Estimated reading time: 8 minutes
1. PCOS gets a new name: polyendocrine metabolic ovarian syndrome
- Polyendocrine metabolic ovarian syndrome, the new name for polycystic ovary syndrome: a multistep global consensus process in The Lancet
Polyendocrine metabolic ovarian syndrome (PMOS) is the new terminology selected to replace polycystic ovary syndrome (PCOS) as the name of this well-known condition. The name change addresses two longstanding problems: the term “PCOS” reduces a complex metabolic and endocrine condition to a fertility problem, contributing to stigma and fragmented care, and it is simply inaccurate as many patients with this condition do not have cystic ovaries. PMOS better reflects the broad constellation of symptoms that may include diabetes, dermatologic conditions, depression, anxiety, cardiovascular disease and irregular menses, among many others. This article, published this month in The Lancet, outlines the implementation strategy and rationale behind this change, which was the outcome of years of effort by an international coalition of experts. The new name was selected through consensus among the many stakeholders who were involved in this process, with the aim of improving care and outcomes worldwide. This article is a useful reference for providers to understand the goals and effort behind this change.
2. ACOG updates cervical cancer screening recommendations
- ACOG Committee Statement: Screening for Cervical Cancer in Obstetrics & Gynecology
Regular screening can significantly reduce the chance of developing cervical cancer, and the appropriate tests and intervals of testing have continued to evolve. In this update from ACOG, they endorse the 2026 Women’s Preventative Services Initiative’s (WPSI) updated cervical cancer screening guidelines. For patients 21-29 years old, the recommendation is unchanged: screen every 3 years with cytology alone. For patients ages 30-65 years old, they now endorse clinician-collected primary HPV screening every 5 years as the preferred option; co-testing with cytology and HPV testing remains an acceptable alternative. Patients who have been adequately recently screened may discontinue screening at age 65. The statement acknowledges that patient-collected HPV self-sampling is available and may reduce barriers for some patients, but notes that data on appropriate self-sampling intervals is limited and raises the potential for overscreening. These new guidelines can help guide providers seeking to provide up-to-date cancer screening for their patients in outpatient settings.
3. Doxy-PEP may be losing effectiveness against gonorrhea
- Durability of doxycycline effectiveness against gonorrhoea after implementation of post-exposure prophylaxis in southern California, USA: a retrospective, test-negative, observational study in The Lancet Infectious Diseases
Doxycycline post-exposure prophylaxis (doxy-PEP) is CDC-recommended for individuals at high risk for acquisition of sexually transmitted infections (STIs). A dose of 200mg of doxycycline PEP should be taken within 72 hours of unprotected intercourse (vaginal, anal or oral) to prevent infection with chlamydia, gonorrhea or syphilis. However, real-world data suggests that gonorrhea rapidly develops strains that are resistant to doxycycline, and tetracyclines in general. In this retrospective study of nearly 50,000 individuals assigned male at birth in southern California, doxy-PEP retained effectiveness against chlamydia and syphilis consistent with prior data. However, its effectiveness against gonorrhea decreased substantially over time, with the emergence of a tetracycline resistance gene. These findings raise serious concerns about the durability of doxy-PEP for gonorrhea prevention and reinforce the need for ongoing surveillance and health policy in this area.
4. Support for OTC birth control & willingness to use it
- Women’s Attitudes Toward Over-the-Counter Oral Contraceptive Pills: A Cross-Sectional Survey in Contraception
The FDA’s July 2023 approval of the first over-the-counter birth control pill, Opill, was viewed as an important step in reducing patient barriers to high quality birth control, especially for those patients who have trouble accessing healthcare. However, a new survey finds a meaningful gap between support and uptake. In this cross-sectional survey of more than 5,000 reproductive-aged cisgender female patients, 85% expressed support for an OTC birth control pill, but only 43% were willing to use Opill themselves, and only 45% would recommend it. The authors also identified that a significant portion of the respondents had concerns about the efficacy and safety of Opill. This research indicates that broad policy support does not necessarily correlate with actual uptake; the authors call for further efforts and public education campaigns to increase awareness about both the availability of this option as well as its efficacy and safety profile.
5. Early-career CNMs providing abortion care
- Midwives as Abortion Care Providers: Evidence from a National Survey of Early Career U.S. Midwives in Contraception
Certified nurse midwives (CNMs) are either explicitly permitted or not explicitly excluded from providing abortion care in 25 of the 33 states where abortion remains legal after six weeks’ gestation. CNM abortion care, however, is under-researched and likely underreported in large abortion surveillance networks. In this analysis of national survey data, 18% of early-career CNMs reported providing abortion care, including 26% of early-career CNMs in abortion protective states; most of these providers (93%) practiced outside traditional family planning clinics. The authors stress the importance of researching CNMs as abortion providers and supporting programs to train CNMs to ensure access to abortion care.
