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Contraceptive Pearls


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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: 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 Pearls

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

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