Thanks, Birth Control

#ThxBirthControl Sally Rafie Choose Control croppedThe availability of birth control has played a direct and powerful role in countless aspects of all of our lives.  For all of these reasons and more, today is the day that we hope you will join The National Campaign to Prevent Teen and Unplanned Pregnancy, Bedsider, and me in saying, “Thanks, Birth Control.”

  1. Thanks for fewer unplanned pregnancies (women using birth control carefully and consistently account for only 5% of all unplanned pregnancies).
  2. Thanks for giving us the freedom to plan a family on our own terms.
  3. Thanks for more economic opportunities for young women and men.
  4. Thanks for greater educational attainment.
  5. Thanks for improved maternal health.
  6. Thanks for being so amazingly awesome that it is used by 99% of women who have had sex.
  7. Thanks for helping build stronger families.
  8. Thanks for being one of the nation’s top 10 greatest public health achievements of the last 100 years, according to the CDC.
  9. Thanks for reduced public spending.
  10. Thanks for fewer abortions.
  11. Thanks for reminding us of something that has great bi-partisan support.
  12. Thanks for building stronger relationships.
  13. Thanks for fewer health disparities.
  14. Thanks for less child poverty.
  15. Thanks for helping countless individuals better plan for their future and realize their dreams.
  16. Thanks for fewer low birth weight babies.
  17. Thanks for being so darn cost effective (public funding for contraception saves nearly $6 in medical costs for every $1 spend on contraceptive services).
  18. Thanks for saving countless panties and other clothing items from being stained by unregulated periods.
  19. Thanks for helping women manage heavy and/or painful periods (and the resulting lost days from work, costs for feminine products, and treatment costs).
  20. Thanks for treating acne.
  21. Thanks for preventing cancer.
  22. Thanks for coming in lots of different forms to choose from.
  23. Thanks for helping women skip pesky periods.
  24. Thanks for treating prementrual syndrome and premenstrual disphoric disorder.
  25. Thanks for letting women and men choose control of whether/when they want to have children.

Why are YOU thankful for birth control?  Tweet (#ThxBirthControl), post something on Facebook, share one of Bedsider’s clever digital postcards, or add a comment here.  Need some ideas?  The National Campaign has plenty.

Thank you and thanks birth control.

The Underground Birth of Birth Control

Practices to prevent pregnancy are ancient history.  But it was exactly a century ago when the term birth control was born in New York City.

Margaret SangerIn 1914, a woman by the name of Margaret Sanger began a feminist publication.  In the very first issue, Sanger made it known that an aim of the paper would be “to advocate the prevention of conception and impart such knowledge on the columns of this paper.”  This was a brave move since, at the time, it was in violation of the Comstock Act (banning the circulation of obscene material, including information regarding contraception) that could have landed her in jail.

Sanger was looking for a distinctive name to describe this concept of voluntary parenthood that also conveyed both the social and personal significance of it.  Sanger and her supporters had a brainstorming session.  After reviewing terms that existed in the medical literature and toying with new ones, the group had a short list:

  • Conception control
  • Pregnancy prevention
  • Regulation of reproduction
  • Prevenception
  • Contraception
  • Family control
  • Family limitation
  • Birth-rate control

Then, Sanger and Robert Parker thought of the term birth control and it was finalized.  Archivist Peter Engelman has studied Sanger’s work extensively:

The group unanimously accepted those simple and assertive words — maybe the most controversial phrase in the English language since Darwin introduced natural selection in 1859.  …

The coining of the term birth control and its emergence in print set into motion a series of free speech battles that launched the American birth control movement. …

Is there any other social movement that has so fundamentally altered women’s roles or affected, in one way or another, all of our lives?

The organization that Sanger created dropped the term birth control for planned parenthood in 1942 since it was more family-friendly. But birth control remains in wide use to this day. If we dissect the term birth control, it is not the most accurate description of the practices to prevent pregnancy. The goal of our current contraceptive methods is to prevent pregnancy, rather than prevent birth as the term birth control suggests.

What do YOU think of the term?  What term do YOU use or suggest using?


Reference: Engelman P. A History of the Birth Control Movement in America. Santa Barbara: Praeger, 2011. (Photo credit: roberthuffstutter via Flick)

History’s Worst Contraceptives

Think taking a pill every day is a pain?  Dread putting on a condom during sexy time?  Don’t want to make your way to the doctor’s office or clinic to have an IUD placed?  Well compared to what our predecessors have used for birth control throughout history…let’s just say you’d rather not go back in time.

