On and Off the Birth Control Train

Hi Shawna,

I’ve stopped taking my pills a month ago because I wanted to try a different method but I changed my mind and want to stick to pills. I still have 3 filled packs. Is it safe if I start again tomorrow?

Questions about the Pill

PrintHi,

This is a great question!!

You can definitely restart your pills tomorrow or whenever you’d like! Just remember to use a backup method, like condoms, for the entire first week. In fact, you should always use condoms if you are concerned about STD’s or HIV. Also, your period might be slightly off for the first pill pack, but that is normal and OK. If you don’t get a period in 4 weeks, come in for a pregnancy test.

01-condom-and-the-pillpill_condom_300x300_istock_7

 

 

 

 

 

 

 

 

 

Hope this helps answer your question!

In happiness & health,

Shawna

Want more information about the pill, like what to do if you miss a pill, click here!

Reviewed by Kohar Der Simonian, MD

To bleed or not to bleed?? How to control your period using the NuvaRing!

Hi Shawna,

I am going on vacation soon and really don’t want to be on my period. I am using the NuvaRing and my best friend told me that if I kept it in, I would skip my period. Is that true?

-Anonymous

Swim-when-You-Are-on-Your-Period-Step-5

Hi,

Great question! Your friend is right!

Although I have written about the ring before, I have not written about how to use it to skip periods (which is totally safe). For those who have never heard of the NuvaRing or still a bit confused about it, check out my previous blog post by clicking here.

NuvaRing 1

It’s actually pretty simple to skip a period using the ring. Instead of taking the ring out after 3 weeks and going ring free for a week, simply leave the ring in for 4 weeks and immediately replace it with a new ring when the 4 weeks is up. This means there will not be a time in which you aren’t wearing a ring. Don’t worry; your ring is still protecting you against pregnancy during the 4th week, just don’t forget to remove it and replace it when the 4th week is up. You can do this just once or continually. And remember, it’s totally safe not to have a period, so using your ring in this way is a great option for people who hate having their periods.

grace-period-300x199
Let me know if you have any other questions!

In happiness & health,

Shawna

Reviewed by Kohar Der Simonian, MD

Get the Skinny on Weight Gain & Birth Control

Many women are worried about gaining wight on birth control. In fact, it’s something women ask us about nearly every day here at New Gen. Fortunately, it’s not necessarily true. Check out this article written for Bedsider by Jessica Morse, MD, MPH. Some of you might even remember Dr. Morse, she was a clinician here at New Gen a few years ago and she is most definitely missed!

BCM & Weight Gain

What myths have you heard about birth control??? First 3 people who leave a comment about a birth control myth they’ve heard will win a $5 gift card to Starbucks or Jamba Juice.

Gaining weight: Is it the birth control?
If those skinny jeans are feeling a bit too skinny, don’t assume your birth control is the cause.

It’s a common story. A woman starts using hormonal birth control, finds herself gaining weight, and assumes the birth control is to blame. The tricky thing is that lots of research about hormonal birth control shows that, with one important exception, it’s probably not the birth control.

A note on personal experiences vs. the big picture:
Before we lay out the evidence, we want to acknowledge the difference between looking at lots of women on average versus an individual woman. Research tells us about women on average, but not about specific women’s experiences. When we describe what happens for women on average, we are not dissing personal stories. (Bedsider has big love for personal stories!)

Here’s why the big picture is important: it sets our expectations. Being influenced by our expectations is a basic part of human nature. That’s why the placebo effect exists, and it’s why this hatpin trick is gross even though we know it’s fake.
The big picture

Researchers have looked at whether hormonal birth control makes it more likely to get bloated or hungry. They’ve also looked at women’s weight changes over time when using specific birth control methods and compared them with women using methods with no hormones. With one exception, they’ve found no direct link between using hormonal birth control and gaining weight. Here are the details.

IUDs: There are two kinds of IUDs. One kind releases a low dose of progestin hormone (Mirena and Skyla) and the other kind has no hormones (ParaGard). Both kinds of IUDs mainly work inside the uterus, so there are minimal effects on the rest of the body. Studies show no difference in weight changes between women using hormonal IUDs and women using birth control without hormones.

The implant: The implant also releases a low dose of progestin hormone. Because the implant is relatively new, there are fewer studies about it. Early studies showed that about 5% of women using the implant got them removed due to concerns about weight gain. However, the weight changes don’t appear to be different between women using the implant and women using birth control without hormones.

