Questions and Answers
Is significant weight gain a reason to stop DMPA (Depo)?
Question: "Is there a specific amount of weight gain in a client that would be unacceptable to continuing DMPA if that is her method of choice? We have tried other options and she wants to use DMPA despite a significant amount of weight gain. Thank you." Answer: This...
Birth control pill and breastfeeding
QUESTION (submitted 1/09/2022): "When prescribing a birth control for a breastfeeding mom who is breastfeeding at least 4x day but who has experienced breakthrough bleeding, ie got a period, and now wants to start on an oral birth control (wants something easy...
Malpositioned IUD after post-placental insertion
Question: "D" had a Mirena IUD placed at the time of Cesarean section. At her 6-week visit, the strings could not be visualized; so, her provider ordered a pelvic US. The IUD is in utero at the level of the fundus but seems to be turned "sideways." Some of our team...
Abnormal gush of blood with an IUD in place
Question: Hi I’ve had a coil fitted for nearly 6 years and I’ve just lost a large amount of jelly like brown discharge. Is this normal Answer: The term coil is used outside the US to refer to a copper IUD, so I will answer the question assuming this is...
The withdrawal method before QuickStart of an IUD or implant
Question: Dr. Zieman, I am an NP with 8 years of family planning experience in a title X clinic in Oklahoma. Managing Contraception has been very influential in my practice. Due to current politics in my state, I believe initiating contraception via the QuickStart...
How common is delayed menses after taking Plan B?
Question: “I recently saw a 26 yr old female whose LMP was 3/13/22, she had unprotected sex 3/27/22 and took Plan B 3/28/22, experienced spotting 4/4/22 and has not had a regular menses since 3/13/22. Pregnancy test done 5/16/22 and negative. What is the...
How long is the Copper IUD effective for? 10 or 12 years?
Question: "I have a patient that had a copper IUD placed and was advised that it was effective for 12 years. She looked at the Paragard website and of course it reiterates that the FDA has only approved Paragard for 10 years. She is my patient and is asking my advice....
Medical Updates from Dr. Z’s Newsletter
Surprising news about female sterilization Or “permanent contraception†(the new term): It was huge news in 1996 when a large study (CREST) was published and we learned that female sterilization, or having your tubes tied, failed much more often than we had...
My patient, who is 11 years old and is developmentally delayed, fears needles and devices. What contraceptive would you recommend? #501/15
Q:       I am a clinician and my patient today asked a question regarding her 11 year-old developmentally delayed daughter. She has decision making skills at a 4 or 5 year level and is very interested in boys. The mother wants to place her on birth control...
Considering all side-effects of hormonal and non-hormonal contraceptives, what method would you recommend for long-term protection? #411/15
Q:Â Â Â Â Â Â Â Good afternoon! I am a 23 year old female in graduate school who has recently entered into a monogamous, sexually active relationship, both of us negative for STDs/STIs. In the past, I never had sex enough to feel I needed to utilize birth control...