Check out this amusing “History’s Worst Contraceptives” video recapping some of history’s strangest attempts to prevent pregnancy:

This video was created by EngenderHealth as part of their new WTFP?! (Where’s the Family Planning?!) campaign to raise awareness about the 220 million women in developing countries who want family planning services and products but lack access.

Other methods you wouldn’t think twice about using now but your ancestors employed for lack of better options?  Vaginal plugs made of seaweed, grass, or balls of paper.  Sponges soaked in acid.  Condoms made of fine fabric.  Drinking potions.  Injections of human or animal sperm under the skin (the thought was this would create an immune response against sperm in the uterus).

Imagine the desperation.  And the disappointment when these methods failed.

Thanks to modern medicine, you don’t have to endure these bizarre strategies!  Besides thinking Wow or Ew, what are your reactions or thoughts? Heard of any other tricks to prevent pregnancy?

Can You Rely on Your Birth Control for Years?

This is not a yes or no answer, as you may have suspected.  It’s really about HOW MUCH you can rely on your birth control method.  We’ve been discussing how effective different methods are over one year of use, but you may be wondering what to expect after 2, 5 and even 10 years of using the same method.  Keep in mind that people tend to hop between methods or have gaps in using birth control when they want to get pregnant or for other reasons.

Using the same numbers for effectiveness in one year for their calculations, Gregor Aisch and Bill Marsh created an interactive tool to show the likelihood of failure (an unintended pregnancy).  This tool was published in their article in the New York Times last week.  You can hover over any time point between 1 and 10 years to see the number of pregnancies expected among 100 women.

Now go play with the tool!  They have included 15 different birth control methods in their interactive tool.  Here’s a screenshot of how a few of the charts looks when I hover over the 10 year mark on the X-axis (I added the horrified and happy faces for dramatic effect):

NYT Tool Screenshot

The bolded number in the top-left represents the number of women who will have an unplanned pregnancy after typical use of that method of birth control, in this case for 10 years.  The solid line reflects typical use and the dashed line is perfect use.  If you need to refresh yourself on the difference between perfect and typical use, review this previous post.

Of course this tool does not take into consideration a few realities:

  • Women who are not using their method correctly and consistently will either become pregnant or switch methods.
  • Women who are using their method correctly and consistently will likely continue to use the method for a longer duration.
  • Women who use their selected method for a longer duration will take it more correctly and consistently over time as they become more experienced with the method.
Does this change your opinions of the different methods of birth control?  Did you like the interactive tool?  What else would you like to know about birth control?  Enter your comments below!

New Methods of Birth Control Being Developed for Men

A lot of research is being invested in developing new methods of birth control for men. As you may recall from a previous post, birth control options for men are limited to vasectomies, condoms, spermicides, and natural methods like withdrawal right now.

Male Scientists

Here’s a preview of methods in the works:

Pills & Skin Gels

  • Pill. The pill targets muscles in the vas deferens (plumbing in the body that carry sperm from the testicles out through the penis head) to prevent ejaculation from happening. Don’t worry, this drug does not affect the sensation of an orgasm. The pill would be taken 2 to 3 hours before intercourse and could last up to 24 hours. This pill has an added benefit of preventing HIV transmission since the HIV virus is found in semen and there would be no ejaculation. That is why the pill is aptly named Clean Sheets Pill.

Where does the ejaculate go? It is reabsorbed by the body! So there’s no build up. Currently, researchers of this pill are campaigning for funds to allow them to continue studying this method before it can be submitted for FDA approval. You can read more, pitch in or sign a petition to support funding here.

  • Hormonal Gels. These gels combine two hormones — testosterone and progestin — to suppress sperm development. The advantage of this method is that it is easy to apply as it is just rubbed onto the skin once daily.

