In my words: Getting an IUD at UNC Chapel Hill

by Abby Kaufmann, guest blogger and UNC student

After 3 years at UNC-Chapel Hill, I have become very familiar with the general clinic at Campus Health Services but I had never really utilized their Women’s Health Services until this October when I got an intrauterine device (IUD). I am currently interning in a position where 10 hours of my week involves researching articles about reproductive justice issues, many of which are about birth control access and affordability. At the time I began the internship, however, I was not on birth control. The risk I was taking really started to nag at me, making anything intimate seem extra nerve-wracking and less enjoyable until I finally decided to do something about it.

A few weeks prior to making the decision to get an IUD, I had to go to campus health multiple times for a cold that just wouldn’t go away. Each time I was there, I couldn’t help but appreciate the free condoms throughout the building and the pamphlets on safe sex that included tips for queer people. But what really caught my attention were the charts on birth control in every exam room I visited, like this one:

I saw that with condoms, my go-to method of birth-control at the time, there was still anywhere between a 2%-18% chance of getting pregnant (depending upon whether or not they are used correctly).  I had tried things like the pill and the NuvaRing in the past but I was always forgetting when to take the pill or when to replace the ring which I knew made them less effective. I decided that an IUD would be the best way to go; not only are IUDs more effective than birth-control pills and the NuvaRing, they last for years.

The first time I heard about an IUD was in a magazine article in 2012. Even then, I recognized the benefits and expressed interest in getting one to my gynecologist in Cary at the time. She didn’t think it was a good idea and successfully scared me into changing my mind. She told me that, since I had never given birth, it would be painful and that this pain was too much for most of her younger clients so she often had to remove their IUDs. She said that the NuvaRing would be my best option since it would be easier to remember and that it was just as effective as an IUD (I now know that both of these statements were false). I expected a similar reaction at Campus Health but was pleasantly surprised to find a wealth of resources about IUDs and to feel supported by both the nurses and the doctors.

I thought I would be able to just show up, have the procedure, and then go about my business for the next 3 years but this was not the case. When you make an appointment to get an IUD at Campus Health Services, you are required to have a brief consultation first so that you can discuss the various types of IUDs and what to expect during the procedure. After that, I also had to make an appointment for a well woman exam so they could check for STDs, do a pap smear, perform a breast exam, and assess my health in general. While it was a little annoying to have to come back so many times, I realized that it was all because Campus Health actually cared about my overall wellbeing. It also provided a good opportunity to get to know the doctor before the procedure.

Usually, CHS prefers to do the procedure when you are menstruating so that they can rule out any chance of pregnancy (even though they do a pregnancy test anyways) because of the life-threatening risks associated with getting an IUD while pregnant. Because of this, some students may have to wait longer than they would like to before they can get their IUD but in the end, it’s really for their own good.

To say that I was impressed with UNC Campus Health Women’s Services would be an understatement. They made sure I felt comfortable about the procedure not only during the procedure itself but before and after it as well. Never once did I feel judged or discouraged from making my decision.

I would encourage my peers to utilize UNC Campus Health’s birth control resources If you attend a different university, don’t be afraid to contact campus health on your campus to see what services they provide. Also, be sure to check out Bedsider for ways to bring birth control to your campus and to compare methods side-by-side.

I’m thankful for birth control. And I’m thankful that Campus Health Services at UNC understands that, as college students, we already have so many things to worry about and that getting pregnant doesn’t have to be one. #ThxBirthControl

 

Abby originally posted this content during her internship and agreed to let us re-post here with slight modifications as a guest blog. View the original blog post here.

Will This Antibiotic Interfere With My Birth Control?

January in North Carolina means the common cold and the flu kick into high gear. Over the past few weeks, I have seen an increase of prescriptions for antibiotics and cough syrups come to the Campus Health Pharmacy for sick students. Almost every day, I have been asked whether taking antibiotics will interfere with birth control.

