Contraception最新文献

{"title":"Incoming Editor-in-Chief statement","authors":"Blair G. Darney","doi":"10.1016/j.contraception.2025.111318","DOIUrl":"10.1016/j.contraception.2025.111318","url":null,"abstract":"","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"154 ","pages":"Article 111318"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145727838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of tampon co-usage on the pharmacokinetics of segesterone acetate and ethinyl estradiol released from Annovera vaginal ring system","authors":"Marlena G. Plagianos ,&nbsp;Tracy X. Chen ,&nbsp;Narender Kumar ,&nbsp;Shelli Graham ,&nbsp;Heather Sussman ,&nbsp;Harvey Kushner ,&nbsp;George Creasy ,&nbsp;Brian Bernick ,&nbsp;Lisa B. Haddad","doi":"10.1016/j.contraception.2025.111274","DOIUrl":"10.1016/j.contraception.2025.111274","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate effects of tampon co-usage on the pharmacokinetics of segesterone acetate (SA) and ethinyl estradiol (EE) released from Annovera Contraceptive Vaginal Ring System with a 21-day in/7-day out regimen.</div></div><div><h3>Study design</h3><div>We enrolled 24 participants in an open-label crossover study in Canada and the United States. Participants used combined oral contraceptive pills for 28 days before randomization (1:1) to either Annovera alone or Annovera while using four tampons daily on days 2–5 for one 28-day cycle; in the next cycle, participants switched treatments. We evaluated the steady-state interval for SA and EE from days 2-5 for concomitant Annovera and tampon use. We measured serum SA and EE using validated liquid chromatography-tandem mass spectrometry. The primary end point was the area under the curve (AUC) of SA and EE on cycle days 2-3 (AUC_(2–3)). Bioequivalence is established if the 90% confidence interval (CI) of the geometric mean ratio (GMR) for AUC_(2–3) is wholly contained within (0.80–1.25).</div></div><div><h3>Results</h3><div>We observed bioequivalence for SA with GMR of 0.98 (90% CI: 0.921, 1.043) and EE with GMR of 0.97 (90% CI: 0.91, 1.026), for AUC_(2–3), and also for AUC from days 2-5 with GMRs of 1.02 (90% CI: 0.99, 1.06) for SA and 1.02 (90% CI: 0.97, 1.087) for EE. We observed no safety issues or serious adverse events.</div></div><div><h3>Conclusions</h3><div>Individuals using Annovera with 4 consecutive days of tampon use experienced no change in SA or EE absorption. Light/regular tampon co-usage for up to 4 consecutive days should not impact contraceptive efficacy or bleeding profile.</div></div><div><h3>Implications</h3><div>A significant proportion of reproductive-age women use tampons when experiencing vaginal bleeding; they can be reassured that tampon and contraceptive ring co-usage should not affect the contraceptive efficacy of the SA/EE contraceptive vaginal ring.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"154 ","pages":"Article 111274"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145338341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"#DepoProvera, an analysis of the most popular TikTok videos about medroxyprogesterone acetate","authors":"Carter Wolf,&nbsp;Likai Chen,&nbsp;Britta Black,&nbsp;Dawn M. Kopp","doi":"10.1016/j.contraception.2025.111256","DOIUrl":"10.1016/j.contraception.2025.111256","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aims to describe content and assess information quality in top TikTok videos tagged #depo and/or #DepoProvera.</div></div><div><h3>Study design</h3><div>We evaluated the top 100 most viewed videos tagged #depo or #DepoProvera.</div></div><div><h3>Results</h3><div>Many creators were young with 44% being between 20 and 29 years old. Most videos are about a creator’s personal experience (52%) or are educational (35%). About one-third (36%) of creators are medical professionals and their videos have higher mean accuracy scores on the DISCERN scale as compared to videos created by laypeople (<em>p</em> = 0.005).</div></div><div><h3>Conclusions</h3><div>#DepoProvera TikTok videos often depict negative personal experiences shared by laypeople, influencing patient perceptions of this contraceptive method.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"154 ","pages":"Article 111256"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145282200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contraceptive market, utilization patterns, and coverage in Colombia (2020–2025)","authors":"Fabian Dávila ,&nbsp;Favio Cala-Vitery","doi":"10.1016/j.contraception.2025.111285","DOIUrl":"10.1016/j.contraception.2025.111285","url":null,"abstract":"<div><h3>Objective</h3><div>We analyzed contraceptive market dynamics in Colombia by comparing pricing, utilization patterns, and population coverage between insurance-covered and out-of-pocket purchase groups to identify barriers to equitable reproductive health access.