Sex steroids and libido.

The effects of steroidal hormones on sexual desire and motivation are a question still under debate. This paper reviews up-to-date knowledge regarding physiological imprinting and activation by endogenous hormones of central nervous system areas involved in libido during intrauterine life and puberty. The endocrine environment probably continues to play a role during fertile life and the postmenopausal period, but this effect is often overridden by psychological and social factors. The impairment of sexual interest during estrogen-progestin treatment is an infrequent but relevant side-effect whose possible underlying mechanisms are discussed. Both endocrine and psychorelational elements may interact. From the biological point of view, androgen and oxytocin level modification and loss of estrogen fluctuations have been considered, but also the history of hormone-related mood changes could be a risk factor. On the psychological side, both the profound repercussions of the contraceptive choice and consequent responsibility, as well as the high value attributed to sexual experience are probably facilitating elements in the loss of libido under treatment.

Natural contraceptive methods.

PIP: This is a brief review of the available natural family planning methods, the rhythm, basal body temperature, cervical mucus, and symptothermal methods, for use by Italian adolescents and young women who choose to avoid artificial contraception. Data from the last AIED Report show that 50% of Italian adolescent girls aged 16-18 have had coitus, while only 3-7.3% are using contraception, and a high proportion of women having abortions are under 20. The majority of adolescents using natural family planning state that they use the rhythm method, which has a Pearl Index ranging from 14.4-47%. Consistent use of the basal body temperature method can be improved with electronic or digital thermometers which take seconds rather than minutes to use. The cervical mucus method is notoriously unreliable in the post-menarchic period, when anovulatory cycles are common. An electronic instrument is also available to facilitate its use. The symptothermal method, combining cervical mucus, basal body temperature, and other clinical signs, is more difficult to integrate for new users, and no data are available in the literature on its use by adolescents. When the wide variation in menstrual cycle lengths, ovulatory and anovulatory cycles, and the myriad psychosocial barriers to regulated sexuality, a 3-6 month training period, and a committed relationship rarely found in adolescents are considered, it is highly unlikely that any natural family planning method can be recommended to this group of women.^ieng

Desogestrel in monophasic E/P combination: monitoring of endocrine parameters and evaluation of hemostatic function.

The Authors evaluated modifications in androgenic pattern as well as in parameters of androgenic function and coagulation in a group of women treated with a combination contraceptive containing Ethinyl estradiol and desogestrel.

Platelet and coagulation functions during triphasic oestrogen-progestogen treatment.

The purpose of this investigation was the longitudinal evaluation of the hemostatic system before and after 1, 3, and 6 months of treatment with a triphasic oestrogen-progestogen combination. No changes of circulating platelet aggregates, as an index of in vivo platelet aggregability, and of megathrombocytes, an indirect evaluation of accelerated thrombocytopoiesis, were observed. A very slight, but significant, increase of Fibrinopeptide A (FPA), a reliable index of thrombin formation, was found only after 1 month of treatment; after 3 and 6 months, the increase of FPA was not homogeneous and not significant. Antithrombin III activity (AT III) showed no modifications after the first month; after 3 months AT III increased to a small extent, and after 6 months it was similar to basal values. Our findings indicate that the triphasic combination does not modify platelet functions and induces a low-degree activation of coagulation counteracted by an increased activity of the physiological inhibitors of blood clotting.

Hysteroscopy of contact and submucous myomas: differential diagnosis between various benignant clinical patterns.

The AA. report their experience on the use of the contact hysteroscopy in the differential diagnosis between several patterns of benignant endometrial pathology. They agree upon the diagnostic and therapeutic usefulness of this kind of instrumental investigation.