Birth Control

Practical strategies for adjusting combined oral contraceptive formulations to manage side effects and improve patient experiences

How providers can take a patient-centered approach.

Expanding pain management offerings for IUD placements.

A 19-year-old patient (she/they) comes in for STI testing since they recently started seeing someone new. After reviewing their sexual history and ordering appropriate testing, the provider checks in about how their birth control pills are working for them–the chart indicates they’ve been on a combined oral contraceptive for about a year. They reply, “Oh. I stopped taking them a couple of months ago–I heard it's good to take a break once in a while.”   They don’t report side effects and share that the decision was driven by things they kept seeing online. They are not interested in having kids anytime soon.

An 18-year-old (she/her) started a combined hormonal contraceptive pill (COC) three months ago, prescribed by her primary care provider. She’s been taking a pill with 0.15 mg levonorgestrel/30 mcg EE. She’s now following up with you because she’s been feeling moodier since starting the pill. She’s not totally sure if the pill is to blame, but says it’s affecting her quality of life and she’s interested in talking about other options.

DMPA on TikTok, OTC pill sales, Misoprostol & IUD placements, Telehealth abortion & TGD populations, Abortion restrictions & infant mortality

25 y.o G0 patient (she/her) comes into the clinic for an emergency department (ED) follow up. She has a history of endometriosis and has been using a LNG 52mg IUD for contraception and management of heavy menstrual bleeding. She has no other medical conditions and does not take other medications. She went to the ED for new onset shortness of breath and was diagnosed with a spontaneous pneumothorax (collapsed lung), which was ultimately discovered to be a catamenial pneumothorax.