Thread by @BirthControlDoc

Extended use #contraception and #COVID - some friendly reminders:

1) We know from other examples that sexual activity is likely to increase during periods of isolation, especially youth who are left home unsupervised during school breaks. Talk to your kids about condoms and birth control.

2) Long Acting Contraception (implants and IUDs) are the best ways to prevent pregnancy, and can be used by >98% of women.

3) On the topic of LARCS, if you're due for replacement, you can defer your appointment during a pandemic, bearing in mind that:
A) An implant (nexplanon/implanon) works for 4 and likely up to 5 years.
B) A 52mg IUS (Mirena) lasts 7 to 8.
C) A 19.5mg IUS lasts 5 to 6 (need data)

D) Copper IUDs last a long time, most 3-year can last 5 years, 5-year last 10years, and 10 probably last 20 years.

4) If for some reason there is a run on period protection (pads etc) and you're not ready for a cup, remember you can safely skip hormone free (sugar free) weeks on the pill to reduce the number of periods

5) Here's where it gets a bit tricky, but rings actually last 4 weeks inside, meaning a total of 5 weeks apart. You can safely use one Ring a month and change it the same calendar date each month (e.g. the 15th)

6) Patches last 9 days before needing a change, so, again, you can sneak almost an extra week out of three.

7) IMPORTANT: do not extend the hormone free window of your birth control more than 7 days. It's too long. And progestin only pills need to be taken EVERYDAY.

8) Prescribers should ALWAYS wrote a year's supply of contraceptives, ideally dispensed together, but no less than every 3 months. And birth control can safely be dispensed by telemedicine - just get a blood pressure somehow.

9) Follow up appointments for IUD placements or implant placements are not needed if you can check the device location (strings or implant) there is no pain, and no sexual or menstrual concerns.

10) To check strings, place your finger inside your body. The cervix feels like a nose or rubber eraser. You should feel a string (like fishing line) coming from it. If not, get an ultrasound.

11) Oh, and depo can be given to yourself (no appointment needed) and can be stretched to 14 (possibly up to 16) weeks and be effective.

12) Finally, Contraception is important for patients, families and population health. While unnecessary appointments can be deferred, we must ensure continued access to birth control when possible. Fin.