ICYMI: ‘Everything You Need to Know About Birth Control’ with Dr. Sophia Yen


Dr. Sophia Yen is CEO and chief medical officer of Pandia Medical Group, a telemedicine observe that makes a speciality of offering contraception, in addition to a scientific affiliate professor of pediatrics within the Adolescent Division of Stanford Medical College. (Courtesy)

For the reason that cataclysmic Supreme Courtroom choice to overturn Roe v. Wade, medical doctors and clinicians are reporting a rise in demand for various types of contraception, together with emergency contraception like Plan B and Ella, and longer-lasting types of contraception like IUDs and contraception implants. However laws defining life as starting at fertilization, proposed at the national level and in at least eight statehouses around the U.S, places contraception entry in danger.

Particularly on this time of disaster, Dr. Sophia Yen says it’s important we take cost of our personal reproductive well being. Yen is the CEO and co-founder of Pandia Health, the one doctor-led and women-founded and -led contraception supply firm. She is a board-certified doctor with a spotlight in adolescent drugs, and serves as a scientific affiliate professor at Stanford Medical College within the Division of Pediatrics. Yen co-founded Pandia Well being as a result of she believes nobody ought to endure from “capsule anxiousness”—the worry of operating out of contraception and the stress of getting to acquire contraception every month. Her newest well being marketing campaign is to coach the general public about #PeriodsOptional.

In a Ms. webinar on Tuesday, “Everything You Ever Wanted to Know About Birth Control,” Yen broke down the very best types of contraception and emergency contraception, why it is best to take into account skipping your interval, find out how to get abortion drugs (even if you happen to stay in a state with a ban), and extra.

Under, discover recordings of the occasion and a transcript, flippantly edited for readability.

Half 1:

Half 2:

Dr. Sophia Yen: It’s so nice to see such an enormous viewers end up for this discuss.

To start with, if you happen to all don’t learn about it, please learn about PlanCPills.org. I exploit my social media as a platform for public service bulletins, so be at liberty to name this a Pandia public service announcement or only a public service announcement by way of Ms. Journal, however everyone ought to try PlanCPills.org. It’s a nonprofit and it has something and all the things you can probably need to learn about medicine abortion, which may be achieved technically as much as 10–12 weeks after your final menstrual interval. If you happen to go to the web site, you kind in your state, it can let you know what telemedicine suppliers are legally allowed to serve you in your state.

They work with Assist Entry. They’re by Dr. Rebecca Gomperts of the Netherlands, and she is going to by no means come to the U.S. in order that she will be able to’t get sued or extradited. She writes the prescriptions within the Netherlands, the medicines come from India and that’s why you see it’s a 14 to 21 day supply interval, however she will be able to service all states, and it’s solely $110 for the physician assist and the medicine.

One radical factor that my buddy who based PlanCPills, Dr. Francine Coeytaux says is you can take into account getting the drugs prematurely of want. You possibly can skip checking a being pregnant check—simply if you miss a period, take these medicines and it simply brings your interval, so the difficulty of abortion by no means comes into play. It’s simply making your interval common, for these states which can be extra restrictive or which have anti-abortion legal guidelines on the market.

They’ll additionally join you with free medical hotlines you can call you probably have any questions on medicine abortion. There’s additionally a legal hotline that’s free, that’s staffed by If/When/How, which was previously Legislation College students for Selection.

After which quantity two, be sure you know in regards to the web site “After Roe Fell: Abortion Laws by State” from the Heart for Reproductive Rights, and it pulls up this map. Inexperienced is expanded entry, yellow is protected, after which orange and purple and actually darkish purple should not good, and as you possibly can see right here, 26-plus states are actually not good. Then you possibly can click on on the particular state for up-to-date legal guidelines, resembling ready durations or six-week ban or 10-week ban or 12-week ban, so that is only a nice useful resource if you happen to’re doing state-to-state advocacy.

The Center for Reproductive Rights’ “After Roe Fell” tool examines state-level legal guidelines and insurance policies. Its interactive maps group states into 5 classes: expanded entry, protected, not protected, hostile and unlawful.

After which there’s the National Network of Abortion Funds and the National Abortion Federation. There are many disaster being pregnant facilities on the market, and if you happen to do a Google for abortion clinic, 20-25 % of what comes up are these disaster being pregnant facilities. They don’t actually have any medical employees, they inform girls lies about abortion—if you happen to get an abortion, you’ll find yourself sterile otherwise you’ll develop into a drug addict, or all kinds of loopy issues.

However these are two trusted web sites. On the Nationwide Community of Abortion Funds, you go there and you may ask for cash by state, and you probably have cash, you possibly can donate cash by state or you possibly can donate it typically. The Nationwide Abortion Federation is a gaggle of abortion suppliers which can be secure.

Quantity 4, delete your interval apps in case you are in any of these states that aren’t pleasant. Individuals are like, “However they are saying they’ll shield my knowledge,” or no matter. Uh-uh. I went to MIT and I’ve buddies that do forensic pc stuff, and so long as if it was ever in your telephone, ever in your pc, or in case your telephone ever uploaded to the Web, which just about all our telephones do, then they’ll discover that info. So, until you solely preserve it in your laptop computer, desktop and then you definately crush that sucker and then you definately throw it into the ocean, which might not be good for the ocean, then if at any time you’d take into account doing a termination, then it is best to delete your interval apps. If termination is just not in your future, then don’t fear about it, but when it could ever be a priority, maybe sexual assault, God forbid, then that’s one thing you actually need to think about.

