Substance use disorder: contraceptive options counseling

What’s New in Contraception?

Contraceptive Technology Conference!

Biologic sexism of STIs

Excess breast cancer deaths after COVID-19

Contraception for patients with medical conditions

Pelvic Floor Dysfunction

Treating vulvodynia

Puzzling Over the Hurt Down-Under

Serious Mental Illness and Contraception

New 13-Cycle Vaginal Contraceptive System

The Future of Family Planning in Post-COVID America

New ASCCP Guidelines: Implications for FP

On the alert: mood disorders during 2020 stressors

Sex in the Time of COVID-19

Challenges old and new during the pandemic

Reproductive health in the time of Covid-19

Talking about toys

Missed Pills: The Problem That Hasn’t Gone Away

Find the “yes! . . . and” rather than “no” or “but”

Digital Family Planning: the Future is Now

Irregular Bleeding Due to Contraceptives

When she’s low on libido…

Ouch! Best approaches to menstrual pain

Contraceptive efficacy: understanding how user and method characteristics play their part

Strategizing treatment for chronic heavy menstrual bleeding


Untangling the literature on obesity and contraception

High tech apps for no-tech FABM

Menstrual exacerbation of other medical conditions

From Princeton University: Thomas James Trussell (1949-2018)

The Short and Long of IUD Use Duration

Selecting a Method When Guidance Isn’t Clear-cut

Healthcare in the Time of Digital Expansion

The Scoop on Two New FDA-Approved Contraceptive Methods

Pregnancy of unknown location—meeting the challenge

Big “yes” (with caveats) to CHCs during perimenopause

The role of IUDs (LNG IUDs, too!) in emergency contraception

Combined pills’ effect on mood disorders

Abortion in the U.S.: safe, declining, and under threat

Hope for ovarian cancer screening test

Breast cancer still a small risk with some hormonal contraceptives

New treatment modality for BV

Record rate of HPV-related throat cancer

Viruses in semen potentially transmissible

Don’t Abstain from Your Role in Abstinence

Teens births declining but geographic ‘hotspots’ defy trend

Online Medical Abortion Service Effective and Safe

Do Women Really Need to Wait That Long?

Reassuring news on depression and OC use

PMDD: Genetic clues may lead to improved treatment

Breast cancer risk when there is a family history

Body weight link to breast and endometrial cancers (and 11 others)

Family Planning in 2017 and Beyond

Make Me Cry: Depression Link (Again)?

Managing implant users’ bleeding and spotting

Zika: Updated guidance for providers

Pharmacist-prescribed contraceptives

Hot off the press! 2016 MEC and SPR

Zika virus fears prompt increased request for abortion in nations outlawing abortions

Opioid use epidemic among reproductive-age women

Good news on the family planning home front!

War Against Planned Parenthood Hurts Women

Win-win for both treatment and prevention

Center of the Storm


Menopause, mood, mental acuity, and hormone therapy

Emergency contraception for teens

Postpartum Contraception: Now, Not Later

Reproductive tract infections, sexually transmitted infections, or sexually transmitted diseases: “a rose by any other name…”

Are we practicing what we preach?

Be alert to VTE in hormonal contraceptive users

LARC among teens increased 15-fold, but not enough

Brain cancer and hormonal contraception

Free tools: Easy access to the US Medical Eligibility Criteria for Contraceptive Use

Alcohol consumption when pregnancy is unwanted or unintended

Latest Data on Contraceptive Use in the United States

LateBreaker sampler from Contraceptive Technology conference

Emergency Contraceptive Pill Efficacy and BMI/Body Weight

Handout on Unintended Pregnancy and Contraceptive Choice

Ask About Withdrawal (Really!)

Rules to Practice By: Safety First and Cleanliness is Close to. . .

What’s Vanity Fair Got Against the NuvaRing?

Promising New Treatment for Hepatitis C

Numbers matter, so make them simple for patients

The Recession’s Effect on Unintended Pregnancies

Lessons Learned from the Contraceptive CHOICE Project: The Hull LARC Initiative

Applying the “New” Cervical Cytology Guidelines in Your Practice

Acute Excessive Uterine Bleeding: New Management Strategies

Medical indications for IUD use in teens

Whatever happened to PID?

Update on Emergency Contraception New and Improved

Zika virus fears prompt increased request for abortion in nations outlawing abortions
July 2016


Across the Americas, as many as 4 million persons may become infected with Zika virus by early 2017, according to World Health Organization estimates. Most infections will occur outside of North America, where abortion is generally illegal, even for women infected during their pregnancies.