The pill, the patch, and the ring: Birth control pills contain both an estrogen and progestin hormone, and are probably one of the most studied medicines on Earth. Many studies show that the pill does not cause weight gain, yet concern about weight gain is the main reason why women quit taking it. The ring and the patch are similar to the pill in terms of their ingredients and dose, so are not likely to cause weight gain, either.

That important exception

The shot: Most women don’t gain weight because of the shot, but some do. Interestingly, weight gain on the shot seems to be more common in young women who are already considered overweight. Additionally, the women prone to gaining weight because of the shot will usually notice a change within the first six months. If weight gain is absolutely not okay for you, the shot may not be the best choice.

The takeaway:

Understanding all of the details that can affect weight—like diet, exercise, and genetics—can feel overwhelming. The tendency is for people to gain weight throughout their lives, so being a year older is more likely to cause weight gain than birth control. But like we said—this is on average and doesn’t take into account women’s personal experiences. If you think your birth control is affecting your weight in a way you don’t like, talk to your health care provider to find another effective method that works for you.

No matter what birth control you’re using, it’s important to get a daily cardiovascular workout. And no one says you have to leave the bedroom for that.

Jessica Morse, MD, MPH

Exercise & Eating

Thank you Bedsider and Dr. Morse for busting this common myth!

In happiness & health,

Shawna

Don’t forget to leave a comment about birth control myths you’ve heard to win a $5 gift card to Starbucks of Jamba Juice!

Stick It Before You Kick It! The 101 on the Birth Control Patch!

Happy 2014!!

This is the first blog of the year! Yay! It’s also the last Friday of the month! Why is that important? Well, I will now only be posting new blogs on the last Friday of the month! I may sneak additional blogs in from time to time but from here on out, you can expect to see a new post at the end of the month. Don’t worry though; you can still contact me by email anytime you have any questions – askshawna@yahoo.com

The first blog of the year is about the birth control patch. I have gotten several emails lately with questions about the patch and so I’m here to tell you all about it! And as always, feel free to comment or email any additional questions you may have.

What is the birth control patch?

T_BC_the-patchThe birth control patch is a small patch that sticks to your skin to prevent pregnancy. Like other methods of birth control, the patch includes a combination of an estrogen (estradiol) and progestogen (progestin) to prevent pregnancy. If used correctly, the patch is a very effective (meaning it works really well) at preventing pregnancy.

How does the birth control patch work?

The patch works by “telling” the ovaries not to release an egg (called ovulation). If no egg is released, there is nothing for sperm to fertilize (the fertilization of an egg by sperm results in pregnancy). However, if the patch is missed or used incorrectly, the ovaries don’t get the message (and may release an egg) making pregnancy possible if there has been recent unprotected sex (sex without a condom).

How to use the patch:

Patch How ToWear the first patch for 7 days. At the end of the 7 days, take off the first patch and apply a new patch in a different location (see below for acceptable patch locations). At the end of those 7 days, take the second patch off and apply a new one in a different location. After the end of those 7 days, take the patch off and DO NOT apply another one. Instead, leave the patch off for 7 days. That’s, 3 weeks on & 1 week off.

It’s during those 7 days of NOT wearing a patch that most women get their period (however, some women may or may not bleed the entire 7 days). Regardless of whether or not you are still bleeding, start a new patch only when the 7 days are complete. No sooner and no later.

Never go more than 7 days without wearing a patch, if you do, you may get pregnant.

Don’t use lotions or makeup on your skin near where the patch is

Don’t put the patch on the same part of your body for 2 weeks in a row – skin may become irritated. Also, don’t wear the path on your legs or breasts.

Some women experience breast tenderness when they first start using the patch. That generally goes away within a few weeks.

Before applying a new patch, think about the clothes you may wear that week and whether or not the patch may be visible.

Why some people love the birth control patch:

What to do if a patch falls off or I make a mistake?  

Issues and mistakes with the patch happen. Although the patch is designed not to come off the skin, it’s definitely possible. Also, sometimes patch users forget when to take off or put on a new patch (if you forget often, you might want to consider switching birth control methods). Knowing what to do if that happens can help prevent an unplanned pregnancy. Read the following for some general instructions on what to do if a patch mistake happens!

