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

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

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

Staying Safe All Summer Long

Ahh summer… a time for picnics in the park, fun in the sun, and summer romance! With school getting out and summer in full swing many people will have a lot more time for a summer lovin’!

summer-love-sunflower

That being said, this week’s blog is all about how to keep yourself safe and protected from unintended pregnancy, STDs, and HIV.

First tip, consider stopping by New Gen (or your local sexual health clinic) to get some routine STD testing. All that is required is that you pee in a cup! The urine will then be tested for chlamydia and gonorrhea – two very common infections. These infections are passed from one person to another through female vaginal fluids and male ejaculatory fluids (cum and pre-cum) of people who are infected. Although it is most commonly passed through sexual intercourse (penis in vagina or penis in anus), it can also be transmitted (passed from one person to another) orally (mouth on penis/vagina/anus). Unfortunately, people with these infections don’t always know they have them because they often don’t have any symptoms. We recommend this test about once a year (under the age of 25) or if you have had any new partner(s) since your last test. The good news is that both infections are completely CURABLE with antibiotics (meaning after you complete the quick and easy treatment, it’s like you never had it in the first place). So why not take some time now to make sure you are tested and treated before any summer flings?

P.S. Want to know more about chlamydia? Click here! And I just realized I haven’t written about gonorrhea yet. Perhaps that’ll be the next post – unless there is something else you are dying to know about first. Let me know!!!

Okay, so although chlamydia and gonorrhea are totally treatable, they are also totally preventable (along with other sexually transmitted infections). You guessed it: condoms! Remember that condoms require special care in hot weather. Condoms need to be stored at room temperature away from direct sunlight to prevent the breakdown of the latex. For this reason, you should not store a condom in your wallet and definitely not in a hot car. Ideally you would carry your condoms in a bag or backpack but you can also keep a condom or two in a front pocket short-term without any keys or other items that may puncture the condom. If you haven’t used the condoms by the time you get back home, put them back in a cool, dry storage space. You can also buy a condom case or reuse items like mint tins (like the Altoids container) for this purpose.

altoids caseWhat about birth control? Well, many of you will have totally different schedules in the summer. For those of you using the pill, patch or ring, you may have to put some extra effort into remembering to take your pills or to change your patch or ring. If you usually take your pill in the morning before school, now you might need to set an alarm instead. Another option is to sign up at Bedsider.org/reminders to set up an email or text reminder to take your birth control. There are even apps for smartphones that will remind you– “myPill” and “Ring Timer” are some examples.  It’s important to keep on schedule with your birth control because if you don’t, it is less effective and you become more at risk for pregnancy.

bedsider_reminder

Summer is also a time that many people go on long trips. Pill, patch, or ring users need to make sure you have enough birth control to get you through your trip. You can call your pharmacy and see how many refills you have, and if you’re on your last refill, call the clinic to see about getting your prescription renewed. If the Depo shot is your birth control of choice, you will want to make sure that your next shot appointment isn’t scheduled when you are going to be out of town. If it is, give New Gen (or your shot provider) a call and see if they can schedule the appointment before or after your trip, so that you stay covered!

Summer Heart

To all the ladies with an Implant or IUD, you’re all set for the summer!  You have a low-maintenance form of birth control and don’t need to stress about it until your 3 years (Implant), 5 years (Mirena IUD), or 10 years (Paragard IUD) are up! Safe summer lovin’ y’all!

In happiness & health,

Shawna & Angela

Reviewed by Andrea Raider, NP

What do YOU like about your birth control method?

What do YOU like about your birth control method?

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The other day, a patient asked me:  “Which birth control method is the best?”  This is a great question!  Although there are some methods more effective than others, “the best” method is the method that works best for you and your life. Finding a birth control that works for you may take some time as you try out different methods, but luckily we have a variety of methods to choose from.  If you try a method out for 3 to 6 months (about the amount of time needed for your body to get used to the method) and aren’t happy with it or find that you are forgetting to take it, you can try another!

We asked our patients and Facebook fans what they like about their birth control method and this is what they said!  You can start to see that each person has their own reasons for why their method works for them.  Let us know what you like in your birth control by posting a comment or emailing us at askshawna@yahoo.com. Everyone who submits a few sentences about their method will receive a $5 gift card to Starbucks or Jamba Juice!

IUD

“I really like the IUD because I don’t like remembering to take a pill every day. I’ve used it for over 5 years and it’s very effective.”

Implant

“I like the Implant because I don’t have to remember or think about it. It hasn’t made me moody or given me side effects.  I also lost a little weight while using it.”

Depo Shot

“I am on the Depo shot and I like that it is convenient—I am very forgetful with pills. It also just works well with my body.”

