Skyla IUD Advertising: “This is my baby right now”

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Note: “Skyla (levonorgestrel-releasing intrauterine system) is a hormone-releasing IUD that prevents pregnancy for up to 3 years.”

What do you guys think of the Skyla banner ads? I think they’re brilliant. First of all, I love the name of this IUD — it has a friendlier ring to it than “ParaGard“, anyway.

The banner ads are direct and unapologetic about why young women would want them. Skyla is, of course, marketed specifically towards women who haven’t had children yet because they’re smaller. So you’ve got:

Skyla1

A student cradling her books very fondly

Skyla3

An aspiring filmmaker playing around with her camera

Skyla2

A young musician bonding with her cello

These are so charming to me because they show up front that young women can and want prioritize their studies or careers, and that having children is an option. I can see many people having a problem with this. If you’re a student, you shouldn’t be sexually active in the first place! Really? We’re still on this? Can’t we just accept the reality that young people are having sex, and provide the best birth control and reproductive health options for them? Denial will get us nowhere.

I’m not sure if local OB-GYNEs are offering Skyla yet, but it’s definitely an option to look into. I hope they develop a smaller copper version as well, for young women who do want an IUD but have a problem with hormones.

Additional reading

“Are Childfree Women the New Marketing Demographic?”

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I’ve always complained about TV commercials in the Philippines because they all cater to mothers and fathers, and are rarely without children in them. What about all the single ladies? (And all other single genders, of course.) This article, “Are Childfree Women the New Marketing Demographic?” is interesting because at the very least, this hotel is looking at us now!

The Westin New York hotel has just launched a slickly designed package that “caters to women whose personal journeys do not include children.” This vague language is designed to include women who have chosen not to have kids (the so-called “childfree” woman) as well as those who might want kids someday, but just don’t have them right now.

Now of course it’s all about business and finding new markets, but what excites me is that people are starting to see those who identify as childfree as a real and substantive group. We exist! We’re not just aberrations anymore! I hope that this trend finds its way to Manila soon.

The Childfree BINGO

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In Childfree (CF) communities, the BINGO is a set of expected negative comments we get when we say, “I’m not having children.” So here are some of them, with answers! Feel free to add yours in the comments.

You’ll change your mind!

Here’s a fun question: why is it that when a woman says she wants children, nobody ever tells her that she’ll change her mind? Biology is not destiny, especially not in this day and age when modern medicine is more than capable of genetic engineering. When I have a ligation, it’s going to be permanent, just as permanent as having children. You live with all the rewards and regrets either way. Children are a choice, and my mind has been made up.

People who don’t want kids are selfish.

Yes, because all people who want children want them for completely selfless reasons. As sentient beings wired for survival, we’re all selfish. There are people who don’t want children for selfish reasons, just as there are people who want children for selfish reasons. It goes both ways and nobody has the moral high ground over the other. Many people who plan to have children don’t really examine why they want them, but if they did I’m sure they’ll find that they are less than selfless as well.

You were a baby once/ Don’t you LIKE kids?

I still have no idea what being a baby once has to do with anything, but no, I don’t. Simply a matter of preference.

Aren’t you curious to see what they would look like?

That’s a superficial reason to have children, I hope nobody seriously thinks this way.

What if your parents didn’t have children?

Then I wouldn’t be here writing this entry and the world would be none the wiser about my existence. Don’t I care? If I didn’t exist, how would I care? Moot point.

The only reason to get married is to have children.

The only reason to get married was to have children back in the day when children cemented unions between families and provided heirs to the family fortune. Since I don’t have any qualms about leaving any money I’d have at the end of my life to my sister, or to a charity in case she doesn’t want it, this is irrelevant. I have a feeling there won’t be much left anyway. Furthermore, I think that marriage is about companionship, mutual understanding, and growth, and every couple is different so they get there in different ways. I’m a little iffy on marriage myself because of the legal issues involved (conjugal property and whatnot) and the lack of a divorce law in this country. And how about homosexual couples who are in happy marriages, who want to adopt orphans and give them better lives? We really should just get over this argument.

The Bible said go forth and multiply.

Yes, back when there were two people on earth, not seven billion, eight billion by 2025. Also, I am not Catholic.

Children are a woman’s greatest achievement/ You’re not a real woman until you have children.

This deserves an entire essay in itself, but anyone who thinks that the worth of a woman can be measured by the number of children she birthed and raised should be transported back to the medieval ages where this point of view belongs.

Who will take care of you when you’re old?