If a Patch edge lifts up:

Press down firmly on the Patch with the palm of your hand for 10 seconds, making sure that the whole Patch adheres to your skin. Run your fingers over the entire surface area to smooth out any “wrinkles” around the edges of the Patch.

  • If your Patch does not stick completely, remove it and apply a replacement Patch (no backup method is needed and your Patch Change Day will stay the same). Ask your healthcare professional for a replacement Patch prescription so you always have an extra Patch available.
  • Do not tape or wrap the Patch to your skin or reapply a Patch that is partially adhered to clothing

If your Patch has been off or partially off:

  • For less than 1 Day, try to reapply it. If the Patch does not adhere completely, apply a new patch immediately. (No backup contraception is needed and your Patch Change Day will stay the same)
  • For more than 1 Day or if you are not sure for how long, you may become pregnant. To reduce this risk, apply a new Patch and start a new 4-week cycle. You will now have a new Patch Change Day and must use non-hormonal backup contraception (such as a condoms) for the first week of your new cycle

How to purchase a REPLACEMENT Patch:

  • You can get a replacement Patch at the pharmacy where you filled your prescription
  • You will need a replacement Patch prescription from your healthcare professional
  • Unfortunately, Family Pact does not pay for the replacement patch. You will need to pay for the replacement Patch when you pick it up at the pharmacy.

From the Ortho Evra website:

http://www.orthoevra.com/how-use-loose-fall.html

In happiness & health,

Shawna

Reviewed by Kohar Der Simonian, MD and Andrea Raider, NP

A Pill a Day Will Keep an Unintended Pregnancy Away!

What is the birth control pill?

The birth control pill (also called “the Pill”) is a birth control method that includes a combination of an estrogen (estradiol) and progestogen (progestin) to prevent pregnancy. If taken correctly, the pill is a very effective (meaning it works really well) at preventing pregnancy. Although there a lot of different types of pills, they all work the same way. They vary by brand or by the amount of hormones in them. If you are interested in the pill, talk to your clinician about which one might be the best option for you. And if you’ve tried the pill before and didn’t like it for a reason other than forgetting to take it, talk to your clinician about the other types of pills available.

PrintThere is a pill that is progestin only – called the mini pill. The mini pill has slightly different instructions than what is listed below. If you are using the mini pill, please discuss proper usage instructions with your clinician or pharmacist.

How does the birth control pill work?

The pill works by “telling” the ovaries not to release an egg (called ovulation). If no egg is released, there is nothing for sperm to fertilize (the fertilization of an egg by sperm results in pregnancy). However, if a pill is forgotten or missed the ovaries don’t get the message (and may release an egg) making pregnancy possible if there has been recent unprotected sex (sex without a condom).

ovulation-period-920270

How to use the birth control pill:

The birth control pill is most effective (works the best) when taken every day around the same time of day – the first week is especially important. A typical pill pack has 28 pills – 21 of those pills contain hormones and the other 7 do not. It’s during those 7 non-hormonal pills that most women get their period (however, some women may or may not bleed the entire 7 days). Regardless of whether or not you are still bleeding, start a new pack only when the 7 days of non-hormonal pills are complete. No sooner and no later.

ocp_instructions

*Every pack looks a bit different. Some are round. Some are square. Some are rectangular. Make sure you talk to your clinician or pharmacist about which pills are the active pills (the pills with hormones) and which are the non-active pills (the non-hormonal pills taken during the week in which you can expect your period). Also, not everyone starts their new pack on a Sunday. Whatever day you choose to start, be sure it’s the same day every month (meaning, if you start a new pack on Tuesday, every new pack thereafter will start on a Tuesday).

What to do if a pill or two are missed:

It’s common to forget a pill from time to time (if you forget often, you might want to consider switching birth control methods). Knowing what to do if that happens can help prevent an unplanned pregnancy. Here are some general instructions on what to do if you forget a pill or two.

Forget

Number of Pills Missed

When Pills Missed

What to do …

 “Should I use condoms?

First 1 pill

Beginning of pack 

  • Take a pill as soon as you remember.
  • Take the next pill at the usual time.

(This means you may take two pills in one day.)

Yes, use condoms for 1 week.

 

1 pills

First week of pack

  • Take a pill as soon as you remember.
  • Take the next pill at the usual time.

(This means you may take two pills in one day.) 

Yes, use condoms for 1 week.

2 pills

2nd and 3rd week of pack

  • Take 2 pills 2 days in a row

For example, if you forget pills on Monday & Tuesday, you would take 2 pills on Wednesday & 2 pills on Thursday.

