Resuming CT monthly updates! Introducing the new edition of Contraceptive Technology

Here is a quick read on a dozen quick insights from the brand-new edition of Contraceptive Technology.

1. Current national guidelines recommend exiting cervical cancer screening over age 65 for those without a history of CIN2+ who have been adequately screened. However, about 20% of new cervical cancers are in those over age 65, and there are large racial disparities. Moreover, the characteristics of people over 65 are changing in many ways including life expectancy, sexual behaviors, and hysterectomy rates. These data on disparities and changes in the population over 65 are not reflected in the current guidelines.
2. It is useful to distinguish between measures of contraceptive effectiveness and measures of the risk of pregnancy during contraceptive use. If 20% of users become pregnant during their first year, it does not follow that the method is 80% effective, because it is not true that 100% of these individuals would have become pregnant had they not used contraception. Saying a method is 80% effective may be good marketing, but it overestimates the true effectiveness.
3. The dosing interval, effectiveness, bleeding pattern, and side effects of DMPA-SC are similar to those of DMPA-IM. Six of 6 studies demonstrated that at 1 year of use, more participants continued self-administered DMPA-SC than continued DMPA-IM.
4. The year-long ring, Annovera—one of our newer CHC methods—removes the worry about refills. However, if the user removes the ring for more than 2 hours at once or for a total of more than 2 hours across the 21-day period, the ring can be reinserted but a backup method should be used for 7 days, as efficacy may be compromised.
5. Gonococcal antibiotic resistance is a growing concern, and treatment options are limited. The recommended regimen is ceftriaxone 500 mg IM in a single dose (or 1 g IM if weight is 150 kilograms or more. See CEC’s website for updates:
6. Both LGBQ adults and adolescents have higher rates of unintended pregnancy compared to heterosexual cisgender women, potentially due to use of less effective contraception. And for transgender persons assigned female at birth, both patients and clinicians commonly mistakenly think that testosterone is a contraceptive.
7. Understanding the menstrual cycle is very helpful for understanding the mechanism of action for all contraceptives and for understanding why some of the side effects can occur and what to do with them.
8. Many medical problems are worsened by menstruation. Seizure disorders, migraines, IBD, asthma and schizophrenia are all harder to treat during menses.
9. Affirm-Share-Ask (ASA) Cycles is an easy-to-master strategy to demystify and synthesize an array of counseling and communication skills. ASA Cycles incorporate communication skills that help providers build rapport and trust, center patients in the conversation, provide relevant information in a way that is digestible, and assist patients in integrating information.
10. Research suggests that patients may reject or discontinue methods that detract from their own or their partner’s sexual experiences… We cannot predict which users will experience which sexual effects from their methods. For example, LNG IUD users appear no more likely than users of pills or injectables that their method has improved or detracted from their sex life…Ask your clients about how contraceptive methods influence their sexual experiences.
11. Combined hormonal contraceptives (CHC) can alleviate many symptoms during peri-menopause while providing ongoing contraception during that stage in the reproductive lifespan.
12. Resources for abortion services and funding: http://abortionfinder.org/, http://ineedana.com/, http://prochoice.org/find-a-provider, http://plannedparenthood.org/abortion-access, 

If this quick peek piques your interest in the brand new 22nd edition of Contraceptive Technology, you can follow these links to order:

https://www.jblearning.com/catalog/productdetails/9781284255034

https://store.managingcontraception.com/contraceptive-technology-22nd-edition/

Features in the 22nd edition:

• New chapter discusses inequities and disparities in reproductive health
• New chapter offers comprehensive, detailed information on reproductive health care for LGBTQIA+ individuals
• Provides a cutting-edge interpretation and explanation of effectiveness and efficacy rates
• Offers education for students and practicing providers on how to approach conversations with patients on sensitive topics
• Guidance on best practices for challenging situations and perplexing diagnoses on a wide range of contraceptive and sexual health issues