Contraceptives

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

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.

New Low Dose Birth Control Pill For 2009

If you’re the sort of girl who likes to review her ‘contraception career’ regularly, you may like to know that a new low dose birth control pill will be coming onto the market in the first few months of next year with benefits that you may welcome. This new low dose birth control pill will be called LoSeasonique and has just been approved by ‘big brother’- the FDA.

If you already use a low dose birth control pill you may be familiar with those brands that reduce the number of withdrawal periods you have, such as Seasonale, Seasonique and Lybrel. These particular low dose birth control pills are termed ‘extended cycle’ or continuous, birth control pills which are 98%-99% effective in preventing pregnancy if taken as directed. Seasonique and Seasonale have been available for some time now, giving four ‘periods’ a year while Lybrel allows no periods at all.

If you’re like me, you’ll want to know how thorough the trials have been on this low dose birth control pill before rushing off for a prescription. Over a 12 month period, over 2,100 female subjects between the ages of 18 and 41 at 56 sites throughout the United States participated in the trial and completed an equivalent of nearly 21,000 28-day cycles of exposure.

LoSeasonique is a low - dose version of Seasonique and, like Seasonique, reduces the number of ‘periods’ you will get from 13 to 4 per year. Yep, it saves on the cost of pain relief and tampons too.

OK. So what’s in this new low dose birth control pill?

LoSeasonique is a combination (progestin + estrogen) birth control pill.
Each pill contains 0.10 mg levonorgestrel and 0.02 mg of ethinyl estradiol (synthetic estrogen) Seasonique contains 0.15mg levonorgestrel and 0.03mg ethinyl estradiol.
Other low dose pills such as Alesse, Mircette and LoOvral contain the same amount of estrogen as LoSeasonique (0.02mg) but with these you will have 13 periods a year.
How do I take it?
LoSeasonique should be taken daily for 84 consecutive days, followed by the 0.01 mg ethinyl estradiol tablets for seven days.

Benefits of the new low dose birth control pill

• you know when to expect your period
• your periods will be light, shorter and less frequent (4 per year)
• you should get relief from PMS and acne
• your risk of ovarian cysts, ectopic pregnancy, benign breast cysts or lumps and ovarian and endometrial cancer will be reduced

Are there any side effects or disadvantages?
Don’t expect any BUT this new low dose birth control pill is likely to affect some women in similar ways to other low dose birth control pills. I’m afraid it’s individual trial every time girls. However, doctors are unlikely to prescribe this new low dose birth pill for you if you smoke, are over 35 years of age or have health problems such as blood clots, breast, uterine, or liver cancers or serious heart problems.

Warning: Please use your own discretion when using any low dose birth control pill. Seasnoque of these brands of low dose birth control pills mentioned above have been used long enough for anyone to say for certain if there any long term negative side effects.