No

3 or more pills

Any time in pack

  • Do not finish pack. Throw away remaining pills.
  • Start next pack.*

*If you use Family Pact, you can only pick up 3 packs of pills every 3 months. If you throw away a pack and start a new one because of missed pills, you will not have enough pills/packs to last until your next refill. If this is the case, please call New Generation Health Center. We have pills on site that we can give to you.

Yes, use condoms for 1st week of new pack.

I know this was A LOT of information. If you have any questions, you are always welcome to comment, send an email to askshawna@yahoo.com, call or make an appointment at New Gen (415.502.8336).

In happiness & health,

Shawna

Reviewed by Kohar Der Simonian, MD

Happy Halloween!!!

Halloween 1

It’s Halloween and for many of you that means awesome parties! I want to give you a few tips to stay safe while still having  fun!

Transportation

2379856938_377ed25813Transportation is a HUGE piece of the going out puzzle. PLAN AHEAD about how you will get around. Public transportation is great, especially if you will be drinking (more on that next). Make sure you have enough money for the bus or for Bart and be sure to keep track of the time so you don’t miss the last bus/train (set a timer on your phone). Or stash a bit of money away for a cab at the end of the night (keep in mind; it can be tough to get a cab in the city on Halloween night). And if driving is a must, make sure that whoever is driving DOES NOT DRINK AT ALL. It only takes one drink to impair someone’s driving. I know that nobody ever thinks an accident will happen to them, but it does.  If you can, plan for someone to pick you up (parents, older siblings, friends who are not going out, etc.). Whatever you do, be extra safe. All modes of transportation can be a little more dangerous during the holidays.

halloween_1035

Drinking

The first thing many people associate parties with is drinking. Although some of you probably aren’t old enough to drink, I know that may not stop you. I could give you a million and one reasons why you shouldn’t drink (believe me, there are many) but instead I will give you a few tips about drinking as safely as possible. These tips apply to the 21 & over drinkers too!

1. Before you go out, think about and decide how much you will drink. Establishing guidelines before you go out will help you stay aware of how much you are actually drinking. Also, if you are going somewhere you will be spending money on alcohol, bring a small amount of cash rather than an ATM or credit card. Having access to a limited amount of funds will help keep both your bank account in check but also the amount you can drink.

limit 1

2. Drink a glass of water with every alcoholic beverage you have. This will keep you hydrated and slow down the rate at which you are drinking. The slower you drink, the more likely you will be able to monitor the effects of the alcohol and know when you should stop.

water

3. Also, it can be hard to say no when all your friends keep drinking – they may even be encouraging you to keep drinking too.  Although they are probably just trying to keep you in the party mood, drinking more than you are comfortable with or more than you planned is dangerous.  Peer pressure (especially from our friends) is often hard to resist. If know you are at your limit but don’t want to deal with your nagging friends, instead of giving in, have a soda water or coke with a lime or lemon in it, NO ALCOHOL. It’ll look like a mixed drink but only YOU will know it’s actually only water or soda.

Screen-Shot-2013-05-07-at-7.15.46-AMMocktails….get it?? Hehehehe

4. Never leave your drink unattended. I know you have probably heard this a million times but that’s only because it’s great advice. You don’t want to take any chances with someone being able to alter your drink by putting drugs or even more alcohol in it. You don’t want to end up drinking more than planned or become unconscious. Either one can leave you in very unsafe situations.

Buddy system

We often go out with friends so why not make a pact before heading out the door? Making a pact will mean that not only are you required to hold yourself accountable but you will also be accountable to each other. Decide if you will be drinking or not (and if so, how much), decide how you feel about meeting someone and the possibility of making out or hooking up, what you will do if you become separated, and when you should leave. Making a pact will mean that you are looking out not just for yourself but for each other.

buddy

Safe Sex

And of course, the safe sex piece. It wouldn’t be a Just Ask Shawna blog if I didn’t mention something about safe sex.  Even though you may not plan on having sex, I encourage you to bring condoms with you *just in case*. We often see patients here at NGHC who need emergency contraception (the morning after pill) because they ended up hooking up with someone even though they didn’t plan to. It’s better to have condoms and not need  them than to need them and not have them. Stop by New Gen and pick some up! Simply ask the front desk & you’ll get a bag of 40 – no questions asked!!! And if you don’t take my advice and you do end up needing the emergency contraception (the morning after pill), please DO come see us. For more information about emergency contraception and how it works, click here!