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Image courtesy of by Nate Grigg on Flickr

The issue of whether or not antibiotics interfere with the effectiveness of birth control has been a controversial topic for many years. To provide a quick review, there are many forms of birth control that contain both an estrogen and a progestin – pharmacists call these combined hormonal contraceptives.

Combined hormonal contraceptives include:

  • The pill (Yaz, Tri-Sprintec, Cryselle, Heather, etc.)
  • The patch (Ortho Evra)
  • The ring (NuvaRing)

Combined hormonal contraceptives use multiple mechanisms to reduce the possibility of pregnancy. Estrogen suppresses the release of hormones from the pituitary. Progestin suppresses ovulation and thickens cervical mucus to prevent sperm from entering the upper genital tract. Progestin provides most of the contraceptive effects in hormonal contraceptive methods.

Broad-Spectrum Antibiotics and Common Antifungals = OK

Antibiotics routinely used to fight illnesses are the “broad-spectrum” antibiotics. These drugs are called “broad-spectrum” because they can be used to treat a variety of infections caused by many different organisms. These antibiotics include:

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Image courtesy of Global Panorama onFlickr
  • Amoxicillin
  • Azithromycin
  • Clarithromycin
  • Metronidazole
  • Quinolones (ciprofloxacin, ofloxacin)
  • Doxycycline

Common antifungal agents frequently used to treat vaginal yeast infections include:

  • Fluconazole
  • Miconazole

The Centers for Disease Control and Prevention (CDC) classifies broad-spectrum antibiotics and antifungals as category 1 interactions with contraceptives. This means that the CDC has determined that when using a broad-spectrum antibiotic or antifungal, there is no restriction to using them in combination with combined hormonal contraception. Many groups agree with the CDC, including the American College of Obstetricians and Gynecologists. Broad-spectrum antibiotics have not been found to reduce the concentration of hormones in the combined hormonal contraceptives to a sub-therapeutic level that could increase the risk of pregnancy. Therefore, a backup method of birth control is not required for women using combined hormonal contraceptives and broad-spectrum antibiotics. Even patients who may be on a long-term antibiotic, such as erythromycin for acne, will not require a backup method of birth control when taking both the antibiotic and their normal form of birth control.

Enzyme Inducers = Use a backup method

This being said t is still important to ask your pharmacist about whether or not your antibiotic is considered “broad-spectrum,” because there are some antibiotics that do significantly interact with combined hormonal contraceptives.

Antibiotics that are known to definitely affect the efficacy of combined hormonal contraceptives are called “enzyme inducers” because they essentially make your body chew up the hormones in the birth control faster than normal. These types of antibiotics include the following:

  • Rifampin (including some combination antibiotics that contain rifampin)
  • Rifabutin
  • Griseofulvin (used to treat fungal infections)

Rifampin, Rifabutin and griseofulvin are antibiotics known to reduce the levels of hormones in the pill, the patch or the ring. It is very important that women on these antibiotics who also use combined hormonal contraception use a backup method of birth control while they are taking these antibiotics. The CDC has classified these antibiotics as category 3 interactions with combined hormonal contraceptives because when used together, the effectiveness of the birth control is reduced and pregnancy risk is increased.

Remember:

No method of birth control is guaranteed to be 100% effective even when taken correctly and even when using category 1 antibiotics.

Using your contraceptive method correctly, no matter which antibiotic you may need to take, increases the efficacy of the contraceptive method and reduces the risk of pregnancy. Here are some methods recommended by the CDC for how to ensure that your method of birth control is the most effective:

  • If you are taking a pill, make sure to take the pill every day and at the same time every day.
  • If you are using a patch, make sure the patch stays in place and that you change the patch on time, once per week.
  • If you are using a vaginal ring, make sure to remove and replace the ring on time as directed.

When in doubt…

Ask your pharmacist! All of the pharmacists in the Campus Health Pharmacy, located in the basement of Campus Health Services James A. Taylor building, and the Student Stores Pharmacy, located on the third floor of the UNC Student Stores, are happy to talk to you about any questions or concerns you may have. The pharmacists are here to provide further education on how to appropriately take your method of birth control, what to do if you miss a dose, or whether or not you should use a backup method of birth control while you need to take a certain antibiotic for an infection. Asking questions and staying informed is the best way to ensure your health needs are being met.

