In adolescents, depot medroxyprogesterone may be an ideal option,  but its use is associated with poor continuation rates. Although the major problem is menstrual irregularity; the time, expense and inconvenience of a gynaecological visit also pose a barrier to use. Self-administration might make visit unnecessary. Adequate training and counselling regarding bleeding patterns may maximize success rates with self-administration ⁽¹⁵⁾. 

Currently, the need for contraception in a period of life characterized by irregular menstrual cycles as the perimenopause,  represents a social event.

The introduction of new lower-dose contraceptives and progestin-only formulations as implants and IUD-releasing progestin has deeply changed the indications for hormonal contraception,  allowing its use in women in whom it was previously contraindicated ^{(16.17,18,19,20)}. 

Although,  gynecologist’s personal opinions and poor knowledges about this field, often lead to refuse contraception in older women.  Other important problems regard the contraceptive counselling post-abortion, post-partum and the contraceptive guidance for women at risk of sexually   transmitted   diseases   or   affected   by   HPV,  and/or   HIV   infections ^{(21,22,23,24,25,26,27,28,29,30,31)}. 

Although   many   studies   have   shown   a disappointing periabortion contraceptive uptake;  it was found that contraceptive counseling by a dedicate team, during pre-abortion visit, can dramatically improve post-abortion contraception uptake.  In addition,  according to the woman’s preference   it   is   possible   to   provide   immediate   post-abortal   IUD-insertion ^(32,33).

Preconception counselling is very important in adolescent sexually active with type 1-diabetes. In fact,early and unsafe sexual practices may increase their risk for unplanned pregnancy that could result in pregnancy-related complications.

Enhancing   knowledge   and   attitude   towards   preconception   counselling   and reproductive   health   education   may   reduce   these   risks   and   may   permit   a future, healthy reproductive life ^(34,35,36).

Expert counselling is necessary to plan birth control strategy in women affected by chronic serious diseases or transplant-recipients. In these women, sometimes there is difficulty to select a hormonal contraceptive risk-free,  but pregnancy may be even riskier ^{(37,38,39,40,41,42)}.