You spend a ton of money raising children. If you don’t have children, you can have a retirement fund. That’s how you’ll get by when you’re old. You make arrangements for nurses, or even a retirement home. It’s not that hard to fathom. I’m also extremely uncomfortable with the debt placed on children to take care of their parents in their twilight years, and I think it’s a vicious cycle.

Don’t you want to give your parents grandchildren?

Absolutely not. Why would they even want to take part in raising more children, didn’t they endure enough stress the first two times?

Children bring happiness to families.

I think that children bring happiness to families who want them. Furthermore, I’m disinclined to believe what other people say the source of happiness is because if there’s anything I’ve learned in the 23 years I’ve existed on this planet, it is this: People don’t know shit. They tell you one thing and do another, judge you for things they likewise do, and give unsolicited advice on family, love, and happiness based on personal experiences that have absolutely nothing to do with you. So no, dear old savants and denizens, I will not take your word for it.

Nothing is better than “new baby” smell.

What smell are you talking about, the strange milk smell that makes me nauseous, or the diaper stench that sends me running into the next room?

What about the family name/ Don’t you want genetic immortality?

I don’t really understand why people would want to “continue the family name” unless they’re Ayalas, Zobels, Aranetas, or some other family with billions under their name. I am not one of these people, and I couldn’t care less about genetic immortality, which is not guaranteed, by the way, even if you do have children because someone might decide that they don’t want children somewhere down the line. Are people really so convinced of their greatness that they want some part of themselves to become immortal?

It’s different when they’re your own/ It’s going to be worth it!

I have never actually liked children, so this one gets thrown in my face a lot. It’s different when they’re your own… Since I dislike children now, does that mean that I will abhor them when they’re mine? I honestly don’t think I can handle the screaming and constant nagging and lack of peace in the house when there are children around. I’m sure it’s different, but that’s a double-edged sword. It’s possible that you’ll love them, but it’s also possible that you’ll hate them. I have seen websites devoted to this.

People regret not having children, but they never regret having them!

Check out this article: 15 Parents Explain What They Regret About Having Children, or this one: We Need to Talk About Women Who Regret Motherhood. I think it’s important that we’re more open to this discourse. Every decision comes with its own regrets.

This is why speaking frankly about motherhood matters, and why support matters, because what any one woman cannot summon can be summoned by the village, if it exists. And what matters even more than that is giving women the resources to cope with whatever their experience is, and the space to sort through the complex feelings that accompany it, a way for a woman to be a mother and still human, still flawed, still something other than merely an endless vessel of giving. Because as in everything, what we think we “want” is but a sliver of the picture.

Being a parent is the most important job in the world.

Yes it’s an important job, but not every job is for everyone. That’s why we specialize in certain things. Some people are also unhappy with their seriously important jobs and want to quit — I’d argue that being pope is a seriously important job but you know what happened with Benedict XVI. When you’re a parent, You Cannot Quit. That ought to give more people on earth a reason to pause.

But you have such good genes/ People like you SHOULD have kids.

Oh, compliments! Unfortunately, that’s not a very good argument against contributing to the human population that is draining the earth’s resources, causing the extinction of thousands of species every day, and polluting the planet to the point of destruction. We are part of the problem, so I think that some of us should be contributing to the solution.

What if your child is going to be the next president/ find the cure for cancer/ establish world peace?

S/he could also be the next Adolf Hitler or Idi Amin Dada. Well then, I guess we’re never going to find out. It won’t make a difference, you won’t miss what you never had.

If everyone didn’t have kids, the human race would die out!

But I’m not saying anyone else shouldn’t have kids if they want them, I’m saying I don’t want them. Furthermore, the human population increases by 80 million people every year. Pretty secure as a race don’t you think?

Children are the future.

I agree, and thousands of them are in orphanage homes or starving on the streets, which is a more pressing issue than my personal stand on reproduction.

Parting Thoughts

Childfree. This is the term for people who are childless by choice, and their reasons vary wildly. There are many childfree people I admire, not just because of the choice they made but because of the positive contribution they are making to society.

It is such a challenge to become more than what people think you are, or should be. In the end, the only people who will truly be affected by our decisions are us. It is my body, my mind, and my life, and I will choose to live it the way I want to. It really doesn’t matter what anyone else thinks, not even my parents who may have different ideas of how I should turn out. I’m not going to have children because I don’t want to have them. And I’m not going to apologize for thinking differently, for challenging the norms, for daring to ask questions about things which most people take as facts of life.

If you still think I’m going to change my mind then let’s bet on it, I’ll match any figure you can come up with — although I find it hard to believe that anybody would go to that much trouble over what I choose to do with my uterus.