NuvaRing

“I really like the NuvaRing and have been on it for 6 years. It’s great because I am super inconsistent with taking pills and don’t have a reliable system for being on top of it ever. With the NuvaRing, I can leave it in and not have to think about it. Plus, I have this app on my computer that tells me when to take it out and when to put a new one in. Also, I hear it is a lower dose of hormones than other birth control, which I like. Oh, finally for real now, it has also helped regulate pimples!”

Patch

“I really like the patches because they are simple and effective. I also like it because it’s easy to apply and not noticeable.”

Pills

“I like birth control (pills) because it eases the menstrual cycle and helps my period stay regular.”

“I am on (low-dose pills) and I like that the extra low dosage doesn’t make me nauseous.”

Condoms

“I use condoms; I like them the most because they are non-hormonal and they also protect against STDs.”

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As you can see, it’s all about finding what works for you!  Make an appointment at New Gen (415.502.8336) to talk to a health educator about what YOU want in your birth control method.  You can also check out previous blogs written about these various methods by using the search function on the lower right side of this page underneath the archives titled “What Cha Looking For?”.  You can also visit Bedsider.org methods to learn more about the different methods and see videos of women talking about what they like in their method.

P.S.

Many patients also like to know which method is most effective, which can be part of someone’s decision to pick a certain method.  Check out this chart for more about the effectiveness of different methods:

Chart-3

Remember, the effectiveness of all birth control depends on how well you are using the birth control (not forgetting pills, getting the shot on time, removing the ring or patch correctly, etc.)  If you use your method perfectly it will be more effective, and some methods (like the IUD or Implant) are easier to use perfectly! Still have questions? Email us at askshawna@yahoo.com

-Angela Freitas, AmeriCorps member

Reviewed by Andrea Raider, NP

Not Everybody is Doing “It”

abst1

So often sex educators (myself included) get caught up in teaching about birth control methods, STD prevention and generally being sex positive (the idea that sex is a totally normal part of life) that we forget about abstinence.  Sometimes we get so caught up in fighting back against “abstinence only education” (education in schools that only teach students about NOT having sex) in favor of comprehensive sex education (education in schools that teaches about all kinds of things related to sex and sexual health) that we let the idea of abstinence slip right by us (or only briefly acknowledge it). Comprehensive sex education is supposed to be comprehensive, meaning it should include a real discussion about all things related to sex and sexuality, including abstinence.

abstinence

So what is abstinence?  Abstinence is the practice of refraining from some or all aspects of sexual activity for various reasons.  Meaning, it is a fairly flexible term.  Some people engage in all kinds of sexual behaviors other than penetrative sex (penis in vagina or butt) and consider themselves abstinent.  Others don’t engage in any kind of sexual activity (touching, rubbing, oral sex, etc.).  And the reasons behind why people chose what they do, also vary.  Some people want to avoid pregnancy or STDs (considering it is the ONLY way to prevent pregnancy 100% & depending on the behavior, may protect against STDs 100% too).  Others are abstinent for religious or cultural reasons.  Some want to wait until they feel ready (which is different for everyone).  Really, there are many reasons and they vary from person to person.

Also, anyone can be abstinent.  Just because someone has had sex or engaged in any kind of sexual behavior in the past doesn’t mean they have to continue doing so – even if they are still with the partner they had previously engaged in those behaviors with.

Whatever reasons someone has for being abstinent; here at New Gen we completely support you.  That means we can help you figure out what you are and are not okay with or how to talk to partners about your decision.  You don’t have to be engaging in any kind of sex or sexual activity to come to New Gen to talk to a health educator or clinician about sex related stuff.  Not only do we do the medical stuff like STD testing and birth control but we also do a lot of education about sex related subjects.  Including Abstinence.  So come talk to us!

And I have to thank a very awesome young person for reminding me that abstinence is equally important in the conversation about sex.  Precious Listana is a sophomore in high school and has written this wonderful poem about abstinence.

Virginity Unbroken

It’s been 2 years, 6 months and 10 days.
I am just a teen, I’m not ready.
“It’s just another phase baby come and lie with me already”
He tells me, and I wonder
“Is this my relationship?
What choice do I prefer?”
He stares; starts to unzip his clothes.
I whimper.
He stops and listens
Everything stirs around me.
“Please don’t do this!”
He puts his clothes on and yawns.
We sleep.

In happiness & health,

Shawna

P.S. If you are interested in submitting a poem, article, story, artwork or whatever else about reproductive health for this blog I most definitely encourage you to do so. If featured, you could win a $25 gift card to Old Navy!  As always, if you have any questions about this or anything else, email askshawna@yahoo.com.