Estimated reading time: 8 minutes
1. Guidance on managing deep and non-palpable contraceptive implants
- Society of Family Planning Committee Statement: Management and removal of deep and nonpalpable contraceptive implants in Contraception
Contraceptive implants, including Nexplanon, remain the most effective form of reversible contraception and can be safely used by nearly all patients. Most removals are straightforward office procedures, but an estimated 1 to 2% of implants are deeply placed or nonpalpable, requiring a specialized approach. This Society of Family Planning Committee Statement reviews risk factors for deep or nonpalpable implants and stresses the importance of timely access to experienced providers for patients who wish to have these implants removed. It lays out a stepwise approach to removal: reviewing the patient’s history, including prior removal attempts, palpating the insertion site to assess mobility and palpability, and using imaging when needed. The authors also address when providers less experienced with these removals should refer to Nexplanon Centers of Excellence (COEs), and review ultrasound-guided removal techniques for those with more experience. Providers can use this statement to counsel patients, refer appropriately to COEs, or manage deep and nonpalpable implants directly themselves.
2. PCOS gets a new name: Polyendocrine Metabolic Ovarian Syndrome (PMOS)
- From Polycystic Ovary Syndrome (PCOS) to Polyendocrine Metabolic Ovarian Syndrome (PMOS): What Obstetricians and Gynecologists Need to Know in American Journal of Obstetrics & Gynecology
This Special Report reviews the recent international shift from Polycystic Ovary Syndrome (PCOS) to Polyendocrine Metabolic Ovarian Syndrome (PMOS). While the diagnostic criteria for PCOS/PMOS have not changed, specialists made this update in the hopes that the new name will more accurately represent the pathophysiology of the disorder. Some patients with PMOS have ovaries with numerous small follicles, but these are not pathologic cysts, and the term “polycystic” misrepresents the ultrasound finding. The endocrine and metabolic effects of PMOS are central to diagnosis and treatment, and the new name centers those elements for both clinicians and patients. This report gives providers background on the naming change alongside a broader review of the syndrome.
3. Bleeding and cramping patterns by IUD type in the first 90 days
- Bleeding and Cramping in the First 90 Days After Copper or Levonorgestrel Intrauterine Device Placement in Perspectives on Sexual and Reproductive Health
Cramping and bleeding changes are common after IUD placement and a leading reason patients discontinue use. Long-term bleeding patterns by IUD type are well described, but short-term changes immediately after placement are less well characterized. In this sub-analysis of a prospective cohort study, the authors identified 137 patients who initiated use of a copper IUD or levonorgestrel IUD and asked them to report on cramping and bleeding patterns for the first 90 days of use. LNG IUD users reported more total bleeding days over the first three months, driven by more spotting days, while median days of cramping were similar between IUD types. Providers can use this data to counsel patients proactively about what to expect in the first three months after IUD placement.
4. OCP use linked to lower risk of some lower-extremity injuries in athletes
- The Association Between Hormonal Contraceptives and Lower Extremity Injuries in Female Athletes With Sports-Related Clinical Encounters in Sports Health
Oral contraceptive pills (OCPs) are the most common form of contraception in the United States and are frequently used by female athletes for birth control, menstrual control, or other reasons. Hormones, particularly estrogen, can affect metabolism, joint laxity, and tendon stability. This retrospective cohort analysis used a large national database to compare lower-extremity injury rates over five years between OCP users and non-users in athletic clinical encounters. Among more than 40,000 subjects, OCP users had a significantly lower risk of some lower-extremity injuries, including ligament tears and stress fractures. However, the large database source made it difficult to evaluate details of these injuries or to establish causality. These results indicate that OCPs may be protective for some injuries in female athletes, but further study is needed to better understand the specifics of this association.
5. A comprehensive review of combined oral contraception
- Combined Oral Contraception in Obstetrics & Gynecology
This article is part of ACOG’s Clinical Expert Series, which provides in-depth overviews of complex topics in obstetrics and gynecology. This entry offers an in-depth review of combined oral contraceptives (COCs). It covers the biochemistry and structures of commonly used estrogens and progestins, the history of COC formulations, and an extensive review of risks and non-contraceptive benefits. It also incorporates updated information on newer natural estrogens like estetrol and current recommendations on COC use in patients with migraine with aura, along with practical guidance on starting COCs and troubleshooting side effects. This article is a strong review even for those who regularly use COCs in their practice, and is also a good resource for different learners and trainees within the reproductive healthcare space.