“Kids having kids: When choice is not an option”

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This article, “Kids having kids: When choice is not an option,” was published on Rappler the other day. It’s every bit as depressing as the title suggests. Highlights:

  • One in every 10 Filipino women aged 15 to 19 is already a mother or pregnant with her first child, according to the 2013 National Demographic and Health Survey (NDHS). Early pregnancy is more common among poor households, particulary in families that receive less education.
  • The Reproductive Health law requires “age and development appropriate reproductive health education” for adolescents, touching on teen pregnancy, responsible teenage behavior and parenthood. Many classrooms, however, still shy away from teaching about sex, leaving teenagers to seek answers elsewhere.
  • Even among college graduates, only 35.6% think their knowledge about sex is adequate.
  • Girls, however, should not shoulder all the blame, stressed Prescilla Tulipat of the UP Diliman Gender Office. “Their communities lack funds, information, services,” she argued. But frontline workers, such as Barangay Health Workers, are often overworked yet underpaid — hence, leaving several health centers understaffed.

We have a clear problem here and yet people seem to be trying their hardest to ignore it. Here’s a simple solution: educate yourselves, then educate others. It’s going to be slow, but wouldn’t it be great if you knew that you helped someone make better choices, and that they can in turn help others?

Great Reads on Getting an IUD

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Sometimes, when you’re going through the IUD recovery process, it helps to read about other people’s experiences. Here are some of the posts about IUDs that, excuse the melodrama, made me feel that I wasn’t alone in what I was going through.

Ashleyovershares’ My IUD: After The Procedure

I’ve been allowing my body to get comfortable with its new pregnancy-defending friend. I want to again remind everyone that I’m describing this experience as someone who has never really suffered from cramping before – yes, I’m very lucky – so my level of discomfort and pain may be totally different from the next gal’s.

She also posted this hilarious tweet:

tumblr_inline_niouckfvRd1s1bxg3Jenna Sauer’s User’s Guide to Getting an IUD (Jezebel)

For hormone-free birth control, this is all well worth it. Actually, it kind of has to be worth it, because the IUD is my only choice to stay baby-free without a cocktail of artificial hormones coursing through my system (unless and until science improves upon the options). But right now, with my insertion experience fast becoming another victory for memory repression, and the device’s removal a very distant proposition, I’m feeling pretty damn good about it.

Valerie Tarico’s Pamper, pamper, pamper– plus 9 other tips for falling in love with your IUD

If you’re tired of remembering (or forgetting) pills or worrying about condoms or timing your cycle–if you’re tired of missing classes or work or simply feeling bloated and achy for one week each month–maybe it’s time to pick up the phone.

Mccarpentier’s My IUD: How I Learned To Stop Pill-Popping & Love My Cramps (Jezebel)

I’m not going to beat around the bush here — having it installed was not pleasant. Your doctor puts it in when you’re on the rag because your cervix is already dilated, which is messy, and s/he “clamps” your cervix to hold it still, which I think was actually more uncomfortable than a colposcopy. Since I got one of the non-hormone varieties (the ones that release hormones last up to 5 years), I don’t have to have it taken out for 10 years — and I really don’t plan to have that clamp thing inside me again until completely necessary. I was supposed to be able to go back to work afterwards (and maybe I could have, if my doctor had been of the variety that uses local anesthesia), but I went home to a hot pack, some Advil and a bottle of wine.

I definitely related to all of these stories and made me calm down during the worst of it. Almost two months post-procedure and sometimes I forget I even have an IUD. Of course on some days I still feel slight cramping, usually on my left side. I just take a walk when that happens.

I’m looking forward to hassle-free contraception for the next 10 years. If you have questions about how to get an IUD in the Philippines as an unmarried woman who’s never had kids, feel free to comment below.

IUD Checkup News (1 month later)

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I got another TVS earlier this week and everything’s fine!

The OB-GYNE at the diagnostic clinic was terrible, but thankfully, my other much nicer OB-GYNE, let’s call him Dr. L, confirmed that the IUD is where it’s supposed to be. I was nervous at first because at the diagnostic clinic they told me that it slightly shifted downward. Dr. L explained that a little shifting is normal and to be expected.

Behold!

ultrasoundTL;DR: My first IUD and first IUD checkup went ~*~ great ~*~

I Finally Got an IUD!

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After years of obsessing about it, weighing all my options, and talking to doctors and even med school friends, I finally took the plunge and got an Intrauterine Device (IUD). I was excited and terrified at the same time. If you’re wondering why an unmarried 23 year-old is obsessed with getting an IUD, we’ll talk about me, tokophobia, and childfreedom next time.

