Tag Archives: birth control

Nexplanon: The Injectable Birth Control

Posted on May 9, 2013 by Fosgood

Photo (c) Merck Pharmaceuticals.

Last week, I was helping in one of our clinics when I overheard someone say the next patient was getting Nexplanon inserted. Curious one that I am, I asked the Nurse Practitioner if I could watch, with the patient’s permission, naturally. With her approval granted, I entered the room and tried to be as inconspicuous as possible.

She was in her late teens and accompanied by her mother. Although she was on Depo, so received shots every three months, she was very nervous and afraid she’d pass out. After she lay down on the exam table, the NP gave her an injection to numb the area under her left arm. A plastic device containing the small rod was inserted in the numbed area and the rod was inserted. A few adhesive strips and a pressure bandage were placed over the site. The entire procedure took about 5 minutes. Despite her initial anxiousness, she was chatting and laughing with her mother when she left the room.

Nexplanon works for 3 years. Three years without having to remember to take a daily pill, change a weekly patch, replace a ring once a month or get a shot every 3 months. The failure rate with these methods is greatly increased when human error comes into play.

Nexplanon is 99.9% effective in preventing pregnancy, the same as a tubal ligation or vasectomy (female and male sterilization). Along with the other hormonal methods it works by preventing an egg from being released from an ovary, thickening the cervical mucus and thinning the lining of the uterus.

As with any medicine or medical procedure, there are possible, but rare complications. Before you decide on what method works for you, do your research, know your medical history. And always remember that this method does NOTHING to prevent a sexually transmitted infection. To learn more visit www.nexplanon.org or visit Planned Parenthood’s website.

The End of the Yearly Pelvic Exam?

Posted on May 6, 2013 by Guest Post

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For the past three generations, bimanual pelvic exams have traditionally been considered a vital part of well-woman visits. But new research is suggesting that they may not always be necessary on a yearly basis.

Pelvic exams are important for screening for cervical cancer, STIs, and a variety of other health issues, and can make life-saving discoveries. But for healthy women, without a family history of cancer and using protection against STIs, is it a yearly necessity? Ask Your Doctor.

A recent study has been released by the Columbia University Medical Center that suggests annual pelvic exams of women without any symptoms could be an overuse of cancer screenings. (http://www.ncbi.nlm.nih.gov/pubmed/21194307) As a young woman, without a family history of cancer, with a low risk of STIs, do I still need a pelvic exam? For me, the answer is yes – at least until my doctor tells me otherwise. But that may soon be changing, as new guidelines are released about the necessity of annual exams.

Planned Parenthood suggests more frequent pelvic exams if you have any of the following:

a history of abnormal Pap test results
a history of sexual health problems
a family history of certain kinds of cancer
a sexually transmitted infection or a sex partner with an infection
recurrent vaginitis

In some cases, a pelvic exam is needed in order to prescribe hormonal birth control — the pill, the patch, the ring, or the shot. A pelvic exam is always needed for inserting an IUD or fitting a diaphragm.

For some women, a bimanual pelvic exam can be a stressful and anxious experience. In the five years I have been prescribed birth control (and consequently, five bimanual pelvic exams) I have always dreaded my annual visit, even with my wonderful gynecologist. (We have tips on how to make it less scary, though!) Maybe in the future – with further research of course – I will be able to get my prescription without an annual pelvic exam! Until then, I will just keep on making the appointments and keeping this body healthy.

Women’s Health & the ACA: The Benefits for Women

Posted on March 21, 2013 by Guest Post

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We’re so lucky to have two public policy interns here at PPSWCF. She’s writing today on the benefits to women in the Affordable Care Act.

Although we’ve all heard of the Affordable Care Act, it can definitely be challenging to keep up with all of the pieces of President Obama’s expansive health care reform bill. I know that I was overwhelmed by the sheer size of just the first section of the Act. Because of the vast amount of discussion, debate, and misinformation clouding the benefits of the Affordable Care Act I want to take a minute to point out and celebrate some of the huge gains in women’s health care ushered in by this law.

