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Contraceptive Counseling
Contraceptive counseling is a conversation between the patient and a medical professional aimed at providing clear and accessible information about all available contraceptive methods. The goal is to support the choice of a safe, effective, and acceptable method tailored to the patient’s health status, lifestyle, and personal beliefs.
With a mission to support women at every stage of their lives, Nadezhda Hospital has opened a contraceptive counseling office — a space created to provide a calm and professional environment for dialogue between patient and healthcare specialist.
Hormonal contraceptives can be used not only for family planning but also for the treatment of a number of symptoms and conditions in women.
The specialist at the Contraceptive Counseling Office at Nadezhda Medical Center, Paradise Center, Floor 3, is:
- Dr Nikola Donchev – Obstetrician-Gynecologist, holder of the European Diploma in Sexual and Reproductive Health (EDSRH-EBCOG).
Contraceptive counseling provides patients with the opportunity for follow-up consultations to monitor results and ensure long-term safety and peace of mind.
Appointments are required in advance and can be scheduled online via the hospital website or through the call center.
Who is contraceptive counseling suitable for?
- All patients of reproductive age, including:
Teenagers (including those seeking information only);
Mothers shortly after childbirth;
Perimenopausal patients.
- Patients with chronic conditions seeking a method compatible with their disease or medications (including those for whom pregnancy is contraindicated):
Cardiovascular diseases;
Pulmonary diseases – asthma, COPD, cystic fibrosis;
Kidney diseases;
Neurological conditions (migraine, epilepsy, multiple sclerosis);
Psychiatric disorders;
Immunodeficiency conditions or patients on immunosuppressive therapy (e.g., lupus);
Type 1 or type 2 diabetes;
Thyroid dysfunction;
Liver diseases (including cirrhosis, cholestasis);
Inflammatory bowel diseases (Crohn’s disease, ulcerative colitis);
Congenital hemoglobinopathies (thalassemia, sickle cell disease, etc.).
- Patients with oncological diseases, including during therapy;
- Patients with overweight or prior bariatric surgery;
- Patients living with HIV/AIDSPatients after organ transplantation;
- Patients with disabilities.
Why is contraceptive counseling important?
Contraceptive counseling and family planning are integral parts of modern reproductive healthcare. They enable a satisfying and safe sexual life combined with responsible choices and care for the future.
Globally, approximately 50% of pregnancies are unintended. These data highlight the need for better awareness, improved access to modern contraceptive methods, and high-quality healthcare counseling.
Not only the desire for pregnancy but also its timing is crucial for the health of both mother and child. When pregnancy occurs within 12 months after childbirth, the risk of complications for both mother and newborn increases. Therefore, the World Health Organization (WHO) recommends an interval of at least 12 months — optimally 24 months — between childbirth and a subsequent pregnancy.
Finding a contraceptive method that aligns with a woman’s lifestyle, beliefs, and preferences supports effective use, reduces unintended pregnancies, and enables couples to plan healthy intervals between pregnancies.
When can hormonal contraceptives be used for treatment, not only contraception?
All combined oral contraceptives (the pill):
Reduce or eliminate menstrual pain
Reduce the intensity and duration of bleeding (including treatment of anemia caused by heavy bleeding)
Reduce pain associated with endometriosis (including after treatment)
Lower the risk of benign ovarian and breast cysts
Reduce the risk of ovarian and endometrial (uterine) cancer
Help maintain bone density
Continuous use of combined contraceptives (without withdrawal bleeding) is particularly effective for menstrual pain and heavy bleeding. Some authors describe this regimen as “the 21st-century way to take the pill.”
Extended or continuous regimens are also used in the treatment of premenstrual syndrome (PMS).
Some combined contraceptives have anti-androgen (“anti-testosterone”) effects and may improve symptoms in:
Acne (including in teenagers)
Polycystic ovary syndrome (PCOS)
Progestin-only contraceptives (mini-pill, implant, intrauterine device, and depot injection) also have beneficial effects on painful menstruation and heavy bleeding.
All hormonal contraceptives are considered “protectors” of fertility because they reduce the risk of upper genital tract infections (uterus and fallopian tubes) and decrease the risk of ectopic pregnancy.
How does contraceptive counseling proceed?
At the beginning of the consultation, the patient’s needs and expectations are assessed. Age, health status, lifestyle, and future reproductive plans are analyzed to determine the safest and most appropriate contraceptive options.
All modern contraceptive methods are presented — hormonal, intrauterine, barrier, and natural methods. Each method is explained in detail regarding effectiveness, use, side effects, and additional benefits, ensuring informed decision-making.
A comprehensive medical history is taken, including past illnesses, menstrual cycle characteristics, previous surgeries, family history, and current treatments. This step is essential for selecting a safe contraceptive method.
After the medical history, a gynecological examination is performed. If necessary, additional tests may be ordered, such as a Pap smear or microbiological testing, to assess health status and identify contraindications.
The contraceptive method is chosen after discussing effectiveness, potential side effects, and non-contraceptive benefits, while considering the patient’s lifestyle, health status, and personal preferences.
After selecting a method, an individualized follow-up plan is established, including periodic check-ups. Adjustments may be made if needed to ensure long-term effectiveness, safety, and comfort.
Consultant gynaecologist
See also
Aesthetic Gynaecology
Pediatric and Adolescent Gynaecology
