Cleveland Clinic journal of medicine
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Review
Update on current contraceptive options: A case-based discussion of efficacy, eligibility, and use.
With high rates of unintended pregnancy in the United States, it is crucial for clinicians to be well-informed about the full spectrum of contraceptive options to improve reproductive autonomy. We review new contraceptive options including a nonhormonal intravaginal gel, hormonal contraceptives in the form of new pills, patches, and vaginal rings, and combined hormonal contraceptives that contain new estrogens as alternatives to ethinyl estradiol. We review updated prescribing methods for several established hormonal contraceptives such as depot medroxyprogesterone acetate, which is now available for subcutaneous self-injection. Additional choices of available contraceptive methods have important clinical implications that may remove unnecessary barriers to contraceptive use.
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The monkeypox (mpox) epidemic was declared a global health emergency in July 2022. The mpox virus belongs to the same virus family as the smallpox, or variola virus, but the infection is a less lethal threat than smallpox. ⋯ Two vaccines have been developed for mpox prevention, but clarity is needed on when and how to use them. Preventive public health measures and prioritization of resources for managing infectious disease are concerns.
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An initial bone mineral density (BMD) measurement is used to diagnose osteoporosis and decide whether patients need treatment, but the utility of repeating this test in those on treatment or on a drug holiday (ie, during a pause in bisphosphonate treatment) is controversial. Here, we present evidence for and against the use of BMD monitoring in patients receiving antiresorptive therapy or on a drug holiday, and give our recommendations, arguing against a one-size-fits-all approach.