Nov 16

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…

Oct 19

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…

Sep 21

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…

Jun 24

Contraceptive Pearl: Lactation and Hormonal Contraception

Effective contraception helps to optimize birth-spacing, thus improving the health of parents and babies. All patients receiving prenatal care should be counseled about available forms of postpartum contraception, their risks, and timing of initiation. For otherwise healthy birthing parents, most hormonal contraception can be safely initiated in the postpartum period. Theoretical concerns exist surrounding the…

May 18

Contraceptive Pearls: Post Abortion Contraception

Most people ovulate 9-14 days after an abortion. Patients presenting to end a pregnancy may be interested in starting or changing their contraceptive method. Depending on a patient’s medical eligibility, the following contraceptive methods are safe and effective post-abortion: Estrogen/progestin pill, patch, ring Progestin-only pill, injection, implant, IUD Copper IUD Barrier methods Sterilization Fertility Awareness…

Mar 16

Contraceptive Pearls: Progestin Contraceptives and Ulipristal to Treat Uterine Fibroids

Do progestin contraceptives help control the symptoms of fibroids? A recently updated Cochrane review addressed this question. The review examined four studies of 221 premenopausal patients with symptomatic fibroids. The results were inconclusive, with uncertainty about progestins’ effects on uterine bleeding and fibroid size. Ulipristal, on the other hand, showed more promise. A study of…