Contraceptive Pearl: Contraception During COVID-19: Acidifying Contraceptive Gel

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…

Contraceptive Pearl: Contraception During COVID-19: One Year Vaginal Ring

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…

Contraceptive Pearl: Contraception During COVID-19: Non-Coercive Contraceptive Counseling

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…

Contraceptive Pearl: Contraception During COVID-19: One Year Prescriptions

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…

Contraceptive Pearl: Contraception During COVID-19: Post-Placental IUD Insertion

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…

Contraceptive Pearl: Contraception During COVID-19: Self-Administered Progestin Injection: Depo SubQ

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…

Contraceptive Pearl: Contraception During COVID-19: E-Visit Contraceptive Template

COVID-19 is putting a strain on the entire health system, requiring clinicians to step into difficult roles and take on risks they may not have been expecting. To all health care workers out there, we stand with you and are grateful for the tireless work you are putting in to help end this pandemic. We…

Contraceptive Pearl: Contraceptive Counseling Through the Lens of Reproductive Justice

Contraceptive counseling is an art. We adapt and improve as we learn from our patients and our colleagues. The SisterSong Women of Color Reproductive Justice Collective defines reproductive justice as the “human right to maintain personal bodily autonomy, have children, not have children, and parent the children we have in safe and sustainable communities.” The United States…

Contraceptive Pearls: IUD Self-Removal

IUDs are typically removed by clinicians during a pelvic exam in the office. There can be numerous barriers to this arrangement, such as difficulty scheduling an appointment, concern about appointment cost, and clinician refusal of patient’s request for removal. Unsurprisingly, these barriers can raise patients’ concerns about ability to retain control over their own reproductive…

Contraceptive Pearl: Premenstrual Syndrome (PMS)

Premenstrual syndrome (PMS) is a combination of physical and emotional symptoms that begin after ovulation and resolve within the first 4 days of menstruation. Over 90% of women experience PMS at some point during their reproductive years, and approximately 5% of women experience the more severe premenstrual dysphoric disorder (PMDD). PMS symptoms include irritability, fatigue,…