Welcome to another edition of Countdown to 2026, and thank you for visiting the Contemporary OB/GYN website throughout 2025. Below, take a look at the top contraception stories published this year, and catch up on anything you may have missed.

1. Permanent contraception procedures surge post-Dobbs

A multicenter retrospective study published in Contraception reported increased rates of permanent contraception procedures following the June 2022 Dobbs v. Jackson Women’s Health Organization decision, with investigators observing a 51% rise in tubal ligations across 4 academic medical centers. Procedure volumes increased from 445 pre-Dobbs to 674 post-Dobbs, and greater proportions of younger and nulliparous patients sought sterilization in the post-Dobbs period.

Nearly half of surveyed patients in New York and Pennsylvania indicated the political climate influenced their decision-making, and many cited concerns about future access to reproductive health options. Researchers concluded that the Dobbs decision affected the timing and motivations for seeking permanent contraception.

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2. Hormonal contraception linked to emotional regulation

A study published in Hormones and Behavior examined the effects of hormonal contraceptives (HCs) on emotional reactivity and regulation in 179 women aged 18 to 35 years, comparing 87 HC users with 92 nonusers. Participants were assigned to experimental conditions assessing distancing, reinterpretation, or immersion with emotional images.

HC users demonstrated greater emotional reactivity than nonusers, particularly toward negative images, and emotion regulation success was influenced by the type of strategy applied. Investigators concluded that HCs may affect emotional and cognitive processes, suggesting implications for psychological and reproductive health.

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3. AAP issues updated guidance on contraception for adolescents

The American Academy of Pediatrics (AAP) updated its guidance on adolescent contraception in the July 2025 issue of Pediatrics, recommending that pediatricians provide comprehensive, adolescent-centered counseling and access to the full range of contraceptive methods. The policy emphasizes developmentally appropriate care, shared decision-making, and confidentiality, noting that access to private conversations is associated with increased contraceptive use and lower rates of unintended pregnancy.

The statement encourages integration of contraceptive counseling with broader sexual and reproductive health care, including STI screening and HPV vaccination, and supports alternative care pathways such as telehealth and school-based services. Pediatricians are advised to remain informed about state laws governing minor consent and to incorporate ongoing training to ensure provision of evidence-based, patient-centered contraceptive care.

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4. Guidelines for managing pain during IUD placement published

A study published in the American Journal of Obstetrics & Gynecology provided guidance on pain management during intrauterine device (IUD) placement, emphasizing person-centered and trauma-informed care. An expert panel developed recommendations highlighting patient autonomy, informed consent, shared decision-making, and recognition of pain risk factors.

The guidelines advise clinicians to prepare patients for procedural sensations, use supportive and therapeutic language, and apply individualized strategies, including referral for sedation when needed. Investigators concluded that these practices may improve patient experiences, reduce anxiety and discomfort, and lower barriers to IUD uptake, particularly among adolescents and underserved populations.

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5. Hormonal contraceptives linked to increased stroke and heart attack risk

A population-based cohort study published in The BMJ evaluated the risks of ischemic stroke and myocardial infarction associated with hormonal contraceptive use among 2,025,691 Danish women aged 15 to 49 years from 1996 to 2021. During 22,209,697 person-years of follow-up, 4730 ischemic strokes and 2072 myocardial infarctions were reported.

Use of combined oral contraceptives, the vaginal ring, and the hormonal patch was associated with increased risks, particularly for products containing estrogen, although absolute risks remained low. Progestin-only contraceptives were associated with smaller risk increases. Investigators concluded that these findings should be considered when evaluating the benefit-risk profile of hormonal contraceptives.

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