Contraceptive Implant Types and Removal – A Global Perspective

Written by Ellen Stoke, MD In the US, the contraceptive implant has become increasingly popular.1-2 This soft, flexible progestin implant is the size of a matchstick and is inserted subdermally in the upper arm. It was first licensed in 1983 as a six-rod contraceptive system (Norplant), and by 1984, the World Health Organization recommended the…

Possible Drug Interaction Between GLP-1 Agonist and Oral Contraceptives

Written by Sabina Kapkayeva Pharm.D. candidate and Regina Ginzburg, Pharm.D., CDCES, BC-ADM Glucagon-like peptide-1 (GLP-1 agonists) and glucose-dependent insulinotropic peptides (GIP) are increasingly being used in the management of diabetes and/or for weight loss. Several GLP-1 agonist medications available today are known to have interactions with oral hormonal contraceptives, but not through the usual pharmacokinetic…

Expanding Access to the Self-Administered Contraceptive Injection

Depot medroxyprogesterone acetate (DMPA), often referred to by the brand name, Depo Provera, or “the depo shot,” is birth control that is administered as an injection every three months to prevent pregnancy. The most common form is an intramuscular injection, which usually involves going to a health care provider — like a doctor, nurse, or…

Hormonal Contraception, Breast Cancer, and Communicating Risk to Patients

This Contraceptive Pearl clarifies how to communicate risk to address questions regarding cancer risk for users of hormonal contraception.

Insights: Pain Control for Uterine Aspiration

Written by Julia Ellis-Kahana, MD and Mollie Nisen, MD Effective management of pain during uterine aspiration is critical for patient autonomy, satisfaction and safety.1 A patient’s experience of pain is influenced by a combination of distinct physical, emotional, and social factors. Therefore, a multimodal approach, guided by shared-decision making, and incorporating both nonpharmacologic and pharmacologic…

Updated WHO Guidance

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…

Insights: Opioid Use in Pregnancy and Preconception

Written by Evan Fu, PharmD Candidate 2025, and Regina Ginzburg, Pharm.D., CDCES, BC-ADM Opioid use has increased dramatically over the last two decades, including among people of reproductive age. The number of pregnant people with opioid use disorder (OUD) presenting to the hospital at labor and delivery quadrupled between 1999 and 2014.1 A recent data analysis…

Insights: Benzodiazepine Use in Pregnancy and Lactation

Written by Crystal Lai, PharmD Candidate 2025 & Regina Ginzburg, Pharm.D., CDCES, BC-ADM Benzodiazepines are a class of medications indicated for generalized anxiety disorder, seizures, and insomnia. These drugs end in “lam or pam,” such as alprazolam, lorazepam, diazepam, or clonazepam.1 Despite their potential to cause serious adverse effects and potential for abuse, 5% of people…

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…

Insights: Catheter for Uterine Suction (FOCUS) for Severe Post-Abortion Hemorrhage

Written by Sophie Renaud MD, Frank Jackson DO Severe hemorrhage remains one of the most life-threatening complications after miscarriage and abortion, yet treatment options beyond uterotonics and hysterectomy are limited. The Jada device is currently the only approved vacuum device for uterine hemorrhage, but it was only studied for use in immediate postpartum hemorrhage in…