July 11 Is UN World Population Day

The following guest post comes to us via Esteban Camarena, a graduate student at the University of Arizona. He is currently in Brazil doing field research on politics and public health policy. He can be reached at estebanc@email.arizona.edu.

The world’s population is on the way to reaching 8.6 billion people by 2030 — that’s approximately 1.1 billion more inhabitants on the planet in less than 13 years. If we break it down further, that’s 84.6 million more people per year, 7.1 million per month, 1.8 million per week, or 252,0000 people added every day, roughly.

July 11 is UN World Population Day, which aims to create awareness of population growth issues and their relation to the environment and development. With the world’s population increasing every year, the limited amount of natural resources combined with the effect of climate change hinders any country’s ability to achieve sustainable economic growth and development. As the global population continues to grow, so too does the demand for food, water, energy, and land.


An investment in women’s health is an investment in families’ economic stability and a country’s development.


The inability to meet these demands will inevitably lead to malnutrition, poverty, and conflict between nations and people. This depletion of resources would particularly affect developing countries where the greatest amount of population growth is expected; in fact, more than half of the anticipated growth will occur in Africa, followed by Asia and Latin America. Among other factors, population growth is concentrated in these developing regions due to limited or lack of access to reproductive health care, family planning services, and sex education. Continue reading

STD Awareness: Do IUDs and Implants Prevent STDs?

Highly effective birth control methods, namely intrauterine devices (IUDs) and implants, have received a lot of well-deserved attention in recent years. They are as effective at preventing pregnancy as permanent sterilization, but can be stopped at any time, and can last from three to 12 years. They are the contraceptive of choice for female family-planning providers, who should know a thing or two about choosing an optimal birth control method. They are fantastic options for teenagers and others hoping to delay pregnancy for at least a few years. And the best news is that, for now anyway, these pricey birth control methods are still available at no cost to Americans covered by Medicaid or health insurance.


For the best protection against unintended pregnancy and STDs, combine condoms with IUDs or contraceptive implants.


If IUDs and implants prevented sexually transmitted diseases (STDs), they would pretty much be perfect — but, alas, like most forms of birth control, they don’t protect you from viruses, bacteria, and other bugs that can be passed from person to person through sex. To reduce their risk for STD exposure, sexually active people must employ other strategies, including (1) being in a mutually monogamous relationship with a person who does not have STDs; (2) being vaccinated before becoming sexually active to receive protection from hepatitis B virus and human papillomavirus (HPV), two sexually transmitted viruses; and, last but definitely not least, (3) condoms, condoms, condoms!

A study published this month looked at college students using IUDs and implants and found that most of them didn’t use condoms the last time they had vaginal sex — 57 percent of women who were not using IUDs or implants used a condom, compared to only 24 percent of women who were using IUDs or implants. That’s not too surprising if pregnancy prevention were the only concern, but condoms are an important addition for anyone seeking to reduce their STD risk. Continue reading

IUDs and Implants: It’s Not Too Late for LARCs

Access to contraception is coming under attack, and reproductive-health advocates are scrambling to find ways to protect it. In December, Obama did what he could to protect Planned Parenthood from losing its ability to serve Medicaid patients. In New York, the state’s attorney general has moved to ensure that New Yorkers will continue to receive no-copay birth control as part of their insurance benefits, and Massachusetts moved to defend Medicaid patients’ right to use Planned Parenthood’s services in the event of federal interference. And, across the country, people at risk for unintended pregnancy are clamoring for highly effective, long-term birth control to see them through the next four tumultuous years.


IUDs and implants can help you and your uterus make it through the Trump administration.


Tom Price, who was confirmed as secretary of health and human services last month, represents the most immediate threat to our birth-control access. As HHS secretary, Price has the power to declare that contraception is not a “preventive” service insurers must make available to their customers with no copay. In one fell swoop, Price could undo the enormous progress the Obama administration made in expanding access not just to all forms of contraception, but to highly effective forms of contraception that had for so long been out of reach to so many.

