Clinical Scenarios

LNG IUD as EC, IUD pain management, thrombosis risks with hormonal contraception, telehealth & medication abortion, adolescent contraception guidance

A 19 year-old patient (he/him) comes to your emergency department in the early morning. He is seeking HIV post-exposure prophylaxis (PEP) following unprotected sex with a male partner the night before. During intake, he discloses that he is transgender and was assigned female at birth (AFAB). He is amenorrheic as a result of testosterone use for gender-affirming hormone therapy. At your facility, cisgender women seeking PEP are also offered EC.

Cancer and contraception, menstrual cups and IUD displacement, vaginal microbiome and contraceptives, OTC birth control knowledge gaps, early medication abortion follow-up

A 25 year-old patient (she/her) is interested in starting birth control four weeks after having her first child. She is breastfeeding but needs to supplement formula one to two bottles a day because of “not having enough milk.” Prior to pregnancy she was happy with a hormonal implant but is unsure if this method is safe while producing milk.

Partner treatment for BV, pain and bleeding experiences during first-trimester abortion, interest in Rh testing and treatment for telehealth medication abortion.

Double dosing UPA for EC not needed for BMI > 30, postpartum implant placement and milk supply, mifepristone to increase efficacy of medication management of EPL.

A 20 year-old patient (they/them) had a birth control implant placed three years ago this month. They are happy with their method and want to keep using an implant for birth control.

A 22 year-old patient (she/her) is currently using an IUD and had it placed at another clinic out of state three years ago. When asked which IUD she has, she is not sure, though she thinks it has hormones. She reports having light, irregular periods. Overall, she is satisfied with the IUD and wants to continue using an IUD for birth control.