To put the significance of this bill into context, it’s important to first recognize that one of the largest challenges for women in this country is finding affordable health care. In fact, according to Health and Human Services Secretary Kathleen Sebelius “more than half the women in this country [have] delayed or avoided preventive care because of its cost”. To combat this state of affairs the Health Resources and Services Administration commissioned the Institute of Medicine to investigate what services are most necessary for ensuring women’s health. In response the IOM identified eight preventive services that are of particular importance to female health. (What are they? Check out Monday’s post for the list.)

Based on the results of this study, the Affordable Care Act has mandated that all insurance companies fully cover the eight identified health services without cost sharing. In essence this means that all insured women will have access to a spectrum of free services, from FDA-approved contraception methods to domestic violence screenings. Since this portion of the law took effect in August of 2012, healthcare has been expanded for an estimated forty-seven million women, many of whom might not have been able to afford the premiums associated with these vital services before now. Additionally, the Affordable Care Act includes a provision requiring insurance plans to end sex-based discrimination by 2014. This means that companies will no longer be allowed to charge women more for coverage than men.

Unfortunately, these new advances are hardly set in stone. Lawmakers have struggled to create legislation that adequately protects both the health needs of women and the rights of religious employers. Currently, explicitly religious employers (such as churches) are not required to pay for services that conflict with their theology, and religiously affiliated organizations (such as some universities) do not have to pay or arrange for contraceptive coverage. Instead, women who are insured through such employers receive contraceptive coverage from separate insurance policies.

Despite these accommodations, this conflict has resulted in a national controversy. So far more than 45 lawsuits have been filed in federal district courts which directly challenge the contraceptive coverage section of the Affordable Care Act. It is believed that at least one of these cases will eventually make its way to the Supreme Court. Furthermore, legislators in the House of Representatives have attempted to overturn the entirety of the Affordable Care Act on more than thirty separate occasions.

There is a great deal for women and all people who value quality healthcare to celebrate in the Affordable Care Act. It is also important for us to be vigilant in defending the new gains associated with this piece of legislation. To learn more about how you can benefit from the Affordable Care Act, and to see a list of free preventive services you may now be eligible for, check out: http://www.healthcare.gov/prevention.

Birth Control Isn’t Always For Contraception

Posted on February 25, 2013 by Eleanor

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If you’ve been keeping up with the news for the past year, there’s been a big brouhaha about birth control. There’s a common misconception that birth control is only used for contraception – that’s simply not true. What are some of the reasons that birth control is used outside of contraception?

Debilitating menstrual cramps (dysmenorrhea).

This one is close to my heart, as it’s the original reason I was put on birth control at age 15. (I didn’t use the contraception part of birth control until much, much later; as you might imagine, just because you’re on birth control doesn’t make you want to have sex with wild abandon.) After you have to go to the ER twice for pain medication due to menstrual cramps, it’s time to see a gynecologist.

Birth control pills are a common prescription to women suffering debilitating, have-to-stay-home-from-work-or-school cramps. This isn’t as rare as you might imagine: according to the NIH, painful menstrual cramps are the number one reason for missed school or work among women in their teens and 20s.

With birth control, the invention of Thermacare portable heating pads*, and prescription medication, I was finally able to go to school during my period. Many other women are too. (Luckily, even though we don’t know exactly what causes them, menstrual cramps do tend to decrease as you age!)

*This post is not sponsored by Thermacare in any way, but seriously, I love them still for dealing with period pain.

IVF (in-vitro fertilization).

So, you’re trying to have a baby – why in the world would you get put on birth control? Well, birth control can regulate your cycle to the point that both doctor and patient can plan around the ovulation process and can harvest the eggs for the IVF process easily. It limits the amount of time missed for work for IVF treatments and it can lead to an easier and quicker IVF process, which is always beneficial to any IVF patient. Yes, in this way, birth control can and does lead to a baby.

Endometriosis, PCOS, and other women’s health issues.

