What is the effect of Nexplanon and POP on bone mineral density?

One of my young patient asked if she could have a copper IUD (mainly for contraception) and at the same time COC (for her acne), since the mechanism is different, is it safe to prescribe both? Thank you

Does that mean pregnancy is no longer an absolute CI to install a hormonal IUD?
Response: I assume you are asking whether I meant that a patient who was never pregnant should not get an intrauterine contraceptive. This is the case. One does not even have to have had sex in order to be considered a candidate for the intrauterine contraeptive. We sometimes use it for patients who have developmental disabilites and require bleeding control. However, it is the case with all contraceptives that one must not use them in a patient who is pregnant.

Does ella need to be prescribed? Can pharmacists give it directly like plan b?
Response: Not at present

How does side effect profile compare for nexplanon vs depo provera?
Response: Honestly, this version of the subdermal implant is fairly new on the market so I don’t have the same feedback from patients than I do from patients using depomedroxyprogesterone acetate. However, in theory, it should have a better side effect profile as the release of hormone is smoother. My experience with the previous iteration of the subdermal implant was that it was better tolerated….I’m hoping this will be the case.

How about mirena and ERT?
Response: My understanding is that the Mirena is an acceptable progestin source for endometrial protection when using ERT.