Estimated reading time: 7 minutes
1. Replacing vs. extending the Nexplanon implant at three years and bleeding patterns
- Bleeding Patterns after Replacing versus Extending the Use of the Contraceptive Implant at Three Years of Use in Contraception
The hormonal implant is a highly effective reversible form of long-acting contraception, and can be safely used by the grand majority of reproductive-aged patients. Irregular bleeding, however, is the most common side effect of the Nexplanon implant and the primary reason for discontinuation. The FDA recently extended the approved duration of use for pregnancy prevention from three to five years, but how extended use affects bleeding patterns has been unclear. In this prospective cohort study of 52 patients with approximately three years of implant use (32 to 40 months), the authors compared bleeding patterns in the month before and after patients chose to either replace their implant or continue with extended use. There was no significant difference in bleeding days between the two groups. The authors caution that this is a small sample size, but providers can use this data to counsel patients who are considering replacing their implant at three years specifically in hopes of changing their bleeding pattern.
2. Quality and completeness of freely available contraceptive decision aids
Contraceptive decision aids have been shown to support informed, autonomous decision-making, and numerous free options are available online. The International Patient Decision Aid Standards (IPDAS) checklist is one of a small number of checklists that can be used to certify decision aids. The United States, however, does not require the certification of decision aids, despite evidence suggesting that the structure and content of an aid has the power to influence users’ decisions. Using the PDAS checklist, the authors assessed 13 freely available contraceptive decision aids and found wide variation in quality scores. While most were written in accessible, unbiased language, many lacked a complete list of contraceptive options and did not clearly describe risks or contraindications. Given the potential influence these tools exert — particularly for patients with limited access to providers — greater standardization is needed to ensure the reliability of freely available contraceptive information.
3. TikTok as a source of information on tubal ligation: who’s creating content and how accurate is it?
- The use of TikTok as a source of medical information regarding tubal ligation: a cross-sectional study in Contraception and Reproductive Medicine
Permanent female contraception (PFC), or female sterilization, by tubal removal or ligation remains the most commonly utilized method of pregnancy prevention in the United States. An ever-increasing number of patients, especially young adults, get their medical information from social media platforms such as TikTok, and this information may influence their decisions about contraception, including PFC. In this cross-sectional analysis of the 101 most-viewed TikTok videos about permanent female contraception, negative and positive tones were equally common, and 16% of videos discussed tubal ligation failure, a relatively uncommon outcome. Videos created by people with medical backgrounds were more accurate and understandable, but 75% of the most popular videos were created by laypeople. The findings reinforce the importance of healthcare providers creating and sharing high-quality content on social media platforms, where engagement-driven algorithms don’t prioritize accuracy.
4. Contraception counseling training at high-volume abortion facilities serving cross-state patients
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