Tag Archives: contraception

Condom Use Among Young African American Men

Today’s guest post was written a sex educator who specializes in peer-to-peer pregnancy prevention programs. He understands the cultural nuances that influence the decisions young people make and works to help youth realize their potential. 

Condom use can be a taboo topic, especially within certain cultures and ethnic communities, including the African American community. When you dissect the African American community into subsets (by age, for example) you see trends in attitudes about condom use. According to the Black Aids Institute, young African American men report a 20.5 percent condom usage rate. It’s alarming to consider that 4 out of 5 young black men are not using condoms during sexual intercourse. Lack of condom use among African-American men can be seen as a direct correlation to higher rates of unplanned pregnancies, HIV, and other STI’s within the African American community.

couple

Research done by the Pacific Institute for Research and Evaluation conducted a qualitative study on condom use behaviors among urban African-American men ages 18-24. That research revealed various reasons for non-condom use:

  • Lack of interest in condom use
  • Lack of immediate access to condoms
  • Inconvenience
  • The mood-killing length of time it takes to put on a condom
  • Partner’s disinterest in condom use

The most commonly expressed rationale for not using condoms among the research participants was their general disinterest in using condoms. It is evident that there may be some cultural perceptions among young African-American men that promote the non-use of condoms during sexual intercourse. Education is a critical component to refute many of the misconceptions that this population has in regards to condom use and it may be highly beneficial for Sexual Health Educators to consider the use of peer-to-peer education.

Some of the perceptions of condom use among young African-American men are driven by peer influence. A literature review of peer-to-peer programs done by Advocates for Youth revealed the following results:

  • Improved reproductive and sexual health outcomes, including reduced incidence of pregnancy, births and STIs
  • Reduced sexual risk behaviors, including delayed initiation of sex, increased contraceptive use and condom use, reduced number of new sexual partners as well as increased abstinence among sexually experienced youth, reduced incidence of unprotected sex, reduced frequency of sex, and increased partner communication
  • Increased incidence of testing and sharing test results, including testing for HIV, for STIs, and sharing positive test results with a partner

Lack of condom use among African-American men has far-reaching public health consequences and effective strategies must be implemented to mitigate the cultural behavioral norms that promote non condom use. Peer education appears to be a promising model to educate young African-American men about the benefits of consistent and appropriate condom use.

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What’s the Best Birth Control for Teens?

Well, the obvious answer is abstinence: 100% effective when used correctly. But what method is second best? Third best?

If you’re a teen reading this, here’s what to expect from your pediatrician, per the guidelines from the American Academy of Pediatrics: they will conduct a developmentally-targeted sexual history, assess risk for sexually transmitted infections, and provide appropriate screening and/or education about safe and effective contraceptive methods. Basically, they will ask you a choiceslot of personal questions that may make you uncomfortable, but it is really important to be honest with them. The information you give them is confidential, meaning they can’t share it with your partners, parents, friends, etc. They can’t match you to the best birth control method for you unless they have all of your behavioral and medical information in front of them. And sometimes it takes a few tweaks to get it right. Your doctor will advise you to spend 3-6 months getting used to your birth control, as it takes time for your body to adjust. Pay attention to any side effects you might be having and report back to your doctor the next time you see them.

implantNow back to what’s best for adolescents. Often, what’s considered the best is heavily influenced by what’s the most effective. Please look at this table so you can see the difference between “perfect use” and “typical use” of each contraceptive method. Take a look at “single-rod contraceptive implant.” This method is considered the best for teens who are or plan to be sexually active because it’s perfect and typical use rates are the same, and after a year’s use, 84% of women choose to stick with it. Unlike pills, patches, rings, and condoms, this type of contraception, also known by its brand names, Implanon and Nexplanon, is hard to mess up. Why? Because it is implanted into the upper arm, where it can stay for up to 3 years, preventing pregnancy. It can even be inserted immediately after birth.

