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…

Contraceptive Pearl: Understanding Reproductive Coercion

Written by Chelsea Faso, M.D. Reproductive coercion is defined as behaviors or policies that interfere with decision-making about contraception and pregnancy. In the US, clinicians have often been complicit in implementing and enforcing reproductive oppression and coercive practices, sending and reinforcing the message: certain groups of people are more fit to parent than others. This…

Contraceptive Pearl: Non-Pharmacologic Options for Pain Control with Intrauterine Device Insertion

Written by Angeline Ti, MD, MPH The experience of pain combines cognitive, emotional, and sensory components, and is often a complex interaction between a person’s past experiences, current state of mind, and what nerves are being irritated. While there are a variety of pharmacologic options for pain control with IUD insertions, there are also non-pharmacologic…

Contraceptive Pearl: Hormonal Birth Control & Weight Gain

Do hormonal contraceptives cause weight gain? One survey of American women indicated that concern about weight gain was the most common single reason for discontinuing combined OCPs.

Contraceptive Pearl: Vasectomy Reversal

Written by Deyang Nyandak, MD. Vasectomy is a safe and effective permanent birth control method. Six to eight percent of married couples in the world rely on this method¹. Compared to vasectomy, tubal ligation has 20 times the risk of major complications and three times the cost².  Some patients regret vasectomy and wish to conceive. People…

Contraceptive Pearl: Special Considerations for People with Substance Use Disorder (SUD)

Written by Sheila Attaie, D.O. Substance Use Disorder (SUD) is a treatable chronic illness.  People with SUD have higher rates of unintended pregnancy, sexually transmitted diseases, infertility, and mortality related to pregnancy; and lower rates of contraceptive use¹. People with SUD face profound stigma, barriers to care, and even criminalization when interfacing with the medical industrial complex.…

Contraceptive Pearl: Does Your Patient Need Backup Contraception After Progestin IUD Placement?

Written by Hannah Rosenfield, M.D. In the past, we suggested backup contraception for 1 week after insertion of a progestin IUD. Is this still necessary? A recent study examined one-month pregnancy rates among individuals who had an IUD placed as emergency contraception and reported intercourse within 7 days post-placement. This analysis included 268 participants who…

Contraceptive Pearl: Birth Control Patches

Updated November 29th, 2022 The three birth control patches available in the US deliver estrogen and progestin transdermally. Some people find a once-weekly patch easier to remember than a daily pill. The newest patch, Twirla, contains lower doses of hormones: Brand Name Estrogen Progestin Xulane 35 mcg 150 mcg norelgestromin Zafemy 35 mcg 150 mcg norelgestromin Twirla 30 mcg…

Contraceptive Pearl: Irregular Bleeding with Hormonal Contraception

Written by Chelsea Faso, M.D. Many patients stop taking contraceptives due to an irregular bleeding pattern. Hormonal contraceptives often cause spotting, especially during the first 3-6 months. Anticipatory counseling about changes in bleeding patterns may help patients adjust to a new method. We can reassure patients that spotting is normal, and that they can stop…