Over 90 Percent of What Planned Parenthood Does, Part 24: Miscarriage Management and Counseling

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 never knew about.

holding handsMiscarriage. It’s a common occurrence — at least 10 to 15 percent of all pregnancies end this way — but one that is not often spoken about. When carrying a wanted pregnancy, its sudden loss can trigger a range of emotions. During this time, Planned Parenthood can help.


There is no “right” or “wrong” way to feel after having a miscarriage.


What Is Miscarriage?

When a pregnancy ends before it has reached the 20-week mark, a miscarriage has occurred; most miscarriages occur within the first eight weeks of pregnancy. Pregnancy loss after the 20-week mark is called stillbirth, and while it isn’t as common as miscarriage, stillbirth occurs in 1 out of 160 pregnancies.

Signs of a miscarriage include vaginal bleeding or spotting, severe abdominal pain or cramping, pain or pressure in the lower back, or a change in vaginal discharge. These symptoms aren’t specific to miscarriage — they could indicate other problems, so visit a health-care provider if you experience them during your pregnancy.

After a miscarriage, you might have pregnancy-related hormones circulating in your body for one or two months. Your period will most likely return within 4 to 6 weeks. While you may be physically ready to get pregnant again after you’ve had a normal period, you might want to consult with a health-care provider about the need for medical tests. You also might need to think about when you will be emotionally ready to try for another pregnancy. Continue reading

Over 90 Percent of What Planned Parenthood Does, Part 23: Preconception Counseling for a Healthy, Informed Pregnancy

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 never knew about.

pregnancyFew moments in life are as important and complex as when a woman makes the decision of whether and when to have children. There are many considerations to take into account when planning to conceive, many of which can affect not only the baby, but the mother as well.

Preconception counseling, a service of Planned Parenthood Arizona, can provide those who wish to conceive with valuable information about their own health, suggestions about how to best manage their wellness for pregnancy, and education about a range of outcomes (including the possibility of miscarriage). Preconception counseling can assist you in creating an environment focused on optimal health for both you and your future child.

These counseling services include:

  • targeted medical history with focus on teratogenic exposures, ethnic background, and family history
  • social history with focus on risk factors for sexually transmitted diseases (STDs), tobacco, alcohol, and street drug use
  • history of chronic illnesses
  • physical exam
  • labs as indicated (STDs, diabetes screening, etc.)
  • genetic counseling referrals as indicated
  • immunization review
  • folic acid utilization
  • review of current medications and possible hazardous exposures

The above list might seem long and detailed, but upon closer examination, you might not know what all of these things mean. What are teratogenic exposures? What does folic acid have to do with a healthy pregnancy? Let’s look at some of these topics in more depth. Continue reading

Let’s Talk Contraception: Contraceptive Patches

Is there a topical birth control available, you ask? No contraceptive cream or ointment has been developed yet, but yes, there is a patch that can be applied to your skin that is almost 99 percent effective at preventing pregnancy.


Patches are easy to use, discreet, and provide excellent birth control.


It’s called a transdermal patch and there is only one available by prescription in the United States. The Ortho Evra patch (or the generic version, called Xulane) is a small, sticky plastic patch that you apply to your skin: one patch each week for three weeks and then no patch for one week before you start the cycle again. While you wear a patch, it releases both a progesterone hormone, norelgestromin, and an estrogen hormone, ethinyl estradiol. This hormone combination is absorbed through your skin and enters your bloodstream to prevent pregnancy, much like oral birth control pills. It is discreet and can be worn comfortably and confidently during bathing, showering, swimming, and exercising without fear of its falling off. As a matter of fact, the patch has been rigorously tested in many situations, and these studies have shown that when applied properly, the patch loosens or falls off less than 2 percent of the time.

Contraceptive patches come in boxes of three for each month. To use a patch, you open a packet and apply one patch to clean, dry, intact (not irritated or injured) skin. It is recommended to apply it to areas on the buttocks, abdomen, upper torso but not breasts, or outer part of upper arm. It should not be applied to areas where it could be rubbed off, such as under a bra strap. Most users apply the patch the first day of their period or the Sunday after the start of their period. When you initially start using the patch, you will need to use a back-up contraceptive method such as a condom for the first seven days. If you are switching to the patch from birth control pills or the vaginal ring, you apply your first patch on the day you would usually start your next pill pack of pills or insert your next vaginal ring. In that case you do not need to use a back-up method of birth control. Continue reading

STD Awareness: Gardasil and Males

menIt’s Men’s Health Month, and yesterday was the last day of Men’s Health Week, which means we’re going to look at a men’s health issue that is usually ignored: the impact of human papillomavirus (HPV) on the male population.

You’ve probably heard of HPV in discussions about cervical cancer and Pap testing. But HPV doesn’t care about gender, and is perfectly content to invade cells in anyone’s genital tract, mouth, throat, or anus. In males, HPV can cause genital warts as well as anal, oropharyngeal (mouth and throat), and penile cancers.


HPV will cause more oral cancer than cervical cancer by 2020.


The good news is that most HPV infections can be prevented by a vaccine called Gardasil, and you don’t need to be female to get it. However, few males are actually getting the HPV vaccine: In 2012, 20.8 percent of U.S. males 13 to 17 years of age had received at least one dose of the HPV vaccine, but only 6.8 percent completed the three-dose series.

