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GYN
CMECNE

Hormonal Contraception Benefits – Beyond Pregnancy Prevention

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Learning Objectives and CME/Disclosure Information

This activity is intended for healthcare providers delivering care to women and their families.

After completing this activity, the participant should be better able to:

1. List the symptoms that can be improved with hormonal contraception
2. Identify the clinical conditions that are not affected by use of hormonal contraception

Estimated time to complete activity: 0.25 hours

Faculty:

Susan J. Gross, MD, FRCSC, FACOG, FACMG
President and CEO, The ObG Project

Disclosure of Conflicts of Interest

Postgraduate Institute for Medicine (PIM) requires faculty, planners, and others in control of educational content to disclose all their financial relationships with ineligible companies. All identified conflicts of interest (COI) are thoroughly vetted and mitigated according to PIM policy. PIM is committed to providing its learners with high quality accredited continuing education activities and related materials that promote improvements or quality in healthcare and not a specific proprietary business interest of an ineligible company.

The PIM planners and others have nothing to disclose. The OBG Project planners and others have nothing to disclose.

Faculty: Susan J. Gross, MD, receives consulting fees from Cradle Genomics, and has financial interest in The ObG Project, Inc.

Planners and Managers: The PIM planners and managers, Trace Hutchison, PharmD, Samantha Mattiucci, PharmD, CHCP, Judi Smelker-Mitchek, MBA, MSN, RN, and Jan Schultz, MSN, RN, CHCP have nothing to disclose.

Method of Participation and Request for Credit

Fees for participating and receiving CME credit for this activity are as posted on The ObG Project website. During the period from Dec 31 2017 through Jan 25 2023, participants must read the learning objectives and faculty disclosures and study the educational activity.

If you wish to receive acknowledgment for completing this activity, please complete the post-test and evaluation. Upon registering and successfully completing the post-test with a score of 100% and the activity evaluation, your certificate will be made available immediately.

For Pharmacists: Upon successfully completing the post-test with a score of 100% and the activity evaluation form, transcript information will be sent to the NABP CPE Monitor Service within 4 weeks.

Joint Accreditation Statement

In support of improving patient care, this activity has been planned and implemented by the Postgraduate Institute for Medicine and The ObG Project. Postgraduate Institute for Medicine is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

Physician Continuing Medical Education

Postgraduate Institute for Medicine designates this enduring material for a maximum of 0.25 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Continuing Nursing Education

The maximum number of hours awarded for this Continuing Nursing Education activity is 0.2 contact hours.

Read Disclaimer & Fine Print

Hormonal contraception, as a class, can be used to correct menstrual abnormalities, increase predictability and reduce blood loss, among other benefits.

CLINICAL ACTIONS:

Consider hormonal contraception to address the following:

  • Dysmenorrhea
  • Excessive menstrual bleeding
  • PMDD / PMS
    • Combined oral contraceptives (OCs) only – 30 mcg ethinyl estradiol, drospirenone
  • Menstrual migraines without focal neurologic signs, nonsmokers, under 35 years of age
    • Extended cycle or continuous hormone contraception
  • Hirsutism/ acne
    • Combined OCs only
    • Ring, patch and progestin-only as methods are less effective

SYNOPSIS:

Control of menstrual bleeding is a significant benefit of hormonal contraception methods. In addition, OC users have a 50% reduction in risk of endometrial cancer, a benefit that persists for up to 20 years after use. The levonorgestrel intrauterine system effectively treats endometrial hyperplasia without atypia; however, data are limited in its role in hyperplasia with atypia. Reduction in risk of ovarian cancer parallels the duration of combined OC use, with a decrease of about 20% for every 5 years of use. Recent, but not past, use of OCs appears to lower risk of colorectal cancer.

KEY POINTS:

  • Hormonal contraception probably has no role in the following:
    • Prevention/treatment of follicular or corpus luteum cysts
    • Prevention/treatment of osteopenia or osteoporosis
    • Prevention of the development of leiomyomas
  • Bone loss during contraceptive use is likely analogous to that which occurs with breastfeeding and is rapidly reversed
    • Past users of DPMA and progestin implants have similar bone densities to non-users
  • Diagnosis codes:
    • Dysmenorrhea N94.6
    • Menorrhagia N92.4
    • Premenstrual dysphoric disorder F32.81
    • Menstrual migraine G43.829

Learn More  – Primary Sources:

ACOG Practice Bulletin No. 110 : Noncontraceptive Uses of Hormonal Contraceptives

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Related ObG Topics:

ACOG Practice Advisory: Counseling Patients About Breast Cancer Risk and Hormonal Contraception
Managing Abnormal Uterine Bleeding with Ovulatory Dysfunction
Endometrial Hyperplasia – Current Nomenclature and Treatment
Current Hormonal Contraception Methods and Breast Cancer Risk: Prospective Cohort Data
CDC Resources: Contraception in Women with Medical Conditions (US MEC)
Practical info for your gynecology practice

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Computer System Requirements

OBG Project CME requires a modern web browser (Internet Explorer 10+, Mozilla Firefox, Apple Safari, Google Chrome, Microsoft Edge). Certain educational activities may require additional software to view multimedia, presentation, or printable versions of their content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Flash, Apple QuickTime, Adobe Acrobat, Microsoft PowerPoint, Windows Media Player, or Real Networks Real One Player.

Disclosure of Unlabeled Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Disclaimer

Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information
presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

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