Contraceptive Pearls

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Contraceptive Pearl: Ulipristal Acetate Myths

Written by Veronica Flake, MD Ulipristal Acetate (ella, UPA) is an effective emergency contraception (EC) method, given as a one-time, 30-mg dose, which can be used for up to 120 hours after unprotected sexual intercourse to prevent pregnancy. UPA is a selective progesterone receptor modulator with antagonistic and partial agonistic effects that prevents or delays…

Contraceptive Pearl: Considerations in Contraception During Perimenopause

By Natalie Cheung-Jones, DO During perimenopause, some people have inconsistent ovulation and irregular menses. Despite these changes, pregnancy occurs for 30% of pregnancy-capable people ages 40-44, decreasing to 10% by ages 45-50.¹ Though menstrual cycles may be unpredictable, studies indicate that ovulation occurs in 87% of cycles up to five years before menopause and 22%…

Contraceptive Pearl: Understanding Conventional and Non-Hormonal Approaches to PCOS

By Lakshmi Sundaresan, MD Polycystic Ovary Syndrome (PCOS) is a common endocrinological phenomenon, often manifesting with symptoms of irregular periods, coarse facial/terminal hair, and glucose intolerance.¹ Conventionally, treatments for PCOS are tailored to the manifestations of hyperandrogenism, insulin resistance, and menstrual irregularities that patients experience. In 2023, the International PCOS practice guidelines were updated to…

Contraceptive Pearl: Best Practices for Developing Contraception Patient Education

By Silpa Srinivasulu, MPH Increasing access to accurate, easy-to-understand information about contraception can help people take action and make informed health care decisions. RHAP develops its patient education materials to ensure they are easily understood and actionable. We follow the International Patient Decision Aid Standards (IPDAS)* to produce quality materials that: Provide facts about contraception,…

Contraceptive Pearl: Hormonal Contraceptives and Mood

By Rachel Chisausky, DO Do hormonal contraceptives affect mood? Studies in a general population yield conflicting results, showing decreased, increased, or unchanged depression scores.¹ Limitations of current data include few randomized control trials, small sample sizes, the possible conflation of psychosocial factors associated with contraception initiation, the predominant focus on combined oral contraceptives (COCs), and…

Contraceptive Pearl: Difficult IUD Insertion and Removal

By Lori Atkinson, MD and Maya Bass, MD MA FAAFP With the increased use of long-acting reversible contraception, clinicians are more likely to encounter difficult intrauterine device (IUD) insertions and removals in their practice. Below are a few strategies and techniques to help troubleshoot these procedures.   Difficult IUD Insertions  IUD insertions are most commonly…

Contraceptive Pearl: Practices of Consent and Autonomy for Patients with Disabilities, Part 2

Written by Maddie Fowler, Spark Dariy, Amy Stone Last month’s Pearl discussed key practices of consent. Here, we share unique considerations for those with physical disabilities, intellectual and developmental disabilities (IDD) or cognitive impairment, non-speaking patients, and deaf patients. Physical Disability People with physical disabilities may require additional assistance during the exam. Without making assumptions,…

Contraceptive Pearl: Practices of Consent and Autonomy for Patients with Disabilities, Part 1

Written by Maddie Fowler, Spark Dariy, Amy Stone Many disabled people have been systematically disempowered and taught to prioritize compliance over self-advocacy. People with disabilities experience sexual assault at over three times the rate of nondisabled people, rising to seven times the rate in people with intellectual and developmental disabilities (IDD).¹ Therefore, it is critical…

Contraceptive Pearl: Discussing the Contraceptive Patch and BMI

Written by Angeline Ti Two contraceptive patches are currently available in the United States: one containing norelgestromin (NGMN) 150 mcg/day with ethinyl estradiol (EE) 35 mcg/day (Xulane1 or the generic Zafemy2) and a newer one containing levonorgestrel (LNG) 120 mcg/day and EE 30 mcg/day (Twirla3). When prescribing the patch for patients with larger bodies, there…

Contraceptive Pearls

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

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