Contraceptives

This will be my last post before I have a break over Christmas and New year so I thought I would make it a quick ‘reference’ one that could be used in an ‘emergency’ during the holiday.

You could find  yourself in this situation

Great Christmas Eve party and Laura’s bash last night was the best ever BUT….in the cold light of day you suddenly realise that you’ve missed taking 2 low dose birth control pills in a row and you had champagne ‘Christmas’ sex both nights WITHOUT a condom. Sperm can survive up to 5 days inside you so if you have no Plan B to take, what action can you take NOW to reduce your chance of getting pregnant?

Tony Thornton, CEO of Planned Parenthood says about four low dose 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.

Using your low dose birth control pill for emergency contraception is the next best thing if you are really in a desperate situation so below is a dosage guide for some of the popular brands.  If your brand is not listed, check the leaflet in the pack for instructions for ‘emergency use’.   PHONE a 24 hour clinic for advice as well!

Use a barrier method for 7 days as backup protection too (ie. a male or female condom plus spermicide)   Sex without condoms is UNCOOL -  know that you are exposing yourself and your future partners to sexually transmitted diseases.  The percentage of teenagers with Chlamydia is staggeringly high so get tested, stay clean and brag about it!

If Plan B is not available to you the Food and Drug Administration has declared the following brands of low dose birth control pills to be safe and effective for emergency contraception if used in the higher doses as recommended. See RHS of this post for further information on pills mentioned:

Ovral (1 dose is 2 white pills)

Alesse (1 dose is 5 pink pills)

Levlen or Nordette (1 dose is 2 light-orange pills)

Lo/Ovral (1 dose is 4 white pills)

Tri-Levlen or Triphasil (1 dose is 4 yellow pills)

A copper IUD  will also be effective if inserted within 5 days following intercourse but this method of long term birth control should not be rushed into for emergency measures without thorough discussion with a health professional.

Check with a health professional at once if you need emergency contraception and you are breastfeeding - even though there are no actual studies to prove that hormonal contraceptives damage a baby, please be cautious with ALL medications you take. Whatever you swallow is absorbed by your body and eventually passes through your milk and reaches your baby- do you really want your baby to have to cope with huge doses of hormones, alcohol or drugs? Your baby has no ’say’ in the matter so even though you find yourself stressed in this emergency situation, put the baby first and please don’t  panic if you have to include bottle feeds for a while.

Wishing you a very safe and loving Christmas and a New Year that brings you happiness and fulfillment in all you do,

See you in January then,

Kindest regards Carole

This post is more about your cervix, girls, than your low dose birth control regime. The photos I’m linking to in this post may be a bit ‘icky’ for some of you but please don’t let it put you off looking at them- they are fantastic and the woman who shares them with us is to be commended for giving us this ‘gift’ of herself.

Do you live period to period when it comes to managing your birth control or do you have a PLAN for the whole 30-35 years of your ‘contraception career’? If you’ve planned your method of birth control and are protecting yourself against STIs for even the next 3 years, well done - but that low dose birth control pill you may be using is only one of the partners on the team. The other important partner in your long term contraception career, apart from your sexual partner(s) that is, is YOUR BODY. The better you know it, the better partner it will be to you during your ‘contraception career’.

Like many young girls , you were  probably offered the low dose birth control pill when you embarked on your ‘contraception career’ and it’s possible that apart from the condom,  all the other birth control methods available (there are14) were not mentioned. Being able to mix n’ match birth control methods is a real advantage as your life changes over the next 30 odd years.  If you know what a cervix looks and feels like (some say it feels like the tip of your nose) you’ll understand better how these different methods work and you may feel less squeamish and more confident about using them.

Knowing what your cervix looks like will add to your knowledge of your body and management of your birth control methods:

• entrance or neck of your uterus/womb- it is through this little opening that the lining of your uterus is shed each month if you do not get pregnant
• ‘fits over the cervix’ - you’ll hear this when discussing how to use a diaphragm, cap, femidom
• cervical mucus- this is where it comes from, what it looks like and how its consistency changes during your menstrual cycle and as a result of using hormonal birth control methods
• cancer ‘of the cervix’ - is cancer of this part of your body
• a cervical smear test or Pap test - sample cells are taken from here to check for abnormalities
• ‘inserted THROUGH the the neck of the cervix’ - it is through this little opening that an IUD is inserted
• “her cervix is fully dilated” - a phrase you’ll hear during labour when a baby is ready to enter the birth canal, the opening is measured in cms and monitored throughout labour (10cms usually means ‘fully dilated’)

Before you click away ‘cos you think the next bit is going to be boring Biology, do you know how your cervix changes on each day of your menstrual cycle and how these changes relate to other monthly changes in your body, PMS included? By the time you’ve finished looking at these photos and reading the captions, I’ll lay a femidom to a condom that you’ll be passing this link onto several of your friends and going “Wow”.

