Estimated reading time: 8 minutes
1. COCs vs. POPs for heavy menstrual bleeding: a systematic review
Heavy menstrual bleeding (HMB), defined as excessive or heavy menses that interferes daily life, is a common problem that affects millions of reproductive-aged individuals worldwide. Hormonal medications, either combined estrogen-progestins or progestin-only methods, are the primary treatment approach for HMB, but direct comparative data have been limited. In this systematic review, the authors reviewed 10 studies published between 2000 and 2025 that compared combined oral contraceptive pills (COCs) and progestin only pills (POPs) for HMB management. The synthesized evidence affirmed that both are effective for the treatment of HMB. However, COCs were associated with more side effects, including nausea, headaches and weight gain. POPs, specifically drosperinone, demonstrated an improved side effect profile alongside high effectiveness. These findings offer useful information for counseling patients on their options and underscores the need for additional comparative research on this topic.
2. Five-year efficacy and safety data for the Miudella copper IUD
The copper T380A intrauterine device (Paragard IUD) has been the only option for hormone-free long-acting reversible contraception (LARC) in the United States since its approval in 1984. In February 2025, the Food and Drug Administration (FDA) approved a new copper IUD, Miudella, which contains significantly less copper than Paragard and is smaller and more flexible. Initially approved for 3 years based on the manufacturer’s Phase 3 trial data, updated data now supports Miudella’s safety and efficacy for up to 5 years. Importantly, participants reported decreasing rates of bleeding and pain over time. This evidence is reassuring for both patients and providers. The availability of a second copper IUD option expands access to non-hormonal LARCs for the first time in over 40 years, further supporting autonomy and reproductive freedom.
3. VTE risk may be lower with “body-identical” estrogen COCs
Combined oral contraceptives (COCs) are an effective method of contraception and are also used to treat menstrual disorders, acne, endometriosis, and other conditions. While the benefits largely outweigh risks, COCs carry a small but clinically significant risk of venous thromboembolism (VTE) particularly for specific patient populations. Most COCs contain ethinyl estradiol (EE), a synthetic form of estrogen, but some newer formulations use “body-identical” estrogens, such as estetrol or 17β-estradiol valerate, designed to more closely mimic endogenous estrogen. Initial European data suggests that COCs using these compounds may have a different safety profile than EE-containing pills. To explore this theory, the authors of this study reviewed adverse event reports that had been submitted to the Food and Drug Administration (FDA) through October 2024. They found that COCs containing body-identical estrogens showed a substantially lower proportion of VTE reports than COCs containing EE, with rates more comparable to progestin-only pills. While this data is based on more recently released formulations, it is consistent with international data that suggests a similar improvement in safety with body-identical estrogens. These results should prompt further research, as the implications for COC users worldwide could be significant.
4. OTC Opill users demonstrate appropriate self-screening for contraindications
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