Contraception

Concerns about asymptomatic sexually transmitted infection (STI) in women at high risk should not delay placement of an intrauterine device (IUD) in women who also are at risk of undesired pregnancy, according to a study by investigators from the University of Pittsburgh. The results, in 366 patients from an inner-city clinic, were presented at the 2014 ACOG Annual Clinical Meeting.

A second-prize paper presented at ACOG 2014 evaluates the risk of uterine perforation for levonorgestrel IUDs and copper IUDs and reports an unexpected finding.

Don’t let time constraints and large patient loads prevent you from providing a thorough well-woman visit. Are you covering all the bases?

Expert Mary Jane Minkin, MD, is quoted in an article in Women’s Health that profiles a study from the Journal of Sexual Medicine.

Marijuana and e-cigarettes can cause harm in more ways than you may think. Do you ask your patients about their marijuana or e-cigarette use? The numbers may surprise you.

Diet can’t cure endometriosis, but dietary recommendations could be part of the treatment. Find out here why choosing certain foods may help reduce symptoms.

A striking number of sexually active women experience reproductive coercion by their male partners, and their ability to use contraception and plan pregnancies may be compromised.

A study scheduled to be presented at the American Academy of Neurology’s 66th annual meeting in April suggests a possible connection between use of hormonal contraception and risk of multiple sclerosis (MS).

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.