“The IUD is a little, t-shaped piece of plastic that gets put in your uterus to mess with the way sperm can move and prevent them from fertilizing an egg. Sounds odd, but it works like a charm. IUDs offer years of protection—between three and twelve, depending on the type you get. And if you want to get pregnant, you can have the IUD removed at any time.” – Bedsider.org

The biggest draw for me was that IUDs are in the 99+ % range of effectiveness. You’d hear some stories of them failing, sure, but you have to remember that they are in the very small minority and this is as close to 100% as you can get without a tubal ligation. My previous two OB-GYNEs did not think an IUD was a good idea for me, and I only found the right doctor through a friend who got hers there too. There are several reasons why an OB-GYNE might decline from giving you an IUD.

“So what are these common reasons?”

  1. You’re too young, and for some conservative doctors, unmarried
  2. You haven’t had children yet
    1. Insertion is apparently more painful if you haven’t been, shall we say, stretched out
    2. It’s allegedly more likely to fall out
  3. Your behavior does not put you at such a risk that you’ll need a 99+ % method
  4. You have Pelvic Inflammatory Disease or other infections, or are prone to them
  5. You have an STD, i.e. gonorrhea or chlamydia

If you ask me, reasons 4 and 5 are the only ones that should truly be considered. Reason 1 is more imposition of values than anything else, reason 2 is debatable, and reason 3 is silly because there is no such thing as too effective. I got told reasons 1 through 3, by the way.

“What’s the procedure for getting an IUD?”

  1. You need to get a pap smear at least a month beforehand. An IUD does not cause infections, but it will aggravate an infection if you already have one. That’s why the pre-procedure pap smear is very important. The doctor will be able to give you the necessary antibiotics to clear up any issues you’re having.
  2. You choose between the two types of IUDs: hormonal and non-hormonal (copper).
    1. Hormonal IUDs — the more common one is Mirena, which is good for 5 years. I’m not sure if the new one, Skyla, is already available in the country. Skyla is good for 3 years and is specifically geared towards younger women who haven’t had children yet. It works like the BC pill but better because there’s no room for human error such as forgetting to take a pill. Your periods may stop altogether, by the way.
    2. Non-hormonal or copper IUDs — ParaGard, good for 12 years. It (1) releases copper into the uterus which works as a spermicide and (2) changes the lining of the womb, making it less suitable for a pregnancy. This is the one I have. It can make your periods heavier than they were before.
  3. If you are cleared by your OB-GYNE to get an IUD, and you’ve already decided on which one, you can set up an appointment. According to my doctor, it should be done during the proliferative phase of the menstrual cycle (the phase after menstruation). It could also be done as emergency contraception if you had unprotected intercourse in the last 120 hours.
  4. There are drugs you have to buy before your procedure. This may vary, but for me it was:
    1. Doxycycline 100 mg (twice a day for 7 days, beginning on the night before the procedure)
    2. Mefenamic Acid 500 mg (2 tablets an hour before the procedure, every 8 or so hours afterwards)
  5. You have to sign a consent form which states that the procedure might be painful and that you’re okay with that.
  6. The procedure itself will take around ten minutes.
    1. The OB-GYNE will talk to you about your life choices, what the process is going to be like, and how to maintain your IUD.
    2. S/he will conduct the initial Trans-vaginal Ultrasound (TVS) to check the size and shape of your uterus.
    3. Like during a pap smear, s/he will insert the cold metal speculum.
    4. S/he will measure your uterus. This is the part that hurts the most.
    5. S/he might dilate your cervix. This was uncomfortable but not really painful.
    6. S/he will trim the IUD’s strings to the correct size, then insert it. This also hurts, but not as much as the measuring part.
    7. S/he will do another TVS, this is the one you will get a printout of, showing the little T that is your new IUD.
  7. Afterwards, I advise that you wear a sanitary pad for any discharge. And you will probably have to wear pantyliners for the next couple of weeks because as the body adapts to the IUD, discharge will be continuous.
  8. The next 24 hours will be hell. The level of pain depends on your tolerance of course, but I haven’t met anyone who said they weren’t in pain for those 24 hours. It’s like the worst dysmenorrhea of your life multiplied by ten. I took a lot of mefenamic acid, slept a lot, and used a hot water bottle whenever I felt fine enough to stand up.
  9. After your first period, you’ll probably completely forget that it’s there.
  10. You need to get another TVS sometime after your first period to check on its position. After that, you just need your annual OB-GYNE visit, pap smear, and TVS.