Birth control can help in some of the more difficult gynecological issues for women, including endometriosis. (Don’t know what endometriosis is? Find out in our post.) It’s a recommended treatment for taking away some of the pain, as “[b]irth control pills…decrease the amount of menstrual flow and prevent overgrowth of tissue that lines the uterus.” For those living with PCOS (polycystic ovarian syndrome), birth control can reduce acne and male hormones of PCOS as well as regulate cycles.

So, three ways birth control pills are used, none of which include contraception. Have you ever used birth control pills to help with something not related to contraception?

The Female Condom: One Step Forward for Feminism, One Step Back for Pleasure

Posted on February 19, 2013 by Firdaus

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Image copyright bedsider.org

For years I have been distributing Female Condoms (also known as FC) throughout our health centers, and while I understand they are about 95% effective at preventing pregnancy if used properly every time, I’d never used one myself. I’ve pulled them out of their packaging, I’ve touched them, squeezed them, and demonstrated how they work using a model. The Feronia Project has advocated for its ability to empower females to take charge by using the FC, but in my vagina…huh?

So, in the spirit of Valentine ’s Day romance, my partner and I decided to pop in a FC and take it for a spin. I’d used the Nuva Ring in the past, so I was prepared for the way it might feel to have a flexible plastic ring inside my vagina during sex, but was unprepared for how it felt to have that ring connected to a plastic baggie, connected to a second ring that remained around the vulva. In a word: ouch.

For me, the female condom was extremely uncomfortable and problematic. Though an excessive amount of lube was used, it didn’t change the fact that I felt like it would tear at any moment, and I had to hold it in place externally so that it didn’t slip inside of me. The external ring that holds the FC open around the vaginal opening was extremely uncomfortable to me, pinching and rubbing hard against my very sensitive labia. Agh!

For him, it was very uncomfortable as well. I asked him to rate it like a homework assignment, and he gave it a full “C.” He was wary of it coming out, and the plastic baggie sound/feel was hardly arousing. So, for us, the male condom wins.

We lasted a full minute before we had to take it out and replace it with a male condom. With proper communication, we were able to navigate the situation with ease and a little humor, without dampening the night’s appeal.

I support the idea of the female condom whole-heartedly! It’s important that females are able to have a barrier contraceptive method to protect them from sexually transmitted infections and pregnancy, just as males do. However, something a little softer, smoother, and less baggie-like might feel more appealing (for us anyway).

Don’t just take my word for it! Everybody is different. Every partnership is different. It’s most important that you find the best method for YOU! Readers, have YOU used a female condom?

Emergency Contraceptive Vending Machines Are Now Legal

Posted on February 6, 2013 by Guest Post

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Shippensburg University Plan B Vending Machine. Copyright, Think Progress.

We’re happy to welcome in Dave from theohface.com, a blog that discusses sex, gender and sexuality issues from a sex positive perspective. (Check out his post on the female condom; he also wrote a great post on how grapefruit may get you pregnant.) He’ll be guest posting monthly about sexual health from a male perspective; reach him at his blog or on Twitter: @theohfacedotcom

Having emergency contraceptives available at all times to college students is important because they are most effective within 72 hours of intercourse. Some campus health centers close over the weekends and others don’t have on-campus pharmacies so these vending machines are crucial for women who wish to use Plan B within the allotted window of time. It is also a good option for women who don’t feel comfortable talking to a pharmacist or health practitioner in order to get their contraceptives. We still live in an era in which contraception is controversial and the anonymity that these machines provide is surely appreciated That being said, it seems as though the times are changing and this FDA ruling is a big step towards a more rational conversation about contraception.

The major catch with these machines is that Plan B is restricted for use amongst people aged 17 and older. The concern that will invariably be brought up is that people under the age of 17 will use these machines to acquire emergency contraception. (Personally, I don’t really understand this particular age restriction, 17 years old seems fairly arbitrary to me but hey, I don’t make the rules, I just write about them.)