Optimize your contraception. The implants beats vasectomy, which completely blows my thoughts. That’s one thing you set in your arm, lasts for 3 years, can beat the snip-snip. After which the IUD with hormone beats tubal ligation. I feel it’s loopy sufficient that your physique may get pregnant on tubal ligation, as a result of it’s not simply snip-snip, burn, it’s snip-snip, take out an inch, tie, and burn, and you continue to get pregnant on that, and the IUD with hormone beats that.

Dr. Yen ranks the effectiveness of assorted contraception strategies.

After which subsequent comes up the copper IUD. Be sure you know if you happen to’re on the copper IUD that the 2 main uncomfortable side effects, and there have been numerous copper IUD customers on this name, are extra blood, extra cramps, and so if you happen to’re the type of one that feels each single cramp, perhaps not the copper IUD. If you happen to’re the one that bleeds like stink, perhaps not the copper IUD. If you happen to’re the type of one that’s like, “Oh, is that blood? Is that my interval?” Sure. You. You, the copper IUD. So, the copper IUD is wonderful in that it lasts out for 10 years. The IUD with hormone can final from 5 to seven years.

Then comes the shot, the ring, the patch, the capsule, and the one cause the ring, patch, capsule are available that order is the ring, you have got 12-13 occasions a yr to mess up, the patch, you have got 52 occasions a yr you can mess up, and the capsule, you have got 365 occasions a yr you can mess up.

After which comes condoms. We all the time suggest condoms to forestall in opposition to sexually transmitted infections. Simply assume everybody has each sexually transmitted an infection below the solar, as a result of 90 % of individuals with chlamydia don’t have any signs in any respect. Lots of people with HPV—be sure you get your HPV vaccine, if you happen to haven’t gotten it—they do not know that they’ve it, after which you have got intercourse after which a pair weeks later you get HPV, I assume that particular person had HPV, so higher secure than sorry.

And know that there are completely different thicknesses of condoms, and so at our teen clinic at Stanford, I satisfaction ourselves in getting the very best condoms with the very best sensation, the thinnest condom with out breakage, in order that approach you have got an ideal expertise and also you’re extra seemingly to make use of it.

After which withdrawal, lots of people do use, however withdrawal is just not the best technique, and notably for the one with the penis. Ultimately the physique will adapt and have untimely ejaculation, which is an embarrassing type of factor. But additionally as quickly because the penis is erect, there’s some pre-ejaculate on there that has 10,000 sperm, and I ask individuals, what number of sperm does it take to get pregnant? Only one! Although often you want like 1,000 at the least, however 10,000 sperm within the pre-ejaculate. So, as quickly as penis is up, throw that condom on. Don’t do withdrawal, there’s a danger, nevertheless it’s all about no matter works for you, no matter is finest, and what your danger tolerance is for getting pregnant.

So, there’s a new patch on the market and it’s known as Twirla. Typically, as an educational, we don’t like to talk in title manufacturers. What’s completely different about this one is it has levonorgestrel, whereas Xulane, the unique patch, has a distinct progesterone in it.

Twirla is a hormonal once-weekly contraception patch delivering a low dose of estrogen. It accommodates levonorgestrel and ethinyl estradiol. (Courtesy of Twirla)

The opposite factor is after they checked out Xulane and the blood ranges of estrogen, it was extra like a 50 microgram capsule, whereas most movies are 30-35 microgram, and so typically, medical doctors didn’t like the unique patch as a result of it was too excessive of a hormone, and so this patch was particularly made to have a decrease, extra acceptable hormone.

The unfavorable is it’s $190 as a result of it’s title model versus $110. Nonetheless, because of the Inexpensive Care Act, you probably have insurance coverage, your dad and mom’ insurance coverage or your private insurance coverage and even Medicaid, Medi-Cal, it needs to be lined with no copay, no deductible, as a result of because of Obama and Biden, who handed the Inexpensive Care Act, that’s the regulation that they handed—until your employer is spiritual resembling Passion Foyer or the Catholic Church, or the Jesuit schools like Georgetown, USC, Santa Clara College. The comparability is a normal contraception capsule is $15 per 30 days.

It’s not for individuals who have a BMI 30 or larger as a result of primary, it doesn’t work so properly, and quantity two, you’re at larger danger of blood clots.

So, the geek in me needed to share this graph. The realm below the curve is how a lot estrogen you’re uncovered to, and the extra estrogen you’re uncovered to, the larger danger of blood clot.

So, a 35 microgram capsule right here is up and down, up and down, up and down, nevertheless it doesn’t matter a lot the up and down, however simply the realm below the curve, if you happen to have been to paint this in, is how a lot estrogen you’re uncovered to, and the unique patch is up right here, so you possibly can see that’s numerous estrogen you’re uncovered to, and the brand new patch was developed to imitate the 30-35 microgram capsule.

There’s a one-year vaginal ring, and after I first heard about it, I used to be like, that is wonderful. It’s going to completely destroy the IUD/implant market as a result of there’s a bunch of medical doctors that may’t do the IUD or implant, however actually we will prescribe you a hoop and you may simply stick the ring up there for a yr. So, you heard me proper, you can simply stick the ring up there for a yr. What’s loopy is after they introduced it to the US, the FDA is like, properly, are you able to check it the place it’s three weeks in, one week out so that girls can have an arbitrary bleed one week out of 4? And so they did, and it really works, however know that it was initially examined overseas and it was examined for simply go away it in for a yr, so that you completely may simply go away it in for the yr, however that’s off-label.