Two men wearing horse costume, waiting in dressing room

Do you have any other tips or suggestions for a safe Halloween??? If so, leave a comment and choose from a Starbucks, etsy-announces-gift-cards-0e42146f33Jamba Juice, or movie ticket gift card. If we get 5 or more comments, I will choose someone at random to win a $25 Old Navy gift card! So if you leave a comment, encourage your friends to do so too!

In happiness & health,

Shawna

Reviewed by Kohar Der Simonian, MD

happy-halloween

New Faces at New Gen!!!!

I know it’s been longer than usual since my last post and I am so very sorry BUT I promise I have a good reason. All of us here at New Gen have been really busy training 4 new health educators!!!! Two of the new health educators are the new AmeriCorps members and the other two are San Francisco State University Health Education interns. We are so grateful that these four have joined us. They are proving to be great additions to the New Gen team and like all staff, they are extremely comfortable discussing all things related to sex and relationships so don’t hesitate to ask them questions. So without further adieu, here they are!

AmeriCorps:

AlondraCardenasPhotoHola! My name is Alondra and I am a new Health Educator at New Gen. I have plenty of experience working with teens as a tutor and teacher’s assistant. I am very excited to be working here and helping young men and women make the best reproductive health choices for themselves!
I am originally from Mexico, but grew up in the South Bay. My interests include dancing to a variety of music like cumbia and hip-hop, traveling and going to the beach! I also love to eat delicious, home-cooked Mexican food!

My name is Zoe and I’m a Health Educator at New Gen. I’ve worked at other health centers and clinics doing front desk, Zoeadministration, and translating, but this is the first time I’ve had the opportunity to do education and counseling. I love working with adolescents because they’re still very much in the process of figuring out who they are and becoming comfortable with themselves and in their relationships. It’s a great time to start forming habits and practices that will lead to a healthy and happy life!

I grew up in Pittsburgh, PA, but chose the cornfields of Ohio as the backdrop for my college education. After graduation I spent a brief time in rural Guatemala translating for doctors and physical therapists before making the big move to the Bay Area! So far I’m loving the urban life, spending my free time exploring the city and the natural beauty that surrounds it, enjoying free concerts, finding new spots to eat lunch, doing yoga, and trying to learn how to cook! I’m so excited to work for a health center that values and protects the patient’s right to all kinds of reproductive and sexual health services.

SFSU Health Education Interns:

AriannaHello, my name is Arianna, I am currently in San Francisco State’s Health Education program and I am interning at New Gen for my final semester. Ever since high school, I’ve always had an interest in adolescent reproductive health. Growing up in a Catholic school from K-8th grade, I was never introduced to topics of sex, relationships, or reproductive health. It wasn’t until I started going to school at a public high school, that I began learning about sexual health.
It started with a 15 year old me learning about birth control from a guest speaker in my English class. This lesson made me feel empowered to take control over my own body and protect myself and encourage others to do the same. I was “that one friend” in the group who convinced and encouraged everyone to get on some type of birth control. And I was always the first one to call when someone was nervous to go to the school based health center alone. While working as a Health Educator at New Gen, I hope I can be a valuable resource to youth and empower them to take care of their reproductive and overall health and well being. One of my goals is to make sure that youth leave here with the knowledge and skills to make their own informative decisions on their health and relationships with others.

Hi everyone! My name is Elaine. I’m interning at New Gen and loving it. I’m a super senior at San Francisco State University Elaine2with a genuine passion in health and wellness. I love spending time in nature, whether that be hiking, hula-hooping, practicing yoga, searching for stones, or just hanging out with loved ones. I’m a vegetarian and very much enjoy cooking. I’m happily involved with a partner of three years and loving life with him in it! We have a pact to travel to a new place every year we are together. As for me, my life is an open book- no questions are off limits!

So next time you’re in the clinic and you see these lovely faces, say hello!!!! And if you’re interested in learning more about either programs click here – AmeriCorps & SFSH Health Education – they are both fantastic ways to get involved in the health care field. But I must admit I am a little biased, I am a graduate of the SFSU Health Education program.

In happiness & health,

Shawna

P.S. I promise I will try not to lag so much between postings. To help me out, send me your questions at askshawna@yahoo.com