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

Pro-Choice Friday News Rundown

  • Deja Foxx

    Let’s kick this thing off with some good news — two states have passed laws making it easier for women to access birth control! Yay! (Elite Daily)

  • If you live in the Phoenix metro area, you may wanna check out this handy map on the prevalence of STDs in your ZIP code! (ABC 15)
  • In other local news, Tucson teen Deja Foxx is a fearless powerhouse. She courageously advocates for others, heroically stood up to Sen. Jeff Flake, and sings the praises of Planned Parenthood every chance she gets. We are SO in awe of her and SO thankful for her advocacy! (WaPo)
  • Extensive research by the National Bureau of Economic Research shows there are broad economic benefits of increased contraception use — not just for women but for society overall. (Salon)
  • Of course sexism played a huge role in Hillary’s 2016 election loss. (XX Factor)
  • Rewire‘s Yamani Hernandez explains why framing abortion as an economic issue that affects our survival may be the only way to make people understand how crucial our right to this choice is. (Rewire)
  • Texas’ maternal mortality rate doubled over a two-year period. Not coincidentally, this was the same two-year period of time in which the state gutted Planned Parenthood and forced most of our health centers in the state to close. Additionally, more than half of all births in Texas are paid for by Medicaid, but coverage for new mothers ends just 60 days after childbirth. The majority of the 189 maternal deaths the task force looked at from 2011 to 2012 occurred after the 60-day mark. (Texas Observer)
  • Texas also has the highest birth rate in the U.S. (more than half paid for through Medicaid), and one of the highest teen pregnancy rates in the country. Medicaid births — most likely unintended pregnancies — rose in areas where access to PP was barred. (Austin Chronicle)
  • And in case you were wondering, Texas is not done clobbering reproductive options and rights. Their governor just signed what is being described as a “sweeping anti-abortion law.” (The Cut)
  • The latest medical science discovery: A vaginal gel containing tenofovir, an antiretroviral drug used to treat HIV infection, was three times as effective at preventing HIV in women who had healthy vaginal bacterial communities as it was in women with a less beneficial mix. (Science News)
  • Gotta love this headline: “President Who Bragged About Extramarital Sex Appoints Top Abstinence Advocate to HHS” (XX Factor)

STD Awareness: Is Bacterial Vaginosis a Sexually Transmitted Disease?

Not to scale: Gardnerella vaginalis under a microscope. Image: K.K. Jefferson/Virginia Commonwealth University

Gardnerella vaginalis under a microscope. Image: K.K. Jefferson/Virginia Commonwealth University

Bacterial vaginosis, or BV, is the most common vaginal infection among people 15 to 44 years of age. It’s caused by an overgrowth of harmful bacteria, such as Gardnerella vaginalis. A healthy vagina hosts thriving populations of Lactobacillus bacteria species, but when these “good” bacteria are crowded out by certain types of “bad” bacteria, the vaginal ecosystem can be shifted, causing BV.

There is a lot of confusion about BV. Is it a sexually transmitted disease (STD)? What are the symptoms? How can you avoid it?

All good questions. Let’s examine them one by one.

Is BV an STD?

The consensus seems to be that BV isn’t officially an STD, but even reliable sources have somewhat contradictory information. Planned Parenthood doesn’t list BV as an STD on their informational webpages. The Centers for Disease Control and Prevention (CDC) does include BV on their STD website, but also says that “BV is not considered an STD.”

On the other hand, the Office on Women’s Health says that “BV can … be caused by vaginal, oral, or anal sex” and that “you can get BV from male or female partners.” And there’s an entire chapter devoted to BV in the premier medical textbook on STDs, and its authors say that, while sexually inexperienced females can get BV, “the weight of evidence supports sexual transmission” of G. vaginalis, the bacteria species most famously implicated in BV infections.

