In May, 2020, the FDA approved a new contraceptive gel containing lactic acid, citric acid, and potassium bitartrate. The brand name is Phexxi. The gel acidifies the vagina, creating an environment that’s hostile to sperm. The gel does not contain nonoxynol 9, the active ingredient in spermicides (which can irritate the vagina and raise the…
In 2018, the FDA approved a one-year contraceptive vaginal ring. It’s a flexible silicone ring that slowly releases segesterone acetate and ethinyl estradiol. The brand name is Annovera. The label instructs patients to insert the ring for three weeks and remove it for one week, repeating the cycle a total of thirteen times before starting…
Coercive contraceptive practices have a long history in the United States, beginning in the era of slavery and extending to forced sterilizations as recent as 2010. Forced contraception has targeted primarily low-income, incarcerated, disabled, Indigenous, Black, and Latinx people. Knowing this horrific history, how can we adjust our contraceptive counseling to avoid any semblance bias…
What’s a simple way to improve adherence to prescription contraceptives? Easy: prescribe a one-year supply. One-year prescriptions also decrease trips to the pharmacy and the health center, thereby promoting social distancing in the time of COVID-19. Dispensing a year’s worth of contraceptives is even better than prescribing a year’s worth. In the states that allow…
An intrauterine device (IUD) can be inserted immediately postpartum, minutes after delivery of the placenta. Post-placental IUD insertion is simple and safe, with a low rate of complications. This video demonstrates the procedure. Pregnant patients who choose an IUD can get one without experiencing the risk of an extra office visit during the COVID-19 epidemic. The risk…
Hendriks, E, Rosenberg, R, Prine L. Am. Fam Physician. 2020 May 15;101(10)599-606. Link: https://www.aafp.org/afp/2020/0515/p599.html Abstract Ectopic pregnancy occurs when a fertilized ovum implants outside of the uterine cavity. In the United States, the estimated prevalence of ectopic pregnancy is 1% to 2%, and ruptured ectopic pregnancy accounts for 2.7% of pregnancy-related deaths. Risk factors include…
Depot medroxyprogesterone acetate (DMPA) can be prescribed as a subcutaneous injection that patients give themselves at home. The self-administered version helps patients avoid the need for office visits during the COVID-19 pandemic. This method, also known as Depo SubQ, contains the same hormone, works in the same way, and has the same medical eligibility criteria…