</div></div><div><h3>Study Design</h3><div>We conducted a retrospective analysis (2020–2025) using Colombia's national pharmaceutical databases (SISMED, BDUA, CUM-INVIMA). We examined pricing (maximum cost per minimum dispensable unit), annual market values, utilization (defined daily dose per 1000 women-years), and population coverage (couple years of protection) by comparing insurance-covered versus out-of-pocket purchase groups.</div></div><div><h3>Results</h3><div>Hormonal IUDs showed minimal price variation ($144.00 insurance versus $145.11 out-of-pocket). Injectable contraceptives achieved 72% price reductions while emergency contraception maintained substantial price disparities with out-of-pocket prices up to 25 times higher than insurance-covered prices. Out-of-pocket purchase groups accumulated 64–70% of the total annual market value ($29.9–48.6M) through oral contraceptives and emergency contraception. Insurance-covered purchase groups accounted for 31–36% ($17.0–29.0M), specializing in subdermal implants. Out-of-pocket groups dominated total contraceptive utilization (78–86% of defined daily doses) versus 14–22% for insurance-covered groups. National contraceptive protection increased from 28% (2020) to 37% (2022), then stabilized at 33% (2023–2024). Insurance-covered groups reached only eight to10% of the population despite providing highly effective methods.</div></div><div><h3>Conclusions</h3><div>Colombia's contraceptive market demonstrates persistent segmentation and structural barriers beyond pricing. Policy interventions require strengthening insurance-covered service delivery capacity and implementing targeted out-of-pocket sector reforms to ensure equitable access.</div></div><div><h3>Implications</h3><div>Policy makers should strengthen institutional capacity for long-acting reversible methods while ensuring commercial equity for comprehensive contraceptive access.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"154 ","pages":"Article 111285"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145440348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pilot randomized control trial assessing interpersonal quality of contraceptive counseling via telephone vs video","authors":"Emily Freeman ,&nbsp;Rachel Paul ,&nbsp;Megan Dorsey ,&nbsp;Jennifer A. Reeves ,&nbsp;Tessa Madden","doi":"10.1016/j.contraception.2025.111273","DOIUrl":"10.1016/j.contraception.2025.111273","url":null,"abstract":"<div><h3>Objectives</h3><div>To compare the interpersonal quality of contraceptive counseling delivered via telephone vs video.</div></div><div><h3>Study design</h3><div>We conducted a pilot randomized controlled trial at a single Title X clinic. Staff informed patients about the study during appointment scheduling. Research staff contacted patients to assess for eligibility and interest, then enrolled and randomized participants to telephone- or video-based contraceptive counseling. Participants completed an electronic survey after counseling. The primary outcome was quality of contraceptive counseling, assessed using the Interpersonal Quality in Family Planning scale. Participants completed questions adapted from the Telehealth Usability Questionnaire, a validated measure of the quality of the telehealth services. We conducted intention-to-treat and per-protocol analyses for video vs telephone visits using appropriate bivariate tests.</div></div><div><h3>Results</h3><div>Between May 2022 and June 2023, 269 patients scheduled telehealth counseling appointments. We screened 245 (91%) for eligibility; 232 (95%) were eligible. Of the eligible participants, 214 (92%) were enrolled and randomized; 200 (94%) completed counseling and the survey. Participant demographics were similar between groups. In the intention-to-treat analysis, most participants in the video and telephone groups had high interpersonal quality of counseling, defined as a top score on Interpersonal Quality in Family Planning (80% vs 75%, <em>p</em> = 0.44); quality of counseling was similar for the per-protocol comparison (79% video vs 76% telephone, <em>p</em> = 0.62). Participants reported a high level of usability with both counseling modalities.</div></div><div><h3>Conclusions</h3><div>Participants reported high interpersonal quality with telephone and video visits for contraceptive counseling. Telephone-based telehealth can further increase access to care, especially for patients with limited access to web-based video conferencing.</div></div><div><h3>Implications</h3><div>We found similarly high interpersonal quality of contraceptive counseling performed via video and telephone telehealth visits. Our findings, along with others, can support policy changes to increase access to telephone-based telehealth.