It has not been adequately evaluated in these with a BMI larger than 29. It’s efficient, as efficient because the capsule/patch/ring typically. It doesn’t require refrigeration. The unfavorable is it’s costly, $2,500, however as I discussed earlier than, you probably have insurance coverage, below the Inexpensive Care Act, it needs to be accessible with no copay, no deductible.

The unfavorable of it’s it solely has 13 micrograms of estrogen, and as an adolescent drugs specialist, we usually suggest at the least 30 micrograms of estrogen till you’re 30 years outdated. When you’ve got lower than 30 micrograms of estrogen, it’s not good to your bone density, and later once you’re 50-60-70, you’ll have a better danger probably of getting a fracture. So typically, at any time when I give this discuss, a bunch of individuals with uteri will flip over their contraception capsule pack and be like, I’m on 20 micrograms of estrogen. So, if you happen to’re below 30 and also you’re on 20 micrograms of estrogen, it’s not good to your bones—in order that’s your public service announcement or academic scientific pearl to take house right this moment.

The FDA authorized the contraception capsule for distribution in the US by prescription in 1960, however it’s presently solely accessible with a prescription from a physician or pharmacist. (Sarah C / Flickr)

There’s numerous discuss of over-the-counter birth control, and naturally I assist all contraception drugs going over-the-counter. The important thing to know is that not all drugs are the identical. There are 40 completely different contraception drugs in there, and the one which has utilized to go over-the-counter is a progesterone-only capsule. The joke in drugs is: What do you name a girl who’s on a progesterone-only capsule? You name her Mama or pregnant, as a result of the progesterone-only capsule with norethindrone in it, in case you are late by three hours—you’re flying throughout the US, you overlook, you mess up your time zone, you keep out late at a film or no matter like that—you want emergency contraception if you happen to had heterosexual intercourse up to now 5 days and/or if you happen to intend to have intercourse within the subsequent three to 5 days. You’ll want to have backup or abstain or use a condom because the hormone builds again up.

So, it’s not a really forgiving capsule, however if you happen to’re anal retentive and you may take the capsule at the very same time day by day plus or minus two hours, then you definately’re good, however numerous girls have a tough time adhering to that routine.

It’s one thing that we usually give to breastfeeding girls as a result of if you happen to give them a normal contraception capsule with estrogen, that impacts the breast milk in that it might probably lower the manufacturing, in order that’s why we additionally name girls on the progesterone capsule Mama, as a result of they’re usually breastfeeding.

Know that I’m involved that the progesterone-only capsule goes over-the-counter. I feel it completely ought to, but when individuals all like, “Oh, it’s over-the-counter,” and so they go there, we may have numerous pregnant individuals with uteri on our fingers.

After which the subsequent capsule that’s up for going over-the-counter is a 20 microgram capsule, and as I simply mentioned, if you happen to’re below 30 years outdated, we don’t suggest lower than 30 micrograms of estrogen to your bone well being. Nonetheless, if you happen to’re a big-boned girl, you can most likely get away with it—however for individuals who have a better BMI, it’s really higher to be on a better estrogen one, the usual estrogen, not the 20 microgram, as a result of you must get a sure degree to forestall eggs from coming out and for the tactic to truly work.

So, high three causes for lacking a capsule. Primary and two is forgot, away from house, no new pack. What are you able to do about it?

There’s an alarm. An acquaintance of mine has a contraception capsule holder, so you probably have the usual 4 by 7, you slip it in, and once you come out a capsule, it notes it. And if you happen to don’t come out a capsule by a sure time at evening, it can preserve pinging you till you do. After which one other one is an additional journey pack. Ask your physician to provide you some additional packs so you possibly can have one in your journey. I all the time have one in my journey toiletry bag after which I carry one on-person as a result of if my baggage will get caught I don’t need to be actually screwed or bleeding after I don’t need to bleed.

After which know that as a physician, I didn’t know that if I write dispense one, refill occasions 11 or 12, that I’m really tying you to the pharmacy and forcing you to go each single month. A pharmacy can’t increase a physician’s prescription, however they completely can constrict it. So, you possibly can educate your physician, “Dr. Sophia Yen at Stanford mentioned you can dispense 13 packs at a time, and if the insurance coverage doesn’t cowl it or no matter, they’ll shrink it, however if you happen to’re okay with it, please dispense a yr at a time”—after which 17 packs if you’re skipping the last week and skipping your month-to-month withdrawal bleed, since you’ll want extra packs since you’re skipping.

After which lastly, supply providers.

Dr. Yen explains why it’s secure to skip your interval.

So, now emergency contraception.

Going from left to proper, left being simplest, proper being least efficient.

Primary is the copper IUD. The latest research that did a head-to-head with the copper IUD and the levonorgestrel IUD commonplace dose 52 milligrams, confirmed zero out of 300-plus people who used the copper IUD for emergency contraception received pregnant. With the levonorgestrel, it was like three out of 313—and so the excellent news is if you happen to have been to point out up within the ER and also you wanted emergency contraception, you can throw down a copper IUD and there’s nearly zero probability of you getting pregnant.

So, if it have been me, my daughter, my buddy that was sexually assaulted and we needed the bottom doable probability of being impregnated by a rapist, copper IUD. Most ERs, and notably tutorial ERs, so like Stanford, UCSF or UPenn, any affiliate of an enormous hospital, can name an ob-gyn to come back down and throw up a copper IUD.

