Contraceptives

Let’s get a few facts clear about Plan B 
Plan B is specifically intended for use by a woman after she has had unprotected intercourse, to avoid a pregnancy –this emergency contraceptive is NOT in the same category as the low dose birth control pill when it comes to the amount of synthetic hormones it delivers into your body.  Plan B delivers much higher doses of hormone than your regular, low dose birth control pill.. Sales of Plan B have soared now that it is easily available over the counter if you are over 18. While it’s good to always have a pack of Plan B in the bathroom cabinet, it should NOT be used more than twice a month and should certainly not be relied upon as your only form of continuous birth control.

Why you may need Plan B

The condom breaks, it was a drunken sex error you regret, you’ve missed a pill, you’re 2 weeks late for your depo shot or heaven forbid, you’ve been raped.  There are many reasons for avoiding an unwanted pregnancy, even though you may well get an unwanted ’something else’ (STI) if you used no condom!

Today’s low dose birth control pills contain much LESS synthetic hormone (20-35mcg) than the first birth control pills of the 1960’s which contained 150mcg of progestin.  I mention progestin and the dosage to impress upon you the HIGH DOSE of hormone you consume when you take Plan B - because Plan B contains a whopping 750mcg progestin (levonorgestrel) and there are associated side effects.  Many types of  low dose birth control pills also contain estrogen, which causes serious side effects in some women so for this reason ‘combined’ birth control pills will never be sold over the counter.

When to Take Plan B

Preferably, within 12-24 hours of sexual intercourse but Plan B is still effective if you take the first dose within 72 hours. After this time you still have the option of having an IUD fitted which will prevent  implantation of a fertilized egg ( this is an issue for those who believe this a form of abortion so counselling may be needed)

Side Effects -  nausea, abdominal pain, fatigue, headache, changes in your period, dizziness and breast tenderness. You may not get all of these but be prepared for the nausea.

If Vomiting Occurs - within one hour of taking the first dose, you may need to repeat the dose so see a doctor. You may also need some anti nausea medication although nausea is less with Plan B than with combined emergency contraception pills that contain estrogen.  Often the nausea will be mild and will disappear after a day or so, do not take more pills than recommended if you have not vomited.

Breastfeeding women can take Plan B as it only contains progestin which will not interrupt milk production

There are ‘morning after’ pills that contain estrogen, called the Yuzpe method, but these are not commonly used any more because they have more side effects and are less effective  than Plan B - (57%) compared to the levonorgestrel method (85%)

If Plan B is not available
The FDA has approved some ‘regular’ low dose birth control pills for use in higher doses as emergency contraception.  A list of these low dose birth control pills and the number of pills you need to take can be found on this earlier post. Tony Thornton, CEO of Planned Parenthood in Lubbock said about four birth control pills will achieve the same effect as an emergency contraceptive but you should contact a pharmacist before taking more than the recommended dose of your current low dose birth control pill.

More facts about Plan B.

• plan B does not protect you against STIs or HIV
• if you are already pregnant, Plan B is not an abortifacient (will not abort the fetus)
•  if your period is more than a week late, get a pregnancy test as you should not take Plan B if you are pregnant. If you experience any severe abdominal pain, you could have an ectopic pregnancy which requires immediate medical attention
• there is no need for a medical history to be taken or a physical examination to be carried out before using Plan B

Costs for birth control have risen, sadly, so check to see if you qualify for free or subsided Plan B at your nearest health care clinic or Family Planning Centre. That link again for a good video and for:  Using regular low dose birth control pills for emergency contraception

With the party season fast approaching how about being well prepared to avoid using Plan B with a collection of fun condoms on a stick?  You could go halves in the cost with a friend and hand out these attractive ‘lollipops!

Your perfect partner has been diagnosed with Chlamydiosis and thinks he is ‘doing the right thing’ by passing on a prescription for you from his doctor for an STI med- what he doesn’t know is that this medication may not be the perfect partner for your low dose birth control!  In cases where doctors believe that a patient’s partner will not or is unable to, seek treatment for an STI, they will provide EPT (Expedited partner therapy) along with some resource material for follow up and testing.  Don’t just take your partners word for it that all will be ’sweet’ if you just take the meds.

What is EPT ?

The Centers for Disease Control and Prevention, define EPT as  “the practice of treating sex partners of patients with sexually transmitted diseases without an intervening medical evaluation or professional prevention counseling.” Not all states have the same regulations about EPT but each doctor should be aware of their own state’s ruling.

Using the same antibiotic medication as your partner for an STI can be effective if you have the same STI as your partner and DO NOT have a pelvic infection or another type of STI such as syphilis, trichomoniasis or HIV.  Additional treatment is available for these diseases but  it’s always smart to go to your doc or a clinic as soon as your partner tells you he’s infected with an STI.  Don’t let it get to the ‘confessional stage’ though before you get checked out anyway, especially if you have more than one sex partner.  If he does sheepishly slip you that prescription, it should come with some extra written information about allergies, Q&As and some guidance about other STIs - read it THEN go to the doctor  because…..
The ‘downside’ for you if your partner hands you an STI medication prescription is that, unless your partner is one in a million, he will not be able to tell his doctor about any of your food allergies, other meds you take or your medical history- any of which could prevent the STI medication from being prescribed for your use.  With the best intention in the world, your partner could be putting you both at risk- especially if you are taking a low dose birth control pill.
IF you are taking low dose birth control pills and you also take the doses of doxycycline that you got with that extra prescription your partner brought home for you AND you continue to be sexually active, you may become pregnant due to the interaction between the two medications- go see your doctor soon.

