Say you have a 32-year-old patient who avoided Pap tests for 6 years due to discomfort and a prior traumatic pelvic exam. She recently saw an advertisement about “at-home HPV self-swab kits” and asks whether she can do that instead of a speculum exam in clinic. She wants to know if self-collected HPV testing is accurate, whether it would replace a Pap test, and if it is an appropriate option for someone with no prior abnormal results.
The short answer - YES! There are new and exciting ways to screen for cervical cancer. Let’s review!
HPV and Cervical Cancer
In the United States, 1 in 4 people are not up to date on cervical cancer screening, and nearly half of those diagnosed with cervical cancer have either never been screened or are overdue for screening,1 and 90% of cervical cancers are attributable to HPV. Despite numerous initiatives aimed at increasing screening, significant and persistent racial disparities in cervical cancer incidence and mortality remain, underscoring the critical role of both cervical cancer screening and HPV vaccination in reducing disease burden. We have work to do!
HPV Vaccination Recommendations (U.S.):
Age Group | Recommendation | Dosing Schedule |
Ages 9–14 | Routine vaccination recommended (can start at age 9) | … |
Have you heard that Depo medroxyprogesterone acetate (DMPA) use is associated with a brain tumor called meningioma? It has been in the news because there are currently multiple lawsuits against Pfizer, which makes Depo-Provera, the brand name for DMPA.
Here's what you need to know:
What is meningioma?
Meningioma is the most common tumor in the head and is three times more common in women than in men. While it is benign and does not metastasize, it can compress the brain and cause neurologic problems such as headache, seizures, and paralysis. Treatment is usually surgical excision. Unfortunately, meningioma recurs within 15 years, even after complete surgical removal, about 30% of the time.
Injectable progestins and meningioma
In September of 2025, JAMA (Tianqi Xiao, Pranav Kumar, & Mina Lobbous, 2025) published a retrospective study of over ten million US women who had been on hormonal birth control, assessing the risk of meningioma. They found that the people who had been on DMPA, an injectable progestin contraceptive, for more than 4 years or started DMPA after age 31 were more than twice as likely to develop a meningioma (Relative Risk 2.43 when compared to controls who did not take contraception).
Although correlation does not prove causation, this finding is…
In a recent New England Journal of Medicine article, legal and clinical experts examine a troubling reality emerging across the U.S.: in the years since Dobbs v. Jackson Women’s Health Organization, some of the greatest harms to pregnant patients are occurring not outside the healthcare system, but within it.
The article, Supporting Clinical Best Practices after Dobbs, authored by Michelle Oberman, J.D., M.P.H., Lisa Soleymani Lehmann, M.D., Ph.D., and Yvonne Lindgren, J.D., J.S.D., describes how state abortion bans have disrupted long-standing standards of care. Clinicians are often forced to navigate vague, untested laws while trying to make urgent medical decisions. The result, the authors argue, is a “yellow-light” moment in medicine — cases where the right clinical path is unclear not because of medical uncertainty, but because of legal fear.
We are honored to have the Reproductive Health Hotline (ReproHH) named in this review as one of the primary resources for clinicians seeking information on clinical best…
Many healthcare providers have encountered the following scenario: A patient experiencing vaginitis reports having several “yeast" infections a year – sometimes it’s itchy, other times it smells funny.
They’ve used over-the-counter creams and pills prescribed by their provider in the past. But, the problem persists, and so they ask if you can prescribe something to help, preferably through a teleconsultation rather than an in-person visit.
Vaginitis is an inflammation of the vagina that is quite common and, sometimes, frustrating to correctly diagnose. It is responsible for 6 to 10 million office visits per year. The economic impact of over-the-counter treatment of vaginitis is $4.8 billion globally.
The different causes of vaginitis can be difficult to identify, which can make self-diagnosis and virtual diagnosis inaccurate. It’s essential that clinicians accurately diagnose the cause of vaginitis and help patients access the appropriate treatment regimens. That’s why the Reproductive Health Hotline (ReproHH) is here to support you with information about diagnosis and treatment options!
Bacterial Vaginosis vs. Yeast Infection
To start, the two most common causes of vaginitis are bacterial vaginosis (BV) and yeast infection.
Want to hear more about the Reproductive Health Hotline (ReproHH) and other useful resources for healthcare providers?
Principal Investigator Dr. Jen Karlin recently sat down for the Afaxys Candid Conversations in Public Health podcast, where she discusses the launch of ReproHH as a free, nationwide service that provides real-time confidential support for clinicians managing questions about contraceptive care and reproductive health.
Dr. Karlin and the hosts also explore how clinicians can stay up-to-date in sexual and reproductive health (SRH) while balancing evolving evidence, patient needs, and time constraints. In addition to ReproHH, the discussion covers helpful tools and practical continuing medical education strategies.
Watch the episode, "Clinician Resources for Lifelong Learning: On the Front Lines of Sexual & Reproductive Health" below:
To utilize the hotline, call 1-844-ReproHH (844-737-7644) after reading our Terms…
It's been an exciting few months following the launch of the Reproductive Health Hotline (ReproHH) this summer. As a resource for all U.S.-based clinicians and community health workers, we've enjoyed guiding callers through their questions about sexual and reproductive health (SRH) using evidence-based best practices.
As a new resource, it's important to get the word out about our hotline, and ensure providers are aware that our free and confidential service is available to them. That's why we are proud to share that ReproHH has been featured in MedPage Today®, a popular online news service for healthcare professionals!
The article "Physicians Can Call New Hotline With Reproductive Health Questions" covers the launch of ReproHH, which was one of our inspirations, and our process for taking calls in and out of California. As a reminder, all callers must read and acknowledge our Terms of Service before receiving clinical education from our staff.
Read below for a snippet from the article, and read the full article on MedPage Today…
Last week, we crossed an exciting milestone here at the Reproductive Health Hotline: Answering our 100th call! Since our launch this summer, call volume has been growing steadily, and we are pleased to have surpassed the triple-digit mark.
The topic of our 100th call was on Mycoplasma genitalium, sometimes known as “Mgen."
What is Mgen?
Mgen is a lesser-known sexually transmitted infection (STI) that is often asymptomatic, but can also be a potential source for cervicitis, urethritis, or potentially pelvic inflammatory disease (PID).
How Should I Manage Mgen?
Mgen should always be tested for when a patient is experiencing recurrent or refractory symptoms, either through urine or a vaginal swab.
Because Mgen often demonstrates macrolide resistance, treatment is a two-step process: The sequential use of doxycycline first to decrease bacterial load, followed by moxifloxacin for a >90% success rate.
Resources
A few good resources to learn more about Mgen include the CDC Treatment Guidelines or the…