Contraceptive Pearl: Nexstellis

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…

Contraceptive Pearl: Contraception for Patients With a Current or Prior History of Eating Disorders

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…

Contraceptive Pearl: Contraception For Patients with Disabilities: A Brief Introduction

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…

Contraceptive Pearl: Discussing Emergency Contraception & Weight

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…

Contraceptive Pearl: Vasectomy Counseling

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…

Contraceptive Pearl: Hormonal IUDs

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…

Contraceptive Pearl: Over-the-Counter Access to Oral Contraceptives

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…

Contraceptive Pearl: HIV Counseling & Screening for People Without HIV

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…

Contraceptive Pearl: Contraceptive Counseling for People Living with HIV

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…

Contraceptive Pearl: Preconception Counseling for People Living with HIV

Written by Samantha Hyacinth with support from The Well Project By the end of 2019, about 1.2 million people aged 13 and older were living with HIV in the United States.¹ Because HIV is transmitted mainly via sex and injection drug use, it carries more stigma than other chronic diseases. People living with HIV are unfairly portrayed…