Next in line are IUDs (intrauterine devices) in terms of effectiveness. There are two types of IUDs, hormonal and copper, lasting between 3 and 10 years. The copper IUD can be used as emergency contraception. What single-rod implants and IUDs have in common are their effectiveness in preventing pregnancy, ease of use, and their long-term coverage. They are often referred to as LARC’s, or long-acting reversible contraception. LARCs are as effective as birth control methods (aside from abstinence) can get without being permanent (like sterilization).

ALL birth control comes with side effects. You must weight the benefits and risks with your doctor. And remember, only abstinence and condoms will give you protection from sexually transmitted infections. It is a good idea to use your hormonal birth control WITH condoms.

If you are a parent reading this, there are a plethora of resources out there for you. Start with the American Academy of Pediatrics to read the most current guidelines. Visit Advocates for Youth to learn what to say and when to say it. Call your local Planned Parenthood affiliate as most have educators that you can talk to, learn from, ask questions, and even practice with.

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Microchip Birth Control Technology

microchipBack in 2012, Microchips Biotech Inc., tested out new microchip technology on osteoporosis patients. When it turned out successful, the Bill and Melinda Gates Foundation jumped at the opportunity for using microchip technology to prevent pregnancy. Clinical trials in humans could begin as early at 2016 and microchip birth control could be on the market as early as 2018.

So how does it work? Much like Implanon, the microchip is implanted under the skin, but unlike other contraceptive implants, you don’t have to get it removed when you want to try to conceive… you just TURN IT OFF! With a REMOTE CONTROL! And we should mention that it can release daily hormones for 16 YEARS! No other implant can do that. Early estimates put the cost at $1,000, which is just 17 cents a day!

Luckily, for women in first world countries, there are a myriad of birth control options. So for the squeamish among us, we have the option of bypassing implants, while still maintaining our reproductive freedom. But think for a second about the estimated 80 million women in developing countries who had an unintended pregnancy in 2012; of those women, at least one in four resorted to an unsafe abortion. Think about the barriers for those women: lack of education, cultural taboos, corrupt governments, lack of health care, lack of autonomy, and even logistical barriers like distribution of contraception – it’s not like women who live in isolated areas of Niger (which has added problems like Boko Harem) can just swing by the drug store on their way home from work. 

Giving women and families the power to control their fertility literally changes the world. How? Read this article: 10 Facts About Contraception (And How It Changed the World) That Every Man and Woman Should Know. Think about the impact just for the woman – for 17 cents a day – a marked reduction in unintented pregnancies, birth rates, abortions, maternal deaths, and birth complications such as obstetric fistula.

As with any new scientific and cultural breakthrough, there are hurdles ahead. Stay tuned for developments in this incredible microchip technology because the applications are endless and promising and bring so much hope. 

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Which Emergency Contraception is Right for You?

Emergency Contraception aka Plan B and the morning after pill is used to prevent pregnancy. It GD*5768580is not an abortion pill. This method works by preventing the ovaries from releasing an egg.

  • After unprotected sex
  • The condom slipped off or broke
  • A female was using a birth control method but not taking it correctly (ex: she was taking the pill but forgot to take it two days in a row)
  • A female was raped
  • A female was under the influence and unsure if her partner used a condom

There are 3 Emergency Contraception options for women to prevent pregnancy:

  • Next Choice One Dose and Plan B One-Step: works best when taken within the first 3 days after unprotected sex and is 89% effective at preventing pregnancy. This means that if 100 women take the medication, 11 could still become pregnant. The pill can be taken up to 5 days after unprotected sex, but it is less effective on the 4th and 5th day. This method of emergency contraception may not work as well for women who have a BMI (body mass index) over 25 and won’t work for women with a BMI over 30. If women are in the higher BMI category they will need to get a prescription for Ella or have an IUD inserted. Both brands are available over the counter and there are no age restrictions.
  • Ella: 85% effective if taken with 5 days after unprotected sex and works for women well for any BMI below 35. If a woman has a BMI greater than 35 it may still work but not as well. Ella is only available by prescription from a medical provider.
  • Paraguard (aka Copper IUD): 99.9% effective if inserted within 5 days after unprotected sex and can prevent pregnancy for up to 12 years. The IUD is inserted by a medical provider.