The same webpage on which the CDC declared BV not to be an STD also says that it can be transferred between female sexual partners. Indeed, women who have sex with women have higher rates of BV. Since vaginal fluid could spread BV, partners can change condoms when a sex toy is passed from one to another, and use barriers like dental dams when engaging in cunnilingus (oral contact with the female genitalia) or rimming (oral contact with the anus).

What about heterosexual transmission? Continue reading

Is Douching Safe?

This vintage douche ad claims that its product is “safe to delicate tissues” and “non-poisonous.”

Douching is the practice of squirting a liquid, called a douche, into the vagina. Many people believe it helps keep the vagina clean and odor-free, and some are under the impression that it helps prevent pregnancy and sexually transmitted diseases. An estimated 25 percent of American women 15 to 44 years old douche regularly. But just because douching is widespread doesn’t mean it’s safe; indeed, there are two possible mechanisms by which douching might be harmful.

First, douching might alter the pH of the vagina, changing its ecosystem. You might not think of a vagina as an “ecosystem,” but the bacteria and other microscopic organisms that live there sure do — and altering their habitat can harm the beneficial microbes that live there, opening the door for disease-causing microbes to take over the territory. Frequent douching can result in the vagina’s normal microbial population having difficulty reestablishing its population.


Douching increases risk for infections and fertility problems, and has no proven medical benefits.


Second, a douche’s upward flow might give pathogens a “free ride” into the depths of the reproductive tract, granting them access to areas that might have been difficult for them to reach otherwise. In this manner, an infection might spread from the lower reproductive tract to the upper reproductive tract. Douching might be an even bigger risk for female adolescents, whose reproductive anatomy is not fully formed, leaving them more vulnerable to pathogens.

While douching is not guaranteed to harm you, there is no evidence that it is beneficial in any way. Establishing causation between douching and the problems that are associated with it is trickier — does douching cause these problems, or do people who douche also tend to engage in other behaviors that increase risk? So far, the best evidence indicates that douching is correlated with a number of diseases and other problems, including sexually transmitted diseases (STDs), bacterial vaginosis, pelvic inflammatory disease, fertility and pregnancy complications, and more. Continue reading

Does Douching Work?

illustration of a douching apparatus from an 1882 medical handbook

As a newly minted teenager, I was helping my mother go through some of my recently deceased great-grandmother’s things. I held a mysterious object in my hands and studied it curiously, puzzling over its unfamiliar form, pastel color scheme, and floral pattern. Finally, I gave up: “What is this?” I exclaimed. My mom, instantly uncomfortable, muttered her answer through clenched teeth: “It’s a douche bag,” she replied.

I remember being rather scandalized, but also a bit amused to be holding a piece of ancient misogynist history in my hands. Even as a junior high student, I knew that douching was marketed toward women with the message that their vaginas were “dirty” and in need of “cleansing” — scientifically invalidated ideas to which we surely no longer adhered. It seemed fitting that we were sorting through the belongings of a person born in the 19th century, dividing them into the useful and useless. Surely the douche bag belonged in the latter category.


Just because douching products are available in drugstores doesn’t mean they’re safe or effective.


Little did I know, more than 20 years ago, that douching hasn’t exactly been relegated to a historical footnote. Overall, nearly 25 percent of American women 15 to 44 years old douche regularly — which is down from nearly a third in 2002. Douching rates may vary by ethnic group: CDC data from 2005 found that 59 percent of non-Hispanic black women, 36 percent of Latinas, and 27 percent of white women douche. Socioeconomic status and education level can also be a factor.