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"154 ","pages":"Article 111273"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145338347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the availability and accessibility of medication abortion pills in Nepal pharmacies: Reported versus actual provision practices","authors":"Nished Rijal ,&nbsp;Angel M. Foster","doi":"10.1016/j.contraception.2025.111254","DOIUrl":"10.1016/j.contraception.2025.111254","url":null,"abstract":"<div><h3>Objectives</h3><div>The Nepal government allows medication abortion pills to be dispensed from pharmacies if the patient has a prescription. We aimed to assess the availability of medication abortion pills, with and without a prescription, from pharmacies and the provision practices of pharmacy workers in Eastern Nepal.</div></div><div><h3>Study design</h3><div>We conducted a cross-sectional survey among 489 pharmacy workers to document knowledge, availability, and provision practices related to medication abortion pills. After a month, we revisited 180 pharmacies using a mystery client approach to understand actual provision practices. We analyzed these data with descriptive statistics.</div></div><div><h3>Results</h3><div>Pharmacy workers in about 16% (<em>n</em> = 28/180) of surveyed pharmacies reported selling medication abortion pills. In contrast, mystery clients obtained these pills without a prescription in more than one-third (<em>n</em> = 69/180, 38%) of their visits. All mystery clients obtained mifepristone and misoprostol either through combination packages (<em>n</em> = 59/69, 86%) or in separate packages (<em>n</em> = 10/69, 14%). Mystery clients paid an average of 1062 Nepali Rupees (NRS) (approximately USD8), about 1.6 times more than the NRS654 (approximately USD5) price reported during the survey. Pharmacy workers asked mystery clients questions about gestational age to confirm pregnancy status and provided information on the timing of use and possible side effects.</div></div><div><h3>Conclusions</h3><div>Despite the current regulatory status, our findings suggest mifepristone and misoprostol are available without a prescription in about two out of five community pharmacies in Eastern Nepal. Supporting efforts to ensure women seeking medication abortion pills from pharmacies have up-to-date and medically accurate information appears warranted.</div></div><div><h3>Implications</h3><div>Pharmacies are increasingly becoming key players in the community-based distribution of mifepristone/misoprostol in Nepal. Supporting pharmacy workers to provide medication abortion pills without a prescription at scale could advance equitable access to abortion care. Ensuring appropriate training for pharmacy workers is essential to safeguard service quality and safety.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"154 ","pages":"Article 111254"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145282146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postpartum permanent contraceptive procedures: A 360-degree qualitative investigation","authors":"Kathryn Crofton ,&nbsp;Amelia Johnston ,&nbsp;Savannah Kaszubinski ,&nbsp;Sarah J. Betstadt ,&nbsp;Elana Tal ,&nbsp;Rachel Flink-Bochacki","doi":"10.1016/j.contraception.2025.111281","DOIUrl":"10.1016/j.contraception.2025.111281","url":null,"abstract":"<div><h3>Objectives</h3><div>To explore interdisciplinary factors affecting completion of postpartum permanent contraceptive procedures (PPC) after vaginal delivery.</div></div><div><h3>Study design</h3><div>We conducted a multi-center qualitative study surrounding completion or non-completion of PPC at three academic institutions from July 2023-March 2024. We recruited patients who desired permanent contraceptive procedures following vaginal delivery. We conducted semi-structured interviews with patients and their nursing, obstetric, and anesthesia teams. With pre-identified areas of inquiry including barriers and facilitators, as well as inductive coding in Dedoose, we used a grounded theory approach to thematic analysis, concluding data collection after thematic saturation.</div></div><div><h3>Results</h3><div>We interviewed 19 patients (11 completed and eight non-completed procedures) and completed 49 staff interviews (mean 2.5/patient). We identified three major themes: (1) The antenatal focus on overcoming obstacles to PPC completion can overshadow standard perioperative counseling and hinder procedure fulfillment; (2) Healthcare workers’ personal values influence their motivation to ensure these procedures are completed; (3) Obstacles are similar for completed and noncompleted procedures, with the difference often being a champion to optimize interdisciplinary collaboration and advocate for care.