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 –

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:

In happiness & health,


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

Prescription for Success – The Pharmacy Low Down!

Hi Shawna,

I just finished my last pack of pills – how do I get more?


Good Question!

Prescription and pharmacy questions are some of the most frequently asked questions we get – it’s about time I blog about it.

Before I begin, let me clarify some terms.

Prescriptions: Medications that require a clinician’s approval.

Over the Counter Medications: Medications, like Tylenol or NyQuil, which can be purchased without a clinician’s approval.

Refill: A refill is more of your medicine that you already have a prescription for. Some medicines are only needed once whereas other medicines are needed over a long period of time – like birth control pills.

Pharmacy: Where medications, both prescriptions and over the counter, are dispensed and/or sold. Walgreens, CVS, and Safeway are some of the most common pharmacies used by NGHC patients.


Many places give patients a piece of paper (like the one below) that they must take to a pharmacy in order to get their prescription but here at NGHC we send prescriptions electronically (like an email).

Rx Pad

Picking up your prescription:

Go to the pharmacy counter and let the pharmacist know you are picking up a prescription. Give them your picture ID (if you have one) and your Family Pact Card. It’s okay if you don’t have an ID because they can verify your identity by asking you various questions (like birth date or address). But it’s really important to have your Family Pact card because it’s the reason the medications we prescribed you are free. Without this card, the pharmacist may attempt to charge you for your medication (which can be very expensive). 

*Family Pact does not cover all medications but it does cover the medications we prescribe at NGHC (like birth control and STD treatment). It will not cover the cost of other medication (like acne or asthma medication). If you have any questions about this, ask the person prescribing you the medication or the pharmacist.


If you have any questions about the medication, be sure to ask the pharmacist. Common questions include:

        Should I eat before I take this medication?

        Should I avoid certain food or alcohol when taking this medication?

        How long should I take this medication for?

        Are there any side effects from taking this medication?

It’s really important that you get all your questions answered. Some medications can have some very bad consequences if taken incorrectly.

If you forget to ask the pharmacist or are too embarrassed, you can call NGHC and ask us. We’d be happy to answer any questions about the medication that we prescribed to you.

Before you leave the pharmacy, check the label on the prescription and make sure everything is correct. If not, let the pharmacist know. The medication will also likely come with a sheet of information about the medication. Make sure you read it, especially if you have never taken the medication.

The picture below shows you how to read a medication label. All medications will have this information.



If you are taking a medication more than once, like the birth control pills, you will need refills. For almost every patient we prescribe birth control to, we also give refills. Look at the label and see if you have any refills left. If you do, call the pharmacy BEFORE you run out and ask them to refill the prescription. Be sure to pick it up before you run out.

If the label says you have no refills left, call NGHC and ask for a refill. Whoever takes your call will deliver the message to one of the clinicians so they can send in another prescription for you. It may take a few days for that to happen so make sure you let us know before you are completely out of your medication.


All your personal information, including your prescriptions, is confidential. The pharmacy is not allowed to tell anyone, including your parents, about your medications. However, if you use the same pharmacy your family does, we suggest informing the pharmacists that you really do need all your medications confidential. Make sure they have your phone number and know how to contact you if you share your phone number with family.

A few pharmacy tips:

If you use any major pharmacy, like Walgreens or CVS, you can pick up your prescription at any location. You can either walk in or call the location you want to pick them up at and tell them that you normally pick them up elsewhere but that you’d like to get them there. All larger pharmacies are connected and can see where your prescription was sent. Just note, it may take a little longer for your prescription to be ready.

Some major pharmacies have apps that make ordering and refilling super easy. Ask your pharmacy if they have an app.


I hope this answers some of your questions about prescriptions and pharmacies. If you still have questions, let me know (I know this stuff can be a little confusing).

In happiness & health,


Reviewed by Kohar Der Simonian, MD

Happy Pride Everyone!!!

New Gen joins in on celebrating LGBTQI Pride!

We are not claiming to be experts on this subject. Like all kinds of people, many LGBTQI people have their own way of explaining what their identity means to them or what their experience may be . This blog is just a brief view into what is a huge and active conversation around the world. If you find yourself wanting to learn more, or want to join in on that conversation, we include some sites to check out at the end of this blog.

This past weekend, June 29-30, was Pride Weekend in San Francisco—a weekend when people from across the country and throughout the Bay Area come together to celebrate the LGBTQI community. According to the SFPride website, this event is “the largest LGBT gathering in the nation.” This is something for all San Franciscans to be proud of!

