Contraceptive Pearls: Depot Medroxyprogesterone and Meningiomas

Written by Mariela Cabrera, MD Depot medroxyprogesterone acetate (DMPA), considered to be one of the oldest forms of modern contraception, received FDA approval in 1992.1 It has proven to be a safe, reliable, and convenient method of contraception for many people. It is a progestin-only form of contraception that is administered intramuscularly or subcutaneously.4 Because…

Contraceptive Pearls: Combined Oral Contraceptives

Written by Marielle Jamgochian, MD Combined oral contraceptives (COCs) are one of the most common birth control methods used today.1 There are dozens of formulations of COCs, all of which contain an estrogen and a progestin. For pregnancy prevention, COC efficacy is similar across all formulations. Thus, choice of pill can be guided by the…

Contraceptive Pearl: Hormonal Contraception & Weight: What is the Evidence?

Written by Catherine Casado-Pabon, MD Body image and perception of weight gain influence both patients’ and clinicians’ contraception decision-making and counseling. Nearly half of women* using contraception will switch or discontinue their selected contraceptive method within the first year of use.1 While there are many reasons people discontinue or change their contraceptive method as needs…

Contraceptive Pearl: Updated WHO Guidance on Contraception

Written by Angeline Ti, MD, MPH Earlier this month, the World Health Organization (WHO) released the 6th edition of the Medical Eligibility Criteria for Contraceptive Use (MEC) and the 4th edition of the Selected Practice Recommendations for Contraceptive Use (SPR). Clinicians in the US may be familiar with the similarly named guidance, the US MEC…

Contraceptive Pearl: Providing Contraceptive Care in School-Based Health Centers

Written by Lisa Maldonado, MA, MPH There are more than 2,500 school-based health centers (SBHCs) across the country.1 SBHCs present a vital opportunity to integrate contraceptive care within primary care services for adolescents. These centers are uniquely positioned within the school environment—where students spend a significant portion of their time—to deliver comprehensive primary and preventive…

Contraceptive Pearl: Federal Policy and Access to Contraception

Written by Silpa Srinivasulu, MPH Since it took effect in 2012, the Affordable Care Act (ACA) has mandated that public and most private health insurance plans cover the full range of contraceptive methods (at least one form in each of the 18 method categories) and related services and counseling for people with reproductive capacity without…

Contraceptive Pearl: Hormonal Contraception After Breast Cancer

Written by Marissa Ghant MD, Mark Pearlman MD, Justine Wu MD, MPH Annually, 1 in 6 new breast cancer (BC) diagnoses occur in reproductive-aged individuals.1 Those at risk for unplanned pregnancy should receive contraceptive counseling. Per the Society of Family Planning/Society of Gynecologic Oncology Guidelines2 non-hormonal methods should be first line methods, emergency contraception (including levonorgestrel-containing)…

Contraceptive Pearl: Tobacco Use in Pregnancy and Preconception

Written by Sondos Kasab, Pharm.D. candidate and Regina Ginzburg, Pharm.D., CDCES, BC-ADM Tobacco use can interfere with fertility.1,2 In people with testes, tobacco use can lead to sperm defects. In people with uteruses, tobacco smoke leads to increased testosterone and decreased estradiol and progesterone levels. This hormonal imbalance decreases the ovarian reserve and disrupts ovulation.2…

Contraceptive Pearl: An Overview of Pharmacologic and Non-Pharmacologic Pain Control Options for Intrauterine Device (IUD) Placement

Written by Meera Nagarsheth, MD Intrauterine devices (IUDs) are a safe and effective form of contraception and have numerous non-contraceptive benefits. However, pain and discomfort during IUD placement are commonly reported.1 The CDC’s 2024 US Selected Practice Recommendations (SPR) for Contraceptive Use recommends counseling patients on pain management options prior to IUD placement.2 Both actual…

Contraceptive Pearl: Contraceptive Implant Localization: Non-Palpable Implants

Written by Ellen Stoke, MD In the United States, the contraceptive implant is a single, soft, flexible progestin rod that is inserted subdermally in the upper arm. Globally, two-rod systems are also available and some patients still have a discontinued six-rod system in place. All contraceptive implants should be placed superficially, but occasionally patients and…