“So how much did this entire thing cost?”

The procedure cost 2300 PHP, the medicines were another 200 PHP. The upcoming TVS is about 600 PHP. All in all you should prepare something like 3500 PHP for the entire adventure, including your taxi ride home from the clinic. Do not commute, I repeat, do not commute home. Get in a taxi and get yourself to bed as soon as possible. Your body will make you take the rest of the day off. If you live alone, you should also prepare food and drinks beforehand so you won’t have to go out.

“What happens if I still get pregnant?”

Yes it can happen, but rarely. This is why it’s nice to always, always have a backup method. Spermicides, condoms, the BC pill if you’re using a copper IUD like me, or withdrawal will all make your chances of getting pregnant lower.

In the event that you do fall pregnant, you also have to understand that an IUD raises your risk of having a miscarriage to 40 – 50%. It also raises the risk of having an ectopic pregnancy, in which case the pregnancy must be terminated. If you become pregnant, your OB-GYNE will recommend the removal of the IUD, which may also result in a miscarriage. That said, I’ve read stories of women carrying to term successfully even with the IUD left inside, so it’s really a case to case basis.

“How do you feel about your copper IUD?”

ParaGard has been great and hasn’t given me any problems since the hellish 24 hours post-procedure. I occasionally got strange crampy feelings down my left side or bottom abdomen during the first month, but the frequency lessened and lessened with time. I’ll update when I get another TVS this week.

IUD Removal

You can have it removed at anytime, and that procedure costs a lot less!

Additional Reading

Emergency Contraception 101

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Please refer to updated version 12162015.

So you had unprotected intercourse. You shouldn’t have, but you did. And now here we are! Fret not, you can fix this. You can use emergency contraception, a.k.a Plan B or the Morning After pill.

Here’s What You Do

  1. Ensure that it has only been 120 hours since your last unprotected intercourse. The closer you are to the zero hour, the better.
  2. Buy a pack of Nordette birth control pills. They usually come in a 21-pill pack and the active ingredients are ethinyl­ estradiol (30 mcg) and levonor­gestrel (150 mcg). If you’re in the Philippines, Mercury Drugstore has this for less than 200 PHP.
  3. Take 4 active pills at once.
  4. Wait 12 hours, document your side effects just in case.
  5. Take 4 more active pills.
  6. Get yourself to an OB-GYNE sometime this week to discuss more stable birth control methods because this is not healthy.

Rules, Actual Rules (New Section!)

  • Take it in at most 120 hours. See FAQ item 1.
  • If you vomit within three hours after taking a dose, retake. See FAQ item 10.
  • Do NOT have unprotected intercourse in the week after taking ECP. See FAQ item 15.

Notes

  • If the pack you got has 28 pills instead of 21, that’s fine. Each pack has 21 active pills and 7 placebo or reminder pills. Take the active pills.
  • The active ingredient you’re really going for is the levonorgestrel, not the ethinyl estradiol.
  • Technically, any pill that gives you a total of 1.5 mg of levonorgestrel (0.75 mg doses 12 hours apart) will do.

Side Effects

As usual, it depends on the person. Common side effects include nausea, vomiting, withdrawal bleeding, bloating, cramps, and mood swings. This is because of the intense hormonal spike that you induced. So hopefully if you do this, you do it just this once.

FAQs

I am taking off from this post where a ton of readers left their comments.