For those of you who don’t know, vaginal douching is the practice of flushing the vagina with a liquid, which is administered through a nozzle that is inserted into the vagina. Some people believe that douching cleanses or deodorizes the vagina, or can prevent pregnancy or infections. Some might think their partners expect them to douche, or that douching will “tighten” or “rejuvenate” their vaginas.  Continue reading

Pro-Choice Friday News Rundown

  • Plan BBring out the balloons, champagne flutes, and noisemakers. Look what the cat is dragging in come 2017: MALE BIRTH CONTROL NOT IN THE FORM OF A CONDOM! (The Daily Beast)
  • Are men treated differently than women when buying emergency contraception? (New York Daily News)
  • Overriding Democratic Gov. Jay Nixon’s veto, Republican lawmakers in Missouri have forced a 72-hour waiting period for abortions into law. They now join South Dakota and Utah as having the longest waiting periods in the United States. Additionally, there are no exceptions for victims of incest or rape. (USA Today)
  • Texas gubernatorial candidate, Wendy Davis, bravely shares her personal abortion story. (Cosmopolitan)
  • Crowdfunding platform, GoFundMe, has banned all fundraisers and content related to abortion. What other safe, legal medical procedures have they banned fundraisers for, you ask? None that we know of. (Salon)
  • Is there any facet of the anti-choice movement that isn’t hypocritical? The corporations opposing the birth control mandate in the Affordable Care Act mostly do not offer any parental leave to help you out with the baby they want you to have no choice but to conceive. (RH Reality Check)
  • Republicans have seemingly done an about-face on birth control, and have been talking an awful lot lately about the Pill being made available over the counter. Please don’t be fooled. They want the entire cost burden to be on the individual woman rather than covered by insurance. I’m trying to think of any other preventive medications they feel this way about off the top of my head, but for some reason I’m drawing a big ol’ blank! (Time)
  • Bustle has an interesting piece on the most restrictive abortion laws in America and, as you may have guessed, it’s really quite painstaking to get an abortion anywhere in this country. (Bustle)
  • Vaginas are magic and powerful vessels and now their contents can make medicine! (Nature)

STD Awareness: Bacterial Vaginosis and Chancroid

Editor’s Note: Please see our post of November 2, 2015 to learn if bacterial vaginosis (BV) can cause sores, and to get the scoop on whether or not it’s actually an STD.

Sexually transmitted diseases can be caused by viruses, bacteria, protozoans, and even animals. Bacterial vaginosis and chancroid are both infections caused by bacteria, which means that they can be treated with antibiotics. While bacterial vaginosis only affects people with vaginas, chancroid disproportionately affects people with penises. You can seek diagnosis and treatment for bacterial vaginosis and chancroid at a Planned Parenthood health center, as well as health clinics, private health-care providers, and health departments.

Bacterial vaginosis is caused by an imbalance of bacteria species in the vagina. Image: renjith krishnan / FreeDigitalPhotos.net

Bacterial vaginosis is caused by an imbalance of bacteria species in the vagina. Image: renjith krishnan / FreeDigitalPhotos.net

Bacterial Vaginosis
Bacterial vaginosis seems to be most commonly caused by the bacteria species Gardnerella vaginalis. Scientists aren’t quite sure how this infection is caused, but risk seems to correlate with a change in sexual partners, having multiple sexual partners, douching, or using an intrauterine device; it can also occur in females who have never been sexually active. It is more common in pregnant women. There is no counterpart to this infection in males, although G. vaginalis can be found in their urethras; this raises the possibility that bacterial vaginosis can be sexually transmitted, in which case it could be directly transmitted between two females or indirectly transmitted from one female to another via a male.

Bacterial vaginosis seems to result from an imbalance in the vaginal flora (“flora” is a somewhat fanciful term for the bacteria that live in your body; under normal circumstances they are harmless and even beneficial). Vaginas usually are habitat to a population of bacteria called Lactobacillus, which produce hydrogen peroxide as a byproduct. When the number of Lactobacillus declines, G. vaginalis is able to move in on Lactobacillus’ old territory. The decrease in Lactobacillus and increase in G. vaginalis leads to a rise in the vagina’s pH. The new vaginal environment is less acidic and more alkaline; a vaginal pH of more than 4.5 is one criterion for the diagnosis of bacterial vaginosis. Another symptom includes a vaginal discharge that may smell somewhat fishy. There might also be genital itching or pain during urination. It is also possible not to have symptoms. Continue reading