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This is an updated version of our September 2022 Contraceptive Pearl written by H. Reeve Bright, with updates written by Ruth Lesnewski. You can read September 2022’s Contraceptive Pearl on our website. Over-the-counter (OTC) oral contraceptive pills (OCPs) are available in over 100 countries. Requiring a prescription for OCPs creates access barriers, especially for the…
Written by Iffie Ikem Most combined oral contraceptives (COCs) are made from a combination of ethinyl estradiol and a progestin. However, in 2021 the FDA approved Nextstellis (Drospirenone-Estetrol), a new combined oral contraceptive containing Estetrol. Synthesized in a laboratory using a plant source, estetrol is chemically equivalent to the estrogen made by the human fetal liver.1-2…
Written by Sadia Contraception for patients with a current or prior history of eating disorders is similar to contraception for people without a history of eating disorders. Clinicians should first establish the extent of a patient’s eating disorder since there are several eating disorders with varying clinical manifestations. Commonly known eating disorders and their special…
Written by Liza Brecher Contraception for people with disabilities, including physical and cognitive disabilities, is similar to contraception for people without disabilities. Clinicians should discuss patient’s goals for pregnancy, parenting, and overall health to identify the contraceptive method that works best for each person. Most patients with disabilities are able to provide informed consent. Avoid…
Written by Samantha Hyacinth We are able to offer patients more options for emergency contraception (EC) than ever before. Now, those who have unprotected sex or a contraceptive failure can choose between 1.5 mg levonorgestrel, 30 mg ulipristal acetate (UPA), the copper IUD (Cu-IUD), and the 52 mg levonorgestrel IUD (LNG-IUD). Unfortunately, not all of…
Written by Heather Stevens, MD Vasectomy is a highly effective method used for permanent sterilization for people with testicles. This method has been used for over 100 years across the world. Vasectomies are done in an outpatient setting with local anesthesia, and have very low complication rates. Though vasectomy is less expensive and safer than…
Written by Samantha Glass Hormonal intrauterine devices (IUDs) have been in use for over thirty years. Levonorgestrel-IUDs prevent pregnancy primarily by inducing a sterile inflammatory response in the uterus that is toxic to sperm and ova, with additional hormonal effects on the endometrium and cervical mucus. There are various hormonal IUD options that are effective…
Written by H. Reeve Bright Requiring a prescription for oral contraceptive pills (OCPs) creates access barriers for patients. Over-the-counter (OTC) OCPs are available in over 100 countries throughout the world, but not in the United States. As of July 2021, 21 states offered pharmacist-prescribed birth control pills, but no states offered over-the-counter OCPs.¹ Recently, HRA Pharma…
Written by Samantha Hyacinth with support from The Well Project Approximately 1 in 7 of the estimated 1.1 million people living with HIV in the US are unaware of their diagnosis.¹ About 40% of new HIV cases involve transmission from someone who is unaware that they have it. Because it is important to start antiretroviral therapy as…
Written by Samantha Hyacinth with support from The Well Project Major advancements in HIV treatment and prevention mean that people living with HIV are no longer limited to condoms for contraception. Most patients with HIV have the full range of contraceptive options. Studies of couples all over the world show that when a person living with…
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