There is a common belief that CHCs adversely impact mood, but the published evidence is significantly flawed, [1] 1 and recent publications have been conflicting, either demonstrating a protective effect or not, report Shaalini Ramanadhan and Alison Edelman. It is important to note that the study reporting an increased risk of depression in COC users had a risk estimate well below 2, which is considered by epidemiologists to be not significant. In those with existing depression, CHC use does not appear to worsen the condition. Read more…

Given the growing number of reproductive-aged individuals with a BMI ≥ 30 kg/m2 the impact that weight might have on hormonal contraceptive efficacy is important for public health as well as for personal health. Although it does appear that obesity adversely affects contraceptive steroid hormone pharmacokinetics (e.g., drug levels and how drugs are metabolized), the literature has been conflicting regarding the impact on effectiveness. Shaalini Ramanadhan, MD, MCR, and Alison Edelman, MD, MPH, explored the issue for the 22nd edition of Contraceptive Technology. Read more…

During perimenopause, undesired pregnancies occur at ratios similar to or even higher than younger age groups, and almost half of these pregnancies will be terminated. In the United States, roughly one-third of pregnancies occurring in the 40- to 45-year age cohort are unintended. However, perimenopausal women may use contraception less consistently than younger women, possibly due to a lower perceived risk of pregnancy. Clinicians should continue to offer pregnancy prevention counseling and services to patients until…Read more…