6. Hormonal contraceptive use and cancer risk in BRCA1/BRCA2 carriers
- Hormonal contraceptives and cancer risk in women with a BRCA1 or BRCA2 pathogenic variant in Breast Cancer
Patients with pathogenic BRCA1 or BRCA2 variants face an increased lifetime risk of breast and ovarian cancer and are advised to consider risk-reducing surgery, such as bilateral salpingo-oophorectomy, at specific time points. Data on how hormonal contraceptives, including combined oral contraceptive pills (COCs) and the levonorgestrel IUD, affect cancer risk in this population is limited. To explore this question, the authors of this study conducted a retrospective cohort study on over 1,700 BRCA1 and BRCA2 carriers in a large healthcare database in Israel, drawing on the higher prevalence of BRCA mutations among people of Ashkenazi Jewish descent. BRCA1 carriers showed no significant change in cancer risk with COC use. BRCA2 carriers who used COCs showed a reduced risk of both breast and ovarian cancer, particularly with long-term use. Levonorgestrel IUDs did not change risk profiles for either variant. The authors call for continued research focused on individual BRCA variants.
7. ACOG strengthens salpingectomy recommendations for ovarian cancer prevention
- Salpingectomy for the Prevention of Epithelial Ovarian Cancer in Obstetrics & Gynecology
Removing the fallopian tubes (bilateral salpingectomy) has been increasingly linked to a reduced risk of ovarian cancer later in life. This updated ACOG Clinical Practice Update reviews recent supporting data and strengthens recommendations for opportunistic salpingectomy in patients who have completed childbearing and are undergoing intraabdominal surgery. A previous clinical practice update already recommended removal of the fallopian tubes whenever a patient is undergoing hysterectomy, but given mortality rates with ovarian cancer, robust data showing protective benefits of salpingectomy, and minimal risk of salpingectomy in patients already undergoing abdominal surgery, the authors also recommend salpingectomy at time of non-hysterectomy gynecologic surgeries as well as non-gynecologic surgeries generally. The authors also discuss supporting non-ObGyn surgical specialists in performing the procedure. This guidance is relevant for anyone counseling patients on contraceptive options or performing intraabdominal surgery.
8. Medication abortion is equally safe and effective for minors
- Effectiveness and Safety of Medication Abortion with Mifepristone and Misoprostol in Minors in American Journal of Obstetrics & Gynecology
Medication abortion with mifepristone and misoprostol is highly safe and effective, but some state-level legislation has targeted minors’ access, citing insufficient safety evidence in younger patients. This retrospective cohort study identified 1,444 minor patients who received medication abortion between 2021 and 2025 and compared outcomes with adult patients from the same period. Completion rates for minors were non-inferior to adults (95.7% versus 92.8%), and complication and ER visit rates did not differ significantly by age group. Follow-up rates were in the low 60th percentile for both groups, typical for medication abortion studies. This data support that medication abortion is equally safe for minors.
9. Navigating unclear abortion referral systems in a restricted state
- “Are We Allowed to Refer Patients?”: U.S. Physician Experiences Facilitating Abortion Care in a Restricted State in Perspectives on Sexual and Reproductive Health
Abortion care is heavily restricted or completely banned in many areas of the United States, and many patients in restrictive regions rely on local providers and institutions to facilitate and enable referrals for care. However prior research suggests these referral pathways are often confusing or ineffective. In this qualitative interview study, the authors spoke with 21 ObGyns practicing in Wisconsin during a period of perceived total abortion ban following Dobbs. Participants described lacking clear systems or guidance for helping patients access care, and some were unsure whether referrals were even permitted, often resorting to indirect or informal workarounds. Physicians reported that the lack of a formal referral system threatened patient safety and contributed to moral distress, leading many to build their own informal systems. The authors call for formalized partnerships between institutions to reduce the burden on both patients and providers navigating local restrictions.
10. State abortion restrictions linked to worse infant health outcomes
- State-Level Abortion Policies and Infant Health Outcomes in JAMA Network Open
It has been well-established that abortion bans lead to an increased number of full-term pregnancies and deliveries and researchers have hypothesized this also drives worse outcomes for newborns from undesired pregnancies, for example among patients who would have sought abortion due to limited resources or difficulty accessing prenatal care. This retrospective cohort analysis examined the relationship between state abortion restrictions enacted between 2005 and 2022 and adverse newborn outcomes, including low birth weight, preterm birth, low Apgar scores, and infant death, across more than 64 million births. They found that most abortion restrictions (gestational bans, limits on abortion provision, ultrasonography requirements, limits on insurance coverage, and hospital transfer agreements) were associated with adverse infant outcomes. These results provide compelling evidence linking abortion bans to infant health.