When I took my 13 yr. old daughter with me to watch me have my annual Pap test and to find out what a cervix looked like, eyebrows were raised (this was over 15 years ago) Thank goodness I had a ‘with it’ doctor back then but even these days I do not hear of mum’s being encouraged to give this simple gift to their daughters. That little visit took away any mystery/fear around the test for my daughter when she came to have her own Pap test a few years later and it set the scene for us to talk about sex ’stuff’ when she started having boyfriends.

You’re probably saying, “Forget it- there’s no way I’d go with my mum to watch that!”  Obviously the ‘comfort’ factor for both you and your mum is a big issue here so let’s assume this communal visit ISN’T going to happen - the next best thing you can do to acquaint yourself with this important part of your body is to take a look at these fantastic photos of the changes that occur in your cervix during each day of your menstrual cycle.

The photos of cervical mucus are really helpful too, for those of you well past teenagehood, with regular menstrual cycles and an interest in practising natural birth control.

Yesterday you couldn’t tell your best friend what a cervix looks like could you - today you can - fantastic!

Yesterday I told you about the newest version of the female condom, the FC2, under review by the FDA advisory panel for marketing in the US.  The good news is confirmed that this potentially less costly method of birth control received unanimous backing-  the FC2 is still highly effective in preventing pregnancy AND STIs.

The lower price (30%?) should also make this new female condom more attractive to women which means that we females can have peace of mind and even more choice regarding how we manage our ‘contraception career’.
“I find it empowering to be able to take charge and put on the female condom myself,” says Linda Arnade, a health worker in Chicago who has used FC for three years. “I like being able to put it in several hours before sex, and the fact that the material feels stronger than latex. I once had a male condom break, but that’s never happened to me with the female condom.” Manufacturer studies show 50 to 70 percent of users find the device acceptable once they have experience using it.

The cost of producing this newer version can be reduced because the new material (synthetic rubber)  allows a method to be used that is similar to the one for producing male condoms. Cost estimates range from $1.40 to $2.10 for consumers and about half that for health care organizations that distribute it.

Safe if you have an allergy to latex- the synthetic rubber is ‘user friendly’.

Most other countries have already adopted FC2 - this recent FDA approval also enables the new female condom to be sold in more countries overseas, as the U.S. Agency for International Development needs FDA approval before it can buy the cheaper version
“Female condoms are the only woman-controlled method of safer sex, and we also know what the birth control pill did for women: it allowed them an unprecedented control over their reproductive status,” said American Social Health Association Vice President Deborah Arrindell.
Mary Ann Leeper, an adviser and former president of Female Health Co said ” Even with approval, it will take time for the company to relaunch it for U.S. consumers. The company is looking for a marketing partner to help distribute it more widely.“  Health advocates say that if the government moves quickly in recommending FC2 approval, the new condom could be on U.S. pharmacy shelves--and in the hands of aid organizations that distribute it worldwide–some time in 2009.  Let’s hope they DO pass on the production savings.