</div></div><div><h3>Conclusions</h3><div>Unlike most surgeries, the completion of PPC centers around overcoming barriers (such as operating room availability and healthcare team motivation), rather than patient needs. The propensity for clinician advocacy to detract from perioperative patient care is a novel finding, and it sustains a culture where contraceptive requests are actualized based on care-team factors rather than patient needs. Ultimately, the discretionary nature of procedure fulfillment invites bias and hinders patient-centered care.</div></div><div><h3>Implications</h3><div>Interdisciplinary, systems-level solutions are necessary to improve the fulfillment of desired postpartum permanent contraceptive procedures. Centering counseling and practices around patients’ informational and care needs as opposed to healthcare team values and limitations could improve both provision and quality of postpartum contraceptive care.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"154 ","pages":"Article 111281"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145427236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing access to emergency contraception: Results from a no-cost program in Utah","authors":"Erica Torres,&nbsp;Sarah Elliott,&nbsp;Gentry Carter,&nbsp;Alexandra L. Woodcock,&nbsp;Madeline Mullholand,&nbsp;David K. Turok","doi":"10.1016/j.contraception.2025.111288","DOIUrl":"10.1016/j.contraception.2025.111288","url":null,"abstract":"<div><h3>Objective</h3><div>We assessed no-cost uptake of the two FDA approved emergency contraception methods via University of Utah pharmacies.</div></div><div><h3>Study Design</h3><div>In January 2023, we began providing levonorgestrel 1.5 mg (available over the counter) and ulipristal acetate 30 mg (requires a prescription) to Utah residents aged 18+ (complying with University interpretation of state law), without cost or gender restrictions. A limited informational campaign informed people they could access up to three doses of each emergency contraception type through the University’s MyChart patient portal, without requiring prior provider visits. The portal provided information about both emergency contraception options including greater efficacy of ulipristal acetate. Requests underwent advanced practice clinician review, prescription preparation and fulfillment. Medication pickup occurred at any University of Utah pharmacy location in-person or through mail delivery system. We analyzed de-identified electronic health record data to assess user demand, demographics and emergency contraception preference.</div></div><div><h3>Results</h3><div>During the two-year study period, we received a total of 2559 requests, 1279 in 2023 and 1280 in 2024. We provided 1094 individuals (42.8%) with levonorgestrel 1.5 mg, resulting in 2318 dispensed pills and 1465 individuals (57.2%) with ulipristal acetate 30 mg resulting in 3259 dispensed pills. Most levonorgestrel (690/1094, 63.1%) and ulipristal acetate (981/1465 67.0%) users requested multiple doses. In-person pharmacy dispensing increased from 860 recipients (67.2%) in 2023 to 1001 (78.2%) in 2024 <strong>(</strong>p &lt; 0.001) with corresponding shipments decreases across 13 Utah counties.</div></div><div><h3>Conclusion</h3><div>Eliminating cost and provider visit barriers resulted in sustained demand and patient preference for ulipristal acetate, the more effective emergency contraception method.</div></div><div><h3>Implications</h3><div>This study supports removing cost and access barriers to emergency contraception, showing high demand for ulipristal acetate, and sustained use when offered without provider visits. This model demonstrates an innovative and feasible approach to deliver equitable access across diverse populations and regions via electronic portals and mail delivery systems.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"154 ","pages":"Article 111288"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145477115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Copyright info/Contents","authors":"","doi":"10.1016/S0010-7824(25)00527-X","DOIUrl":"10.1016/S0010-7824(25)00527-X","url":null,"abstract":"","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"154 ","pages":"Article 111336"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145908805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expanding the discourse on patient perceptions of LARC: Beyond trust and relief","authors":"Parth Aphale,&nbsp;Himanshu Shekhar,&nbsp;Shashank Dokania","doi":"10.1016/j.contraception.2025.111252","DOIUrl":"10.1016/j.contraception.2025.111252","url":null,"abstract":"","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"153 ","pages":"Article 111252"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145584141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}