Special Issue "New Insights into Contraception".

Today, a diverse range of contraceptive techniques is available to women; this, coupled with continued positive trends in female children and adults' educational attainment, will hasten declines in fertility and continue to slow population growth [...].

Temperament, post-partum depression, hopelessness, and suicide risk among women soon after delivering.

The aim of the authors in this study was to assess the prevalence of postpartum depression and evaluate the association of affective temperaments with emotional disorders in a sample of 92 pregnant women consecutively admitted for delivery between March and December 2009. In the first few days postpartum, women completed the Suicidal History Self-rating Screening Scale, the Beck Hopelessness Scale, the Edinburgh Postnatal Depression Scale, the Temperament Evaluation of the Memphis, Pisa, Paris and San Diego Autoquestionnaire, and the Gotland Male Depression Scale. Fifty percent of the women reported an Edinburgh Postnatal Depression Scale score of 9 or higher, and 23% a score of 13 or higher. Women with a dysphoric-dysregulated temperament had higher mean scores on the Beck Hopelessness Scale (p < 0.05), the Gotland Male Depression Scale (p < 0.001), the Edinburgh Postnatal Depression Scale (p < 0.001), and the Suicidal History Self-Rating Screening Scale (p < 0.01) than other women after adjusting for covariates. Multiple logistic regression analysis with the temperament groups as the dependent variable indicated that only the Gotland Male Depression Scale was significantly associated with temperament when controlling for the presence of other variables. Women with a dysphoric-dysregulated temperament were 1.23 times as likely to have higher depressive symptom scores. Future studies should evaluate the effectiveness of psychiatric screening programs in the postpartum period as well as factors associated with depression and suicidality during the same period.

Italian consensus conference on epilepsy and pregnancy, labor and puerperium.

To facilitate an integrated and rational approach to the care of women with epilepsy of childbearing potential, a group of experts appointed by Italian scientific societies in the fields of epileptology, neonatology, pediatrics, neuropediatrics, child neuropsychiatry, obstetrics, and gynecology held a joint meeting in Santa Trada di Cannitello, Reggio Calabria, Italy, on October 15-16, 2004, with the aim of reaching consensus on the optimal management of these women. An ad hoc system for the classification of available published evidence and the opinions of experts was developed and used to grade recommendations on different aspects related to counseling, diagnostic, and treatment issues. The present document summarizes available evidence on the reciprocal interactions between epilepsy, antiepileptic drugs, fertility, contraception, pregnancy, delivery, breastfeeding, and the offspring. Recommendations are made concerning the information and counseling that should be provided to women with epilepsy with respect to issues related to contraception, conception, pregnancy, labour, and puerperium. More detailed recommendations on the same issues are provided to physicians and other healthcare professionals involved in the care of these women, with special reference to choice of effective contraception, optimization of antiepileptic drug therapy, use of prenatal diagnostic tests and other monitoring procedures, and appropriate management practices in relation to childbirth, puerperium, and the care of the child.

Seventy-five microgram desogestrel minipill, a new perspective in estrogen-free contraception.

Progestin-only minipills have been available for over three decades, yet their use has been limited, because of a documented lower efficacy when compared to pills that combine estrogen and progestin. The availability of a new low-dose progestin-only minipill containing 75 microg desogestrel (DSG) offers a new perspective, since, in a large multicenter study, this minipill gave a crude Pearl index of 0.41 and an adjusted one of 0.14, which is comparable to indices found in clinical trials of oral contraceptives. This minipill also allows for a 12-hour tolerance time in taking the pill. The high effectiveness of the DSG minipill is attributable to an almost constant inhibition of ovulation, as shown by the absence of elevated progesterone circulating levels and inhibition of follicular growth in the vast majority of cycles studied. Since irregular bleeding patterns are observed with all minipills, patterns experienced with DSG 75 microg have been compared to those obtained with levonogestrel 30 microg. As expected, the more pronounced ovarian inhibition produced wider bleeding variability with DSG, but also less bleeding overall. The DSG minipill is suitable for lactating women and represents a valuable addition to oral contraception.

Menopause, a global perspective.

This paper attempts to provide a global perspective of the menopause as a period in a woman's life. It is growing in length, year after year and there is a need to place these years in the overall context of ageing. There are many fallacies about ageing. The most serious is the view describing old people exclusively as a burden for society, when in fact they can and should be considered as a resource. Women live longer almost everywhere in the world. Growing evidence indicates that the process of ageing differs in a considerable way in the two sexes. This difference may, at least in part, be due to sex-related differences in the regulation of stress response mediators. In addition, variability in the mitochondrial genome also displays a sex-specific impact on longevity. Restricting the discussion to longevity in the female, a paramount role must be given to sex hormones in improving a woman's ageing. Indeed, it is the fall in oestradiol production that qualitatively changes the ageing perspective in the human female, since oestrogen secretion plays a major role in guaranteeing a woman's psycho-physical equilibrium during the fertile period. These considerations represent the philosophical basis for post-menopausal hormone replacement therapy.