This whole thing came about because Shippensburg University in Pensylvannia installed a Plan B vending machine on campus and instead of telling them to remove it the FDA made the decision to grant them and any other college or university the legal right to have emergency contraceptive vending machines. It’s a brilliant idea and a step towards a future where women’s health decisions are more firmly in their own hands. In fact, for $25 it can be in their hands 24 hours a day seven days a week without having to talk to anyone at a a clinic or pharmacy. I think that’s something worth celebrating.

Condoms: Don’t Flush ‘Em!

Posted on January 31, 2013 by Mary

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Today, we’re re-rerunning an oldie but a goodie, all about the reasons why you should not flush your condom. Seriously – don’t do it!

As a Sex Educator, I sometimes find myself on the phone with a complete stranger saying something like, “eh, I have kind of an unusual question…” A few days ago I uttered those words when I called my local Water Reclamation Manager. I asked him if he would take me on the journey of a flushed condom.

When I give a condom demonstration in the community, inevitably I have someone say, “why would I throw my used condom in the garbage when I can flush it down the toilet?” Here’s why:

When you flush a condom, there’s a chance that you could clog your toilet. It might come back up immediately or when you least expect it, like when your boyfriend’s mom is over for dinner. (It could also damage your septic system, if you don’t have city sewer.) If you are lucky enough for the condom to clear your toilet, it is going to start traveling towards a water reclamation facility (WRF). My source tells me that they rely on gravity and a downhill flow of the pipes to get the waste at least part of the way there. Because many of the pipes stretch for miles, a pump is usually needed to get the waste all the way to the WRF. This is potential problem area #2 (no pun intended). Non-organic waste (condoms, diapers, feminine hygiene products, cigarette butts, cotton swabs, reinforced paper towels, etc.) often gets trapped in these pumps and someone has to go REMOVE IT BY HAND. Ewww. If the condom does make it through the pump, there’s another filtering process at the WRF, but my source says that sometimes, stuff gets through that process too. He says that occasionally, you can find condoms and tampon applicators on the fields where reclaimed water is used to irrigate! Double ewww. I mean, who wants their delicious Florida strawberry growing inches away from a used condom?!

Here’s what you should do instead: wrap your used condom in toilet paper or a tissue and put it in the garbage. Latex is biodegradable, but not in water. The Water Reclamation Manager says that if you put it in the garbage, it will go to a landfill and/or be incinerated. When they remove non-organic waste from the pumps or at the WRF, it also ends up at the landfill and/or is incinerated. Here’s what should go down a toilet: #1, #2, and #3 (vomit). We really don’t need taxpayer money replacing pumps all over town because people refuse to dispose of condoms properly.

An aside: When the Manager told me that the non-organic waste has to be removed by hand from the pumps, I told him that they aren’t paid enough for what they do. “Actually,” he said, “this is a great career and we make a decent living…tell that to your readers.”

Free Birth Control for Girls in France

Posted on January 15, 2013 by E.G. Hanna

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Next year, France is set to provide free birth control for girls aged 15 to 18. They will not need parental approval or notification, but it is not clear to me whether they will need a physical examination. While there was some opposition from a Catholic organization, the new law was not controversial. A member of the opposing organization, CLER, says “the French government would do better to spend the money on more effective sex education in schools rather than on contraception.” But while learning how to prevent pregnancy is important, it isn’t very useful unless you can obtain the tools needed to prevent pregnancy. Because the birth control is free of charge, “French health officials say the new measure will help protect teenagers who are from low-income families, and from families where sexuality is a taboo subject.”

France’s actions are setting an excellent example for what conscientious, evidence-based health-care looks like. Meanwhile, here in the US, we are moving towards free birth control…slowly. Right now, the Affordable Care Act “only applies to people who currently have private health insurance. Even if you have private health insurance, the coverage might not kick in for a few months or a couple of years – it depends on your plan.” It also only covers certain brands and kinds of birth control, and more importantly for young women who are on their parents’ insurance, it does not provide much privacy. Low-income women without insurance and women whose families are not supportive of their choice to use birth control are not likely to have solid access to birth control under our current laws.

I’m happy France is taking action to protect it’s young women from unwanted pregnancy, and I’m looking forward to seeing how the law affects the rate of unwanted pregnancies among teenagers. Hopefully, once insurance-covered birth control becomes common here in the US, our rates will go down and birth control will become less controversial overall.

