1. ACOG practice update on BV partner treatment
- Concurrent Sexual Partner Therapy to Prevent Bacterial Vaginosis Recurrence in Obstetrics and Gynecology
This ACOG Clinical Practice Update reflects growing data on treating sexual partners of patients with bacterial vaginosis (BV). While partner therapy has been studied numerous times with mixed results, a more recent study from 2025 in the New England Journal of Medicine found significant improvement in outcomes when male partners were treated with both oral and topical agents. There is also evidence that BV behaves similarly to sexually transmitted infections based on both observational and microbiological data. Using the 2025 study’s eligibility criteria, ideal candidates for partner treatment are patients with symptomatic, recurrent BV infections who have a regular male sexual partner. However, providers can consider shared decision-making for patients with BV who do not meet these criteria, such as those in same-sex relationships, or those with recurrent but asymptomatic BV. More research is needed to clarify how best to extend partner treatment for BV to a broader cohort of people.
2. ACOG Committee Statement on Contraception Access
- Access to Contraception in Obstetrics and Gynecology
American College of Obstetricians and Gynecologists (ACOG) has updated its Committee Statement on Access to Contraception for the first time since 2015. The Statement underscores that access to contraception is fundamental to the health and well-being of pregnancy-capable individuals, even as evidence-based contraceptive care has come under increased attack since Dobbs in June 2022. ACOG highlights the importance of shared decision making, shifting the focus from the “most effective” methods to the best method for each individual patient. It also calls on reproductive healthcare providers to familiarize themselves with the history of coercion and institutionalized racism surrounding contraceptive care and to actively work to rebuild trust and reduce stigma among historically disenfranchised populations. The statement emphasizes the importance of being able to counsel on non-hormonal contraceptive methods in depth, as well as consider discontinuation of contraception to be integral to reproductive autonomy. Finally, both insurers and healthcare institutions should make all FDA-approved contraceptive options available, so that patients do not have to alter their selections due to copay or cost. This Committee Statement acknowledges the increasing need for advocacy and education in this area since the Dobbs decision and provides helpful references.
3. First trimester Rh immune globulin administration
- Provider Perspectives on De-Implementation of Routine Blood Typing and Rh Immune Globulin Administration in the First Trimester: A Qualitative Study in Women’s Health Issues
Historically, patients with Rh-negative blood types have received a dose of Rh immune globulin (Rh IG) for any vaginal bleeding in pregnancy to prevent sensitization and the formation of Rh antigens which can lead to the formation of dangerous antibodies in a future pregnancy. However, emerging research has shown that sensitization is extremely unlikely prior to 12 weeks gestational age, and forgoing Rh IG could reduce barriers to care, particularly for pregnant individuals seeking abortion. As practice recommendations evolve in response to updated science, it is helpful to understand healthcare professionals’ points of view. For this study, the authors interviewed obstetrician-gynecologists to better understand their perspectives on the de-implementation of Rh IG for first trimester bleeding. Study participants were generally aware of new evidence and embraced updated recommendations, but also described the difficulty of changing longstanding medical practice due to a variety of factors, including discrepancies between guidelines and institutional protocols. These insights can inform strategies to align clinical practice, institutional policies, and emerging evidence when de-implementing low-value or unnecessary interventions.
4. Abortion and EC knowledge among young people
- Adolescent and Young Adult Knowledge of Abortion and Emergency Contraceptive Rights Post-Dobbs in Journal of Pediatric and Adolescent Gynecology
Since the 2022 Dobbs v Jackson decision removed the constitutional right to abortion, abortion has been increasingly visible in media and political discourse and media since the Dobbs v Jackson decision in 2022. However, much of this public information is biased or incorrect. Adolescents and young adults (AYA) already face barriers to receiving abortion and contraceptive care, including lack of information, financial contractions and limited independence. Because AYA frequently seek information online, misinformation about abortion or contraception may further limit their ability to make informed decisions. This survey of nearly 250 AYA ages 14-24 in Colorado assessed knowledge of abortion rights, changes after Dobbs, and rules related to emergency contraception. While they demonstrated a high level of knowledge about emergency contraception (EC), AYA had a much more limited understanding of abortion in Colorado. The majority of participants were unable to answer even half of the abortion-focused questions correctly. These findings suggest that providers may be more comfortable counseling AYA about EC than abortion, and highlight the need to address these gaps to reduce delays or barriers to abortion access.
