Questions and Answers
Estrogen Containing Contraceptives with Migraines with Auras
QUESTION: I know that migraine with aura is a Category 4 contraindication to estrogen-containing contraception, but I have a few nuanced questions about that, which have come up in my clinical practice: 1. What if a person has auras but has never had a migraine? ...
Beware of birth control failures with some of the new obesity medications.
Question: Do GLP-1s impact how well birth control pills work? Answer: While these medications were first approved for the treatment of diabetes, they’ve become popular and ubiquitous for weight loss. Ozempic, Wegovy, Victoza, and Mounjaro are all part of a class of...
Mirena IUD and Menopause
Question: I'm 52 and am, according to my GP currently in menopause, following some blood tests. I have the Mirena in place, the current one is in since December 2019. My last Mirena was removed due to it moving into the lining of the womb. I am experiencing a brown...
4th generation progestins and thrombosis.
Question: What is the recent literature on 4th generation progestins . In my facility my medical director had been advising that if our patients wants to be on this birth control to document that we counseled them on the slight higher risk of thrombosis. Is Slynd a...
Should I prescibe COCs to patients with an aneurysm or high blood pressure?
Question: A patient came with h/o cerebral aneurysm (stable) and h/o pre-eclampsia years ago. She wanted a RF on her coc's but I was not original prescriber. I felt too risky and put her on SLYND. Thoughts? Also, what is your feeling about coc's with women who's blood...
I stopped Depo but still not able to get pregnant.
Question: I took depo after my son was born 2009 and stopped after I heard about the side effects in 2011. Till now I tired to conceive again but just... please help me I'm 34 years old and I'm from Papua New Guinea. Answer: Thank you for reaching out! I will write my...
Can I be reasonably certain this patient is not pregnant and place a LNG-IUD?
Question: Client presents to clinic for LNG IUD. Client has used condoms 100% in the last two weeks and has a negative urine pregnancy test (ucg) on day of visit. Would you insert a LNG IUD? She has no symptoms of pregnancy and has used condoms 100% x 2 weeks. Going...
I missed some pills and my period is late.
Question: I’ve been on my birth control pills for 6 months. Taken every night at 9pm. I missed my birth control for 2 days 3 weeks ago but I caught back up. Ever since then we have used a condom just to be safe. I am currently 5 days late? I am very nervous. What...
What’s the scoop with Phexxi?
Question: I am a Nurse Practitioner at Student Health. One of our physicians sent an article about Phexxi, a contraceptive option to use in conjunction with condoms if a patient did not want to use any standard birth control options. What are your thoughts about this?...
Hair Loss with Nexplanon
Question: “I have a patient that is complaining of hair loss after having Nexplanon placed. Is that common and if so, is there any treatment for it?” Answer: Dear Doctor H., Hair growth / loss is affected by hormones, especially progestins, so it may be a...