Sources: Women’s eNews-Author: Molly M. Ginty

OK, so you feel a bit squeamish about even trying a female condom, called a femidom but your low dose birth control pill is not ‘cool’ when it comes to protecting you from an STI.   Expect your partner to wear a condom?  Excellent-  but it could be fun finding out if you both enjoy a ‘change’ and he is sure to be impressed that you’ve even considered something a bit different.  All part of the sexual learning curve AND combined with your low dose birth control pill, it puts YOU in the total birth control seat.
If you are happy with your low dose birth control regime, having backup, barrier protection of some kind as well is the smart thing to do.  A downside to Femidoms is that they cost more (between $2.80 and $4) than  male condoms, which come in a variety of brands and cost between 50 cents and $2 a piece. If approval is given to market the new version , the FC2 should be potentially less expensive and more durable than the current female condoms on the shelves.
Current female condoms are made of polyurethane whereas this new kind, the FC2 Female Condom, made by Female Health Co, is made of NITRILE - a form of synthetic rubber similar to male condoms. FC2 is being reviewed by an FDA advisory panel this week for its cpacity to prevent pregnancy aswell as HIV and STIs.
The new female condom is exactly the same design and is used in the same way as the current female condom which is made of polyurethane. Both versions are comprised of a sheath with a closed ring on one end that is inserted near the cervix and an open ring on the outer end that stays outside the woman’s body. Male condoms are far more widely used than their female counterpart, although you could argue that the female condom has the advantage of providing greater protection by covering part of a woman’s outer genitals. Go HERE for dias. on how to fit a female condom.
I hesitate to mention another ‘off putting’ aspect of using a femidom that rumour has it some gals complain about and that’s the rustling sound during sex, bit like putting it in a plastic bag, eh?  Well, don’t knock it till you’ve tried it at least once, if only for a giggle- sex is fun remember?   Barbara Hastings -Asatourian of Contraception Eduction Ltd. in the UK  has been working in the sexual health arena for decades and demonstrates the femidom often- here’s what she told me in an email the other day about the noise issue: “My experience of the legendary “rustle” is that it doesn’t! Female condoms have so much lube on them there’s no noise at all. The dry ones I use in demonstrations make a very little noise, and that might be where this off putting piece of folk lore came from. If there is the slightest noise to hear from a female condom one would have to have ears very close one’s vagina, and be paying a dysproportionate level of attention to it! The other noises around sex tend to be louder and more interesting, and a lot more real! Remember there may be extra pleasure to be had from positioning the female condom’s outer ring on or near the clitoris. Now that has to be worth trying….”
Many other countries, especially Africa,  have already adopted the new female condom to prevent the spread of the HIV virus but the FDA needs to sanction the product before it can be sold in the US. Watch this space folks!  Best prices for female condoms can be found at this site - just type  “female condom” into the search box. I’ll let you know when I find a site that sells the new version too.
Tomorrow I’ll let you know the decision of the FDA advisory Panel.

This is a quick, lighthearted post about condom fashion- I’m pushing the ‘condom consciousness’ at this time of year for obvious ‘party’ reasons.  Take a look at these wonderful creations from the 4th China Reproductive Health New Technologies & Products Expo in Beijing last year.

CONDOMS RULE, OK?  Don’t leave home without them.

Do you have a friend who sends you a text message so that you won’t forget to shop for your low dose birth control pill?  “As if!”  you laugh, well in the UK  the government plans to do just that.  It is estimated that this will cut 73,000 pregnancies each year and save the National health Service (NHS) £100 million. NHS bosses reckon every £1 spent on contraception saves £11 on unwanted pregnancies.

If you live in Britain and you go to your GP for a prescription for your low dose birth control pill, you will be asked if you want to join the system that sends you a text message when your course of pills is about to run out and books you in for the next appointment.  You will also be able to phone in for advice on which birth control is best for you.  And women who leave clinics with only temporary protection - or none at all - will be sent texts urging them to return for follow-up checks.

This is great if you live month to month and don’t have 3 months of low dose birth control pills in stock but it doesn’t help with the chore of having to remember to take that pill at the same time DAILY.

You’ll be a rare bird if you haven’t forgotten to take your low dose birth control pill at least once during the month.  Hopefully you have a routine for pill taking that serves you well most of the time, (if you have a foolproof tip, let me know and I’ll share) however, with Christmas parties already in swing you’re in danger of crashing in the wee hours, sleeping in late and completely forgetting that little round pill-your faithful ‘child protector.’

To avoid that “Damn it!” moment and a dash for the emergency pack, see if one of these tips will work for you:

First of all, please read the package leaflet at least once when you open your pack of Ortho Tri Cyclen or other brand of contraceptive pill. If you have, you will know how important it is to take the pill at the same time each day. There is a reason for this- it helps to keep a steady and measured dose of hormones supplied  to your body throughout 24 hours AND throughout your whole cycle and it also helps to minimise any side effects you may experience, such as spotting and breakthrough bleeding.

1. ‘Out of sight out of mind’ is an old saying that doesn’t just apply to people!   It is true when it comes to taking medication- if the pills are not right there in front of you why would you think about them?  Putting your pack of contraceptive pills out of sight will not help you to establish a good ‘pill taking’ habit so make sure your contraceptive pill pack is next to your toothbrush or by that glass of water on the bedside table or in the drawer alongside your jar of night cream.
2. OK, so your job has ridiculous shifts or you travel a lot and routines keep changing- you must find a new routine to ‘attach’ your pill taking act to!  Carry your contraceptive pill pack in your handbag and take it with lunch/ morning/afternoon coffee BUT do follow the same routine daily so that you are still supplying your body with its steady, measured dose of hormones throughout that 24 period. If you have a long drive home, get into the habit of taking a pill with a juice in the car so that you don’t get caught up in the ‘dinner’ stuff when you get home and fall exhausted into bed and forget.