5. Vaginal ring efficacy and tampon use
- Effects of Tampon Co-usage on the Pharmacokinetics of Segesterone Acetate and Ethinyl Estradiol Released from Annovera Vaginal Ring System in Contraception
Annovera is a combined hormonal vaginal ring containing ethinyl estradiol and segesterone acetate, a progestin, that can be used for up to one year. Some users experience irregular vaginal bleeding with Annovera, and may use tampons for menstrual hygiene. Prior research established that tampon use does not affect the pharmacokinetics of the NuvaRing, the combined hormonal vaginal ring that is changed monthly. This study evaluated whether concurrent use of tampons with Annovera affects systemic blood levels of the active drugs within the ring. Participants using Annovera were instructed to use tampons during cycle days 3 to 5. They underwent blood tests at regular intervals to assess their hormone levels. These levels were compared to the hormone levels of patients who were using Annovera without concurrent tampon use. The authors found that tampon use did not affect systemic levels of ethinyl estradiol or segesterone acetate, and did not raise any concerns about reduced efficacy. Users of both types of combined hormonal contraceptive rings can be assured that they can safely use tampons without an effect on pharmacokinetics.
6. WHO MEC and SPR updates
- The WHO Medical Eligibility Criteria for Contraceptive Use 6th edition and the WHO Selected Practice Recommendations 4th edition: update and future direction in BMJ Sexual & Reproductive Health
This brief article outlines the methodology behind the World Health Organization’s Medical Eligibility Criteria for Contraception Use (MEC) and Selected Practice Recommendations (SPR), now in their 6th and 4th editions, respectively. U.S.-based clinicians may be more familiar with the Centers for Disease Control and Prevention’s (CDC) MEC and SPR, which are versions of the WHO’s guidelines that are adapted for a United States audience. This publication discusses the review process and highlights specific studies that were used to help the WHO’s experts make their updated recommendations. We will review some of these studies in greater depth, below. For providers, understanding how WHO developed its latest MEC and SPR can bolster confidence in using either the WHO or CDC versions and supports more transparent, evidence-based counseling about contraceptive safety and best practices.
7. Repeated EC pill use
- Safety of repeated use of emergency contraceptive pills in the same menstrual cycle: a systematic review in BMJ Sexual & Reproductive Health
Emergency contraception (EC) is available as pills or intrauterine devices (IUDs). The WHO MEC presents three options for EC pills: levonorgestrel 1.5mg, ulipristal acetate 30mg, and a regimen of combined oral contraceptive pills. While IUDs are effective and provide long-acting contraception that can help prevent pregnancy for years after the initial encounter, it is not always feasible or preferred for individuals to gain access to a healthcare provider for IUD placement soon after unprotected intercourse. EC pills are often more accessible and convenient, especially the levonorgestrel format, which is available over the counter. This systematic review examined whether repeat EC pill use within the same cycle is associated with any adverse events. Only six studies met inclusion criteria, and all had a high risk of bias and low certainty of evidence. The studies only evaluated risks associated with levonorgestrel and ulipristal acetate; combined oral contraceptive pill EC was not studied. Although data is limited and lower-quality, these studies suggest that there is little risk of adverse events from repeated doses of EC pills during a single menstrual cycle. However, additional study is needed in order to expand knowledge on this topic.
8. Breastfeeding and progestin-only birth control
- Progestogen-only contraception use during breastfeeding: an updated systematic review in BMJ Sexual & Reproductive Health
While some breastfeeding individuals can reliably use lactational amenorrhea during the first six months after delivery, most will resume ovulating within the first months after delivery and may desire contraception to avoid pregnancy. Because progesterone decline after delivery is involved in lactogenesis, there have been longstanding theoretical concerns that progestin-containing contraception might affect breast milk supply. A 2016 WHO systematic review evaluated whether progestin-only contraception (POC) during breastfeeding was linked to adverse effects on breastfeeding or infant outcomes and failed to find any associations. This updated systematic review evaluated new data since 2016, identifying 11 new studies on this topic. Consistent with prior findings, the updated evidence did not demonstrate any negative effects on breastfeeding or infant well-being that were associated with the use of progestin-only contraceptives. Importantly, new studies included preterm infants, expanding the populations for whom we have reassuring data. Many studies were small or at risk of bias, ongoing research is needed in this area, but current evidence supports the safety of POC during breastfeeding.
9. IUD safety during breastfeeding
- The safety of intrauterine devices during breastfeeding: an updated systematic review in BMJ Sexual & Reproductive Health
A 2016 review round a small increase of uterine perforation with intrauterine device (IUD) placement placement among breastfeeding individuals. To inform updates to the WHO MEC, this systematic review aimed to create an updated examination of evidence on IUDs and breastfeeding. The authors analyzed 38 articles, including 16 new articles published since the prior review in 2016. The authors found that IUDs do not appear to increase the risk of adverse breastfeeding events, and similarly, breastfeeding does not appear to increase the risk of most adverse IUD-related events. However, the updated data continued to suggest a small increase in uterine perforation risk with IUD placement during breastfeeding. Many of the studies in this systematic review had a risk of bias and lacked complete information on subjects’ breastfeeding experiences. Overall, absolute risk of uterine perforation with IUD placement is very low, and breastfeeding patients can be counseled that IUD placement remains safe for them.