Editorial Trends in contraception in the coming years

Abstract

Contraception is one of the fields of gynecology that has undergone many changes during recent years and its many problems are still not completely solved. We have to face one of the most striking problenis in the modern world: the growing poverty in the developing world and the growing prosperity in the developed world. One of the main goals of public health is to create the conditions in which demographic transition to stability can be approached.This implies a need to consider contraception as an important tool to be used properly during the coming years. In Europe, there are still differences between north, south, central or eastern countries. We need to consider not only the modern contraceptive technologies, but also the demographic and sociocultural evolution which should precede the technical evolution of contraceptive methods. The rates of population growth in Europe vary widely; in all countries the mortality rate has decreased but the fertility rates show big differences, being the more dominant factor in population growth.The gap between fertility and mortality rates varies widely from region to region. In this sense, population will be determined by fertility, and fertility is highly related to contraceptive prevalence. The differences in total fertility rate between countries can be explained by the variability in contraceptive use but also by other factors, mainly cultural, such as marriage pattern, induced abortions or the working status of women. The marriage pattern ha5 changed: couples are getting married at an older age and they start having children later. On the other hand, the age of nienarche is now earlier. Both factors have increased the time between the age of becoining fertile and the arrival of the first child, so that young people, mainly adolescents, are one of the groups with which our Society is concerned. Induced abortion is still one of the major problems in Eastern and Central Europe; the prevalence of contraception is low and fiequently, the only solution is repeated abortion. In some countries, abortion is performed illegally and the morbidity rate is high. Contraceptive methods, mainly hormonal, are refused because of the fear of complications. So information is needed regarding the benefits and risks of contraceptive methods and abortion. Another determinant of the total fertility rate is the income per capita of a country and the economic status of the women. These conditions have changed widely during recent years and vary throughout Europe.The working conditions of women have been a major determinant of the age at which a woman has her first child and whether she uses contraception. Methods that can provide high eficacy with safety, with good cycle control and without interference with the quality of life, are still one of the major targets of contraception. In the near future, the European Society of Contraception has to consider seriously all the above facts, to study the plurality not only of Europe but of all the world, to improve contraception for everyone, independently of their economic or social status. New methods of contraception should be developed, taking into account the needs and wishes of the various populations, and forging a link between the technological innovation of the scientists and the users. The EuropeanJournal ({Contraception and Reproductive Health Care was initiated with this idea in mind and we will work steadily in that direction. There is still much work to do from the scientific point of view; we need to continue to investigate new methods that could ensure the basic elements of reproductive health: the capacity to control fertility and enjoy safe sexuality, success in the procedure of producing a healthy baby that can grow in good conditions, and finally, security, in the sense that the process of controlling fertility and bearing a baby can be carried out under the best conditions for everyone.