PCOS: Erasing the Stigma

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

Let’s Talk Contraception: Can I Use Birth Control to Skip a Period?

In 2003, the FDA approved Seasonale, an extended-cycle birth control pill. This pill, a combination of estrogen and progestin, is taken daily for 84 days followed by one week of inactive (placebo) pills, allowing a woman to have her period once every three months — four times per year.

Since that time, several other extended-cycle birth control pills have been marketed, including Lybrel, released in 2007, which offers women continuous contraception coverage with only one period per year.


Using birth control to skip periods doesn’t result in side effects quite this exaggerated.

Prior to Seasonale’s debut, certain types of birth control pills could be taken back to back, allowing users to have period-free weddings and honeymoons, or to treat certain conditions, such as endometriosis. But there was no consensus about how to use birth control pills this way, and no actual product marketed specifically for this type of use. Early studies on extended-cycle pills reported that users were highly satisfied using pills to have fewer periods — and wanted to continue using these pills to reduce periods after the study was completed.

Can skipping periods be beneficial or harmful? Is this a lifestyle choice that’s not “natural”? How many “normal” periods do you need in a lifetime? Continue reading

Over 90 Percent of What Planned Parenthood Does, Part 15: Fertility Awareness Education

FAM calendarWelcome to the latest installment of “Over 90 Percent of What Planned Parenthood Does,” a series on Planned Parenthood Advocates of Arizona’s blog that highlights Planned Parenthood’s diverse array of services — the ones Jon Kyl never knew about.


Fertility awareness is not the same as the rhythm method.

Let’s start there.

It’s a common misconception that is, at best, a massive oversimplification that misconstrues the concept and may lead people to dismiss or deride fertility awareness out of hand. In reality, a lot of people could benefit from a more thorough understanding of fertility, as many sexually active couples spend a lot of their lives trying to control it — whether to avoid or achieve pregnancy. Planned Parenthood health centers provide education in fertility awareness-based methods (FAMs) for a variety of purposes.


If fertility awareness is not just the rhythm method, what is fertility awareness?

For someone having menstrual cycles, fertility awareness involves monitoring cycle signs and symptoms — predominantly cervical fluid and basal body temperature, though these are often supported or “cross referenced” by tracking other signs as well — in order to determine when a person is approaching ovulation and/or to confirm when ovulation has already taken place.

How does that even work?

Fertility awareness-based methods rely on a few underlying assumptions about fertility and the likelihood of conception:

  1. For pregnancy to happen, there must be both sperm and an ovum (egg) present.
  2. Ovulation — the release of an egg from the ovary into the fallopian tube — occurs once per menstrual cycle.
  3. Sperm can survive inside someone with a uterus for approximately five to six days. (Note: The actual number a given person or couple will want to use for this assumption can vary a bit depending on whether their main goal is to achieve or avoid pregnancy.)
  4. The ovum itself is viable in the fallopian tube for approximately one to two days. After that, it begins to disintegrate, and fertilization is not possible during that cycle. (Again, different couples may use different assumptions depending on their goals.) Continue reading

Are Pap Tests Accurate?

If you follow health news, you might have noticed some controversy over certain cancer-screening methods: Does the evidence support mammograms as a tool to reduce breast cancer deaths? Are PSA tests effective in saving lives from prostate cancer? These are questions that we are beginning to answer as more and more evidence comes in. But don’t let these questions dissuade you from all cancer screening.


With regular Pap testing, cervical cancer is almost 100 percent preventable.


In fact, although we’re reevaluating data for other cancer-screening methods, we have mountains of solid evidence that the Pap test is one of the best cancer-screening methods out there. Because it detects signature mutations that mark cells as headed toward becoming cancerous, Pap testing detects “pre” cancer while other cancer-screening techniques, like mammography, only detect cancer.

Cervical cancer used to be a top killer in developed nations — and it remains a major cause of death in countries without widespread health-care access — but in the last 50 years, cervical cancer deaths fell by 70 percent in the United States, transforming cervical cancer from the leading cause of cancer death among American women to a less common, nearly preventable cancer. Despite this, you might hear people complain that the Pap test isn’t accurate, citing the possibility of receiving “false positive” or “false negative” results.

