Contraception

Intrauterine devices (IUDs) are an effective form of long-acting reversible contraception (LARC) with low complication rates, yet adolescents are more likely than adult women to request early removal of the devices, according to a new study in Obstetrics and Gynecology.

Navigating the complexities of privacy in the adolescent gyn patient can be tricky. Here, Deborah Ottenheimer, MD, a specialist in adolescent gynecology, shares her protocol for providing confidential medical care to teen patients.

More Ob/Gyns are probably discussing sex with teenage patients than pediatricians, but a new study serves as a good reminder that physicians need to initiate these conversations.

Patients with excessive bleeding need treatment now. First-line options include progestin-only therapies, the Munro regimen, and DMPA and short-course oral MPA.

The levonorgestrel IUD is particularly helpful in patients with abnormal uterine bleeding who require an interval therapy before surgery can be performed, Harvard physicians find.

Among women who choose IUDs or implants and then discontinue use, the most common subsequent contraceptive choice is another long-acting reversible contraceptive.

New research shows low-dose intrauterine contraceptive devices are safe and effective in preventing pregnancy after 3 years, and their use could be expanded among women who have not had children.

Use of depot medroxyprogesterone acetate for 24 months was associated with a significant decrease in bone mineral density compared with nonhormonal contraception.

The use of a single 1.5-mg dose of levonorgestrel instead of two 0.75-mg doses given 12 hours apart is a viable alternative method of emergency contraception.

Discontinuation rates at 6 months among users of long-acting reversible contraceptive methods are low and not increased among adolescents and young women.

The use of oral contraceptives in women with BRCA1/2 mutations was associated with a reduced risk of ovarian cancer.

Women who took oral contraceptives for at least 3 years were twice as likely to have glaucoma, new research shows. The causative effect, however, is unknown.

Medroxyprogesterone acetate (MPA) and tranexamic acid effectively treat heavy menstrual bleeding, but more adverse effects and less patient satisfaction are reported with MPA use.

Abuse inflicted during childhood is lasting. Remember that adult patients may be survivors of child abuse, which makes them at risk for being in abusive relationships and for abusing their own children.

Misoprostol for cervical ripening prior to insertion of an IUD in nulliparous women not only did not improve ease of insertion for the provider but resulted in increased procedure-related pain.

A commentary on ACOG Practice Bulletin Number 133: Benefits and risks of sterilization

Properly timing subsequent pregnancies is important for both mothers and babies. It’s often accomplished with postpartum contraception, which may be out of reach for low-income women. A recent study in Obstetrics & Gynecology looked at how prescription of postpartum contraception through publicly funded programs affects the interval between pregnancies.

The duty to nonmaleficence suggests that it might be most ethical to deny patients when what they want presents too much risk, and too little benefit--even at the expense of respecting their autonomy.

The increased availability of emergency contraception to women and girls irrespective of age is victory for all of us.

Despite several studies indicating that women with copper IUDs suffer from worse dysmenorrhea than those who don’t have the device, a recent study published on April 11, 2013, in Human Reproduction indicates that this may not be entirely accurate.

University students who use combination hormonal contraceptives to schedule a bleeding cycle do so for convenience rather than relief of symptoms, according to a new study by University of Oregon investigators. And family or friends--not health care professionals--are the source of information on how to manipulate method use for many of these women.

Research presented at the American Urological Association (AUA) annual meeting in San Diego, California, has linked the use of oral contraception (OC) and chronic pelvic pain symptoms (CPPS) and pain during sexual climax.

There is insufficient evidence to determine that hormonal contraceptives do not influence glucose and lipid metabolism in women with diabetes mellitus, concluded a systematic review conducted by the Cochrane Fertility Regulation Group.

"We need a complete shift in how we offer contraception to patients." So said the Principle Investigator of the CHOICE Project, Jeffery Peipert, MD, vice chair for clinical research at Washington University School of Medicine in St. Louis, at ACOG's 61st annual clinical meeting on Tuesday.

Most women think both hormonal contraception and pregnancy are safe and many have fewer concerns about pregnancy than contraception, researchers from the University of Rochester reported at the Annual Clinical Meeting of the American College of Obstetricians and Gynecologists (ACOG).

The Contraceptive CHOICE Project, a research study at Washington University in St. Louis, found that offering long-acting, reversible contraception (LARC) to women first, citing its low-failure rates, reduced rates of unintended pregnancy and abortion and increased continuation rates.

The female hormone megestrol acetate (MA) improves appetite and is associated with slight weight gain in patients with cancer, AIDS, and other underlying pathology, but comes with significant adverse events.

The FDA has approved an application to market the emergency contraceptive Plan B One-Step for use without a prescription by women 15 years of age and older.