Or for all of those strategies, you technically have as much as 5 days to make use of them, but when it have been me, my buddy, my daughter, my affected person, my buyer, I say if the condom pops at 3 a.m. in a heterosexual relationship, you need the drugs in that particular person with the uterus’s mouth by 3:10. No cuddling, huddling, snuggling, ready until the morning after. ASAP, as a result of as quickly because the egg pops out, most of those strategies won’t work. Nonetheless, I feel the copper IUD will nonetheless work. The copper IUD is a few sturdy stuff.

However I’m not a fan of the copper IUD as a result of extra blood, extra cramps. So then you can throw down the hormonal IUD and then you definately’d have contraception for the subsequent 5 to seven years—so know that that’s doable, and if you’d like the hormonal IUD as emergency contraception, you’re going to should cite Dr. Sophia Yen or New England Journal of Medicine 2021.

After which there may be Ella, and that’s the one which’s prescription solely. So, Ella beats Plan B at each single time interval, and if it have been me, my daughter, my buddy, and that is what we do at Pandia Well being, we all the time suggest Ella, and the rationale why is it beats Plan B at each single time level and it really works as much as a BMI of 35, in order that’s hitting up on Plan B and its generics. It’s nice, it’s over-the-counter, but when your BMI is 26 or larger—and that’s the PSA of the day, everyone please, go to a BMI calculator, calculate your BMI, and if it’s 26 or larger, Plan B and its generics don’t work so properly for you, and in case your BMI is 30 or larger, it doesn’t work in any respect. This is essential info that I ask all of you to please get on the market to the general public.

After which lastly, if you happen to’re caught in the course of nowhere and all you’ve received is a bunch of contraception drugs which have both levonorgestrel or norgestrel in it, usually you possibly can take 4 drugs now, 4 drugs in 12 hours—however once more, all these different ones are a lot better choices, however if you happen to’ve received nothing else and also you’re alone and you may’t get to a physician throughout the subsequent 5 days to get no matter you want, then that’s an possibility.

So, that is simply displaying you % pregnant on UPA, which is Ella, versus levonorgestrel, which is Plan B, and Plan B has larger being pregnant charges at each single time level in comparison with Ella, and the opposite bonus about Ella is that if your physician writes for it, once more, free. No copay, no deductible.

After which right here’s simply going over once more, in case your BMI is 26 or larger, which is about 147 kilos for five-foot-three, 176 kilos for five-foot-nine, the generic emergency contraception and Plan B should not so good, and in case your BMI is 30 or larger, it doesn’t work in any respect. In case your BMI is 35, then your solely possibility is the IUD.

Get emergency contraception prematurely.

And in addition focus on it with anybody with a penis, as a result of if I have been the particular person with the penis and my particular person is like, oh, crap, or I used to be like, oh, crap, the condom popped, I’d be like, I’m not going to say something. I’ll stand by her facet, and if something occurs, I’ll assist her choice, however why be the bearer of dangerous information? But when you understand about emergency contraception and be like, oh, the condom popped, and then you definately whip out your Plan B since you’re the one with the penis, after which the one with the uterus could be like, ha ha, I’ve some Ella, so that’s the superb world, but when these with penises don’t learn about emergency contraception, they might not fess up when the condom pops.

If these with penises don’t learn about emergency contraception, they might not fess up when the condom pops.

So that you need emergency contraception simply sitting within the nook ready for the emergency to occur, since you need it there when you have got a fireplace to place out the fireplace so it can save you the state of affairs. You don’t need it and also you run to the pharmacy, it’s closed, the pharmacist gained’t give it to you as a result of in opposition to their spiritual perception, though it doesn’t…levonorgestrel emergency contraception has no impact as soon as the egg and sperm hooks up, has no impact on implantation, however who’re you to go argue with the pharmacist at three AM, proper? So, get it prematurely of want.

We really write on our prescriptions for Ella, please give the affected person with the farthest expiration date, as a result of in any other case they’ll provide the one which expires right this moment.

After which as you select on-line telemedicine, if it’s your physician, go proper forward, but when it’s selecting between two on-line corporations, be sure you know what’s good versus dangerous. Who’s the CEO, founder, traders? Are they after you for cash or are they extra mission pushed?

I prefer to say I’m the one CEO of a contraception supply firm that has taken the oath: Do no hurt. Can’t say the identical of the MBA individuals on the market. Do they listing their suppliers’ first and final title? Is there numerous turnover and that’s why they don’t listing anyone’s title? Are their suppliers medical doctors or nurse practitioners or PAs? To not diss these individuals, however MDs have usually extra coaching. How a lot coaching have they got? What number of years?

Are they decide in or decide out? And for instance, one firm was like, I’m going to put in writing this prescription for feminine condoms and I’m going to ship it to your home until you cease me, so usually not a good suggestion. Extra like, would you want some emergency contraception? Okay. That is the one we suggest. Okay. You’re good with that? We’ll invoice your insurance coverage. We’ll ship it to you, however not I’m going to ship this to you until you inform me.

After which lastly, I like the generalists, however I’ve spent the previous six years simply specializing in contraception and that’s all I do, so I understand how to handle the uncomfortable side effects, I do know what works in a single group versus one other group. In the event that they’re a generalist and so they’re doing urinary tract an infection and so they’re wanting in your nostril and your ears, they might not know as a lot about contraception as someone who solely does contraception.

