Birth Control Services

What is birth control? 

Birth control, otherwise known as contraception, is any method, medicine, or device used to prevent pregnancy. Medicine is a common way to prevent pregnancy and can be provided with a prescription order from a doctor or pharmacist.

How can I get birth control today?

  1. Schedule a visit: schedule your online visit and we will work with you to provide a personalized birth control plan. Your options include pills, injections, patches, or rings. 
  2. Health information: while we may not need a complete history on your health, we may need some information in order to make sure we provide the best care possible. Before your visit, you may be asked to fill out a form regarding your information, and you may be asked more about your medical history during your visit. 
  3. Your options: once we speak with you, we look at what your insurance may cover as well as what options you prefer. 
  4. Medication dispensing: In the same visit, you will be provided with a prescription for birth control that may be filled at one of our partners pharmacies or then pharmacy of your choice. You can pick up your birth control right away or have it mailed or delivered to you.

Will my insurance cover my visit?

The short answer is maybe.

If you have Medi-Cal insurance, your insurance will cover your visit and birth control medication as well. Medi-Cal will also be able to cover the cost of condoms.

If you have another type of insurance, your insurance will cover the cost of birth control medications but will not cover the cost of the visit. Our visit fees ($15-45) are lower than most other healthcare providers. You can use your health savings account or flex savings account to pay for the visit fee.

And you only need one visit per year. Any follow up communications (via email, text, or phone) or additional visits are included with no extra fee.

Photo by Karolina Grabowska on Pexels.com

5 Tips To Remember Your Birth Control

Remembering to do something as important as taking your birth control everyday and on time can be quite difficult — Especially with our hectic schedules! Here are some tips and tricks to help remind you:

1. Put it next to something you use every day.

Do you brush your teeth at about the same time everyday? Do you wear contacts? Do you take other medicines? Try pairing one of these daily routines with taking your birth control.img_4904

2. Use your phone.

In this day and age, our generation is attached to their phones. Why not have a special alert or alarm to remind you to take your birth control? Maybe even choose the crying baby ringtone?

  • Alerts. Advice from prior experience: Have two alerts. Due to busy schedules, sometimes it slips your mind even if you saw your alarm go off. Better safe than sorry!
  • Apps. Some of us love our apps! Everheard of WomanLog or MyPill? Or even Google calendar? There are lots of apps you can try.
  • Messages. Sign up for free text message reminders to take your pill from Bedsider. These messages will put a smile on your face and help you remember to take your pill.phone-alert

3. Not interested in technology?

  • Use sticky notes! Add one to your bathroom mirror or maybe even on your coffeemaker? Add it anywhere you know you’re bound to see it everyday.
  • If you have a to-do list that you love checking off, add another bullet point for your birth control. It’s a task you must complete each day!

4. This one is for all the fur-mommies out there!

Cats and dogs are persistent when it’s time to feed them. They’re always right on the dot. So, what did I do? I placed my birth control right next to the cat food. Whenever they alert me to feed them, it’s an instant reminder to take my pill as well. It’s perfect because they don’t stop meowing until fed! This can work with other furbabies too.

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5. Put it in your wallet.

Work and school are busy, but you always have a lunch break. Need to pay for lunch? What do you do? You open up your wallet! It’ll be the first thing you see. I’ve even seen women use their pill pouches as wallets and store some cash or credit cards. Want something a little more unique? Try one of these hand-painted pill wallets.

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Anything to Add?  We know many of you have your own ways of remembering to take your pill on time everyday, so please share in the comments! Reading about what works for you might help another reader!


Bianca

About the Author:

Bianca S. Faridian is a third-year pharmacy student at the University of California San Diego Skaggs School of Pharmacy and Pharmaceutical Sciences.

Hormonal Birth Control Now Available Directly At Pharmacies in California

Like our neighboring state to the north, pharmacists in California can now prescribe and dispense birth control directly to women.  Now this warrants a happy dance!  Women now have another choice in how they get their birth control.  They can either go see their primary care provider, Ob/Gyn, family planning clinic, or go straight to the pharmacy.  At the pharmacy, women will have their choice of birth control pills, patch, ring, or injection.  All thanks to a state law passed back in 2013.  So why the delay?  It took 2 and 1/2 years to develop and approve the protocol because of the multiple rounds of revisions.