Before the Affordable Care Act, long-acting reversible contraception (LARC) methods like IUDs and implants were known to be highly effective — not just cost-effective, but also simply the most effective in terms of preventing pregnancy. However, the high upfront costs closed the door to many potential users. Let’s do some quick-and-dirty math: A copper IUD could set you back anywhere from $500 to $932, but it lasts for 12 years. That means it costs $3.50 to $6.50 per month, compared to the Pill, which can cost $10 to $50 a month out of pocket. Clearly, the IUD makes the most financial sense, but for many of us, a medical bill charging upward of $500 doesn’t fit into our budgets. Better to rely on methods like the Pill, which cost more over time, but aren’t as hard on the wallet of someone living paycheck to paycheck or on an otherwise tight budget. Continue reading

Ovarian Cancer, Endometrial Cancer, and the Pill

The most popular method of birth control in the United States is the Pill, followed by tubal ligation (permanent sterilization, or getting your tubes tied) and condoms. The Pill is a hormonal method of contraception, while sterilization and condoms are nonhormonal. The distinction between hormonal and nonhormonal methods of birth control are simply that the former contain synthetic versions of human hormones, while the latter do not.


By suppressing ovulation and thinning the uterine lining, the Pill can reduce risk of ovarian and endometrial cancers.


Glands in our bodies, called endocrine glands, produce hormones; additionally, testes and ovaries — which are parts of the human reproductive system — manufacture hormones. Human hormones are powerful chemicals, which do all sorts of jobs, from triggering puberty to helping us extract energy from the foods we eat. So it’s not a huge stretch to wonder if exposure to the hormones present in certain birth control methods — such as the Pill, in addition to the patch, the ring, the shot, the implant, and some types of IUDs — might have unintended effects on the body. Because hormones can play a role in cancer — either in protecting against it or aiding in its development — researchers are very interested to know if the Pill might increase or decrease risk for various types of cancer.

It’s actually a bit tricky to investigate the possible associations between the Pill and various types of cancer. First of all, there are dozens of types of birth control pills, all with different versions of synthetic hormones, at different dosages, and in different proportions to one another. Furthermore, the types of oral contraceptives on the market change over time — today’s birth control pill is not your mother’s birth control pill. Studying “the Pill” as a single entity could obscure differences between brands. Secondly, most cancers tend to develop later in life, many years after someone may have taken oral contraceptives. Researchers need to be careful to control for all the variables that might increase or decrease cancer risk. Continue reading

Contraception Then and Now

When it comes to contraception, one thing is for sure: We’ve come a long way! And while the future might have even better things in store, like reversible male birth control, superior condoms, or remote-controlled implants, a look into the past reveals that modern contraceptors have a bevy of fantastic options to choose from. Unlike couples who had to forgo contraception or obtain birth control from the black market, nowadays Americans wishing to prevent or postpone pregnancy can select from a variety of legal, effective, and increasingly accessible family-planning methods.


While the history of birth control is fascinating, today’s contraception is the very best.


Let’s look at some old-fashioned birth-control methods and see how they stack up to their modern-day counterparts.

Linen and Guts vs. Latex and Polyurethane Condoms

Most people think of female condoms as new inventions, but the first condom recorded in history was made out of a goat’s bladder and inserted into the vagina — way back in 3000 BC. Ancient civilizations, from the Romans to the Egyptians to the Japanese, made penile sheaths and caps with a variety of materials, including linen, leather, lubricated silk paper, intestines, and tortoise shells. Linen and intestines remained popular through the Renaissance era.

A condom, with user manual, 1813. Photo: Matthias Kabel

Charles Goodyear might be most famous for tires, but his discoveries in vulcanizing rubber also led to the development of rubber condoms in the mid-1800s. Unfortunately, the Comstock Act of 1873 outlawed the manufacture and sale of contraception, and condoms were driven into a shadow economy. In the 1880s, New Yorkers might have been lucky to find black-market condoms made from surplus animal intestines, which were manufactured by Julius Schmid, a German immigrant who otherwise specialized in sausage casings — before his business was shut down by the New York Society for the Suppression of Vice. Condoms weren’t legal in the United States until the Crane ruling of 1918, just in time for the 1920 invention of latex, a form of rubber that was much stronger and more elastic — and with a shelf life of five years vs. rubber’s three months. By the 1920s, Schmid was once again on top of the condom game, peddling brands like Sheik, Ramses, and Sphinx.