Identifying with one or more of these terms is totally personal. It is 100% OK if you don’t identify with any of these terms or don’t know which of these you consider yourself right now. It’s also totally normal if how you identify changes over a lifetime. While the identities represented by all these letters may be separate, many of the people in these groups have come together to support each other and work for a common cause of acceptance, equal rights and access to services. Even if we don’t personally identify with any of these letters, many of us have loved ones, friends, coworkers, and neighbors who do. As a clinic, we welcome LGBTQI patients and do our best to make every person comfortable!

 So what do all these letters stand for exactly? They represent different kinds of

Sexualities—Based on sexual attraction and romantic love: homosexual, heterosexual, bisexual, queer.

Gender Expression—Based on how a person wants the world to see them: feminine, masculine, transgender*, androgynous*,   or genderqueer*.

*Some transgender people may identify simply as female or male, while others may identify as trans.

*Androgynous: some people desire to look neither masculine nor feminine.

*Genderqueer: some people desire to look sometimes feminine, sometimes masculine, sometimes both or neither, and not stick to one gender at all times.

Biological sexesBased on sexual anatomy: male, female, intersex.

All three of these identities can and do include more than just appearance — identity is never that simple. As you read on, you’ll see there is a lot of grey in between.


L: Lesbian. Women who are attracted to other women.

G: Gay. Someone who is attracted to other people of the same sex. A man who is attracted to other men OR a woman who is attracted to other women.

B: Bisexual. A person who is attracted to people of both sexes.

T: Transgender. A person who identifies as a different gender than the biological sex they were assigned at birth based on their sexual organs. The gender with which someone identifies does not necessarily have to do with their sexual orientation (heterosexual, homosexual, bisexual, queer).

Q: Queer. Some people prefer to call themselves “queer” instead of “gay” or “bisexual” because they feel it is less confining (they may feel attracted to people regardless of gender or not want to think about attraction in terms of two genders or sexes).

I: Intersex. A person who is biologically both sexes. This can mean they have the hormones, genes, and/or anatomy of both a male and female.

It can be a huge leap for someone to open up to friends, family, health care providers, employers or coworkers about any one of these identities. That’s what make events like Pride Weekend so awesome!

Happy Pride Everyone! This past weekend and everyday!

Barbara Haupt

For more information check out:

San Francisco LGBT Community Center – Resources for LGBTQI people an queer education.

LyricActivities, tutoring, recreation, health and sex ed. for GLBTQ youth

SFQueer A Calendar for Queer events and activities in the Bay Area

The Trevor Project 24 hr. suicide prevention and crisis hotline

Transgendered San Francisco Support and social group for the Transgender community.

Intersex Society for North America

National Center for Lesbian Rights

Gonorrhea — Hard to Spell, Easy to Catch!

Okay, this may sound very familiar to the blog about chlamydia and that’s because chlamydia and gonorrhea are very similar.


Gonorrhea is a very common sexually transmitted infection in the United States and we see it often here at New Generation Health Center.

What is Gonorrhea?

Gonorrhea is a bacterial infection caused by bacteria called Neisseria gonorrhoeae

How Do People Get Gonorrhea?

Gonorrhea is 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). Meaning, it’s possible to get gonorrhea in your vagina, penis, anus, or your mouth, depending on how you have sex. Gonorrhea can also be spread from an untreated mother to her baby during childbirth. However, if a pregnant woman is receiving prenatal care she is tested and treated for any STD’s making this type of transmission far less common.

You can’t catch gonorrhea from a towel, doorknob, or toilet seat.

*Anus is the butthole

What are the Symptoms of Gonorrhea?

Unfortunately, most people don’t experience any symptoms and therefore don’t know they have it. The lack of symptoms is why gonorrhea is such a common infection – it is easily passed unknowingly!

But for those who do have symptoms, they usually go as follows:

For women symptoms may include vaginal discharge; pain and/or burning with urination (peeing); vaginal bleeding between periods; and/or pain during sex. Women with gonorrhea are also at risk of developing serious complications from the infection, even if symptoms are not present or are mild. That’s why it’s super important to get tested regularly.

For men symptoms may include white, yellow, or green discharge from the penis and/or pain with urination (peeing). Sometimes men with gonorrhea can get painful or swollen testicles.

For both men and women, anal infections may not cause any symptoms.  But if symptoms are present it may include discharge, itching, soreness, bleeding, or painful bowl movements (pain when pooping).

Infections in the throat may cause a sore throat but usually cause no symptoms.


How is Gonorrhea Treated?

Fortunately, gonorrhea is curable. Just 2 pills and an injection (shot) of antibiotics and no bodily fluid exchanges for a week (meaning no sex or sex with a condom) and it’s gone like you never had it. But treating it once doesn’t mean you can’t get it again in the future if you are re-exposed. That’s why it’s important that any partners you have also get tested and/or treated and that you use condoms to protect yourself in the future!

What is the Test for Gonorrhea?