3. If you’re off on a Christmas holiday , keep your contraceptive pills within reach- preferably in your hand luggage, not in your suitcase in case it gets lost. Don’t leave them in the hotel bathroom either, keep them in your purse so you can enjoy the events of your trip without worrying about being hours late in taking your pill.

4. Get some help if you just can’t seem to manage the pill taking routine yourself- explain the problem and your daily schedule to your doctor or health care provider and they may be able to suggest something that hadn’t occurred to you.

5. Remember to keep a spare pack of low dose birth control pills (and emergency contraception) on hand so you don’t run out and miss the first few days of your next pill cycle. Use your mobile phone, pc at work or a calendar to ‘alarm’ you one week in advance of your start date for a new pack.
Just a thought: You may wish to consider swapping over to long-lasting injections, an IUD or an implant (suitable for women aged between 18 and 45) if you habitually forget to take your low dose birth control pill.  I’d suggest waiting till after the festive season to do this to avoid any unwanted possible side effects with the new birth control method.

You could try leaving this video on constant play for subliminal brainwashing in your bedroom  if all else fails!  It would drive me mad but hey, whatever works for you.

And for extra ‘peace of mind and goodwill toward men ‘ this Christmas - never leave the house without your condoms - take these festive ‘condoms on a stick’ to a party  and you’ll be the centre of attention!

Low Dose Birth Control is helping lots of women control their acne but in really severe cases of this condition, Accutane may be prescribed, which can cause birth defects if you become pregnant while on it- this means that you are taking a huge risk if you rely SOLELY  on your low dose birth control method to stop you from getting pregnant.

The excerpt below is from a recent article I found on treating acne and if you take Accutane for this condition, as well as some form of low dose birth control to prevent pregnancy, please read the warnings.  Hopefully your doctor will already have warned you that it is VITAL that you do get pregnant while taking Accutane.  It is your responsibility to make sure that you ‘double up’ by using an additional method of contraception along with your low dose birth control.

If you have questions after reading this excerpt, you know what to do- go back and discuss your birth control regime with your doctor.

TIP: Always have a pregnancy test kit on hand while you are taking Accutane.

Excerpt:

“What are the important warnings for females taking Accutane?

You must not become pregnant while taking Accutane, or for 1 month after you stop taking Accutane. Accutane can cause severe birth defects in babies of women who take it while they are pregnant, even if they take Accutane for only a short time. There is an extremely high risk that your baby will be deformed or will die if you are pregnant while taking Accutane. Taking Accutane also increases the chance of miscarriage and premature births.

Female patients will not get their first prescription for Accutane unless there is proof they have had 2 negative pregnancy tests. The first test must be done when your prescriber decides to prescribe Accutane. The second pregnancy test must be done during the first 5 days of the menstrual period right before starting Accutane therapy, or as instructed by your prescriber. Each month of treatment, you must have a negative result from a urine or serum pregnancy test. Female patients cannot get another prescription for Accutane unless there is proof that they have had a negative pregnancy test.

A yellow self-adhesive Accutane Qualification Sticker on your prescription indicates to the pharmacist that you are qualified by your prescriber to get Accutane.

While you are taking Accutane, you must use effective birth control. You must use 2 separate effective forms of birth control at the same time for at least 1 month before starting Accutane, while you take it, and for 1 month after you stop taking it. You can either discuss effective birth control methods with your prescriber or go for a free visit to discuss birth control with another physician or family planning expert. Your prescriber can arrange this free visit, which will be paid for by the manufacturer.

You must use 2 separate forms of effective birth control because any method, including birth control pills and sterilization, can fail. There are only 2 reasons you would not need to use 2 separate methods of effective birth control:

1. You have had your womb removed by surgery (a hysterectomy).
2. You are absolutely certain you will not have genital-to-genital sexual contact with a male before, during, and for 1 month after Accutane treatment.

If you have sex at any time without using 2 forms of effective birth control, get pregnant, or miss your period, stop using Accutane and call your prescriber right away.

I recommend that all patients should read the rest of this Medication Guide. Here’s the link to the FULL article