Substance use disorder (SUD) has risen dramatically in the US over the last several decades. However, the impact of SUD on reproductive health remains understudied. Individuals with SUD face a 70 percent higher likelihood of unintended pregnancy; and yet, no standardized guidelines exist on how to provide high quality contraceptive care for the SUD population. In addition to more common social determinants of health, such as housing instability, insurance status and a history of medical abuse and mistrust, the SUD population also faces unique disparities when accessing reproductive healthcare.

Chronic opiate use and medications for opiate use disorder (MOUD) are frequently accompanied by amenorrhea. This can create a perception of infertility where individuals underestimate their pregnancy risk. Current research has failed to establish the prevalence or physiology of these menstrual changes – especially with novel MOUD such as buprenorphine or naltrexone and higher potency doses of modern-day fentanyl. It is further unknown if these physiologic changes contribute to misconceptions about contraception and reproductive potential.

In this project, we aim to describe the current menstrual changes in a cohort of individuals with SUD. We will also examine if and how menstrual changes (specifically amenorrhea) correlate with contraception use. Long-term, we hope to use this project to inform future studies on the physiology of menstrual changes secondary to chronic opiate use and avenues to improve reproductive healthcare for individuals with SUD.