Sterile Urine Cup

EASY!  Pee in a cup!!! That’s all we ask you to do here at NGHC anyway. Other clinics may take a swab (use a big Q-Tip) of the vagina, penis, or anus. The sample (pee or swab) is then sent to a lab where it takes about a week to process and get the results.

*If someone is on the receiving end of anal sex (meaning a penis is being put into their butt) a swab will be used to test instead of urine.  

We recommend that sexually active teens and young adults test for gonorrhea at least once a year. More if they have more than one partner or are having unprotected sex (sex without a condom).

Routine testing is important (even if no symptoms are present) because if gonorrhea is left untreated it can lead to a more serious infection that can cause infertility (not being able to get pregnant) in the future.

rectal-cultureHow Do You Prevent Gonorrhea?

Play Safe

Luckily, this is also easy! Use condoms. Condoms prevent the sharing of fluids. No exposure to fluids = no gonorrhea! Also, talk to your partner(s) about their STD status. If they haven’t been tested recently, you may want to wait to have sex.

Get tested! Use Condoms!

Check out San Francisco City Clinic for more information!

In happiness & health,


Reviewed by Kohar Der Simonia, MD

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’!


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 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.


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

Meet the Faces of New Generation Health Center: Part 3

It’s been a few weeks — you know what that means! Meet the Faces of New Generation Health Center: Part 3! I am especially excited to introduce these women because they have written several awesome blogs for JustAskShawna. So without further adieu meet Barbara, Angela, and Mei-Lani.

BarbaraI’m Barbara and I’ve been at NGHC since the end of September. I have never worked in any other health clinics– this is my first! I have always loved working with women and young people, and enjoy the more personal nature of reproductive health. Many young people have not yet had to deal with many medical issues, and so this particular kind of health is a key avenue into caring for our bodies and our relationships. It also inherently brings up many emotional and relationship-related issues for people, and I have a background in counseling and psychology so I find this super stimulating with every new client. I learned to speak Spanish five years ago when I lived with a host family in Argentina for a year.

In my spare time, I love to have conversations, cook, bake, travel and explore the outdoors. I particularly love camping, swimming and lying flat on my back in the sun on a nice grassy patch or stretch of beach. Dinner parties are also a favorite. I grew up on two islands (my mom on one and my dad on the other) in the Puget Sound, near Seattle. Then I went to college in a little school upstate from New York City. I don’t really remember any particular classes in school on reproductive health, other than vaguely covering the basics in health class. From this I sort of think my school must have had a pretty hands-off philosophy when it came to sex-ed. Luckily my mom was more than happy to share way too much with me from a very young age.

AngelaHola, my name is Angela! I joined the New Gen team in September as a Health Educator and am excited to support SF youth in taking charge of their sexual health. I’ve spent most of my life in the Bay Area, except for stints in South Africa, Pennsylvania and New York. In college I took classes on female sexuality and felt empowered to know how to keep my body, mind, and relationships healthy. After working as an outdoor educator for 3 years, I decided to switch gears and pursue my passion for sexual health. I worked at the Pittsburgh AIDS Task Force and earned a Masters degree in Health Education. Outside of work, I like to spend my time dancing, hiking and playing with my cats Muenster and Brie.

Mei2Hey there, my name is Mei-Lani. I’m a volunteer Health Educator that you might see in the clinic or maybe out in your school. I grew up loving the snow in Alaska, but moved to San Francisco for the culture, community, and to be around my family. I speak Spanish even though I am half Chinese. When I’m not in the clinic, you might find me out biking, cooking, running around outside, doing yoga, or taking pictures.

I got into working with teens after doing research with Chilean teens about what influenced their decisions on birth control and sexual health. It made me think a lot about how in the US there isn’t enough good info or comfortable teachers for teens to learn about sex. All I can remember about my high school sex ed was a handout on the pill and a teacher who passed around cauliflower to tell us that it was like genital warts (I still have a hard time eating cauliflower). I’m happy to be here to give you all the right info that lets you make your own decisions over your own health.

Aren’t these ladies awesome?? If you see them around the clinic don’t hesitate to say hello or ask them any questions you may have. Next month you’ll meet Jenny, Leslie, and Tino!!! Stayed tuned!

And from everyone here at NGHC, we hope you have a wonderful and safe Memorial Day weekend!

In happiness & health,



What do YOU like about your birth control method?

What do YOU like about your birth control method?


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 Everyone who submits a few sentences about their method will receive a $5 gift card to Starbucks or Jamba Juice!


“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.”


“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.”


“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!”


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


“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.”


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


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 methods to learn more about the different methods and see videos of women talking about what they like in their method.


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:


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

-Angela Freitas, AmeriCorps member

Reviewed by Andrea Raider, NP