High global rates of unintended pregnancy (>40% of all pregnancies) are relatively stagnant despite a broad array of female contraceptive options. Data suggest many men are enthusiastic to utilize novel, reversible, male contraceptives, particularly those that may be administered orally. Hormonal male contraception utilizes androgens or androgen-progestin combinations to exploit endocrine negative feedback, interrupting the hypothalamic-pituitary-testicular axis to suppress spermatogenesis. Modifications of testosterone allow for tailoring of steroid activity and show promise as single agent hormonal male contraceptives. The addition of progestin activity by molecular modification of testosterone could enhance the degree and speed of sperm suppression compared to testosterone alone using a single, exogenous steroid. Moreover, modifications that block reduction of testosterone to dihydrotestosterone could diminish androgenic stimulation of prostate tissue. This review summarizes data in the development of modified androgens for male hormonal contraception and suggest a path forward for these molecules in helping to fill the gap in contraceptive technologies for men.

Although medication abortion drugs technically require a prescription in India, research suggests that they are often available directly from pharmacies. We conducted a mystery client study in the capital city of Delhi to explore the availability, accessibility, and pharmacy dispensing practices of mifepristone/misoprostol in the absence of a prescription.

Abortion is a critical public issue in Brazil where over 800,000 abortions might occur each year, with approximately 250,000 admitted to emergency departments due to complications from unsafe procedures. A new bill seeks to amend the Brazilian Penal Code (Código de Processo Penal), classifying the practice as a felony for patients over 22 gestational of weeks, even in cases where the practice is already legally foreseen (e.g., derived from sexual abuse, as an attempt to save pregnant individuals at high-risk, or due to fetuses' anencephaly). This bill undermines several Sustainable Development Goals (SDGs) endorsed by the United Nations, particularly those related to health (Goal 3), gender equality (Goal 5), and inequality and poverty reduction (Goal 10). Amongst the extensive list of potential solutions to the abortion challenge that Brazil currently faces, a feasible and plausible alternative relates to investment in education, in particular sexual education aimed at adolescents.

To describe the childfree population seeking permanent contraception, identify barriers to receiving care, and characterize the incidence of regret.

Health care insurance claims are an increasingly common data source for health outcomes research. While researchers have successfully used several claims data sources for many obstetric and gynecologic questions, use of claims data for abortion and contraception research poses a number of challenges. In this update on the state of the science in identifying abortion in claims data, we review claims data generally, describe commonly used claims data sources, and detail specific reasons why abortion may be underestimated in claims even when employing best practices. We provide examples of successful approaches for identifying abortion in claims, and importantly, spell out limitations when making comparisons across site of care, states, and policy contexts. As increased attention is turned to identifying abortion across diverse settings, it is critical best practices are applied so that the most appropriate inferences regarding abortion incidence across contexts over time are drawn.

To evaluate the effects of a multilevel postpartum family planning (PPFP) intervention on the reduction of unintended pregnancies and induced abortions in China.

To understand the rates of first trimester medication and procedural abortion provision, sufficiency in abortion training, and factors associated with abortion provision among Obstetrician-Gynecologists (OB/GYNs) in Massachusetts.

The debate over extending the legal time limit for abortion in Belgium has intensified in recent years. Healthcare providers must refer patients seeking abortion beyond the legal deadline to other countries, such as the Netherlands, where the time limits are more permissive. In light of this situation, we analyzed the demographic and social characteristics of patients requesting abortion after 14 weeks of gestation and compared them with those seeking the procedure within the legal limits.

To evaluate if the type of abortion patients prefer differs for those with a history of intimate partner violence (IPV) compared to those without a history of IPV.

To examine the association of body mass index (BMI, kg/m) with time to fetal expulsion for individuals undergoing medication abortion over 13 weeks METHODS: This is a retrospective cohort study of singleton pregnancies undergoing medication abortion > 13 weeks at a single academic medical center between 2020 and 2024. Our primary outcome was time to fetal expulsion. We categorized BMI into three groups (>25, 25-29.9, and ≥30) and compared median time to fetal expulsion. We used multivariable logistic regression models to assess the association of BMI with time to delivery ≥24 hours.