Please see the chart below for a side-by-side comparison of the 3 methods. If you still have questions you can chat with a Planned Parenthood educator online or text a question to 774636.

best-emergency-contraception

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Contraceptive Use in Developing Countries: A Growing Concern

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.

Health demonstration, Nigeria.The issue of contraception is a continuing concern around the globe. This concern is elevated among women of reproductive age who live in developing countries and can’t afford to sustain large families nor have access to adequate health care. Providing couples, especially women, in third world countries with access to effective contraceptives would improve the health status of individuals and the nation as a whole. There are numerous reasons and advantages to improving the availability, access, and use of contraceptive for women in third world countries.

More women are seeking effective contraception in order to prevent unwanted pregnancies. This number has risen from 716 million in 2003 to 867 million in 2012 and keeps rising. Most of this need for contraception was among women in the poorest countries, which also saw the highest population growth within this period (Guttmacher Institute, 2013). These nations also had the worst maternal and child health outcomes with very high rates of morbidity and mortality.

A report by the United Nations Population Fund (UNPF) in 2012 stated that greater access to family planning methods would save developing countries more than $11 billion a year. These savings would come from reduced costs of care for mothers and newborn babies. The report also states that about $2 billion a year would provide enough contraceptives to meet the needs of developing countries. This point is further buttressed by the fact that having fewer children has been very beneficial for developed countries both financially and with regards to health outcomes.

Using Nigeria as an example, the UNPF study revealed that if the fertility rate fell by one child per woman, the economy would grow by at least $30 billion!

In 2012, the United Nations declared access to contraception to be a ‘universal human right’. However, this human right isn’t being realized for millions of women around the world especially for women in developing countries. Sadly, these women are continually faced with difficult choices and serious consequences of unintended and unwanted pregnancies.

The agencies and organizations that are trying to empower women in these nations are faced with constant social, political, and religious oppositions. They are also faced with persisting negative cultural ideas about contraception. Real change requires community-wide, multifaceted interventions, life skills, access to youth-friendly services, women-friendly policies, and the support of the country’s leadership. Changing negative perceptions of modern contraceptive methods would go a long way in improving women’s health by preventing unwanted pregnancies and even reducing the burden of STIs.

Saving lives, improving the quality of life, and empowering women is a goal that can be achieved in developing nations with continuing effort and dedication. My firsthand experience of this issue has really made it a very important topic to me and I would love to hear about your experiences and comments with regards to women’s health in developing countries.

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Busting IUD Myths: 4 Facts that May Surprise You

We’ve talked about IUDs here on the Feronia Project before, and we’ve had no shortage of love for them. I’ve personally used the Mirena and the ParaGard, and think that they’re both fabulous.

But whenever I end up talking about IUDs with people, I often run into folks who wince and ask me how I got over my fear. There are a lot of misperceptions out there about IUDs, and I’ve talked about 4 of the most common below (Including 2 that I had before I got mine!)

Childbirth: You don’t have to have had children in order to use an IUD.
The myth that IUDs are only for people who’ve given birth was one that I ran into when I was first looking to get my IUD, and it’s persisted, even though the WHO and the American College of Gynecologists both say that there’s no reason for this restriction.

One reason this myth keeps lingering is that Bayer, the company that makes the Mirena IUD, only recommends it for women who have had a child. But! That’s because when they were going through the process of FDA approval, they only included studies on women who had had children. Therefore, any use other than that is considered “off-label,” but it’s still perfectly safe.

