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Thank you for visiting the Contemporary OB/GYN website throughout 2024. Below, take a look at the top stories published this year, and catch up on anything you may have missed.

1. Understanding combined oral contraceptives and breast cancer risk

In a April 2024 interview, Mitchell Creinin, MD, director of the Complex Family Planning Fellowship at the University of California Davis Health, discussed the association between combined oral contraceptive (COC) use and breast cancer risk.

For decades, COCs only contained the estrogen ethinylestradiol (EE). However, the amount of EE included in COCs has decreased over time, with the aim of decreasing venous thromboembolism (VTE) risk.

Data has indicated the risk of VTE is not impacted when shifting extremely low doses, but irregular bleeding risk increases when decreasing dosages at this level. This has led irregular bleeding to be the most common reason for discontinuation among COC users.

While an association has been established between COC use and increased breast cancer risk, the details of this association are unclear. The literature available primarily focuses on COCs containing EE, which is the main source of breast cancer risk. As COCs incorporate new estrogens such as estradiol and estetrol, those risks may not be present.

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2. New data shows elinzanetant's efficacy in treating menopausal symptoms

In an interview from ACOG, JoAnn Pinkerton, MD, highlighted new phase 3 data about the safety and efficacy of elinzanetant in managing menopausal symptoms presented at the 2024 ACOG Annual Clinical & Scientific Meeting.

Elinzanetant was evaluated in the OASIS-1 and OASIS-2 trials, with the treatment of hot flashes compared to placebo. Both primary and secondary efficacy endpoints were met, indicating improvements in hot flash frequency and severity at weeks 4 and 12.

Elinzanetant is a dual neurokinin-1,3 receptor antagonist, working in the thermoregulatory zone of the brain. This differs from other treatment options such as fezolinetant which is only a neurokinin-1 antagonist.

Pinkerton expressed eagerness from the rapid efficacy observed by week 1, as well as the benefits observed on sleep and mood. This indicated elinzanetant as a potential therapy for managing moderate to severe hot flashes, sleep disturbances, and mood.

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3. COVID-19 vaccination and its impact on menstrual cycles

Timing of COVID-19 vaccination has been found to affect the menstrual cycle differently during distinctive phases, according to late-breaking research presented at the 2024 ACOG Annual Clinical and Scientific Meeting.

In an interview with Contemporary OB/GYN®, Alison Edelman, MD, MPH, professor and ob-gyn at Oregon Health and Science University, shed light on the effects of COVID-19 vaccines on menstrual cycles, offering critical insights for both patients and health care providers.

Key findings from the study revealed that the timing of vaccination during the menstrual cycle is crucial. Vaccination during the follicular phase—the beginning of the menstrual cycle—can lead to a slight lengthening of the cycle by approximately 1 day. However, vaccination during the luteal phase—the second half of the cycle—does not seem to affect cycle length. These findings align with existing knowledge that events occurring in the follicular phase can influence menstrual cycle length, said Edelman.

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4. March of Dimes 2024 Report highlights preterm birth crisis

In an interview with Contemporary OB/GYN, Amanda Williams, MD, MPH, interim chief medical officer for the March of Dimes, discussed the 2024 March of Dimes report card on preterm birth in the United States.

Williams highlighted the concerning findings from the report, noting that the United States has received a D+ grade for preterm birth for the third consecutive year, with a national rate of 10.4%. This indicates that approximately 1 in 10 US babies are born preterm, totaling over 370,000 births annually. Williams explained that more than a third of the largest US cities received an F grade, indicating even higher rates of preterm birth in those areas. Shed identifies 2 primary factors contributing to this crisis: insufficient prenatal care and a rise in chronic conditions, such as obesity, hypertension, and diabetes, which increase the risk of preterm birth.

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5. Updated FLUBLOK label expands influenza vaccine options for pregnant women

In a recent interview, Ruth M Carrico, PhD, DNP, APRN, a family nurse practitioner and infectious diseases expert, discussed the updated FLUBLOK vaccine label to include safety in pregnant women.

Carrico expressed her excitement about the update, particularly in light of her experiences treating pregnant women who have developed influenza. FLUBLOK, a recombinant influenza vaccine, has been included in Centers for Disease Control and Prevention recommendations for pregnant and expectant patients since 2016, but now has updated safety data in this population. This inclusion adds to the range of available vaccines, allowing health care providers more flexibility when recommending influenza vaccinations for this vulnerable population.

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