Jordan Wood is a 4th-year student pharmacist at the UNC Eshelman School of Pharmacy. She grew up just down the road in Hillsborough and attended UNC-Chapel Hill for her undergraduate degree. In her free time, she enjoys horseback riding and baking. 

References:

  1. Hatcher, R. A. (2011). Combined Oral Contraceptives (COCs). Contraceptive Technology(p. 303). New York: Ardent Media Inc.
  2. Centers for Disease Control and Prevention (CDC). (2010). Appendix B: Classifications for Combined Hormonal Contraceptives. Retrieved from http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5904a3.htm
  3. ACOG practice bulletin. No. 73: Use of hormonal contraception in women with coexisting medical conditions. Obstet Gynecol. 2006;107(6):1453-72

Condom-free, non-hormonal male birth control?

by Mary Koenig

What is it?

Vasalgel is a non-hormonal, long-acting, and reversible form of male birth control. Developed by the Parsemus Foundation — a nonprofit organization that works to develop low-cost medical approaches, Vasalgel is a one-time polymer injection based on a different technology called RISUG (reversible inhibition of sperm under guidance) developed in India over 15 years ago. Based on initial animal trials, Parsemus expects that Vasalgel will be as effective in preventing pregnancy as vasectomy.

How does it work?

Vasalgel works by physically blocking the vas deferens, the tube through which sperm pass on their way out of the body. The polymer can be flushed out with a second injection for anyone who wants to start having children.

Who can it benefit?

Obviously, Vasalgel could benefit men who have sex with women; who want to be in control of the birth control methods they use; desire a long-lasting, reversible, one-time method; or who worry about the effectiveness of other forms of birth control.

Vasalgel could also benefit women who have male sexual partners who cannot or would rather not use any of the forms of female contraception available due to their side effects and health impacts.

It could drastically reduce the number of unintended and unwanted pregnancies.

Lovers
Photo by Ben Cutshall, “Lovers.” Flickr, Creative Commons.

Vasalgel could also benefit society as a whole. Including men in the conversation about who controls or is responsible for birth control — a responsibility that has historically, for the most part, fallen on women’s shoulders only — could change the ways we think about . This could create more equitable relationships between men and women, and in society as a whole.

What are the risks?

Because of the way it works, Vasalgel does not protect against the transmission of STIs (sexually transmitted infections) like barrier methods do. Some doctors have expressed concern that men using Vasalgel may be less likely to also use a barrier method — like a condom or female condom — with new or untested partners, increasing their risk for STI.

When can we expect Vasalgel to be available?

The Parsemus Foundation aims to start human trials for Vasalgel next year and estimates that Vasalgel may be on the market as early as 2017.

 

Mary is a recent graduate of UNC-Chapel Hill and a program assistant with UNC Student Wellness. She is interested in health equity, social justice advocacy, and violence prevention initiatives. When she’s not working, she likes to play and listen to music, cook, and snuggle with her cats, Buffy and Giles.

I Hate These Blurred Lines….

You know the tune, you’re probably singing it right now…. So let’s talk about it!  Not about the video, the lyrics, or implications of it — other people have done a great job analyzing that- but let’s talk about the content matter. Continue reading

How do you remember?

Writing it on your hand.  Making a Google task.  Asking your roommate or partner to remind you.

What do you think these things are trying to help someone remember to do?

Prevent pregnancy, of course!

These are just some of the many ways that I’ve heard women use to try and remember to take their birth control pill daily, change their patch weekly, or replace their ring monthly.  Considering that the last big study of pregnancy showed that about 50% of pregnancies in the United States were unintended, many of these methods might not be working so well.  Luckily there are some new ways to reliably remind you or your partner about their birth control and even doctors appointments.

Continue reading