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Long Acting Reversible Contraception…FOR MEN!

Today’s post is by “Obi,” a Nigerian doctor conducting his field experience at Planned Parenthood as part of his MPH program. He was a general practitioner in his home country with main interest and expertise in maternal and child health.

Over the past decades the tedious, but important job of using contraception has mostly been the woman’s – from daily pills to injections to invasive surgical procedures – the burden is uneven. I come with good news!

A relatively new long acting reversible contraceptive (in the biz we call them LARCs) is currently being tested on men in India with a likely release to the general public by 2017. It was created by Professor Sujoy K. Guha from the Indian Institute of Technology with the name Reversible Inhibition of Sperm Under Guidance (RISUG). It is being spearheaded by Parsemus Foundation. Like a vasectomy, it is an outpatient procedure and needs a tiny incision in the male genital area but unlike vasectomy, it’s more easily reversed.

Here’s a brief description of how RISUG/Vasalgel works:

  • a pin hole-sized incision is made at the base of the scrotum
  • the physician locates and gains access to the vas deferens
  • Vasalgel is injected into the vas deferens and then carefelly placed back into the scrotum

vasalgelThat’s it! Vasalgel is made up of two chemicals which mix when injected and thickens to make a polymer lining the vas deferens. Its specific mechanism of action is that it lines the wall of the vas deferens and lets sperm flow through it but ruptures the sperm cell membrane as they pass by. Fantastic, right?!

Vasalgel can be effective for up to ten years. When the male wants his fertility back, a solution of dimethyl sulfoxie or sodium bicarbonate (baking soda) and water is injected into the vas deferens, which flushes it out. The procedure has been proven in clinical trials to be very effective and there are some side effects like scrotal swelling and pain but those were very limited. As you know, female contraceptives also have side effects (good and bad) so you can expect the same from a male contraceptive. It is important to note that Vasalgel will NOT prevent the spread of sexually transmitted diseases.

Have you heard of this simple, yet innovative LARC procedure for men? What do you think?

To read a similiar article, see The Daily Beast.

STD Testing During Pregnancy

cdcSo you just found out you or your partner is pregnant. There are so many things to think about, but one thing many people never think about is getting tested for STDs. Most prenatal visits include testing but it’s also important for a new or old partner to be tested so infections are not spread to mom during her pregnancy. To varying degrees, all infections have the potential to affect a developing fetus. Knowing what tests to ask for depend on risk factors such as age, number of partners, use of condoms or barriers, possible exposure and drug use. Here are the Centers for Disease Control and Prevention’s 2010 STD Testing Guidelines:

Chlamydia 

Screen all pregnant women at first prenatal visit; 3rd trimester rescreen if younger than 25 years of age and/or high risk group.

Gonorrhea 

Screen all pregnant women at risk at first prenatal visit; 3rd trimester rescreen women at continued high risk. Risk factors include: young women aged 25 years or younger, living in a high morbidity area, previous GC infection, other STDs, new or multiple sex partners, inconsistent condom use, commercial sex work, and/or drug use.

Syphilis

Screen all pregnant women at first prenatal visit; during 3rd trimester rescreen women who are at high risk for syphilis or who live in areas with high numbers of syphilis cases, and/or those who were not previously tested or had a positive test in the first trimester.

Bacterial Vaginosis

Test pregnant women who have symptoms or are at high risk for preterm labor.

Trichomoniasis 

Test pregnant women with symptoms.

Herpes (HSV)

Test pregnant women with symptoms.

HIV 

Screen all pregnant women at first prenatal visit; rescreening in the third trimester recommended for women at high risk for getting HIV infection.

Hepatitis B

Screen all pregnant women at first prenatal visit: retest those who were not screened prenatally, those who engage in behaviors that put them at high risk for infection and those with signs or symptoms of hepatitis at the time of admission to the hospital for delivery. Risk factors include: having had more than one sex partner in the previous six months, evaluation or treatment for an STD, recent or current injection-drug use, and an HBsAg-positive sex partner.

Human Papillomavirus

There is not enough evidence to make a recommendation.

Hepatitis C 

All pregnant women at high risk should be tested at first prenatal visit.

To find out more information about STDs during pregnancy, visit the CDC website.

How Can You Help?: Getting Involved with the Reproductive Health Movement!

volunteerAre you interested in getting involved with the politics of sexual and reproductive health? Have a passion for reproductive issues, but don’t know what to do with it? At a loss for how to get your feminist foot in the door? Here are some easy steps to take to get involved!

