Tag Archives: infertility

Why Periods? False Hopes, Popes, and the “Grandfathered” Withdrawal Bleed

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The birth control pill and other hormonal contraception are popular. Menstrual periods are not. Hormonal contraception can be used to suppress menstruation — so why isn’t this method, called “continuous contraception,” more popular?

For decades, packets of birth control pills have typically contained 21 “active” pills and seven “placebo” pills. These placebos — sugar pills — trigger bleeding (which most people think of as a menstrual period, even though it’s technically called a withdrawal bleed). Because menstruation is natural, some people think this withdrawal bleed must somehow be healthier. But there are actually no health benefits — and it might also increase risk for pregnancy.

There is no reason to have a period when on the birth control pill — unless you want one.

Last month, British medical guidelines were revised to recommend continuous use of the birth control pill — that is, with no week-long “break” designed to trigger a withdrawal bleed. We could have been skipping our periods since the Pill was introduced in 1960 — so why is it only now that we are coming to see them as optional?

A flurry of recent articles has touted a rather conspiratorial claim: that the monthly bleed was included in an attempt to make the Pill more palatable to the pope. The Telegraph quoted reproductive health expert John Guillebaud: “John Rock devised [the week of placebo pills] because he hoped that the pope would accept the Pill and make it acceptable for Catholics to use. Rock thought if it did imitate the natural cycle then the pope would accept it.”

Many journalists, pundits, and bloggers have expressed outrage that we’ve been putting up with decades of unnecessary bleeding (and all the attendant pain, headaches, and missed work) just because of an unsuccessful attempt to appease the pope before most women of reproductive age were even born. But the history of the placebo week is more complicated. Continue reading →

The Scoop on IUDs: Busting Myths About a Highly Effective Form of Birth Control

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One of the most misunderstood forms of birth control is the IUD — short for intrauterine device. This contraption is inserted through the cervix and into the uterus to provide years of no-fuss pregnancy protection, making it a reliable and cost-effective method for anyone not planning to have kids any time soon.

Thanks to the zero-copay birth control mandate, an IUD should be free to most people with health insurance, and it’s about as effective as getting your tubes tied — with the option to remove it if you decide to start trying to get pregnant. Regardless, it’s not as popular as condoms or the pill. There are many reasons for that, but the fears and rumors surrounding IUDs might be one of them.

IUDs are highly effective birth control options.

In response, Planned Parenthood Arizona’s family planning and primary care director, Deanna Wright, NP, shed some light on some of these fears surrounding IUDs.

Can I have an IUD if I’ve never given birth before?

Even some physicians won’t provide IUDs to patients who have never given birth, based on the idea that only people who have already had children can handle IUD insertion.

“This is completely untrue,” says Wright. “In fact, the American College of Obstetrics and Gynecology encourages clinicians to offer LARCs, including IUDs, as the first method of contraception to all patients. They recently reaffirmed this position in May 2018.” Continue reading →

STD Awareness: STI vs. STD … What’s the Difference?

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When it comes to sexually transmitted diseases, the terminology can be confusing. Some people use the phrase “STD,” some people insist “STI” is the proper set of initials, and every once in a while you might catch someone using the term “VD.” Over the years, the parlance has changed. What’s the deal?

VD: Venereal Disease

Blaming women for STDs (aka VD) is an age-old tradition.

“Venereal disease” has been in use since at least the 1600s (the Oxford English Dictionary cites a 1667 publication referring to a “a lusty robust Souldier dangerously infected with the Venereal Disease”). Around a century ago, Americans flirted with heavily euphemistic expressions, such as “social diseases,” but mostly, “venereal disease” was the terminology of choice for the better part of four centuries — slightly less euphemistic, as “venereal” was derived from Venus, the Roman goddess of love, sex, and fertility. Additionally, since at least the 1920s it was frequently shortened to “VD.” Those of us of a certain age might still remember hushed talk of VD among our grandparents, parents, or peers.

Around the 1930s, public health experts started wondering if referring to VD as a separate category of disease stigmatized these infections and those who carried them, dampening motivation to fight them with the same fervor with which the community battled other infectious diseases like influenza, smallpox, and scarlet fever. In 1936, Nels A. Nelson proposed replacing “venereal disease” with “genito-infectious diseases,” but that never caught on — you haven’t heard of GIDs, right? Continue reading →

STD Awareness: Gonorrhea’s Latest Dubious Honor

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Wanted: Scientists who can develop novel antibiotics

A few years ago, the Centers for Disease Control and Prevention (CDC) put out a “greatest hits” list of antibiotic-resistant pathogens. More recently, in late February, the World Health Organization (WHO) followed suit with a dirty-dozen list of 12 “superbugs,” which was composed mostly of potentially fatal microbes that are becoming increasingly impervious to the drugs that once easily killed them. These are the bacteria WHO believes represent the greatest microbial threat to human health, and the list was compiled in the hopes of providing direction — and motivation — to pharmaceutical researchers who are desperately needed to develop new antibiotics.

Investing in antibiotic development now will save lives later.