A Pap test looks for abnormalities in cervical cells, and you can receive one of these four results:

True Positive: Cellular abnormalities are detected, and they are in fact present. True Negative: Cellular abnormalities are not detected, and in fact the cells are normal.
False Positive: Cellular abnormalities are detected, but the cells are actually normal. False Negative: Cellular abnormalities are not detected, but are actually present.

When we receive a true positive result, we can receive treatment for precancerous lesions that in fact might otherwise lead to cancer. Likewise, when we receive a true negative result, no further treatment is needed. Continue reading

Over 90 Percent of What Planned Parenthood Does, Part 7: Pap Testing

Low-grade lesions of cervical cells, which can be treated before progressing to cancer. Image: National Cancer Institute

Low-grade lesions of cervical cells, which can be treated before progressing to cancer. Image: National Cancer Institute

Welcome to the latest installment of “Over 90 Percent of What Planned Parenthood Does,” a series on Planned Parenthood Advocates of Arizona’s blog that highlights Planned Parenthood’s diverse array of services — the ones Jon Kyl doesn’t know about.

Pap tests are not beloved — there, I said it. Many people who receive them hope for the day that medical science devises an equally effective but noninvasive test, whatever that might entail, as they may find them to be anything from slightly awkward to incredibly traumatizing. However, the evidence overwhelmingly shows that access to Pap testing (also called Pap smears) has transformed cervical cancer from a top killer into something that can be caught early and treated before it can do much damage. As a tool to reduce cancer deaths, Pap tests have been a resounding success.


In countries with widespread access to Pap tests, cervical cancer rates have plummeted.


A Pap test involves an instrument called a speculum being placed into the vagina to hold it open while a health care provider uses a small spatula or a tiny brush to collect cells from the cervix, which is at the opening of the uterus. These cells are analyzed in a laboratory, where a technician can determine if they are precancerous. (Cervical cancer is caused by a sexually transmitted virus called human papillomavirus, or HPV.) When caught in its precancerous stages, cervical cancer can be treated with procedures such as colposcopy and cryotherapy.

Pap testing guidelines have recently changed. Continue reading

Over 90 Percent of What Planned Parenthood Does, Part 5: Thyroid Testing

Diagram of human head and neck, illustrating thyroid gland.

Image: Medline Plus

Welcome to the latest installment of “Over 90 Percent of What Planned Parenthood Does,” a series on Planned Parenthood Advocates of Arizona’s blog that highlights Planned Parenthood’s diverse array of services — the ones Jon Kyl doesn’t know about.

“When was the last time you had your thyroid checked?” the nurse practitioner asked me. I was at my annual exam, discussing heavy menstrual bleeding.

“I’m not sure,” I replied. “Maybe never?”

Really, I was thinking to myself, What’s a thyroid?

As it turns out, the thyroid gland does a lot of the work that regulates the body’s metabolism, which is sort of a big deal for overall health. It means that when the thyroid is overactive — as in the case of hyperthryoidism — or when the thyroid is underactive — as in the case of hypothyroidism — symptoms can show up in a variety of areas, such as: Continue reading

Coming Soon: A More Effective Emergency Contraception

new-contraceptive-pill-ellaAnother tool for the prevention of unintended pregnancy has recently been approved by the FDA: ulipristal acetate (marketed under the brand name ella®), a type of emergency contraception that can be taken up to five days after unprotected sexual intercourse. The medication is already in use in Europe, and the FDA conducted its own clinical trials before approving it as a prescription contraceptive on August 13. Ella was found to be safe and effective, and better at preventing pregnancy than current forms of emergency contraception, such as Plan B.

While Plan B can be taken up to three days after unprotected intercourse, its effectiveness is dependent upon how soon it is taken after sex. Plan B taken immediately after unprotected intercourse is more effective than when it is taken three days afterward. Ella, on the other hand, has been found to be just as effective on the fifth day as it is on the first day. According to the New York Times:

Women who have unprotected intercourse have about 1 chance in 20 of becoming pregnant. Those who take Plan B within three days cut that risk to about 1 in 40, while those who take ella would cut that risk to about 1 in 50, regulators say. Studies show that ella is less effective in obese women.  Continue reading