Skyla, a newer, smaller hormonal IUD, went through FDA approval using studies that included women who hadn’t had a child. Since it can be marketed to everyone, it’s helping to put this myth to rest.

Ectopic Pregnancy: IUDs actually reduce your risk of an ectopic pregnancy.
Before getting an IUD, I’d heard about ectopic pregnancies, how dangerous they can be, and I’d often heard about them in the context of IUDs. However, because IUDs are very effective at preventing sperm from fertilizing an egg, the risk of an ectopic pregnancy is lower with an IUD than it is without birth control, or if you’re on a less effective method of birth control.

Abortion: IUDs don’t cause abortions, and won’t affect an existing pregnancy.
IUDs generally work by preventing fertilization. The copper ions in the ParaGard act as a spermicide, and the progestin in the Mirena and the Skyla IUDs thicken the cervical mucus, which prevents sperm from entering the uterus. Very rarely, sperm can make it through and fertilize an egg, in which case each of the IUDs prevents implantation. Even in these cases, the IUD is still a contraceptive, since a pregnancy doesn’t begin until a fertilized egg implants.

Infection: IUDs don’t increase your risk of STDs.
They don’t protect against getting them in the future, but they don’t put you at any greater risk for getting them, either. You will want to get tested for STIs as part of getting your IUD, though, because you’ll want to be sure to treat any existing infections so that the insertion doesn’t create new problems.

Now IUDs – like any form of birth control – aren’t for everyone. Some medical conditions, like fibroids, just won’t work with an IUD. Anyone with a copper allergy would need to avoid the ParaGard, and those who want to avoid hormonal methods wouldn’t be good candidates for the Mirena or the Skyla. So if you’re in the market, you’ll want to take some time to talk with a healthcare provider about the pros and cons of each option. I know that mine have worked really well, and I adore them – I hope you find a method you love just as much!

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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.

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Which is the Most Effective Birth Control?

We get asked this question ALL THE TIME: “What is the most effective form of birth control?” And although we can tell you how effective various methods proved to be in clinical trials, there is a whole lot more to consider when selecting a birth control method.

pillsIt is great that we now have so many options to choose from, but it can be difficult to make a decision and know which method is best. In terms of hormonal birth control options, we now have the following options: the pill, patch, ring, shot, IUDs, and implant. When used as directed, all of these methods are over 99% effective at preventing pregnancy. If you are splitting hairs, the hormonal IUD (Mirena) is at the top of the heap at 99.9% effective and the pill is 99.2% effective.

However, when trying to decide which method is right for you, it is more important to look at which method is going to meet your needs as an individual. For instance, you may think the pill sounds like a great option, but if you aren’t someone who is going to remember to take it every day it won’t be very effective. Or, if you don’t like the way your body feels on synthetic hormones, your options will be limited to behavioral and barrier methods of birth control like abstinence and condoms, respectively. Here are some questions you might want to ask yourself to help you narrow down your options:

  • Will you have trouble remembering to use this method?
  • What side effects are you willing do deal with?
  • Is cost an issue or will insurance cover it?
  • Do you want something that has hormones in it?
  • Do you need something that also protects against STD’s?
  • Are you afraid or embarrassed to use a particular method?
  • Do you have pre-existing medical conditions that would preclude you from using a particular type of birth control?
  • Are you a smoker?
  • Do you need to use a method that is not visible to others?

Check out Planned Parenthood if you need any additional information on a particular method or are still having trouble identifying the right method for you. The website also has a helpful birth control quiz. Remember to be 100% honest with your medical provider about your medical history and health habits. Also, people rarely find the perfect birth control for them the first time – you may need to try a few before you settle on your favorite.

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How Grapefruit May Get You Pregnant

Close up of red grapefruit and pills isolated - vitamin concept

We’re happy to re-run a post from 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.) 

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.

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Emergency Contraceptive Vending Machines Are Now Legal

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

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.

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