  1. Is it still effective after 120 hours? Some sources say you can go up to 150 hours. After that I guess it would just be a matter of luck.
  2. Will they ask me for a prescription? Maybe yes, maybe no. Depends on the Mercury Drugstore branch attendees. You either go to every branch until someone sells you a pack, or you lie and say you left your prescription at home but you have been using it for a while. Read this.
  3. How many times can I use this method? Ideally, never. It screws with your hormones, and after all those side effects I think you wouldn’t want to do this more than once.
  4. But I bought the pack and it says take one a day for 21 days! Yes, that’s how we normally take the pill. You’re doing the emergency route. Think of it as one teaspoon of sugar in your coffee on a normal day vs. four teaspoons of sugar in a liter of water because you have gastroenteritis.
  5. Will I die? Extremely unlikely, unless you’re really dodgy on the heart. In which case, go to your OB-GYNE!
  6. What if I’m too scared of the side effects you talked about? Well then you’re just going to have to deal with the side effects of being pregnant which, surprise, are exactly the same! With the very small difference that you have to take care of a child for the next 18 years.
  7. If it doesn’t work and I get pregnant, will it affect the baby? No, it’s just hormones. When you take it, you basically have the hormones of four pregnant women in you. Crazy side effects, but won’t cause birth defects.
  8. What if I’m too ashamed to buy the pills? Get one of your more adventurous friends to buy it for you, or just suck it up because if you’re too ashamed to buy pills then good luck dealing with the social stigma of an unintended pregnancy.
  9. What if I’m not experiencing any side effects?! That is some superhuman strength right there I tell you. Just be calm and take a pregnancy test next month.
  10. Do I need to retake it if I vomit? “If you vomit within three hours of taking the ECP, you should see your pharmacist, doctor, or Family Planning clinic for advice and further tablets.” (Pharmacy Live)
  11. Can I take this while on my period? Yeah okay but since you’re already on your period and if you had intercourse just 120 hours ago, your menstrual cycle says you’re safe.
  12. How will I know it worked??? I know you’re worried AF, but besides taking a pregnancy test or waiting for your period, I don’t know. And if the digging I’ve done on the subject on the internet is to be trusted, nobody does either. There are a lot of factors that go into this (where you are in your cycle, what contraceptives you took, etc) so there’s really just no way of knowing immediately after taking ECP that it worked. Go ask reddit if you want more people to weigh in on that, but users there agreed that we just. Don’t. Know. Yes it’s a hassle but I can’t do anything about this. See also: FAQ item 13.
  13. It’s been several days since I took ECP, and now I’m bleeding, and it’s darker and less heavy than my normal period. What is happening? This is the withdrawal bleeding I mentioned earlier. It’s a fake period, and is NOT the start of your actual period. Why does it happen? Because you ingested a ton of hormones and when those hormones leave your body, you go through withdrawal just like with any other drug. With normal pill users, the withdrawal bleed happens on day 24 or day 25. Basically, pill users don’t ever actually menstruate, it’s all fake. Read this if you want to learn the nitty-gritty of pill use. As for your period, you’re going to have to be patient; it may be delayed due to the ECP. Just stay calm. If you want to be absolutely sure, then take a pregnancy test a month after the unprotected intercourse happened.
  14. Can I take more than 8? No. Put that pill pack down, you’re going to be fine.
  15. I haven’t taken any pills before, can I do this? Yes. Also consider going on the pill to avoid more of these episodes.
  16. Can I have unprotected sex right after I do this emergency procedure? Seriously? SERIOUSLY? Let’s put it this way… You left the stove on and the house almost burned down. You managed to put out the fire. And you’re going to leave the stove on again? Come on now. “ECPs are only good to protect against one act of unprotected sex. They work by blocking ovulation, but only for a few days, so if you take them and have unprotected sex again afterwards, you’re significantly increasing your risk of a pregnancy. If you have unprotected sex again within a few days of taking the pills, there will be more sperm waiting in the fallopian tubes when the egg is eventually released.” (Bedsider.org 2014)
  17. What do I do with the 13 leftover pills? Keep it in your purse if you think you’ll need it again.

Other Methods

  • You can try to procure the real Plan B, just make sure that you’re getting it from a supplier you can trust. This supplier quotes it at 3000 – 3500 PHP.
  • I have heard that Vitamin C can be used as an emergency contraceptive but I do not endorse it. I don’t know anyone who’s done this.
  • You can get a copper IUD inserted by your OB-GYNE within 120 hours and it will also work as emergency contraception. Cost is 2500 PHP and up, and you can keep using it for the next 12 years. According to the US CDC, it’s 99.92% effective. Read this if you’re considering it. Not for the squeamish!

Let’s Talk About BC Pills

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Some Facts Before We Get Started

  • The birth control (BC) pill  is 91% effective on its own. The US Department of health has this nice infographic if you want to know more.
  • After 1 year of typical use, 9 in 100 women on the BC pill will fall pregnant. Over 10 years of typical use, that number rises to 61 in 100. Check out this article for more on that.
  • There are two basic types: combination and mini-pill. The latter has a lower dosage than the former. Read about that here.
  • It works by: (1) tricking your body into thinking you’re pregnant, thereby stopping you from releasing egg cells, (2) thickening the cervical mucus so the sperm can’t enter, and (3) keeping the lining of your uterus thin so that a fertilized egg can’t attach to it even if it gets through the first two mechanisms. Check this out for more on that.
  • You can get BC pills for as low as 45 PHP at any drugstore so it’s one of the cheapest forms of hormonal BC.
  • Standard PSA: They do not protect you from STDs.