After which quantity seven, don’t name it contraception. Let’s make it “hormone remedy” to degree the enjoying floor. There are a bunch of various causes to make use of contraception not for contraception. Know that 70 % of individuals on hormonal contraception drugs are additionally utilizing it for non-birth management causes.

The medical neighborhood has achieved an ideal job drilling it in your head, you need to bleed each month.

Dr. Sophia Yen’s Ted Discuss on why durations are optionally available.

So, I assumed I got here up with the concept that you don’t should bleed each single month, however I used to be incorrect. Dr. Coutinho came up with it in 1999, however I’ll provide the background to grasp.

I spotted making an attempt to get pregnant, the one cause these of us with uteri bleed is we construct up that lining and we’re like, embryo? Oh, no embryo. Bleed. After which we construct it up once more? Embryo? No embryo. Bleed.

And as you all know, we get our first interval at 12 and a half and we get our final interval at 50. Why are we build up the liner? Each time you construct up that lining, it might probably mutate and switch into endometrial or uterine most cancers. Each time you come out an egg, you danger ovarian most cancers, and truly by being on the capsule/patch/ring for 5 years, you lower your danger of ovarian most cancers by 50 %.

So, individuals will then say, oh my gosh, nevertheless it’s not regular to not bleed each month, and sure, the medical neighborhood has achieved an ideal job drilling it in your head, you need to bleed each month, and sure, if you happen to’re in a primary world nation, have sufficient vitamin, and also you’re two years after your first interval, it is best to bleed each single month.

Nonetheless, Dr. Beverly Strassmann, an anthropologist, studiess the Dogon tribe of Mali in Africa—and that’s not like centuries in the past, it’s lately—and she studied them for 736 nights, and what she discovered, on the left, the Dogon girls had 100 durations of their lives. In the US, these of us with uteri have 350 to 400, so we’ve sufficient durations for 3 different individuals with uteri, and the rationale for this, they begin their durations later, 16, we begin at 12. Principally once you hit 100 kilos or 22 % physique fats, you get durations as a result of your physique is like, oh, I’ve sufficient vitamin to assist one other being. And so they have seven durations per yr, we’ve 13, once more, vitamin, however extra importantly, they’ve eight or 9 youngsters.

What number of durations you have got once you’re pregnant? Zero. What number of durations do you have got once you’re solely breastfeeding each two to a few hours? Zero. And so right here, pregnant or breast feeding is the norm. Right here, incessant menstruation is the norm. So, it’s extra pure to have fewer durations than what we’re presently having.

So, higher with secure hormones or no bleeds. Pimples, arthritis, despair, diabetes, seizures. When you’ve got painful or heavy durations or PMS or PMDD, if we do away with your interval, then we do away with that drawback. The primary reason behind anemia in menstruating girls is menstruation, and it can lead to much less ovarian, endometrial, colorectal most cancers.

Each time you construct up that lining, it might probably mutate and switch into endometrial or uterine most cancers. Each time you come out an egg, you danger ovarian most cancers.

Simply so that you all know, the primary reason behind missed faculty and work below the age of 25 is dangerous, evil durations. So, you probably have dangerous, evil durations, please see a physician. Please get remedy.

And know that environmental, it’s 10,000 to 13,000 tampons and pads.

If you happen to’re not on any hormones or medicines to cease your durations, it is best to have a interval each month, primarily to be sure you don’t have being pregnant, thyroid, or tumor in your head, however know that we now have the know-how to make durations optionally available.

I’ll cease there and have Roxy take it again.

Roxy Szal: Thanks, Dr. Yen. That was extremely informative.

We heard about maybe much less well-known emergency contraception. Who knew that inserting a copper IUD after unprotected intercourse may forestall being pregnant higher than Plan B? For me, that was type of a game-changer after I heard that.

We additionally discovered in regards to the significance of figuring out actually who’s prescribing your contraception and what are their motives and what’s their background.

We talked about all of the accessible contraception choices, we talked about emergency contraception choices, we talked about interval choices—or lack of a interval—choices. The significance of getting abortion drugs and emergency contraception in your medicine cabinet for a rainy day.

Treatment abortion makes use of two varieties of drugs: mifepristone, which interrupts the stream of the hormone progesterone that sustains the being pregnant; and misoprostol, which causes contractions to expel the contents of the uterus. (Robin Marty / Flickr)

I’m getting some questions within the chat, so I’m simply going to open up the ground now to have Dr. Yen reply a few of your questions and so we will type of course of collectively what Dr. Yen simply talked about.

Somebody would love you to rapidly make clear the distinction between Plan B and Plan C.

Dr. Sophia Yen: So plan A is your regular, on a regular basis contraception, and hopefully you selected an excellent one, like a long-acting reversible contraceptive or the one-year ring, or the capsule, the patch, the ring, which aren’t pretty much as good because the longer performing ones.

Plan B is a euphemism for the complete emergency contraceptive class, which we talked that there are 4 completely different emergency contraception choices. Know in regards to the IUD, learn about Ella, all of which beat Plan B and its generics.

