Contraceptive Pearls

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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: 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: 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…

Contraceptive Pearl: Pregnancy with an IUD in Place

Written by Mayra A Hernandez Schulte, M.D. The Intrauterine Device (IUD) is over 99% effective at preventing pregnancy. While pregnancy is rare with an IUD in place, it requires special management when it occurs. Pregnancies that occur with an IUD in place have a higher chance of being ectopic, so it is important to obtain…

Contraceptive Pearl: Who Needs a Pregnancy Test When Starting Contraception?

Many clinicians or clinic protocols require a pregnancy test for patients who are starting contraception or receiving contraceptive care. However, a routine pregnancy test is not necessary for everyone starting contraception; it can act as a barrier to telehealth care and a negative test can provide false reassurance in some situations. The US Selected Practice…

Contraceptive Pearls

This monthly clinical e-newsletter highlights evidence-based best practices for contraceptive care

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