1. Call local organizations (like Planned Parenthood) and find out what they need!

Non-profits always need some kind of help. Non-profits that deal with sexual and reproductive health care have the potential added issue of having to deal with a lot of opposition. There is almost certainly some kind of help that your local organization needs. Simply calling the organization you are interested in, and asking them how you can help is a great start! Here at Planned Parenthood of Southwest and Central Florida, we are always in need some kind of support from our advocates. Sometimes we ask them to come out to rallies or events, sometimes we ask them to call local politicians when dangerous legislation comes up, and sometimes we ask them to volunteer their time. Speaking of…

2. See what you can do to volunteer!

Non-profits NEED volunteers. We rely on volunteers for a variety of essential tasks. We have patient escorts to help minimize patient interactions with protesters, neighborhood canvassers, phone bankers, volunteers who do data entry, volunteers who table community events, and much, much more. Most of these jobs aren’t glamourous, but they make a HUGE difference for the patients and employees. Volunteering is a great way to learn more about issues you care about, and to get to see how organizations work behind the scenes. It might also help you explore a career path in the area of reproductive health!

3. Keep UPDATED!

If you are already reading sexual health blogs like Feronia, it seems like you are well on your way to keeping informed and staying current! Making sure that you have accurate information is an important step to being a good advocate for reproductive health. Unfortunately, so much inaccurate information is spread throughout the media that just staying informed can be a great way to get involved! Some other websites you might like to check out are Planned Parenthood’s tumblr and RH Reality Check for other places to get your news and up-to-date sexual health information.

4. Consider donating.

Donations are a GREAT help to many organizations and something non-profits need to keep providing the services they offer. Not everyone can make financial contributions, and that’s more than understandable. However, lots of people think that they have to donate large amount of money to organizations to be helpful, and that’s simply not true! Every little bit of donations help, and if you’ve ever been interested in donating to an organization like Planned Parenthood, you shouldn’t stop yourself because you can’t give on the level of mega-wealthy donors! Another option is to give a small amount every month, and most organizations have it set up so that this can be done automatically! This is a great way to give more over time, while still avoiding having to give large sums all at once.

Panorama: A Groundbreaking Prenatal Test for Women Over 35

In case you didn’t know, once you turn 35, your pregnancies will be deemed “high risk” by the medical community. It isn’t necessarily because you are an unhealthy person, but the egg from which your child will become, is also 35+ years old. And with age, comes more genetic abnormalities and complicated pregnancies.

Women under 35 will most likely experience the “old way” of testing, which includes a series of blood tests and the “anatomy ultrasound,” which typically occurs around 20 weeks. But if you’re over 35 (or have other risk factors) imagine learning the sex of your baby as early as nine weeks into your pregnancy (optional, of course)! Imagine that that very same blood test could also test for the following:preggo

  • Trisomy 21 (Down syndrome)
  • Trisomy 18 (Edwards syndrome)
  • Trisomy 13 (Patau syndrome)
  • Turner syndrome (Monosomy X)
  • Sex chromosome trisomies
  • Triploidy
  • 22q11.2 deletion (DiGeorge)
  • Angelman
  • Prader-Willi
  • Cri-du-chat
  • 1p36 deletion

This simple blood draw, performed at your OB’s office, tests for the aforementioned conditions by separating the fetus’s DNA from the mother’s. Here’s the science…

how it works

Within 7-10 days, your OB will go over your results. If the test reveals that you fall in the “high risk” category, more specialized tests such as Chorionic villus sampling (CVS) or Amniocentesis may be recommended.

Panorama is not intended for women carrying multiples or who have received a bone marrow transplant or for women who have become pregnant using donor eggs. If your insurance doesn’t cover Panorama, there are other tests available to you.

Watch the company’s video and visit their website for more information. Here’s a great graphic that compiles the clinical data. So what do you think? Would you be willing to give a vial of blood to know very early in your pregnancy if there was a genetic abnormality?

*As with all medical issues, remember that we are educators, so be sure to ASK YOUR DOCTOR about this and other concerns.

Fun Friday: Celebrating Joan Rivers

Like her or not, Joan Rivers paved the way for many female actors/comedians. As this must-read TIME article notes, she was a feminist icon, even if she didn’t set out to be.

Joan Rivers, pictured here in 1965, was born Joan Alexandra Molinsky in Brooklyn N.Y. on June 8, 1933. Michael Ochs Archives/Getty Images

Joan Rivers, pictured here in 1965, was born Joan Alexandra Molinsky in Brooklyn N.Y. on June 8, 1933. Michael Ochs Archives/Getty Images

Your Options After a Miscarriage

Mizuko Kuyo figures – image via Stacie Bingham

Miscarriages are incredibly common – around 1 in 5 known pregnancies will end in miscarriage, and even more occur before the pregnancy is recognized. All told, it’s a process that somewhere between 15-30% of female-bodied people will go through at some point.

But like lots of things when it comes to reproductive health, it seems like hardly anyone talks about this in our society, no matter how commonplace it is. Some of this is an unintended consequence of the “12-week rule” many people follow – they don’t share news about their pregnancy until after the first trimester, because they want to wait until things are more certain. Since the majority of miscarriages happen during those first weeks, it’s often the right decision for someone newly pregnant to make – telling people about a miscarriage can be really, really tough. But it means that those people who do end up dealing with a miscarriage can feel very alone, since they don’t know that a lot of their friends and family have also had to make their way through it.

