Keywords

These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Adolescent sexuality and reproductive health care is a discussion topic with issues related to adolescent pregnancies, termination of undesired pregnancies, contraception for adolescents, prevention and treatment of sexually transmitted diseases, and other gynecological pathologies [1–4].

In the USA, adolescent pregnancy accounts for more than 750,000 pregnancies per year, of which 82 % are unintended. A large number (64 %) also occur among young women 20–24 years old [5].

The failure rate of combined oral contraceptives (COCs) during adolescence is estimated between 5 % and 15 %. During the last years, an effort was undertaken to reduce the dose of ethinyl estradiol (EE) in COCs. However, the decrease of the dose had negative effect on the physiology of the menstrual cycle. On the other hand, early attempts to develop 17β-estradiol (E2)-based COCs (Ε2–COCs) accompanied with prolonged or heavy uterine bleeding and discontinuation rates [6–8].

In addition, it was found that EE was responsible for several side effects of COCs, related to the liver function, venous thromboembolism and hypertension. Thus, research was directed to the development of new COCs with E2 and new progestins as the dienogest, drospirenone, nomegestrol acetate, and other components. An emphasis was given to the development of new progestins with both progestagenic and antiandrogenic efficacy [9, 10].

Furthermore, the noncontraceptive benefits of the new-generation E2–COCs were studied in combination with the favorable effects of the progestins as: the improvement of acne, the regulation of the menstrual cycle, the prevention of endometrial and ovarian cancers, the prevention from benign ovarian cysts, the management of endometriosis, the severity of pelvic inflammatory diseases (PID), the protection of bone mass, the management of the polycystic ovarian disease (PCO), as well as the beneficial effect on the liver function and the lipid profile (Table 4.1) [8, 11].

Table 4.1 No contraceptive benefits of E2–COCs
Full size table

Regarding the regulation of the menstrual period (MP), a significantly shorter MP was succeeded as well as less menstrual, withdrawal, breakthrough bleeding, and spotting. Furthermore, the new E2–COCs have been used for the management of dysfunctional uterine bleeding (DUB) and dysmenorrhea, especially in cases with endometriosis [12].

Beneficial effects have been reported on the endocrine—biochemical and haemostatic markers, on the thyroid function, the adrenal indices, the SHBG, the inflammation markers, as well as on the lipid and carbohydrate metabolism [13–16].

Furthermore, the E2–COCs, as it was previously reported, are used for the management of the menstrual irregularities, dysmenorrhea, and PMS as well as for the improvement of the PCO clinical features.

Adolescents are usually unaware of the beneficial effects of COCs, and especially for the effects of the young generation pills. Thus, consultation on contraception should include franc explanation on the use and action of the pills as well as for their long-term beneficial effects [1, 2].

On the other hand, the COSs “negative effects” should be considered before treatment [17, 18]. The myths and misconceptions on the COCs use and especially the beneficial effects of the new-generation E2–COCs, as these were very well presented, at the 12 European Congress of Contraception (Athens, 2012), are very much related to the COC’s compliance. For this reason, proper consultation should be provided to young people and their families to avoid discontinuation and unwanted pregnancies[7].