Contraceptive Pearls

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Contraceptive Pearl: Alternative Positions for Pelvic Exams

Written by Samantha Hyacinth When we think of the pelvic exam, many of us picture a person lying on their back on an exam table with their heels in foot rests or leg rests, known as the lithotomy position. For some people, this position is not physically possible or comfortable.* There are many conditions that…

Contraceptive Pearl: Postpartum Contraception

Written by Partners in Contraceptive Choice and Knowledge (PICCK) Prenatal care visits and the delivery stay are the optimal times to address postpartum contraception. Waiting until a postpartum visit to discuss a contraception plan is not sufficient, as 50% of people have sex before six weeks postpartum¹⁻² and 40% do not come to this visit.³…

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

This is an updated version of our September 2022 Contraceptive Pearl written by H. Reeve Bright, with updates written by Ruth Lesnewski. You can read September 2022’s Contraceptive Pearl on our website. Over-the-counter (OTC) oral contraceptive pills (OCPs) are available in over 100 countries. Requiring a prescription for OCPs creates access barriers, especially for the…

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 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 Pearls

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

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