After which Clan C is the brand new euphemism or the brand new cool, hip solution to say medication abortion, and so medicine abortion is mifepristone and misoprostol. Two drugs. You’re taking considered one of them now, after which, I consider 24 or 48 hours, you are taking the opposite 4 drugs of 1 kind in your cheeks, that’s known as buccally, and also you let it sit there for half-hour, after which no matter is left after half-hour you drink down, or you are able to do it intravaginally. Intravaginally has fewer uncomfortable side effects. Nonetheless, if you happen to’re in a state that’s hostile to reproductive rights, abortion rights, you won’t need to put in your vagina as a result of if you find yourself within the ER and so they discover the drugs, then there is likely to be a problem, however that’s only a tip.

Roxy Szal: Fascinating, as a result of I hear lots of people, particularly uninformed lawmakers, equating all of them collectively and performing like they’re abortifacients, so thanks for that.

Dr. Sophia Yen: Yeah, so observe up on that. If you happen to’re pregnant and you are taking Ella, Plan B and its generics, or a bunch of contraception drugs, nothing will occur. We don’t suggest doing it as a result of simply waste of cash. Ella, theoretically, we don’t know what it may do, however at that dose, it most likely doesn’t do something.

When you’ve got a constructive being pregnant check, emergency contraception is just not the reply. If you wish to terminate, you want a medicine abortion, Plan C, otherwise you want a surgical abortion. When you’ve got a constructive being pregnant check, don’t use emergency contraception. It won’t work. It’s a waste of cash.

Roxy Szal: Thanks. Okay. We’ve got one other query. How typically can somebody take emergency contraception and is there a restrict to what number of occasions you possibly can take it, particularly any well being dangers?

Dr. Sophia Yen: So, there isn’t a well being dangers to taking emergency contraception each different day, although I wouldn’t suggest it. They’re very jarring in your system, and the way in which that the Plan B and its generics works is it, like, tells the physique you’re pregnant, and the physique is like, oh, if I’m pregnant, I’m not going to come out one other egg, as a result of then you definately’d have two pregnancies in your uterus at completely different occasions. So, that’s how that works.

If you happen to’re taking emergency contraception greater than as soon as a month or twice a month, you need to be on Plan A, not Plan B emergency contraception. Let’s get you on one thing that works 95-99 % of the time versus emergency contraception, which works 75 and even decrease.

As soon as the egg is popped out, typically it’s too late and it gained’t work in any respect.

Roxy Szal: I’m getting some questions within the chat in regards to the effectiveness of diaphragms.

Dr. Sophia Yen: It’s type of gone out of favor. It’s very uncommon as a result of within the outdated days you needed to go get it fitted. There’s now a diaphragm that’s one-size-fits-all, however the unfavorable of one-size-fits-all is if you happen to’ve given beginning then your cervix is a bit of larger, and so it could not match as snugly, and if it doesn’t match snugly, then the sperm all run in, however sure, it’s undoubtedly an possibility. It simply isn’t pretty much as good as any of the hormonal. It’s extra down in direction of the condom, withdrawal, fertility consciousness technique efficacy.

Roxy Szal: You touched on this in direction of the tip of your presentation, and I feel lots of people are type of curious. Your newest well being marketing campaign about educating the general public about #PeriodsOptional. So, I’m getting a number of questions so I’m simply going to ask you type of usually, you understand, perhaps you can converse on this for a minute or two. What do you would like individuals knew about skipping their durations?

Dr. Sophia Yen: One, that it’s really extra pure to have fewer durations than we’re presently having. So, the take-home is we’re having 350 to 400 when it’s pure to have 100, and that by bleeding, constructing that lining up each single month, we danger endometrial, uterine most cancers, and by coming out the eggs, we danger ovarian most cancers. So, you really lower ovarian, endometrial and colorectal most cancers by not having that withdrawal bleed each single month.

And so I’m a tiger Asian mother in Silicon Valley. I ask anyone with a baby, with a uterus: Is your daughter going to do higher bleeding or not bleeding on the SAT? In marching band? At that volleyball event? Enjoying soccer? Tennis in a white skirt?

The U.S. Girls’s Soccer Workforce ought to discuss to me as a result of. I’d be sure you don’t have any periods around the Olympics.

A Chinese Olympian as properly, she got here out of the pool and she or he’s like, oh, I feel I misplaced a millisecond, and I used to be like, who’s your physician? I wager you was a dude, as a result of if it have been me, I’d flip off your interval.

I ask anyone with a baby, with a uterus: Is your daughter going to do higher bleeding or not bleeding on the SAT? In marching band? At that volleyball event? Enjoying soccer? Tennis in a white skirt?

Roxy Szal: We’re getting questions on abortion drugs. You touched on plan C, so we received a query: How simple is it to get Plan C by way of the mail in states the place it’s unlawful?

Dr. Sophia Yen: If you happen to go to plancpills.org, you will get it on Assist Entry, and it could be to make your interval common, and I’d not examine a being pregnant check, simply in case your interval is just not right here then I’d take it if you happen to can afford $105 a pop, proper? And I do assume having it round, however you can too go to different states the place it’s authorized, however we don’t know the authorized ramifications of coming again and will they arrest you.

I’m not permitting my daughters to use to high schools in any of the states the place they’re unfriendly and don’t respect bodily autonomy, and we’re really going to start out a petition that petitions the governor of each state and the presidents of all the universities, saying, you can have had this, my daughter, cool Asian American, kick-butt pc science main, however she’s not going to your state and she or he’s not going to marry and lift children and develop in your state. You’re going to lose this chance, so you must change your legal guidelines.

