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Practice Bulletin #101, Published January 2010 (Reaffirmed 2016) 1. Most COCs combine a progestin (i.e. synthetic progesterone) for contraceptive effects with 10-35 mcg of an estrogen (usually ethinyl estradiol) to stabilize the endometrium and reduce unwanted spotting 2. COCs are a safe bet for management of heavy menstrual bleeding. If patient responds to COCs, they are most cost-effective for the first year, then it's more effective to switch to a levonorgestrel intrauterine system 3. The levonorgestrel intrauterine systems work better than progestin-only pills (e.g. norethindrone acetate) to reduce heavy menstrual bleeding and patients report greater satisfaction. 4. DMPA and the progestin IUD can regulate the menstrual cycle over the long haul, but will initially increase the irregularity of bleeding. 5. Before prescribing any hormonal contraception, review the US Medical Eligibility Criteria for Contraceptive Use.Show Notes**Visit our friends at The Labor of Love Co. to send a pregnant person in your life a curated maternity or postpartum care package!**Wine pairing: 2018 Pinot Noir from Tres Palacios Theme music by Evan Handyside Logo design by JD Dotson (jddotson1@gmail.com)