How Grapefruit May Get You Pregnant

Posted on January 14, 2013 by Guest Post

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We’re happy to welcome in Dave from theohface.com, a blog that discusses sex, gender and sexuality issues from a sex positive perspective. (Check out his post last month on the female condom.) Look out for more posts from him in 2013; he’ll be guest posting monthly about sexual health from a male perspective.

I was talking to a couple of doctors the other day and somehow we got onto the topic of grapefruit. They told me that grapefruit and grapefruit juice can interact with your body in a way that causes lots of medications to increase in potency, i.e., they become stronger versions of themselves. Good to know, I thought. But then, one of the women we were with mentioned that grapefruit had the opposite effect on some kinds of birth control – i.e., it made them less effective. Well damn, I thought, I gotta look into this! (Clearly, if it doesn’t pertain to sex, I’m not as interested.)

So, I looked into it a bit and here’s what I found: first off, you may or may not know of the different types of hormonal birth control. There are two common types of birth control, ones that release a combination of the hormones estrogen and progestin and ones that only release progestin. (For more information, just click on the link.)

Now, grapefruit gets in the way of the bodies ability to absorb estrogen. If your body isn’t absorbing the estrogen from your birth control pill properly, then the birth control pill isn’t going to work right and you may get pregnant – even if you’re taking your pills properly. Women who are using the progestin-only forms of birth control don’t need to worry about grapefruit though, because there’s no estrogen to worry about in the first place.

If you’re thinking to yourself, what if I have grapefruit in the morning and then take my pill at night? You’re probably out of luck as the effects of the juice last in your system for longer than a day. On the plus side, most oranges don’t have this kind of effect on your body so you can still have your orange juice if you’d like. (This is actually a fairly common side-effect for many pills, believe it or not. Lesson? Be careful with grapefruit juice and medication!)

If you really, really love grapefruit then I suggest you talk to your doctor and ask them what the wisest course of action is. They may reccomend a progestin-only contraceptive or an non-hormonal IUD instead, but until you do that, it might be best to lay off the grapefruit for a bit.

On a side note, apparently grapefruit and Viagra don’t mix either, so you’re not alone.

Ever Heard of Endometriosis?

Posted on January 2, 2013 by E.G. Hanna

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Endometriosis is a medical condition where endometrial cells (cells from the lining of the uterus) implant outside the uterus. This can occur in many places in the body, most commonly the ovaries, fallopian tubes, bladder, outer surface of the uterus or the lining of the pelvic cavity. The cause is unknown, but it tends to run in families, and may be related to the immune system.

Often the number one symptom is pain. Periods may be painful, and the pain may start just before the period. Pain during or after sex, pain with bowel movements, intestinal pain, spotting between periods, and infertility are also symptoms. Because the symptoms of endometriosis are fairly general and vague, you may first be screened for other causes of pain and irregular bleeding, including infection. If endometriosis is suspected, a pelvic exam and/or ultrasound may be done to look for cysts or scarring of the uterus. But the only way to fully diagnose endometriosis is through a minor surgery called a laparoscopy.

This article explains a laparoscopy well: “You will receive general anesthesia before the surgery. Then, your abdomen is expanded with a gas to make it easy to see your organs. A tiny cut is made in your abdomen and a thin tube with a light is placed inside to see growths from endometriosis. Sometimes doctors can diagnose endometriosis just by seeing the growths. Other times, they need to take a small sample of tissue and study it under a microscope.”

If it’s determined that you have endometriosis, there is a variety of management methods you and your doctor can discuss. Pain medication, usually NSAIDs (like ibuprofen) may be used to manage discomfort; birth control pills may be prescribed to “decrease menstrual flow and prevent overgrowth of tissue.” Other drugs used to decrease estrogen levels, surgery to remove growths of endometrial tissue, or even a hysterectomy may be considered.

If you are having pelvic pain, it’s always time to visit the doctor – please visit your doctor for an examination as soon as possible.