Like most taboo topics, this is very culturally specific. The Japanese Mizuko kuyo ceremony recognizes the feelings of loss related to loss of pregnancy, and provides a way for people to address them. Without ceremonies or other established ways of dealing with emotions after something like a miscarriage, though, it’s easy to feel very alone. Intellectually knowing *that* millions of other people have gone through the same thing isn’t the same as hearing about *what* they went through.

And (like many things) this brings me to why I love the internet so much. In-person support after a miscarriage can be incredibly helpful, but it’s not always available to everyone. And it can be difficult to ask for support given the number of ways in which society loves to judge pregnant women. Sites like FirstCandle.org and MyMiscarriageMatters.com can provide a place to hear other people’s stories without having to navigate the minefield of armchair diagnoses and after-the-fact advice on how you could have prevented it.

Dealing with a miscarriage is hard, but knowing that you’re not alone can help make it easier to take care of yourself. Because no matter what you’re going through, you deserve all the care and support you need.

 

Fun Friday: By the Numbers

percentI’m always reading articles, blogs, books about health, especially sexual health. I’m not sure why, but it seems that more people pay attention to percentages or statistics than to words explaining the same thing. SO I’ll keep it sweet and simple and see if this is true for you!

  • 60% of women have had unprotected sex during their period (a bad idea if you really don’t want to take a chance on getting pregnant)
  • 47% of women have called in sick to work because of cramps (see a gynecologist about hormonal relief)
  • 67% of women have been too embarrassed to talk to a health care provider about a concern (honestly, they have heard and see it all before)
  • 60% of women have worried about one breast looking different from another (perfectly normal to have different shapes and sizes)
  • 43% of women have had a condom come off during sex (you have 72 hours to get emergency contraception)
  • 65% of women say they don’t need to have an orgasm to be satisfied
  • 87% of women have looked at their genitals with a mirror

*Stats above from What the Yuck?: The Freaky and Truth About Your Body

Positive Sex Ed Parenting

As a long time sexuality educator, I’ve come across many people who have done a really inadequate job of talking to their children about basic sexuality. I often ask the teens in my classes if they have any trusted adult they can talk to about sex or what messages they have gotten from home. When doing workshops with parents I learned that it’s a rarity to find an adult that is informed and comfortable enough to give accurate, sex-positive messages to their kids. Here are a few things I’ve learned that might be helpful.

Most parents are terrified of their children’s sexuality

Adults have a really difficult time admitting that sexual feelings are part of being human. All the parts that are pleasurable to be touched as an adult were there from birth. Hormones released during puberty certainly increase sexual feelings but even young children masturbate, have crushes, and crave physical (not sexual) contact. Children are curious about bodies and often have questions from a young age. I ask parents to think about what they want for their children when they are in a healthy, committed adult relationship. Don’t you want them to enjoy sex and be able to communicate openly with their partner? How can they help their child become this adult?

A simple first step is when teaching the names of their body parts use the actual names. This is your nose, these are your toes, this is your penis. It’s your body and you have the right to say no to unwanted touch. As the child grows older and more questions come to mind, you should be the one to answer these questions. If you start giving simple, factual answers to these questions when they are a young child, they are much more likely to come to you as a teen when the consequences are so much greater. If they don’t ask questions, use “teachable moments “to give basic information. “Did you see Aunt Sally’s big tummy? She’s going to have a baby! Here’s a book we can look at together that explains how this happened.”

Most parents are even more terrified that their child will be gay

A child’s sexual orientation is determined before they are born. Hormone levels released during the first trimester form much of a child’s basic sexual preferences, gender identity, and brain patterns. Many parents know from a very early age that their child would probably be attracted to same sex partners. How they support their children throughout their formative years is critical in them negotiating the cruelty of peers that is still a huge fact of life for gay youth. We don’t get to create the child we want. We do get to love and support the child we have.

Many parents feel their child is too young for sexual information

I was so horrified when my daughters came home from elementary school and told me some of the things they heard from their peers. THEY WERE TOO YOUNG AND INNOCENT TO HEAR THIS! But hear it they did. They read words written on the bathroom walls, on the back of the bus seats, in books. They were propositioned by boys. They were told about things kids watched at home. Luckily, they felt comfortable enough to tell me, so I could answer their questions with accurate information, explain what words meant so they understood why we don’t use them and give them responses to name calling and bullying. Try as we might to shelter our kids from sexual information, it will find them at a very tender age. It is critical that we educate them with age appropriate information and create an atmosphere where they feel safe talking to us.

Here at Planned Parenthood resources for parents are available to help navigate this critical, often confusing part of parenthood. A recent blog gives an excellent and entertaining example of positive sex ed parenting.

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