Roxy Szal: I simply need to share anecdotally, I stay in Texas and I ordered superior provision abortion drugs by way of plancpills.org. I used to be not pregnant, however I’ve them in my drugs cupboard if there’s a day that I’m pregnant. Plan C needs to assist. They’ve choices like mail forwarding. You will get it mailed to a buddy and have them mail it to you.

This isn’t authorized recommendation. I’d like to plug the If/When/How hotline if you happen to ever get your self into some form of authorized bother, however belief me, PlanCPills thinks it by way of.

Another person requested, on the subject of abortion drugs, if you happen to may converse to the effectiveness of misoprostol alone, and is it simpler to get?

The World Well being Group recommends two regimens for medicine abortion: misoprostol alone or mixed with one other medicine, mifepristone. (Robyn Beck / AFP by way of Getty Pictures)

Dr. Sophia Yen: It’s simpler to get in a Mexico or different nations, however in the US, the pharmacists are starting to question even methotrexate. Individuals are utilizing methotrexate for rheumatoid arthritis, however due to this stigma, the pharmacists are afraid you’re going to make use of it for abortion, and I used to be like, how dare you withhold drugs for a well being situation, any well being situation, since you assume I’d use it for one thing else?

And so sure, misoprostol can be utilized to deal with ulcers. I consider that for mifepristone, it will also be used to deal with completely different cancers, and there’s a complete Feminist Majority Basis background on that that’s wonderful and so cool, nevertheless it’s not as efficient. So, if you happen to do mifepristone/misoprostol, I consider it’s like 92 efficient achieved throughout the right time interval, and with misoprostol, it’d drop to love 80-85, and so then you definately would possibly have to go for surgical termination.

[Note: Study after study has found that self-managed abortion with misoprostol is more than 90 percent effective.]

One other key factor is if you happen to stroll into the ER, they’ll by no means flip you away. They should handle you, and in addition, if you happen to didn’t stick it up your vagina and there are drugs there, there isn’t a solution to inform the distinction between a spontaneous abortion, which is a miscarriage, that’s the medical time period, spontaneous abortion, AKA miscarriage, or a medicine abortion that began and didn’t end. So, you possibly can simply stroll in. You don’t should say any, similar to, I haven’t received my interval and this occurred, and let’s simply go together with spontaneous abortion.

Roxy Szal: Thanks. Fast query, what’s the shelf lifetime of abortion medicine? I consider it’s two years, proper?

Dr. Sophia Yen: Sure, and identical factor with Ella emergency contraception, and Plan B and its generics, so all the time ask for the one with the farthest expiration date. Make it clear to no matter pharmacy which can be filling it in order that they don’t provide you with one which expires within the subsequent month as a result of they assume you’re going to make use of it throughout the subsequent 10 days or the subsequent couple weeks. After which if you happen to’re within the pharmacy, it is a very sensible level, and also you get it, don’t stroll out of the pharmacy. Take a look at the date instantly and be like, no, I need the one with the farthest expiration date, as a result of when you stroll out, you can not return it. No pharmacy can take again medication as a result of they don’t know if you happen to poked holes in it or dipped it in cyanide or one thing like that.

Roxy Szal: Thanks. Somebody requested the query, if we go no durations, how do we all know if we do get pregnant, particularly if we’re a young person or in perimenopause?

Dr. Sophia Yen: You’d have indicators of being pregnant. You’d have breast tenderness. That’s how I knew I used to be pregnant. I usually don’t have any breast tenderness, however after I was making an attempt to get pregnant, in the course of evening, at 3 a.m., bam, the boobs have been like oh, and I used to be like, pee on a stick, pee on a stick, and I used to be pregnant. You’d even have nausea. You’d even have weight acquire.

After which additionally know there have been girls on the capsule, girls on Depo that have been pregnant and it did nothing to the being pregnant, so be allayed, your considerations, that it could not have an effect on the being pregnant. It will not flip it right into a boy or a woman due to the hormones, wouldn’t mutate it or something, however it is best to have being pregnant signs.

Roxy Szal: Okay. We’ve got numerous questions. ‘I exploit a interval app to trace my monitor my cycle for fertility consciousness technique. What options to those apps ought to I exploit if I delete my app?’

Dr. Sophia Yen: So, I’d say paper and pen and a cute little calendar. There’s so many cute little calendars on the market you can purchase. Additionally, ensure it’s a code that solely you perceive, in case someone needs to inform on you.

My concern, you understand, there are people who don’t such as you. There are individuals which can be jealous of you. There’s premeds that need to see you kicked out of the premed line. There’s a sorority sister who you spurned and she or he’s going to get again at you, and that’s the horror of what’s being achieved to this nation, is we’re turning individuals on individuals, and the one that likes to inform on individuals, which I do consider in telling on bullies, however telling on someone who’s caring for their well being, very completely different factor.

Roxy Szal: What about this query: What in regards to the confirmed dangers of pulmonary embolism, even with the patch, not the capsule, in very younger girls?

Dr. Sophia Yen: That was most likely with the 50-microgram capsule and never with the brand new capsule. With any estrogen-containing technique, there may be the chance of pulmonary embolism, there’s a danger of we name venous thrombus clots and all kinds of clots, and the acronym to recollect is ACHES: belly ache, chest ache, headache, eyes, and swelling. So, if you happen to get any of these, that may very well be a blood clot in that space.

So, I’d simply suggest anytime you’re getting on a aircraft longer than three hours, take an ibuprofen or an aspirin earlier than you go on, drink water and stroll round, as a result of greater than three hours sitting, and also you’re on an estrogen-containing factor, you’re at a danger of blood clots.

