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: 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…

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)…

Insights: Medication Abortion and Lactation

Written by C. Peony Khoo, MD, IBCLC Nearly 60% of abortions in the U.S. reported in 2022 were among people who had had at least one prior live birth.1 Given this high proportion of parents seeking abortion, a subset of these people may be nursing. Furthermore, certain contraceptive methods, such as fertility awareness, may be…

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…

Insights: Bleeding Management for Medication Abortion and Early Pregnancy Care

Written By Anita Mutti, MD and Lori Atkinson, MD Patients using mifepristone and misoprostol or misoprostol-alone for management of early pregnancy loss (EPL) or medication abortion (MAB) are expected to have a bleeding phase.1 While these treatments are very safe and effective, a common concern includes excessive bleeding. It is imperative to counsel your patients…

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…

Insights: Tips for Addressing Challenging Questions

Written by Lily Van Tongeren, MD and Maya Bass, MD MA FAAFP During options counseling and abortion care, clinicians and support staff are often asked challenging questions about the abortion process. These inquiries can range from scientific to deeply spiritual in nature. Questions such as “Is there a heartbeat?” and “Does the baby feel pain?”…