Gardasil Is for Everybody: Good News from Australia

This huge disparity in promoting Gardasil to female patients rather than male patients has real-world consequences. In Australia, girls have been vaccinated with Gardasil since 2007, covered by their national health system. Four years into the program, genital wart rates fell by 93 percent in females less than 21 years of age. Even though males weren’t being routinely immunized, genital wart rates fell by 82 percent among heterosexual males in the same age group. That’s because their female partners had received the vaccine, which had the effect of protecting much of the male population. That might sound pretty nifty, but the female-only vaccination policy left out gay and bisexual males, whose genital wart rates saw no corresponding decline. Continue reading

STD Awareness: HPV and Smoking

cigaretteThursday, November 21, is the Great American Smokeout, a day to abstain from smoking — and, one hopes, to quit for good. “That’s great,” you say, “but what do cigarettes have to do with sexually transmitted diseases?”

Good question!

First, let’s talk about HPV. Human papillomavirus (HPV) is known as the “common cold of STDs” — because pretty much every sexually active person will contract it, even people with very few sex partners. Aside from complete abstinence, the best way to avoid an HPV infection is to be vaccinated with Gardasil, which protects against four common HPV strains — two that cause genital warts, and two that cause certain cancers, such as cervical cancer and oropharyngeal cancer. You can further reduce risk by using condoms and dental dams during all sexual activities, limiting sexual partners, and choosing partners who have had few or no previous partners — however, these risk-reduction methods don’t guarantee that you’ll remain HPV-free.


Harmful chemicals from cigarettes can end up in your cervical mucus!


If you’re sexually active, you could have contracted HPV without ever knowing about it. Most infections are asymptomatic (meaning that you never develop symptoms) and transient (meaning that they go away on their own after a year or two). When symptoms do appear, they can manifest as genital warts, penile skin lesions, cervical abnormalities, and signs of cancer elsewhere on the body. And, sometimes, an HPV infection can become persistent, meaning that it doesn’t go away. Luckily, there are steps you can take to decrease risk of developing HPV symptoms, and to increase your chances of fighting off an HPV infection. And one of those things is to quit smoking! Continue reading

Over 90 Percent of What Planned Parenthood Does, Part 18: Cholesterol Testing

vegetablesWelcome 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.


It’s National Cholesterol Education Month.


Heart disease and stroke are leading causes of death in our country, and high cholesterol is a major risk factor for both of these conditions. Most people with high cholesterol don’t have it under control, even though it is both preventable and treatable. According to the National Cholesterol Education Program, adults 20 years of age and older should have their cholesterol checked every five years. And, with two out of three adults suffering from high cholesterol, keeping track of your cholesterol is important.

What is cholesterol?

plaqueCholesterol is a waxy substance, sort of like fat, that can coat the walls of your arteries, forming a “plaque.” This is also referred to as “hardening of the arteries” or atherosclerosis. You’ll often hear comments like, “Those fast-food cheeseburgers will clog your arteries” — regularly eating food that is high in saturated fat can increase the amount of cholesterol that circulates in your bloodstream, increasing your risk for health problems. When arteries have too much plaque, they narrow, and your heart has to work harder to pump blood through your body.

Our bodies need cholesterol to function, but they’re able to synthesize it themselves — unlike many vitamins and minerals, we can make our own cholesterol and don’t need to get it from food. Cholesterol comes in two types: “good” cholesterol, or high density lipoprotein (HDL); and “bad” cholesterol, or low density lipoprotein (LDL). “High cholesterol” refers to high levels of “bad” (LDL) cholesterol in the blood. LDL is what forms plaque in the arteries, while HDL prevents plaque buildup, likely by carrying the LDL to the liver, which processes it before it’s excreted from the body. Continue reading

STD Awareness: Can Oral Sex Cause Throat Cancer?

mouthLast month, actor Michael Douglas gave a frank interview in which he revealed that human papillomavirus (HPV) caused his throat cancer. And, he continued, he got the virus from performing oral sex — specifically, cunnilingus (oral contact with female genitalia). It’s unusual for celebrities to be open about their STD status — and Douglas’ spokesperson has since backpedaled on his comment — so Douglas is to be commended for bringing light to a taboo and little-understood topic. But there were a few things he got wrong, too.


No matter your gender or sexual orientation, performing unprotected oral sex can increase cancer risk.


HPV is a common virus that can be spread by most sexual activities — including vaginal, anal, and oral sex, as well as rubbing genitals together. There are many strains of HPV, which come in two main categories: low-risk HPV, which can cause genital warts; and high-risk HPV, which can cause cancers of the cervix, anus, vagina, vulva, penis, mouth, and throat. The majority of HPV-related cancers are caused by two strains of HPV: HPV-16 and HPV-18.

The good news is that there is a vaccine that can protect you from infection by HPV-16 and HPV-18. Furthermore, most people clear an HPV infection within two years. HPV-related throat cancer is rare, affecting just 2.6 out of 100,000 people.

Can oral sex really lead to throat cancer?

Unfortunately, it is absolutely true that oral sex can transmit HPV, and a chronic infection can cause cancer. Oral sex is indeed sex. It’s not “third base,” it’s not “almost sex,” it’s plain old, straight-up sex, carrying with it the potential for both pleasure and disease transmission. Unfortunately, because so many of us have a lax attitude toward it, fewer people take precautions when engaging in oral sex, and are less likely to use condoms or dental dams. Combined with low vaccination rates for HPV in the United States, the virus is even easier to acquire than it needs to be. Continue reading