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of a barrier, and the concern that this would lead to female promiscuity without consequence. Whether for or against, to call the Pill “revolutionary” would not be an overstatement.
Although I do not know of any clinician who longs for the days of restricted reproductive choice, I know of many a clinician who would admit that at least when there were only one or two hormonal contraceptives, it was a lot easier to tell them apart. My friends who have done international work universally describe how jarring it is to return from a developing nation and enter an American supermarket: the sheer volume of options is dizzying. It would seem that the range of options for those who wish to manipulate their reproductive cycle is similarly imposing. Do we want high or low estrogen to progesterone ratio? Which won’t make people gain as much weight? How about if you are breastfeeding? What does the literature REALLY show about oral contraceptive and reproductive cancers? How about stroke? How about acne? And will Obamacare cover it?
Fortunately, in this edition of OFP, we have a few cheat sheets. Author Erin Rainey, PharmD, BCPS, BC-ADM brings us the article that breaks some of this down, in the cover article “Individualizing Selection of Hormonal Contraception”, which helps the physician streamline the thought process and keep the evidence close at hand. The ensuing conversation with the patient is enhanced by Peter Zajac, DO, FACOFP’s educational handout “Birth Control”. We will not be able to answer all our patients’ questions (“Why does my IUD have the same name as the princess in the Sea World Dolphin Show?” “If I practice a spirituality that attends to the phases of the moon, will oral contraceptives compromise my relationship with the universe?”5) but it will give us a good starting place. We will also discuss hormones and alternatives for the patient with symptomatic menopause, palliative care options for patients with progressive illness, and a policy discussion about a new paradigm of patient activation for population health.
As always, we at the Editorial Staff hope you find this issue of the OFP enjoyable as well as educational. Whatever your clinical leaning, be it at the beginning, end, or change of life, we are certain there will be something of interest to you.
Sincerely,
Merideth C. Norris, DO, FACOFP
Merideth C. Norris, DO, FACOFP