Trial and Error Phase

Birth control pills are definitely not for everyone. Hormones can do all sorts of strange things to your body and they can aggravate existing medical conditions. That’s why it’s important to consult an OB-GYNE before you start taking them. The doctor will be the best person to recommend a birth control method for you, and if you decide on BC pills, you will go through a trial-and-error phase with their advice. You can report any and all side effects to them to make sure that you’re okay. That said, I’ll tell you about how I didn’t consult before taking pills. Back when I was 21, I figured it would be a great time to experiment with pills. I was always obsessed with birth control because I’m tokophobic — we’ll talk more about that in a later post. Before work one day I just went ahead and bought a pack of Trust pills from a drugstore. No, they didn’t ask me for a prescription.

  • Trust by Pond’s Chemical is a combination pill with 21 ochreous tablets (ethinyl estradiol 30 mcg, levonorgestrel 125 mcg) and 7 brown tablets (ferrous fumarate 75 mg equivalent to 24.75 mg elemental iron).
  • It’s less than 45 PHP at Mercury, a little less at TGP or other generic drugstores.

Now this first month with the pill coincided with a very difficult time in my life so I honestly can’t tell you if the pill somehow affected how depressed I was. I’ve read that the pill can cause mood swings in some women, but I can’t give you any real feedback on this. I didn’t gain any weight, I know that’s what some people are afraid of. This is different for everyone though. I took it at 9 am each day, which was easy to remember because that’s when I get to work. The thing with Trust those first few months was that at day 23, when the hormones were leaving my body and I was about to menstruate, I would get these crippling headaches. But that was fine by me, since I knew those were just withdrawal symptoms. At around the third month, I noticed that my stomach was a bit bloated. I weigh less than 100 pounds, even the slightest bloating is very obvious. This was when I went to the OB-GYNE. The OB, we’ll call her Dr. I, spent a good five minutes gently scolding me about my little experiment. I completely agree, I shouldn’t have done that. Then she gave me a prescription for a pill with a different dosage called Althea, to see if this would work better. Remember, finding the right BC pill for you can be a long process.

  • Althea is a combination pill (21 pills with cyproterone acetate 2 mg, ethinyl estradiol 35 mcg).
  • No 7 reminder pills.
  • IIRC it costs around 350 PHP at Mercury.

Althea did not work for me, at all. I felt worse than when I was on Trust and this wasn’t just bloating. I had joint pains and I still don’t even know how that’s possible. After a month, I went back to Dr. I and got a different prescription, this time for Blush. It worked perfectly. I got lighter periods, no withdrawal headaches, and basically it was like I wasn’t even taking pills at all.

  • Blush has the exact same formulation as Trust, but it’s manufactured by Cyno Sure Healthcare.
  • IIRC it costs around 150 at Mercury.

Good things never last. Blush got pulled out for low sales and after yelling why, why at the clerk at the Mercury counter, they gave me the closest thing… Yes, Trust. So I went back to it, and for some reason, the side effects were gone too. I’ve been on this one for over two years and we’re getting along well. Here are three more pills that have worked for people I know.

  • Micropil by Dyna Drug (mini-pill type): norethisterone 400 mcg, ethinyl estradiol 35 mcg. You have to be more careful with the time when it comes to mini-pills by the way. 45 PHP.
  • Nordette by Pfizer (combination type): ethinyl­ estradiol 30 mcg, levonor­gestrel 150 mcg. Fun fact! Nordette can be used as a Plan B (emergency contraception). Read about how to do that here. Make sure to do it within 120 hours though. 100+ PHP.
  • Gynera by Seville Pharmaceuticals (combination type): gestodene 75 mcg, ethinyl estradiol 30 mcg. 500+ PHP.

Weight Gain, Acne, and Other Things You May Have Heard Of

Short answer: IT DEPENDS.

It depends on your metabolism before you started taking the pills, on your diet, on how much water you drink everyday, how prone you are to breakouts, etcetera. In my case, no weight gain, no acne breakout. As I said, the biggest side effect I had was bloating during Trust and joint pains during Althea. There was also the small matter of my (looks around uncomfortably) mammary glands feeling firmer during certain times of the month.

Long answer: Go Ask Alice or learn more about How Stuff Works.

Notes on Menstruation

When you’re using the pill correctly, the lining of your uterus doesn’t thicken and there’s basically no need for you to menstruate at all. Every period you will have while on the pill is just withdrawal bleeding triggered by the drop in hormones. There’s an interesting history as to why pills were made to mimic the natural cycle. It’s related to the Catholic Church and their stance on contraception, which you can read about here. So now that we know that the period is “fake”, what are the implications on your monthly period?