Understanding the relationship between contraception and body weight is an important clinical consideration. Body weight and size has the potential to affect fertility and the effectiveness of some contraceptive methods, although historically this association has not been applied within a person-centered context that would allow individuals to select their preferred contraceptive method. Further, individuals with higher body weights and larger sizes have unmet contraceptive care and counseling needs. This document aims to provide evidence-based, person-centered, and anti-racist recommendations that destigmatize contraceptive care across all body weights. Clinicians should: provide person-centered, unbiased contraceptive care, including counseling pregnant-capable individuals on their risk of pregnancy based on sexual practices and contraceptive use regardless of body weight or size; utilize evidence-based and person-centered contraceptive counseling to offer the full range of contraceptive methods regardless of body weight or size; counsel patients about any risks and benefits associated with body weight and size to assist in their selection of contraceptive methods, including emergency contraception; counsel individuals about the potential for weight change, particularly weight gain, associated with contraceptive methods as a possible factor in decision-making; and counsel individuals regarding the potential impact of weight management approaches, such as bariatric surgery and glucagon-like peptide 1 (GLP-1) agonists, on contraceptive efficacy.

In 2019, the Trump administration introduced rule changes, colloquially known as the "Domestic Gag Rule," to the federal Title X program. As a result, many grantees withdrew from the program. This study aims to assess the impact of the rule change on service provision within the Title X program, both while the rule was in place and in the period following its reversal.

We evaluated the effect of immediate postpartum use of depot medroxyprogesterone acetate (DMPA) on the timing of lactogenesis stage II (LS-II).

Pharmacovigilance data analysis can accelerate the identification of drug-related safety signals or reassure on the safety profile. This study evaluates the venous thromboembolism (VTE) risk of newer combined oral contraceptive (COC) formulations with natural estrogens, such as estradiol (E2) and estetrol (E4), using data from the EudraVigilance database.

We present a case of suspected hepatotoxicity secondary to an etonogestrel contraceptive implant in which the patient presented with vomiting, jaundice, pruritis, elevated transaminases, and hyperbilirubinemia. An extensive work-up, including liver biopsy, was unremarkable. The implant was removed and the patient's symptoms and transaminitis resolved, suggestive of drug-induced liver injury.

To assess changes in type of abortion, gestational duration, and changes in the proportion of out-of-state residents at a university-affiliated clinic in Denver, Colorado after Texas passed Senate Bill 8 (SB 8) that banned abortion after embryonic cardiac activity can be detected.

A pregnancy is in general the result of the sexual interaction of two individuals, with either different or same genders (male, female, non-binary etc) Preventing an unwanted pregnancy is therefore basically a "joint preventive behavior", which can be achieved by gender specific behaviors with gender specific methods in a specific sociocultural environment. This sociocultural environment (circumstances) determines the frame of gender specific behaviors (reproductive rights) and the available gender specific contraceptive methods (contraceptive technology). In the sociocultural history of contraception different models of contraceptive practice evolved from the patriarchal to the female emancipation model, with different balances and imbalances regarding these two basic components. Based on the concept of the "joint preventive behavior" not only reproductive rights including reproductive responsibilities, but also contraceptive choices should be as equally balanced as possible, to allow collaboration between two individuals involved in reproduction. The development and the broad availability of different male contraceptive methods allowing individualization and best fit between the method and the individual profile, will be an important way forward to achieve this goal.

This case report describes episodic symptomatic hypotension following Implanon NXT insertion and symptom resolution after removal. We aim to alert clinicians of episodic hypotension as a possible adverse drug reaction to Implanon NXT, facilitating early intervention and improved patient outcomes.

To estimate the availability of the recently released over-the-counter (OTC) birth control pill (Opill) in retail pharmacies and compare availability across pharmacies based on their chain status and setting.