6. Family medicine abortion provision
- Abortion Provision by Family Physicians Before and After Dobbs: Trends Across Career Stages and State Restrictions in Journal of the American Board of Family Medicine
Family medicine (FM) is the second-most-common specialty of physicians providing abortions in the United States, yet only a small fraction of FM physicians provide abortion care. It has already been established that Dobbs vs Jackson led to a reduction in obstetrician-gynecologist abortion providers around the US. However, less is known about how the court ruling affected FM physicians. In this analysis of American Board of Family Medicine survey data collected at three-year intervals, the overall proportion of abortion-providing FM physicians remained low at 1.4% in 2024, though a modest increase was observed among early-career physicians post-Dobbs. These results highlight the potential for FM physicians, especially those in the first part of their career, to help fill gaps in abortion care, particularly as this population often practices in areas with limited ob/gyn access. However, additional research is needed in order to understand and encourage this interest in the future.
7. ACOG guidance on person-centered pregnancy options counseling
- ACOG Committee Statement: Person-Centered Pregnancy Options Counseling in Obstetrics & Gynecology
This ACOG ethics guideline addresses best-practices for clinicians providing options counseling, the process by which a clinician discusses management options on whether or not to continue a pregnancy in a way that centers the patient’s values, beliefs, preferences, concerns and ambivalence. The statement emphasizes avoiding bias and assumptions and providing evidence-based information about pregnancy-related care and discussing all management options with all patients, regardless of their personal beliefs or institutional/legal restrictions. The statement also stresses the importance of providers supporting patients’ ambivalence during their pregnancies. This guideline can serve as an important reference for providers caring for pregnant patients in any clinical context to make sure patient autonomy is preserved, and decision-making process is supported.
8. Most privately insured patients pay $0 for IUDs, but coverage gaps remain
- Who Is Still Paying Out-of-Pocket for Their IUDs Despite the ACA Contraceptive Coverage Requirement? Analysis of a Large National Cohort Using Claims Data in Women’s Health Issues
Since the 2022 Dobbs decision allowing restrictions on abortion care, research has shown that ObGyns faced with restrictive legislations are more likely to experience moral injury, burnout, and emotional exhaustion, all of which can impact job satisfaction. In this semi-structured interview study of 24 ObGyns across restrictive and non-restrictive states, providers in restrictive states described concrete clinical harms: difficulties providing full-scope reproductive care, unsafe clinical situations resulting from restrictions on evidence-based care, and difficulty meeting patient expectations. Importantly, ObGyns in all states, regardless of practice setting, expressed frustration about political interference in medicine, fear of legal consequences, and resentment about the chronic undervaluing and underfunding of reproductive health. The authors highlight that the current legal and political climate has exacerbated ObGyn workforce burnout and frustrations, and suggest that both legal clarification of the limits of abortion restrictions as well as changes in reimbursement structures are important to maintain job satisfaction in this specialty that is already facing significant shortages.
9. SFP clinical recommendations on telemedicine for contraception and abortion care
- Society of Family Planning Clinical Recommendation: Telemedicine in family planning care part 1+ 2 in Contraception
The Society of Family Planning (SFP) has published a paired set of clinical recommendations on telemedicine in contraception and abortion care. Part 1, “Background and overarching principles”, discusses the well-established efficacy of telemedicine for abortion provision. While it is safe and effective to offer abortion services without ultrasound or laboratory testing in select individuals, this guideline also describes the ways that telemedicine care can be paired with in-person visits to support patients who may prefer to address their needs over multiple encounters. Telemedicine does not have to replace existing care, but is an alternative that may be much more accessible and equitable for many people in the United States.
Part 2, titled “Contraception”, discusses the best approaches for telemedicine delivery of contraceptive care. SFP recommends that providers use any modality – audio, audio/video, or asynchronous – to provide contraception in a safe, equitable, and patient-centered manner. It includes practical guidance on quick-starting contraceptive methods and managing combined hormonal contraception without a known blood pressure value, and notes that telemedicine can facilitate access to all methods, including those requiring in-office placement. In some states, it may even be possible to use telemedicine to sign Medicaid forms for permanent sterilization, bypassing a bothersome in-person visit 30 days before surgery. This clinical recommendation is excellent guidance for anyone who wishes to prescribe contraception using telemedicine.