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Is this safe?  What about the pap smear?  A pelvic examination and a pap smear are not necessary to initiate hormonal birth control.  They are important for other health reasons.  Women will need to complete a health history questionnaire and have their blood pressure taken at the pharmacy.  This helps the pharmacist figure out which methods of birth control are safe.  If the pharmacist finds something concerning in your health history or if you want a long-acting birth control device like the implant or IUDs, then you’ll be referred to a provider who can help with that.  Ultimately, the goal is to improve access to medications where there is a public health benefit.  After the visit, the pharmacist will send a note to your primary care physician to fill them in — unless you don’t want the pharmacist to do that of course.

Interested in getting your birth control directly from your pharmacist?  Give them a call first to find out if they are providing this service.  Just because pharmacists CAN provide this service doesn’t mean they WILL.  California pharmacists want to participate but they are worried about time constraints at the pharmacy that prevent them from taking the time to do this.  Over time, more and more pharmacists will provide this service.  When you call the pharmacy, ask when would be a good time to come in for this service.  Pharmacies have “rush hours” and the pharmacist will be able to give you more time if you  come in when it’s slower.  Some pharmacies may even make appointments for this service.  In California, women of any age can access this service from a participating pharmacist.  No age minimums and no ID checks.  This service is completely confidential and no information can be shared with your parents or anyone else!

What’s this going to cost me?  If you go to the pharmacist for your birth control visit and fill your prescription, the prescription costs will be covered by your insurance the same as if it was written by a different provider.  Unfortunately, insurance companies aren’t paying pharmacists for the visit like they pay physicians and the long list of others who can provide birth control, including nurse practitioners, physician assistants, nurse midwives, and even nurses.  So you may have to pay out of pocket for the visit and submit the receipt to your insurance company and hope they reimburse you (if you try this, please let us know if this works or not!).

Is this a good idea?  This is an enormous step forward in increasing access to birth control.  Hopefully women will appreciate having more choices in where to get birth control.  Next steps?  Ideally more states will pass similar laws expanding access with pharmacist prescribing — Tennessee is already moving forward with legislation and many other states are considering it.  There is also growing support for over-the-counter birth control pills.  

Want to consult with Dr. Sally Rafie, PharmD, BCPS about your birth control and get a prescription?  Fill out the contact form and let her know how to reach you.

Ask Dr. Sally: What Can I Do For Endometriosis Symptoms Since My Birth Control Refills Ran Out?

I was diagnosed with endometriosis 6 years ago and my symptoms improved by taking Beyaz birth control.  My doctor unexpectedly closed her office last month and I have been unable to refill my prescription.  I’ve been off the birth control pills for 3 weeks and I’m experiencing difficult side effects including dizziness, headaches, cramping, and fatigue.  I am not happy with how extremely my body is reacting to the hormonal change.  I would like to try different ways to treat the symptoms of my endometriosis.  I would LOVE to hear more about my options to manage my current symptoms and long-term pain management.

Endometriosis Birth Control Sally Rafie(photo credit: Growley-Ferret via Flickr)

Up to 10% of reproductive-age women have endometriosis, a condition where the endometrial tissue typically found in the uterus exists outside the uterus.  Endometriosis can have a range of symptoms and you’re clearly experiencing some intolerable ones.  Women may experience pain in many forms…just before and during their periods, with bowel movements, with urination, with sex, or general pelvic or back pain.  As many as 1 in 5 women who have endometriosis will experience infertility.  Since you are not trying to conceive at this time, the treatment will be focused on reducing your pain and other related symptoms.

Using A Pain Reliever

To alleviate some of the pain, over-the-counter anti-inflammatory medicines, such as ibuprofen (Motrin, Advil) or naproxen (Aleve) can be taken.  This helps reduce the inflammation that may be contributing to the pain.  These medicines should be used and not acetaminophen (Tylenol) because that works in a different and in this case, less effective, way.  Talk to your health care provider about appropriate dosing since you may need more than what is typically recommended for these over-the-counter medicines.

Manipulating Hormones

To really get at the root of the problem and regulate the hormones, we have to manipulate the hormones by taking hormones.