Injections & Implants

  • Gel Injections. Two different gels – known as RISUG (Reversible Inhibition of Sperm Under Guidance) and Vasalgel – are being developed in India and the United States.  Both of these gels are injected into the vas deferens (the same tubes that are cleaved during a vasectomy) and they work like a plug, blocking the passage of sperm. These non-hormonal forms of birth control require only a single treatment and in addition, would be reversible. The developers of Vasalgel just announced an update this month about success in animal models and now human trials are planned to begin next year, with the hope that the drug would be available for consumers by 2017. You can help by pitching in to the crowdfunding efforts of this social venture. You can follow the updates by liking the Vasalgel Facebook page.
  • Hormonal Injections. Clinical trials found men who were injected with the hormones norethisterone and testosterone every 8 weeks had no sperm in their ejaculate. Additional studies are now planned worldwide involving couples.
  • Implants. The implants contain testosterone and would be placed under the skin of your upper arm. The testosterone would help inhibit the development of sperm and reduce sperm count. Right now, studies are being developed to determine whether these implants work.

Don’t hold your breath on these products. All these potential methods have several more years of research and clinical trials to determine whether they are safe and effective methods.

What do you think about these methods? Men, would you use them? Women, what are your thoughts on your partners using one of these methods of birth control?


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

References:  Nieschlag E. Clinical trials in male hormonal contraception. Contraception 2010;82:457-70.  Meriggiola MC et al. Norethisterone enanthate plus testosterone undecanoate for male contraception. Contraception 2005;90:2005-14. (Photo credit: Craig Anderson via Flickr)

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.

Should You REALLY Be Worried About All Those Birth Control Risks?

Hesitant to start birth control because of side effects? Or worried about long-term effects after years of use? This interview with physician experts gives you practical answers to some of those questions.

Remember there are many birth control options and your health care provider can help you find one that fits your needs.

GR Mail

Before you panic, read what the experts have to say.

birth-control

If you’ve ever leafed through the packet of prescribing information that comes with your birth control, you were probably thoroughly terrified. It’s about as scary as those television commercials that ask if anyone you know has died while taking a certain form of contraception.

It’s true that some health risks have been associated with birth control, but it’s also a fact that hormonal contraception is a safe and effective way to prevent pregnancy, as well as help with a host of other health issues—like alleviating PCOS and endometriosis, calming PMS and acne, and even lowering your risk of ovarian cancer.

So to find out how worried you should really be about these scary health risks, we reached out to three experts: Mary Jane Minkin, M.D., clinical professor of obstestrics and gynecology at Yale School of Medicine; practicing ob-gyn Alyssa Dweck…

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Talking to Your Partner about Your Plans

When it comes to choosing the right birth control, it’s a decision that shouldn’t be left to just one partner in a relationship. Although many men might view the subject of contraception as a foreign matter, it is important that they too are educated and engaged on the options available to them and their partner.

Having this conversation BEFORE you and your partner start having sex is ideal. Not only can this discussion strengthen your relationship by opening lines of communication that might have not previously existed but it also helps build a sense of trust, allowing you to be more intimate with your partner. By sharing the responsibility of planning for safe sex, you and your partner would be setting your minds at ease over the thought of having an unplanned pregnancy or possibly getting a sexually transmitted disease (STD).

Talking to Your Partner about Birth Control

So how do you even begin having this conversation with your partner? Here are some quick tips to help you get started.

Plan ahead.  Don’t wait to have this conversation at the last minute…in the heat of passion. Start the conversation outside the bedroom and choose a time that is good for both you and your partner. If you have trouble finding the perfect time to bring up the issue, maybe consider talking about a TV show, movie, or pop culture event as a conversation starter and then transition into the subject.

Stay calm. It’s natural to be a little nervous when discussing the subject with your partner, especially if it’s the first time you’re bringing it up. But remember the importance of this discussion. You might even feel better about your relationship, knowing that you and your partner are on the same page when it comes to your plans and birth control.

Educate yourself.  Before you start the conversation, read up on the birth control options that are out there and that may interest you. Or better yet, include your partner in this process. Ask them to accompany you to the doctor’s office, clinic or pharmacy so both of you can learn about birth control together and have your questions answered at the same time.

Rehearse.  Practice what you’re going to say in front of a mirror or with a close friend who can give you personal advice. Rehearsing beforehand allows you to go through the points you want to get across in preparation for the actual talk.

Be honest. Express your true feelings and be clear with your thoughts. If you are going to have this conversation, you might as well get all your worries or concerns off your chest. If you don’t feel comfortable expressing your opinions with your partner, that may be a sign that you’re not ready to become intimate physically either.