If you use the low dose birth control pill Yasmin, this pharmacy has by far the best price for the cheaper, generic version called Janya

You may be satisfied with the effectiveness of your low dose birth control but there is one thing it DOES NOT do for you and that is give you protection against STIs. You knew this though- didn’t you?

OK, so you also know about the STI called Chlamydia and you’re confident you won’t get it because you always use a barrier method ( cap, femidom, condom, diaphragm)  of birth control right?  ALWAYS used protection- not missed even ONCE?  Yep, it only takes ONE sexual act (notice I did not write ‘intercourse’) for one partner to pass an STI on to another, male or female so this is a plea for you to consider popping in for an STI test, especially if you have had multiple sex partners. No, it’s not a big deal to get tested. Watch the video I mention below.

You may know that an untreated STI can lead to PID in women (pelvic inflammatory disorder) that in turn can lead to sterility but -did you know that Chlamydia in men can affect sperm function and male fertility?

It’s much less stressful and difficult than you think to get yourself tested!

Watch this video and you’ll see that getting tested for Chlamydia requires no more than guys peeing in a pot and gals doing a vaginal swab THEMSELVES in the privacy of the bathroom.  That’s right- no nurse fiddling about ‘down there’ and it’s all over in a few minutes, literally ‘in and out’!

All consults are completely confidential, even the results are delivered to you discreetly in case you are worried about your parents finding out.
Treatment is easy too:  4 antibiotic tablets and no sex for 7 days at least. Of course the smart thing to do is to always  use a condom anyway, it’s becoming ‘uncool’ not to.

Be a HERO though, if the result comes back positive.  Let your partner(s) know so they can get tested too.

If you’re a bit cash strapped and could use some free birth control for 3 months AND you live with cooee of BEVERLEY read on….otherwise you can skip today’s post.

With the economy spiraling downward, one nonprofit wants to make sure someone doesn’t accidentally have another mouth to feed.

As an incentive not to skimp on protection, new patients who sign up before Dec. 30 will receive three free months of birth control. Existing patients can get the deal if they recommend a friend.

Health Quarters is a state and federally funded nonprofit that provides gynecological exams, health education and prevention services such as birth control and emergency contraception, cervical and breast cancer screening, STD testing and treatment, and rapid HIV and pregnancy testing and counseling.

Health Quarters is at 19 Broadway, Beverly. For more information, call 978-922-4490.

Read full copy HERE

If you are a teenager and thinking of starting a course of low dose birth control pills, you may be a little anxious about going to a doctor for your prescription  in case you are asked to have a pelvic exam or a pap test.  Relax, don’t let this put you off seeking advice on birth control if you have a sexual partner,  as it is unlikely you will need a pelvic exam in the first instance unless you think you may have an infection or severe menstrual issue. If you are 18 or over, health care providers suggest an exam as a general health check anyway.  If you’re wondering what is involved in a pelvic exam, whether it will hurt or how it is carried out, this patient handout gives a good explanation.

Take along a friend  if you prefer and seek a female doctor if you feel more comfortable- YOU are in charge of your sexual health so feel good about being responsible for yourself.

A Pap test or Pap smear is a screening test that helps clinicians detect cellular changes in the cervix (the opening to the womb at the end of the vagina) and will be recommended once you start having intercourse and /or oral sex .  If you’re like me, you’ll want to know what the test shows, how the results are interpreted, why the results are important, what is ‘abnormal’  etc. and this leaflet  gives a good overview. Pap tests are not only looking for cancer- they are to check the health of your cervix.

The only thing you have to find then is an appropriate way of managing your ‘contraception career’ for the next 30 years- it  will be trial and error to begin with but if you’re looking for a low dose birth control pill that suits your metabolism and does not cause you any side effects there are several to check out within the pages in the side bar to the RHS , maybe start with Alesse or Mircette or if you cannot tolerate estrogen at all perhaps a mini pill (progestin only) will be suitable for you.

Don’t forget the Christmas Condoms- there are some good bargains to be had  HERE  as low dose birth control pills DO NOT protect you against STIs.

Calling anyone who parents or educates young people.

Are you comfortable having a healthy conversation with a teenage girl about flavoured condoms? Would you avoid such a discussion at all costs, after all, it’s a guy thing, right? Do you think someone else should talk to her about ‘these things’ or do you believe the subject of birth control should be taboo until she ‘grows up’?

