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…
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…
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…
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%…
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…
By Silpa Srinivasulu, MPH Increasing access to accurate, easy-to-understand information about contraception can help people take action and make informed health care decisions. RHAP develops its patient education materials to ensure they are easily understood and actionable. We follow the International Patient Decision Aid Standards (IPDAS)* to produce quality materials that: Provide facts about contraception,…
By Rachel Chisausky, DO Do hormonal contraceptives affect mood? Studies in a general population yield conflicting results, showing decreased, increased, or unchanged depression scores.¹ Limitations of current data include few randomized control trials, small sample sizes, the possible conflation of psychosocial factors associated with contraception initiation, the predominant focus on combined oral contraceptives (COCs), and…
By Lori Atkinson, MD and Maya Bass, MD MA FAAFP With the increased use of long-acting reversible contraception, clinicians are more likely to encounter difficult intrauterine device (IUD) insertions and removals in their practice. Below are a few strategies and techniques to help troubleshoot these procedures. Difficult IUD Insertions IUD insertions are most commonly…
Written by Maddie Fowler, Spark Dariy, Amy Stone Last month’s Pearl discussed key practices of consent. Here, we share unique considerations for those with physical disabilities, intellectual and developmental disabilities (IDD) or cognitive impairment, non-speaking patients, and deaf patients. Physical Disability People with physical disabilities may require additional assistance during the exam. Without making assumptions,…
Written by Maddie Fowler, Spark Dariy, Amy Stone Many disabled people have been systematically disempowered and taught to prioritize compliance over self-advocacy. People with disabilities experience sexual assault at over three times the rate of nondisabled people, rising to seven times the rate in people with intellectual and developmental disabilities (IDD).¹ Therefore, it is critical…
