Radio Interview About Pharmacists & Birth Control

Last week, I had the pleasure of being interviewed for a radio program about the different areas where pharmacists provide clinical services.  The host of Health Update Radio, Dr. Gerry Graf, is a retired pharmacist himself and was very interested in pharmacist roles with family planning and birth control.  The program aired live last Monday, September 5, 2014.  The portion of the show where I am interviewed can be found in the video clip below.

We talk about why family planning is important for women of all ages from menarche (when a young woman begins menstruating) to menopause.  Some of the topics we discussed include all the different methods of birth control, considerations in women with medical conditions, access and privacy in pharmacies, and contraceptive coverage under the Affordable Care Act and Hobby Lobby decision.

You can access the full program featuring Drs. Steven Atallah and David Ha discussing their roles in trauma care and infectious diseases care on the WS Radio website.

Birth Control Options for Men

Birth Control. The term is almost synonymous with women’s health. That’s probably because women have so many birth control options available to them. There’s the pill, the ring, and the IUD…. just to name a few.

But what’s out there for men? Unfortunately, unlike our counterparts, men don’t have nearly as many options. First off, there is no pill men can take. There has actually been research to develop one, though progress has been slow. For now, birth control options for men are limited to vasectomies, condoms, and spermicides. There are a couple of natural methods that are not as effective, but I’ll go ahead and give you the basics on all your options.

Vasectomy. This is by far the most effective method available to men. It’s nearly 100% effective! During a vasectomy, two tubes located in a man’s testicles are cut and sealed to prevent the flow of sperm. A vasectomy is a great option for men who want a permanent form of birth control and who have no plans for having biological children in the future. Vasectomies have been performed for just over 50 years. Here in the United States, about half a million men get vasectomies each year, many in their late 30s or 40s.

This Guy’s Guide to Sterilization answers your questions in under two minutes: 

Male Condom. Condoms have been used for centuries and are still the most popular type of birth control for men out there. Not only are male condoms readily available at your local drugstore, they are also fairly easy to use. Male condoms are considered somewhat effective at preventing pregnancy since 18% of women relying on this method will have an unintended pregnancy in the first year of use. While male condoms are only somewhat effective as contraceptives, those made of latex are very effective at preventing transmission of diseases and infections.

Spermicide. These are chemicals that kill sperm or stop them from moving. They come as creams, foams, jellies, suppositories, tablets, and films at your local drugstore. Spermicides are not very effective on their own as birth control, so they are commonly used with other methods, such as condoms. Relying on spermicides alone, 28% of women will have an unintended pregnancy in the first year. 

Now on the natural methods…

Withdrawal.  Also known as “pulling out.”  This method refers to a man pulling his penis out before ejaculating. The method is only successful if a man has good control of his body and is able to predict when he reaches the point of ejaculation and pulls out in time. But even so, the withdrawal method has a pretty high failure rate (22% of women will have an unintended pregnancy) and it also doesn’t protect against sexual transmitted diseases.

This Guy’s Guide to Withdrawal video tells you more: 

OUTER-course.  There is no single definition to describe outercourse. It could refer to sexual activity without vaginal intercourse or activity that does not involve any type of penetration (anal, oral, or vaginal). Outercourse is very effective as a birth control method and it also protects against sexually transmitted diseases.

And of course, there’s always the option to abstain or not have sex.

Although men don’t have as large a selection of birth control methods, there are effective options to choose from among those that do exist. If you have any additional questions related to birth control, you can contact us (anonymously if you prefer) or refer to your health care provider.


About the Author: Kevin Vu is a third-year pharmacy student at the University of California San Diego Skaggs School of Pharmacy & Pharmaceutical Sciences.

Reference: Trussell J. Contraceptive failure in the United States. Contraception 2011;83:397-404.

Don’t Blame Birth Control for Population Issues

With more women and men empowered to control their fertility with planning and birth control use, some populations are seeing drops in childbearing.  Some countries are concerned about population declines and are promoting childbearing.  The “baby bonus” programs of Australia and Singapore may ring a bell.

Iran, a country with a population of more than 75 million people, is experiencing a decline in its population.  Supreme leader Ayatollah Khamenei has called for more babies to strengthen national identity.  The ministry of health has offered to help couples pay for fertility treatment.  Now, Iran’s parliament has approved a bill that bans permanent birth control methods and advertising of birth control.  This ban outlaws vasectomies for men and similar procedures for women.  People utilizing these methods of birth control may face up to 5 years in jail.  This comes as a stark change to Iran’s existing family planning policies.

Traditionally, Iran society supported early marriage and parenthood.  As a result, fertility rates were high with 7 births per woman.  However, Iran has been experiencing declines in fertility since the 1960s due to progressive family planning programs and more recent improvements in education.  Iran’s birth rate is currently 1.6 children per woman.  At this rate, the population will slowly decrease and the average age will increase.