Condoms made out of intestines are still on the market, sold as lambskin or “natural” condoms. However, they are not recommended for STD protection: Just as intestines need to allow nutrients to enter the body from digesting food, so too are viruses able to pass through condoms made from intestines. (Sperm, on the other hand, are thought to be too big.) These days, latex is the gold-standard material for condoms, while polyurethane can be used by people with latex allergies. Condoms constructed with these modern materials protect users from unintended pregnancy as well as many sexually transmitted infections, such as HIV and chlamydia. Continue reading

Ten Things Your Mother Never Told You About Condoms

holding condomThere are so many claims made about condoms these days that it’s hard to separate fact from fiction. Perhaps you first heard some of these things from your mother, who sat you on her lap one day and calmly demonstrated proper use, with guidelines for when appropriate. Yeah, right. She probably would have spanked you for even mentioning the word. As for your dad, get real.

Like most of us, you probably first heard about condoms in the locker room or from your friends. Or you read something in a magazine or on social media. As a result, your poor head is filled with various myths, rumors, half-truths, and bad jokes, interspersed with a few actual facts. So, herewith are 10 more half-truths or untruths to add to your noggin.

1 Condoms have a high failure rate. According to one website, “18 couples out of 100 who say they use condoms as their primary contraception method will experience an unintended pregnancy in the first 12 months.” Of course, this includes folks out of this same 100 couples who happened not to be using a condom at the time they got pregnant (or during the whole time) — which greatly reduces a condom’s effectiveness — as well as those who were not using the condoms correctly when they got pregnant. (By the way, though this informative website refers to condomology as “the study of condoms,” starting a sentence with “condomologically speaking” is probably not a good idea.) The failure rate decreases substantially, however, when condoms are properly used: “If used correctly every time you have sex, male condoms are 98% effective. This means that two out of 100 women using male condoms as contraception will become pregnant in one year.” Continue reading

“Instrument of Torture”: The Dalkon Shield Disaster

This Dalkon Shield is archived at the Dittrick Medical History Center and Museum at Case Western Reserve University. Photo: Jamie Chung

This Dalkon Shield is archived at Case Western Reserve University. Photo: Jamie Chung

These days, IUDs, or intrauterine devices, have stellar reputations as highly effective contraceptives. Along with implants, IUDs can be more effective than permanent sterilization, and their safety record is fantastic. We also have powerful regulations in place to keep dangerous medical devices off the market, and the FTC can keep manufacturers from making false claims in advertising.

But a previous generation of birth-control users might associate IUDs with dangerous pelvic infections and miscarriages. That’s because a single device, called the Dalkon Shield, almost single-handedly destroyed an entire generation’s trust in IUDs. At the time of its debut, there were dozens of IUDs on the market — but the Dalkon Shield unfairly tainted the reputation of all of them. With no FDA or FTC regulations reining in untested devices or false advertising, women in the late 1960s and early 1970s didn’t enjoy the protections that we take for granted today. And it was actually the Dalkon Shield’s string, which was made with a material and by a method that hasn’t been used in IUDs before or since, that made it dangerous.


Today, IUDs are the most popular form of contraception among physicians wishing to avoid pregnancy.


We’ve known about IUDs for more than a century, and have made them out of ebony, ivory, glass, gold, pewter, wood, wool, and even diamond-studded platinum. These days, IUDs release hormones or spermicidal copper ions, but these older devices were simply objects inserted into the uterus that acted as irritants, possibly enlisting the immune system to kill sperm. They were not as effective as modern-day IUDs.

The Dalkon Shield was invented in 1968, was made primarily of plastic, and had “feet” — four or five on each side — to prevent expulsion. In 1970, after being marketed independently, it was sold to family-owned pharmaceutical giant A.H. Robins Company, of Robitussin fame. It was manufactured in the same factory where ChapStick was produced, and retailed for $4.35.

Dr. Hugh J. Davis, the Dalkon Shield’s primary inventor, claimed that users of his device had a 1.1 percent pregnancy rate — but that number was based on a small, methodologically flawed study conducted over eight months. In fact, the Dalkon Shield had a 5.5 percent failure rate over the course of a year. The fact that the Shield didn’t provide high protection against pregnancy was a huge problem, but its design also dramatically increased risk for pregnancy complications. Of the tens of thousands of users who became pregnant while wearing the Dalkon Shield, 60 percent of them had miscarriages. Continue reading