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For decades, birth control pills have been used to treat the symptoms of endometriosis. Does evidence support this? The Cochrane Collaborative updated its review of this topic in May, 2018. Reviewers found 5 clinical trials that examined the use of oral contraceptives to control endometriosis pain. Of these 5 trials, three met criteria for analysis. Two…
Cigarette smokers who use estrogen-containing contraceptives have a higher risk of cardiovascular disease. Are electronic cigarettes (e-cigarettes) a better choice? E-cigarettes deliver nicotine. Nicotine’s deleterious effects on the cardiovascular system are well established, but its toxicity is lower when not combined with smoke. There have been no published studies of electronic cigarette use among people…
Opiate Use and Contraceptives Because there are no known interactions between opiates and contraceptive hormones, patients who take opiates are eligible for all birth control methods. Cornford, et al. collected data from 374 patients who were receiving treatment for opioid addictions. Overall contraceptive use was low (at 30%). These patients had high levels of ectopic…
Misoprostol and IUD Insertion Misoprostol, a synthetic prostaglandin, causes cervical dilation and has multiple uses in obstetrics and abortion. Can misoprostol help with IUD insertion, as well? Research has shown that misoprostol self-administered before IUD insertion in nulliparous women did not ease IUD insertion or reduce patient-perceived pain. In fact, several studies found that patients who…
The language we use in the exam room should convey our respect for patients. Before discussing sensitive topics with patients, clinicians should take care to establish rapport. Supportive, non-judgmental, and caring words can allow patients to feel heard and understood. Inclusive phrasing makes no assumptions about sexual orientation or gender identity. Attention to language is…
In June 2017, the internal condom’s manufacturer changed it from over-the-counter in pharmacies to prescription and online-only. There are now four ways patients can get the internal condom: 1. Prescription from a clinician; 2. Prescription from an online clinician; 3. Bulk order through the manufacturer’s website; 4. Community organizations that provide the condom. Patients can purchase…
Patients often switch from one contraceptive method to another. For example, a patient who has trouble remembering to take a pill daily may change from an oral contraceptive to an implant. To minimize the risk of an unintended pregnancy, patients should avoid gaps between methods. That is, patients should go straight from one method to…
Many clinicians schedule a follow-up visit after an IUD insertion. Is this necessary? The CDC does not suggest that patients return for a routine follow-up after IUD insertion. Instead, patients should be encouraged to contact their clinician at any time if they have questions or concern about their IUD. The CDC recommends that at other…
Clinical Question: Can a patient use ulipristal acetate (ella) for emergency contraception more than once a menstrual cycle? Jodi K, FNP New York, NY Jodi’s patient took ulipristal for emergency contraception one week ago and had a second condom rupture six days later. The patient’s body mass index is 31, and she did not want…
This issue reviews which birth control options are best for folks of varied gender experiences, particularly for people taking gender-affirming hormones like testosterone or estrogen.
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