Book vs Nuts

If this policy is implemented, men would have no highly effective methods of birth control available to them.  Women would have the intrauterine devices and the subdermal implant available to them.  But the ability to undergo a quick sterilization procedure would be outlawed.  There are serious concerns that this policy could lead to more unsafe abortions. More than half of all abortions in Iran are done illegally since legal abortions are highly restricted and largely inaccessible.  With the lifetime abortion rate estimated to be 1 in 4 women in Iran, there are already too many unsafe procedures.

Others question whether forcing women into the domestic sphere roles may backfire.  Research from Harvard’s sociology department found that declining fertility may not be linked to birth control use, but rather to gender role stereotypes placed on women.  Other countries experiencing similar drops in birth rates are working to improve conditions so that couples want to plan to have children.  An example of improving conditions is more maternity and paternity leave.

The policy does not go into effect until a panel of theologians determine whether it complies with Islam.

We live in an interesting time where most populations are struggling to reduce unintended pregnancies but a few are now working to promote more pregnancies.


References:

  1. Culp-Ressler T. “Iran Bans Some Forms of Birth Control to Encourage More Women to Have More Babies.” (11 Aug 2014) Available from: http://thinkprogress.org/health/2014/08/11/3469707/iran-birth-control-policy/
  2. Saadat S, et al. Fertility decline in the Islamic Republic of Iran 1980-2006: a case study. 2010. Available from: http://siteresources.worldbank.org/INTPRH/Resources/376374-1278599377733/Iran62910PRINT.pdf
  3. Erfani A, McQuillan K. Rates of induced abortion in Iran: the roles of contraceptive use and religiosity. Stud Fam Plann 2008;39:111-22.
  4. Motaghi Z, et al. Induced abortion rate in Iran: a meta-analysis. Arch Iran Med 2013;16:594-8.

Remembering Your Birth Control

Many popular birth control methods are very effective if taken perfectly, but that effectiveness goes down drastically with typical use.  Perfect use means that the method is used consistently and correctly.  This is not as easy as it sounds for many people despite their best intentions.  For this reason, medical researchers have studied the effectiveness and failure rates of the various birth control methods.  For example, birth control pills are 99.7% effective with perfect use.  But in fact, 9% of women will become pregnant within the first year of using the pill and only 91% of women using the pill will have the desired effect of not becoming pregnant with typical use.  Even more drastic is the difference between the reported 98% effectiveness of male condoms with perfect use when the reality is that 18% of women using male condoms will become pregnant within the first year and only 82% will not become pregnant with typical use.  Many women and their partners may not be aware of these differences.

This distinction is important for two reasons:

First, you will want to consider this when selecting the right birth control method(s) for you.  To select the right birth control method(s) for you, prospective users (women and their partners) should be aware of the effectiveness of all the available methods.  In addition, you will want to be aware of how long the method works/how frequently you have to use it and potential side effects.  More information to come on this to help you make important decisions.

Second, you will want to use your selected method(s) of birth control consistently and correctly.  Now you may be wondering what it means to consistently and correctly use your birth control method.  Let’s use the most popular methods of birth control as examples again.

For birth control pills, this means taking a pill consistently every day and not missing days between pill packs.  Pills are taken correctly if taken at the same time every day.  Studies have shown that women may be missing up to 5 pills per cycle, on average, and many women have gaps between pill pack refills at the pharmacy.  It’s important to look at your daily routine and find a time when it would be easy to take your pill at the same time every day.  Is it easiest to take your pill… First thing when you wake up? As your morning coffee is brewing?  When you’re feeding the dog?  When you brush your teeth in the evening? Right before bed?  If you don’t have a daily routine or can’t find a time to consistently take your pill at the same time, the pill may not be a good birth control choice for you and there are other options that don’t require daily action on your part.  Once you find a time that works, you can set up convenient reminders.  Bedsider offers a free service to send you convenient text message reminders for your pill, patch, ring, or injectable birth control method.  Set up your reminder now.  Not only are these messages helpful reminders, they are also very entertaining:

Bedsider Text Message Reminders

Bedsider Text Message Reminders

For condoms, you need to be sure to use a condom consistently with each act of sex and correctly following these instructions from Planned Parenthood:

Hopefully this information will help you use your birth control to maximize its effectiveness!  As always, I welcome your comments, questions, and suggestions for future posts.


References:

  1. Trussell J. Contraceptive failure in the United States. Contraception 2011;83:397-404.
  2. Hou MY et al. Using daily text-message reminders to improve adherence with oral contraceptives: a randomized controlled trial. Obstet Gynecol 2010;116:633-40.
  3. Castaño PM et al. Effect of daily text messages on oral contraceptive continuation: a randomized controlled trial. Obstet Gynecol 2012;119:14-20.
  4. Pittman ME et al. Understanding prescription adherence: Pharmacy claims data from the Contraceptive CHOICE Project. Contraception 2011;83:340-5.