Birth Control Pill

The first step is to try a hormonal birth control such as a birth control pill with a combination of estrogen and progestin hormones.  When taking a combination birth control pill, eventually the endometrial tissue stops building up.  Talk to your health care provider about which formulation would be best for you.  Typically, a formulation that is progestin dominant and contains a more androgenic progestin will be most effective.  The pills should be taken continuously, and the inactive placebo pills skipped, to get the maximum benefit of reducing pain.

Beyaz is similar to Yaz, a popular birth control pill, with added folic acid (to prevent neural tube defects in case of pregnancy).  While this formulation is progestin-dominant, it is not an androgenic-progestin.  An alternative to try would be to try Loestrin 1/20 or Microgestin 1/20.

Birth Control Shot

Another form of birth control that can help relieve symptoms of endometriosis is the injectable shot, known as DepoProvera (depot medroxyprogesterone acetate).  This shot is given only once every 3 months.

Birth Control IUD

The Mirena intrauterine device releases a progestin hormone to alleviate the painful symptoms of endometriosis similarly to the birth control shot.  The hormone is released locally in the uterus and therefore has fewer side effects such as weight gain and bone loss.  This is also a highly effective form of birth control that, once inserted, works to prevent pregnancy for five years.

Oral Progestin Hormones

If you are not interested in preventing pregnancy while treating endometriosis or this treatment doesn’t give you enough relief, there are other options.  Pills with higher doses of progestin hormone can be used and work similarly to prevent buildup of endometrial tissue.  Side effects may include weight gain and breakthrough bleeding.

Gonadotropin-Releasing Hormone Agonists

These medicines last much longer than the other hormones.  This is a good option for women who did not respond to birth control pills.  These medicines, known as nafarelin nasal spray (Synarel), leuprolide shot (Lupron Depot), and goserelin shot (Zoladex), work by reducing estrogen levels in the body, creating a state similar to menopause.  This medicine has some uncomfortable side effects (see previous post).  Combination estrogen and progestin hormones or progestin alone can be added on to manage these side effects.

Danazol

This is a derivative of the hormone testosterone and was the first treatment actually approved for endometriosis.  It works by counteracting estrogen and comes along with the effects of testosterone, such as unwanted hair growth, mood changes, acne, and deepening of the voice.

Surgery

Surgery is the closest thing to a permanent fix to this problem.  Although one surgery may not be enough and we always have to weigh the risks of surgery with the benefits.

Problematic tissue can be treated by laparoscopically visualizing the lesion and either removing it or ablating it with a laser.  For more severe endometriosis, there are other procedures to interrupt nerve fibers.

Women who are not planning to become pregnant can consider a hysterectomy to remove their uterus, potentially along with the ovaries.  This basically puts a woman in menopause, so there are other symptoms to manage there.

Natural Options

There are some natural options that may help cope with a minimal or mild form of this condition.  See the list in a recent post on this subject.

I hope this information is helpful and guides the discussion with your healthcare provider.

Got a question? Send it to us.

— Dr. Sally Rafie

This is for informational purposes only and is not a substitute for medical advice, diagnosis or treatment, and is not meant to replace a one-on-one relationship with a healthcare provider.

Musings on Birth Control Names and Packaging

Leena, Cryselle, and Loryna… Ever notice how the names for your birth control pills are very different from all your other medications? Even the packaging is distinct and unlike any others. There’s no argument that it’s a lot easier to request a refill of your Yaz or Gianvi than to ask for drospirenone and ethinyl estradiol (the true generic medication names).

What do you think about the names…easy to remember or just silly? How about the packaging…does it help you keep track of pills?

Birth Control Packaging Gianvi Yaz

 

Prosperous Not for Profit

A little while ago I was talking with a friend and realized that among Yasmin, Ella, Lola, Chaya, Jadelle, Yaz, I wasn’t sure if I was speaking about my other female friends or various types of birth control.

For the sake of this not turning into a bad observational humor piece, I realize that a majority of birth control products do have very non-human names and potentially are very hard to differentiate (Ortho-cyclen vs. Tri-cyclen for example).

But how many condoms or even erectile dysfunction drugs are have male-sounding names? Would you ever see a condom called Fred? Chad? or even the perfect condom brand, Dick?

I’m very curious about the reasoning behind these advertising and packaging choices. I’m lucky (or unlucky) enough to not yet have a birth control or women’s health medicine named after me, even though I have a very common white name.

Is there a reason…

View original post 41 more words

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.