Actually you probably have a robust household historical past of everyone getting blood clots, get examined, as a result of you probably have a blood clotting dysfunction, then that may be a no-no for the contraception capsule/patch/ring. At all times disclose your whole medical historical past, however typically. and someone below the age of 25, non-smoker, no blood clots operating by way of their household, the advantages of contraception outweigh the dangers.

Roxy Szal: Some individuals are asking, how can I hear extra from you? And so perhaps, Sophia, if you happen to needed to talk a bit of bit about how does Pandia Well being work? And the way can individuals keep in contact with what you’re speaking about?

Dr. Sophia Yen:. Undoubtedly observe Pandia Well being on all of our socials. We’ve got a ton of movies on YouTube, so if anyone wants intercourse ed assets, something in regards to the capsule, patch, ring or emergency contraception, we got that on YouTube.

We even have, the second Tuesday of each month at 5 p.m. Pacific en español, and 5:30 in English, a Fb stay that we stream to YouTube and perhaps Instagram as properly. So, you probably have a query, you possibly can hit me up stay the second Tuesday of each month apart from when we’ve particular audio system.

I’m pleased to talk to worker teams, would love to talk to worker teams. Hit me up by way of, you understand, both Facebook or Instagram, direct messaging, and say, I’d love to speak to Dr. Yen, how massive is the viewers, I like Zoom as a result of I don’t should journey anyplace and I’ll do it at no cost if it’s 60 or larger individuals. Perhaps I’ll begin charging sooner or later.

And Pandia Health, I began it as a result of I used to be giving that discuss, why do girls miss their contraception, and one of many high causes was didn’t have it of their hand, and my buddy and I have been like, we’ll clear up this. We’ll simply ship you contraception, preserve delivery it till you inform us to cease, after which we ran adverts, free contraception supply, 60 % of the people who responded didn’t have a prescription, and it’s like, don’t you understand in the US you want a prescription? However I’m a physician, I can write prescriptions, and thus Pandia Well being was born.

We are able to ship to all 50 states. When you’ve got a prescription and insurance coverage, you pay us nothing. Simply inform us the place it’s at, we transfer it to our pharmacy and we invoice your insurance coverage, we ship it to your door, and behind me you possibly can see, each bundle comes with one thing pleasant. We presently default to Hello-Chew, however we’ve a partnership with Winky Lux, we’ve given out lube, we’ve given out condoms, we’ve given out Cuterus stickers, all kinds of enjoyable stuff, after which it additionally comes with the Pandia public service announcement, that postcard: Do you know about Plan B’s BMI limitations? Do you know you should use contraception to make #PeriodsOptional?

We ran adverts, free contraception supply, and 60 % of the people who responded didn’t have a prescription. It’s like, don’t you understand in the US you want a prescription? However I’m a physician, I can write prescriptions, and thus Pandia Well being was born.

After which we will prescribe in 14 states, and we encourage contraception tourism, as a result of it’s the main massive states, so if you happen to occur to be going to Vegas, occur to be going to any of the Disneys, if you happen to occur to be going to Texas, New York, Pennsylvania, Georgia, Illinois and also you fill out the questionnaire, give us a blood strain from the previous three hundred and sixty five days, 20 bucks annually to make use of our skilled medical doctors, after which limitless follow-up questions on contraception, benefit from it. Then we will ship it to all 50 states.

We take all non-public insurances. We undoubtedly take California Medi-Cal and Household PACT, however we don’t take all of the little Medicaids but. We’re engaged on these contracts.

Roxy Szal: All proper, y’all, I’m going to begin to wrap this up.

On this post-Roe world, it’s changing into increasingly important for us to take cost of our reproductive well being. This was a vital first step, and we hope we answered a few of your questions and hope you took one thing significant away from this you can apply to your life and share along with your networks.

We at Ms. Journal would love to remain in contact. The best approach to do that is to move to our web site and sign up for our weekly news alerts for MsMagazine.com, which is a spot the place feminists interact with one another and the world for motion and social change, and the place we cowl reproductive justice, voting rights, and different points every day.

Dr. Yen, any closing phrases for our listeners?

Dr. Sophia Yen: Observe us all over the place @PandiaHealth, and if you’d like some loopy radical tweeting political, not related to my employers and Pandia Well being technically, observe me on Twitter @teenmd.

Observe Pandia Well being, share Pandia Well being, share #periodsoptional, pandiahealth.com/periodsoptional, and I even have Dr. Yen’s six tips now that Roe v. Wade has been overturned.

Roxy Szal: Thanks all a lot for attending, and thanks, Dr. Yen, for being such a wealth of knowledge. Discuss to you all quickly.

U.S. democracy is at a harmful inflection level—from the demise of abortion rights, to an absence of pay fairness and parental go away, to skyrocketing maternal mortality, and assaults on trans well being. Left unchecked, these crises will result in wider gaps in political participation and illustration. For 50 years, Ms. has been forging feminist journalism—reporting, rebelling and truth-telling from the front-lines, championing the Equal Rights Modification, and centering the tales of these most impacted. With all that’s at stake for equality, we’re redoubling our dedication for the subsequent 50 years. In flip, we want your assist, Support Ms. today with a donation—any amount that is meaningful to you. For as little as $5 each month, you’ll obtain the print journal together with our e-newsletters, motion alerts, and invites to Ms. Studios occasions and podcasts. We’re grateful to your loyalty and ferocity.

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