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Meet Phexxi – A New Non-Hormonal Contraceptive Gel

About the Product Lactic acid, citric acid, and potassium bitartrate (Phexxi, Evofem Biosciences) is a prescription combination, non-hormonal contraceptive gel approved by the FDA in May 2020. The vaginal gel was found to be 86.3% effective with typical use when inserted up to 1 hour before vaginal intercourse.1 The gel acts as a contraceptive by…

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Reproductive Health During COVID: Eliminating FDA’s Burdensome Barriers to Mifepristone

What is Mifepristone?  Mifepristone is the primary component in the FDA-approved regimen taken to terminate pregnancies through 10 weeks gestation and is seen as an alternative to a surgical procedure.1 Many patients view this as less invasive, allowing for more privacy and control over a personal situation. The standard oral regimen includes mifepristone 200mg followed…

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Can Contraceptives be Vegan? Important Considerations for Vegan Patients

The Vegan Society defines veganism as “a way of living which seeks to exclude, as far as is possible and practicable, all forms of exploitation of, and cruelty to, animals for food, clothing or any other purpose”. Since veganism extends beyond just a diet for avoiding animal products, awareness of medication ingredients is also a…

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Measuring Blood Pressure: An Important Prerequisite to Prescribing Hormonal Contraception

Why is it important to measure blood pressure before prescribing hormonal contraception? Combined hormonal contraceptives (CHCs) are a relatively safe and effective method for your patients in preventing pregnancy and treating other disease states such as menorrhagia, endometriosis, PCOS and more. However, CHCs may increase the risk for a few serious cardiovascular events. This risk…

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Effectiveness of Hormonal Contraceptives in Patients with Higher Weights

Introduction Obesity is becoming more prevalent every year and as pharmacists, it is important to revisit current contraceptive options for these patients. Overweight patients are defined as having a BMI ranging from >25-29.9 kg/m2 and obese patients a BMI >30 kg/m2. Currently there are no safety contraindications in patients with a BMI > 25 kg/m2…

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No Taxation for Menstruation: The Importance of Student Pharmacist Advocates

At the University of Michigan College of Pharmacy, the APhA-ASP chapter’s inaugural Women’s Health Campaign hosted multiple events to educate and engage student pharmacists and the Ann Arbor community. While our Campaign focused on topics directly related to pharmacy, such as contraception and HPV vaccination, we have also taken the initiative to advocate for a…

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Finding Gluten-Free Oral Contraceptive Options for Your Patients

Patients with celiac disease or who otherwise follow a gluten-free diet need to be aware of potential sources of gluten, especially in medications such as oral contraceptives. The FDA defines gluten as “proteins that naturally occur in [wheat, barley, and rye or their crossbred hybrids] and that may cause adverse health effects in persons with…

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Updates in Male Contraceptive Agents

Male contraceptive agents have been highly anticipated as the next step in contraception innovation. To date, several hormonal agents have been developed and tested for safety and efficacy, with three products: Nesterone with Testosterone gel (NES/T), 11β-methyl-19-nortestosterone dodecylcarbonate (11β-MTNDC), and dimethandrolone undecanoate (DMAU). Currently, NES/T is leading in development and contraceptive ability.[1,2] NES/T has been…

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Contraception During COVID-19: Pharmacy Best Practices

Pharmacists should not allow postponed or cancelled appointments to keep patients from accessing birth control. It’s important that patients understand how their pharmacy can continue to meet their contraceptive needs during the coronavirus disease 2019 (COVID-19) pandemic. Pharmacists should inform patients that even though clinics and providers’ offices might be closed, their pharmacy is still…

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Clinical Considerations for Contraception During COVID: Extended Duration of IUDs and Implants

During the COVID-19 pandemic and beyond, patients may desire a contactless method of contraception. The subcutaneous (SQ) formulation of depot medroxyprogesterone acetate (DMPA), Depo-SubQ Provera, is an important option to offer patients. This may be of particular interest among patients who currently come in to the pharmacy or go to a clinic for their intramuscular (IM) injection.

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5 Pearls from the 2020 States Forum on Pharmacist Birth Control Services

The second annual States Forum on Pharmacist Birth Control Services recently was held by the Birth Control Pharmacist project in partnership with the National Alliance of State Pharmacy Associations (NASPA). Due to the coronavirus disease 2019 (COVID-19) pandemic, this year’s meeting was held virtually as representatives from across the United States, as well as Canada,…

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Contraception During COVID: California’s Medi-Cal and FamilyPACT Programs Cover Depo-SubQ Provera

We recently wrote about the importance of offering patients subcutaneous depot medroxyprogesterone acetate (DMPA-SQ) as a contactless form of contraception during the COVID-19 public health emergency. California pharmacists can prescribe DMPA-SQ under statewide protocol upon completing the required training program and obtain payment for the visit for Medi-Cal patients. As of April 9, 2020, California’s…

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Clinical Considerations for Contraception During COVID: Patient Self-Administration

During the COVID-19 pandemic and beyond, patients may desire a contactless method of contraception. The subcutaneous (SQ) formulation of depot medroxyprogesterone acetate (DMPA), Depo-SubQ Provera, is an important option to offer patients. This may be of particular interest among patients who currently come in to the pharmacy or go to a clinic for their intramuscular (IM) injection.

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2020 CDC Update for Contraceptive Use in Women at High Risk for HIV

The CDC published updated guidelines to the 2016 U.S. Medical Eligibility Criteria for Contraceptive Use regarding women at high risk for HIV infection in April 2020.

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Contraception for Your Transgender Patients

Terminology Navigating through a discussion about gender and sexuality with the many terms used today can be confusing. Here is a brief introduction to terminology regarding the multifaceted gender spectrum.1 Cisgender: Gender identity matches assigned gender at birth2 Transgender: Gender identity differs from assigned gender at birth2 Gender nonbinary/queer/fluid: Individuals do not identify with a…

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Twirla: A New Contraceptive Patch

Twirla is a new contraceptive patch that was approved by the FDA earlier this month on February 14, 2020.

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Endometriosis Basics and How Contraception Can Help

What is endometriosis? Endometriosis is characterized as a condition in which endometrial tissue, which normally lines the uterus, develops outside of the uterine cavity in abnormal locations such as the ovaries, fallopian tubes and abdominal cavity.1 Endometriosis is a common cause of chronic pelvic pain in women and can sometimes be associated with infertility.2 It…

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Should We Offer Preconception Services in Community Pharmacies?

Why is preconception care important? Roughly 4 million pregnancies occur in the United States annually.1 A common misconception is that preconception care is only a health care need when there is an intention to become pregnant. However, because nearly half of all pregnancies in the United States are unplanned, most birth defects occur within the…

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Teratogenic Medications and Contraception Management

The use of prescription medications by pregnant women has increased over the past 30 years and with the usage comes an increased associated risk of exposing the fetus to the drugs. These medications can cause fetal abnormalities during a pregnancy. Often, for unique reasons, women are not concomitantly prescribed contraception or are not educated regarding…

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New Report Released on State Efforts to Expand Access to Contraception in Pharmacies

Download free 17-page report describing the current landscape of direct access to contraception in pharmacies, state legislative approaches and experiences, as well as implementation.

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Meet Slynd: A Novel Progestin-Only Pill

What’s this new pill? Slynd® is the new progestin-only oral contraceptive approved by the FDA in May 2019. This novel progestin-only pill (POP) contains drospirenone 4 mg in each active tablet, which is a higher dose than what is found in drospirenone-containing combined oral contraceptives (COCs).  Table 1. Products with drospirenone. Product Name Medication Doses…

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