In response to the Zika virus epidemic, Latin American pregnant women who have no access to legal abortion increasingly turned to an online portal offering medication abortion, reports a study published in The New England Journal of Medicine.[1] The researchers analyzed the trend of requests, finding an increase of 36% to 108% over requests made over the 5 years before advisories alerted women of the dangers of Zika virus during pregnancy.[2] (On June 30, 2016, PAHO published an update stating that 40 countries and territories have confirmed local, vectorial transmission of Zika virus disease in the Region of the Americas since 2015.[3]) The requests were made the online service called Women on Web, a non-profit organization through which physicians prescribe pills such as mifepristone and misoprostol to women early in their pregnancies who live in areas where safe abortion is unavailable.

The researchers compared the trends within a control group, with no expected increase in requests, to the three study groups with legal restrictions on abortion:


  Zika outbreak in country? Health advisory issued?









In the three control-group nations—Chile, Poland, and Uruguay—the researchers found no increase in the number of online requests for abortion pills, indicating that there appeared to be no global increase in requests for reasons other than Zika. The women in study group A increased their number of requests by more than 100% in Brazil and Ecuador, by nearly 50% in Costa Rica and Venzuela, and by a smaller but still statistically significant degree in other nations that had an ongoing Zika virus outbreak and an issued health advisory. The women in study group B showed small increases in requests from Argentina and Peru, and the women in study group C showed no difference in the number of requests. Although the researchers could not directly link Zika-related concerns to the increased demand for abortion pills, the percentage of women reporting Zika fears correlated with the country-specific increases in requests.

What about your patients, here in the United States? No cases of US-acquired mosquito-borne cases have been reported, though cases have been reported in Puerto Rico, the US Virgin Islands, and American Samoa.[4] The U..S Zika pregnancy registry reports that 7 babies born in the United States who were infected outside the United States have been born with microcephaly or other related birth defects. The CDC is monitoring another 287 pregnant women with laboratory evidence of Zika infection.[5] CDC has issued travel notices for pregnant women planning to go to Central and South America and the Carribbean and Pacific Islands.[6]  Infection with Zika virus tends to be mild, requiring no specific treatment. For pregnant women, however, the risk is to their fetuses. Unfortunately, the CDC reports that we do not know the likelihood of infection upon a woman’s exposure to the virus.[7] We also do not know the likelihood of the infection passing to an infected woman’s fetus or, if the fetus does become infected, the likelihood of microcephaly or other birth defects. We also do not know if sexually transmitted Zika infection acts differently than mosquito-borne infection. Currently, no vaccine can prevent infection in the fetus or prevent a consequent microcephalic condition.

“As Zika spreads to the United States, women in the states most likely to be hardest hit, including Texas, Florida and Mississippi, face a situation that may not be so different from that of women in Brazil, Venezuela and Ecuador. Abortion access in these U.S. states has been seriously curtailed after a wave of legislation designed to close clinics,” Abigail Aiken, the lead author of the report and assistant professor at the University of Texas at Austin, wrote in the Dallas Morning News.[8] She called upon health organizations and governments to provide timely and accurate information about the risks of Zika in pregnancy and to support access to safe, legal abortions for women who want them.

[1] Aiken ARA, Gomperts R, Trussell J, Worrell M. requests for abortion in Latin America related to concern about Zika Virus exposure. Letter. N Engl J Med, June 22, 2016. DOI:

[2] Pan American Health Organization, World Health Organization Regional Office for the Americas. Epidemiological alert: increase of microcephaly in the northeast of Brazil. November 17, 2015 (http://www .paho .org/ hq/index .php?option=com_docman&task=doc_view&itemid=270&gid=32285)

[3] Pan American Health Organization, World Health Organization. Regional Zika epidemiological update (Americas) – 30 June 2016. At [Accessed July 1, 2016.]

[4] Centers for Disease Control and Prevention. Areas with Zika. At [Accesssed on June 30, 2016.]

[5] Berkrot B. More U.S. babies with Zika-related birth defects reported by health agency. Reuters, June 30, 2016. At [Accessed June 30, 2016.]

[6] Centers for Disease Control and Prevention. Zika travel information. At [Accessed on June 29, 2016.]

[7] Centers for Disease Control and Prevention. Zika and pregnancy. [Accessed on June 29, 2016.]

[8] Aiken A, Aiken C. We’re failing women amid the Zika crisis. The Dallas Morning News. July 1, 2016. At [Accessed July 1, 2016.]