Listen.  After you had the chance to discuss your thoughts, allow your partner the opportunity to respond and express how they feel. Respect what they have to say and be open to their point of view.

Continue the conversation. Once you have discussed your plans and birth control with your partner once, that doesn’t mean it will be the last time. Be open to future discussions as your relationship evolves. Over time, you and your partner may desire different things out of your relationship so your method of birth control may also change.

For prompts that you could use to help you get the conversation started regarding birth control, pregnancies, or even STDs, check out the Get Talking interactive conversation starter.  The BeforePlay.org website has a lot of great information, memes, and videos about family planning and sexual health.


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

References: Society of Obstetricians and Gynaecologists of Canada (SOGC) website.UC Davis Student Health and Counseling Services website. (Photo credit: adulau via Flickr)

Expert Interview: Dr. Tracey Wilkinson

With the recent changes to expand access to birth control for youth, pediatrician Dr. Tracey Wilkinson helps explain the importance of the progress so far and what still remains to be done.Dr. Tracey Wilkinson

What changes have you seen recently with birth control for youth?

In 2013, emergency contraception (EC), also known as the morning-after pill, was made an over-the-counter medication for everyone.  This means that anyone (girls or boys) can walk into a retail pharmacy or drugstore and purchase EC without having to show identification or find a pharmacy that is open.

How has over-the-counter EC impacted your patients?

Having EC over-the-counter helps ensure that everyone (regardless of age) can access this medication when they need it.  Remember, EC works better the sooner it is taken–so, it is important that when someone needs to get this medication to prevent pregnancy, there are no delays when they go to the pharmacy, doctor’s office, or clinic.

What challenges are your patients facing despite these changes?

There have been a lot of changes to the law regarding EC access over the last few years.  So, it is not surprising that there is a lot of confusion–amongst clinicians, pharmacy staff and even teenagers–as to who can get this medication and when it should be taken.

What needs to be done to address these challenges?

We are going to need to have a lot of education and outreach to both the public and the medical community about the recent changes around EC access.  It is important that youth know about this medication and when to take it, that doctors talk about it with their patients and that pharmacy staff know how to answer questions from consumers buying this medication.

What advice would give youth who would like to get birth control?

First, do some research before you go to the doctor on what types of birth control is out there and what may be a good fit for what you are looking for. Second, it is important that youth find a clinician who they feel comfortable talking to about options for birth control.  These conversations rely on trust and it is important that you find that relationship with a clinician.  Also, remember your rights when going to the doctor’s office, clinic, or pharmacy–you have a right to privacy and confidentiality no matter how old you are.

Is there anything else you’d like to share?  

One of my favorite things as a pediatrician is talking to adolescents as they transition to adults and start making decisions around sexual activity and how to be safe.  Remember, there are a lot of ways to do that and it is important to find a birth control method that works well for you and your partner so that you can stay healthy and also not get pregnant until you are ready.  The number of contraceptive methods continues to increase and so if you don’t like one method–there are a lot of other ones to try!


About the Expert: Dr. Tracey Wilkinson, MD, MPH is a board-certified pediatrician practicing at the Children’s Hospital Los Angeles.  She is also an Assistant Professor of Clinical Pediatrics at the University of Southern California Keck School of Medicine.  Dr. Wilkinson’s research interests are pregnancy prevention and access to contraception.  To make an appointment with Dr. Wilkinson, call (323)669-2113.

One Woman Shares Her IUD Experience

One woman shares her honest experience having the Mirena IUD placed. She is happy with her decision overall.

Looney's Last Word

It hurt like a mo’fo’.

Okay, I was going to stop there, but let me discuss, in the event that other women are wondering. There’s a nice article at http://contraception.about.com/od/iud/ss/iudinsertion.htm that details the whole procedure.

image

Before an IUD insertion, some health-care professionals will advise a woman to take [ibuprofen] an hour before the IUD is inserted.”
Well, I didn’t know that. I guess I should have because I’ve had 2 cervical biopsies and both times, I was told to take some ibuprofen to lessen the pain. But my IUD appointment was so last minute, I didn’t even think about it.

“Check to see if your doctor’s office has sanitary pads; if not, make sure to bring one from home to use after the insertion in case some bleeding occurs.
Yeah. You’ll have that.

At this point, your health-care professional will hold open the vagina by using a…

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