Like it or not, young people ARE having sex and many of them do not have access to the information THEY NEED that will help them to plan their own futures and the welfare of their future families. Of course, sex education will raise many more discussion topics apart from flavoured condoms but if we are to follow through with  our duty of care towards our young people then  we must be prepared to face topics that may be outside our own ‘comfort’ zone.  The quote from Philip Harvey below is to encourage you to see the ‘ big picture’ and to step forwards rather than backwards with the sexual health education of the young people who may look to you for advice.

In my light hearted post on November 5th I mentioned a non profit organisation called DKL International who supply coffee flavoured condoms to Ethiopia. The philanthropist behind this organisation is Philip Harvey who runs Adam and Eve, the largest on-line store of adult merchandise in the United States. Philip’s company now gives away 25% of its profits to good causes and provides 10% of DKI’s total funding.
Why am I mentioning Philip?

Because he is making a difference- all over the world in the arena of birth control, especially in countries where access to contraception is limited.  We don’t need Philip’s funds to make a difference though, we can do it with our own attitude to educating young people about birth control and protecting themselves from sexually transmitted infections.

This is what Philip has to say about a woman’s right to control her fertility :
“My feeling about birth control is that it has an immediate and enormous humanitarian impact for the people who get access to contraception. It has a dramatic impact on infant mortality, it has a marked impact on maternal mortality and it certainly has an impact on family welfare. The ability to control ones fertility, especially for women, is a form of liberation, that I think in and of itself is very important. And in thirty five years of doing this I have never seen a down side.”
How fortunate are we to live in a country where we have so much contraception assistance ‘on tap’, yet teen pregnancy and STI’s stats are alarming?  How fortunate are we that we have inspired teachers and health care providers working tirelessly to improve sex education programmes yet thousands of teenagers in the Western world are still left ’stranded’  from knowledge, unable to separate myth from fact when it comes to sex?
WE ALL need to do MUCH more to liberate our young people and to provide them with a thorough education in all aspects of sexual health. We owe humanity that.
PS. If you need stocking fillers this Christmas for any sexually active young people you know, there are great condom bargains to be found HERE  …and who knows, you may just find a few fun items for another favourite person in your life too?

PPS. It goes without saying that you talk to young guys about using condoms too. Watch this first video on STIs- Chlamydia is the most common STI among teens.

Today something more lighthearted (and ‘good on you’ Barack Obama, we look forward to your support on the contraception front!)

Most of you know that safer sex involves the use of a male condom, whether or not the female partner uses low dose birth control or not. Condoms act as barrier to sexually transmitted diseases but in many countries are not popular for a variety of reasons.

In trying to encourage the use of the condom, here are a few novel ideas launched by condom companies and non profit organizations that will make you smile. I found these little gems in the CCMC PUSH Journal Source: CNN News, collated by Meghan Holohan.

1. Condom Trees for Australia - Got to start with this one first! On my home patch, here in Oz, I think this is a great idea, I just hope that the literally ‘perishing’ sun factor has been catered for! Western Australia has the highest rate of HIV on the continent. Young people hang out under trees in the countryside and the clever public health nurses, in their efforts to distribute condoms, decided to hang condom filled cannisters in the branches. Grabbing a condom was then made easy and private- each month over 3,000 condoms are taken.

Another initiative saw Aborigine teenagers encouraged to sell condoms and keep 50% of the proceeds. Cases of STDs have been reduced even though the number of sexual partners may not have.

2. National Condom Ringtone for India - Bill and Melinda Gates Foundation have donated money for a ringtone to be composed by Acapella singers singing ‘Condom, condom’ in the vein of the pop song,’Barbara Ann’. More than 60,000 people have downloaded the ring tone since August. Would you be comfortable enough to use it or do you still have issues around condoms? In India, the condom is associated with prostitutes so a stigma is attached to using them.

3. Coffee Condoms for Ethiopia - if you hate the smell of latex maybe coffee flavoured condoms will appeal? DKT International, a United Sates nonprofit, created dark brown condoms that reportedly smell like a macchiato (Ethiopia’s favourite coffee) Since the Ethiopians claim to have invented coffee, the coffee condom bolsters their national identity. Not sure if the other flavoured condoms by DKT International would appeal in Oz though - sweet corn (for China) and Durian (for Indonesia) I’m not a fan of Durian myself so I think I’ll pass.

4. Spray On Condoms - “Having trouble finding a condom to fit sir? Just slide yourself into this cylinder, press the button and The Jolly Joe will fix you up nicely”. The 3 minutes it takes for the latex to dry was definitely NOT a benefit of this German’s solution to the snug and natural look! Poor Jan Vinzenz Krause, he’s still waiting for a latex that dries in 5 secs.

With the party season fast approaching it may be an idea to stock up on your supply of condoms and think about a few ‘novel’ Christmas presents.  I’ll scout around for some ideas and include them in my upcoming posts, in the meantime, below is a link to some bargains on the net for condoms as prices will be going up in 2009 and condoms have a shelf life of 3 years if stored properly. I think you can save up to 70% on this particular site.

Undercover Condoms Sales - Click here to view this month’s sale items including Condoms, Lubricants, and more!!

Female condoms (femidoms) are not quite as effective as male ones but if you are allergic to latex they do offer some protection against STIs- watch this video to the end to see how to use one.