Contraceptive Pearl: DMPA and Bone Health

Written by Meghna Nandi, MD Depot Medroxyprogesterone Acetate (DMPA) is a commonly used, highly efficacious, progestin-only injectable contraceptive method. Many contraceptive users are drawn to DMPA for the privacy it affords and the convenience of its three-month (11-15 week) dosing schedule.1 Although DMPA has many advantages, there are concerns over the method’s impact on bone…

Contraceptive Pearl: How Effective is Tubal Sterilization?

Written by Eleanor Bimla Schwarz, MD, MS and Kelly M. Treder, MD, MPH Since the Dobbs decision, as access to abortion services has become more challenging in many parts of the country, the possibility of contraceptive failure has become more distressing. Unintended pregnancy is relatively common, even among patients who use contraception.1 Because many patients…

Contraceptive Pearl: Updated CDC Contraception Guidelines

Written by Angeline Ti On August 6, 2024, the Centers for Disease Control and Prevention (CDC) released updates for the U.S. Medical Eligibility Criteria for Contraceptive Use (U.S. MEC) and the U.S. Selected Practice Recommendations for Contraceptive Use (U.S. SPR). Adapted from guidelines from the World Health Organization, the U.S. MEC and U.S. SPR provide…

Contraceptive Pearl: Marijuana, E-Cigarettes, and Pregnancy

Written by Meghan Hynes This Pearl is the third part of a three-part String of Pearls series that examines the effects of different substances on fetal development and recommends harm reduction strategies to reduce risks involved with substance use during pregnancy. You can read the first two parts on our website. Electronic cigarettes and marijuana…

Contraceptive Pearl: Opioids, Xylazine, and Pregnancy

Written by Meghan Hynes This Pearl is the second part of a three-part String of Pearls series that examines the effects of different substances on fetal development and recommends harm reduction strategies to reduce risks involved with substance use during pregnancy. You can read the first part on our website. Numerous factors over recent years…

Contraceptive Pearl: Harm Reduction Approaches to Substance Use During Pregnancy

Written by Meghan Hynes Although health care professionals and institutions are evolving from treating addiction as a moral failing to treating it as a chronic disease in recent years, substance use during pregnancy remains misunderstood and heavily stigmatized. This stigmatization can negatively affect how health care professionals perceive patients with substance use disorders (SUDs) and…

Contraceptive Pearl: Ulipristal Acetate Myths

Written by Veronica Flake, MD Ulipristal Acetate (ella, UPA) is an effective emergency contraception (EC) method, given as a one-time, 30-mg dose, which can be used for up to 120 hours after unprotected sexual intercourse to prevent pregnancy. UPA is a selective progesterone receptor modulator with antagonistic and partial agonistic effects that prevents or delays…

Contraceptive Pearl: The Latest Updates on the Over-the-Counter Contraceptive Pill

By Joi C. Spaulding MD, MS Opill, a daily progestin-only birth control pill (POP), was first approved for over-the-counter (OTC) use by the United States Food and Drug Administration (FDA) on July 13, 2023. As of March 2024, the pill is now available to people of all ages to purchase at retailers online and in…

Contraceptive Pearl: Considerations in Contraception During Perimenopause

By Natalie Cheung-Jones, DO During perimenopause, some people have inconsistent ovulation and irregular menses. Despite these changes, pregnancy occurs for 30% of pregnancy-capable people ages 40-44, decreasing to 10% by ages 45-50.¹ Though menstrual cycles may be unpredictable, studies indicate that ovulation occurs in 87% of cycles up to five years before menopause and 22%…

Contraceptive Pearl: Understanding Conventional and Non-Hormonal Approaches to PCOS

By Lakshmi Sundaresan, MD Polycystic Ovary Syndrome (PCOS) is a common endocrinological phenomenon, often manifesting with symptoms of irregular periods, coarse facial/terminal hair, and glucose intolerance.¹ Conventionally, treatments for PCOS are tailored to the manifestations of hyperandrogenism, insulin resistance, and menstrual irregularities that patients experience. In 2023, the International PCOS practice guidelines were updated to…