCs does not generally cause xerophthalmia (dry eye).

Symptoms due to alteration of the tear film may appear in women like you who wear contact lenses, especially in those who spend a lot of time at the computer.

The important thing is to never use eye drops, but to keep hydrated by drinking plenty of water and taking breaks after an hour of activity at a PC. Products referred to as 'artificial tears' or specific sprays are available commercially. It's better not to apply them on your own initiative, but to first contact a specialist for a consultation.