A quick primer on antibiotic resistance: Antibiotics kill living organisms called bacteria, but like all living organisms, bacteria can evolve. Just as giraffes evolve longer and longer necks that allow them to eat more and more leaves, so too do bacteria evolve resistance to antibiotics. For example, a resistant bacterium can evolve the ability to spit out the drug before it has a chance to kill it, or it can evolve structural changes to its cell wall that make it impossible for the drug to attach to it.

One superbug, classified as an “urgent threat” by the CDC and a “high priority” by WHO, stands out from the pack. Unlike the other bacteria in these lists, an untreated infection with this bug isn’t thought to be deadly — but it still wreaks enough havoc to merit special attention from such esteemed bodies as the CDC and WHO. That bug is Neisseria gonorrhoeae, and you have one guess what disease it causes. (If you said gonorrhea, you guessed right.) Continue reading →

STD Awareness: Is Chlamydia Bad?

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chlamydiaPerhaps your sexual partner has informed you that they have been diagnosed with chlamydia, and you need to get tested, too. Maybe you’ve been notified by the health department that you might have been exposed to chlamydia. And it’s possible that you barely know what chlamydia even is, let alone how much you should be worried about it.

Chlamydia is one of the most common sexually transmitted diseases (STDs) out there, especially among young people. It can be spread by oral, vaginal, and anal sex, particularly when condoms or dental dams were not used correctly or at all. It is often a “silent” infection, meaning that most people with chlamydia don’t experience symptoms — you can’t assume you don’t have it because you feel fine, and you can’t assume your partner doesn’t have it because they look fine. If you’re sexually active, the best way to protect yourself is to know your partner’s STD status and to practice safer sex.

Chlamydia increases risk for HIV, leads to fertility and pregnancy problems, and might increase cancer risk.

The good news about chlamydia is that it’s easy to cure — but first, you need to know you have it! And that’s why it’s important for sexually active people to receive regular STD screening. Left untreated, chlamydia can increase risk of acquiring HIV, can hurt fertility in both males and females, can be harmful during pregnancy, and might even increase risk for a certain type of cancer. So why let it wreak havoc on your body when you could just get tested and take a quick round of antibiotics?

To find out just how seriously you should take chlamydia, let’s answer a few common questions about it.

Can Chlamydia Increase HIV Risk?

Chlamydia does not cause HIV. Chlamydia is caused by a type of bacteria, while HIV is a virus that causes a fatal disease called AIDS. However, many STDs, including chlamydia, can increase risk for an HIV infection, meaning that someone with an untreated chlamydia infection is more likely to be infected with HIV if exposed to the virus. Continue reading →

STD Awareness: Mycoplasma genitalium

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“I’m not small, I’m just streamlined!” Image of Mycoplasma genitalium adapted from American Society for Microbiology.

In November and December of last year, headlines touting a “new” STD made an ever-so-minor flurry across the Internet. CNN referred to it as “mycoplasma genitalium, or MG” — Mycoplasma genitalium is the name of the teardrop-shaped bacteria that can cause several diseases in the urinary or reproductive tracts, such as urethritis and pelvic inflammatory disease.

M. genitalium is the smallest living organism known to science, having “devolved” from more complex organisms — but that doesn’t mean it can’t pack a punch! While these bacteria have surely been around for millennia, we only discovered them in the 1980s. Since then, we’ve known that M. genitalium fits the profile of a sexually transmitted pathogen — the only reason it made the news last year was that a team of British researchers published further evidence that this bug is indeed sexually transmitted and capable of causing disease.

Genital mycoplasmas can be cured — but a doctor needs to know what she’s looking for in order to prescribe the correct antibiotic!

An infection with M. genitalium could more generally be called a “genital mycoplasma.” The term “genital mycoplasmas” refers to a category of several different species of sexually transmitted bacteria, most notably Mycoplasma genitalium, but also less common species, such as Mycoplasma hominis, Ureaplasma urealyticum, and Ureaplasma parvum. M. genitalium is considered an “emerging pathogen,” because it is only over the past couple of decades that technology has allowed us to study these bacteria, along with other genital mycoplasmas.

Risk factors for infection include multiple sexual partners and not using condoms during sex. It is thought that most people with an M. genitalium infection don’t have immediate symptoms — 94 percent of infected men and 56 percent of infected women won’t notice anything amiss. That doesn’t mean it can’t do damage. Continue reading →

PCOS: Erasing the Stigma

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two womenUntil I encountered health-related issues of my very own, I had never heard of PCOS. There are no PSAs, no health class curricula, and it is not uncommon for many physicians to be unfamiliar with the seemingly unrelated symptoms that can be a detriment to the life of a woman who is affected.

Irregular menstrual cycles, weight gain, sluggishness, thinning hair, depression, acne, infertility, and sometimes (but not always) cysts on the ovaries are what a woman with PCOS may have to battle on a daily basis. Not only must a woman endure the physical effects of this disorder, but also the psychological effects that come with these changes. To be clear, that is by no means a comprehensive list of symptoms.

This is polycystic ovarian syndrome, and it affects more than 5 million women in the United States alone. Continue reading →