Question: I am curious. My understanding is that combined oral contraceptives (COCs) should provide ovarian cyst suppression and/or slow their progression in the setting of presumed polycystic ovary syndrome (PCOS). I had a patient on a COC for almost a year, when she developed a 25 cm mucinous cyst along with other cysts during that time. Read more…

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…