  • You know exactly when it’s gonna happen: 3 – 5 days after you take your last active pill. If it doesn’t happen, stay calm. Sometimes it normal for a fake period to skip while the body is adjusting. If you’re the paranoid kind, take a p-test immediately. The active ingredients in birth control pills don’t affect the test.
  • Periods are much, much lighter because you’re not shedding your uterine lining. Goodbye heavy flow pads!
  • You can opt to menstruate anywhere from once a month to… Well, never. You can also delay your “period” by a few days if it’s going to interfere with, say, a swimming trip. Read this and talk to your OB-GYNE about it.

I also have to mention one other thing, which is breakthrough bleeding. It’s basically unscheduled bleeding, which can happen for a number of reasons. You could be adjusting to the pill, which is perfectly normal, or you could be drinking medicine that is disrupting your hormone levels. Personally though, I’ve never experienced this.

“Will they ask me for a prescription?”

Some drugstores do, some don’t. Those that do will ask you either, “May prescription po ba?” or if you say you don’t have it with you, “Ginagamit na po ba dati?” You can always lie, that’s up to you, no judgment. But you should have a prescription because like I said this is tricky stuff. If you can’t go to an OB-GYNE because you can’t afford it or you just don’t like doctors for some reason, you can probably still get a pack. Of course they won’t sell it to you over-the-counter if you’re like twelve or something, and in which case girl you and I need to talk.

Tips for Taking the Pill

  • Same time, every day. Same time, every day. Same time, every day. Make a phone alarm. Synchronize with friends or officemates who take pills so you can check on each other. I don’t know how, but make sure that you take it at the same time, every day. This is a matter of life and death people!
  • Missed a pill? Check out this guide. Basically, if you missed one, take it as soon as you remember and carry on as usual. It gets more complicated the more you miss.
  • Do not go for the full 7 days without hormones. That’s one big reason why pills fail. Whether you have the iron supplements or not, go without hormones for 5 days only. Day 21 is the last hormone pill, you menstruate on day 24 or 25, you take the next one on day 27.
  • Use back up methods for the first month. I know they usually say back up is only needed for a week, but I feel like that’s tempting fate.
  • The more methods you use, the better it works. So obviously, you’d be a lot less likely to fall pregnant if you use condoms and withdrawal at the same time. Or heap spermicides on top of that!
  • For condoms, 86 in 100 women fall pregnant over ten years of typical use. For withdrawal, that’s 92 in 100 over ten years. This is my favorite resource for this because it shows the difference between typical and perfect use during clinical trials.
  • You can’t use calendar or basal body temperature methods along with the pills because if you’re doing it right, you’re not ovulating.
  • Go to your OB-GYNE and get a pap smear and a TVS once a year just to make sure everything’s right.
  • If for some reason you don’t want people to know that you’re sexually active but they interrogate you about your pills, you can say that you have Polycystic Ovarian Syndrome (PCOS), some sort of hormonal imbalance, severe dysmenorrhea, or you’re using it to treat acne. Again, it’s your life so no judgment.

Other Hormonal BC Methods, with CDC Stats

The pill is the only one you have to take at the same time every single day. That’s why a lot of people don’t like it. If you’re one of these people, there are others you can check out.

  • Injectables (ex. Depo-Provera), repeat injections every 3 months (94% effective)
  • Patch (ex. Evra Patch), stick one on for a week every 3 weeks (91% effective)
  • Ring (ex. NuvaRing), leave in place for 3 weeks at a time (91% effective)
  • Diaphragm, insert before intercourse; replace device every two years (82% effective)
  • Hormonal IUD (ex. Mirena), requires minor procedure at the OB-GYNE; replace after 5 years (99.8% effective)

Hope this helps. Feel free to leave comments, and I’m definitely open to suggestions for other topics to discuss. Stay safe everyone!

An Overview of Birth Control Methods

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With the limited sexual and reproductive health education most of us receive in grade school and high school, it’s no wonder that so many people have no clue which birth control methods are available to them and how much they cost. We have one of the highest rates of teenage pregnancies in Asia, and our population has ballooned to more than 100 million as of 2014. So I’ve compiled a list of readily available birth control methods in order of ease of access for regular Filipinos like you and I. This list is by no means comprehensive. Some methods like birth control pills and the IUD will be discussed more extensively in other posts. If you need to know more, follow the links provided, conduct your own research, and talk to your OB-GYNE.

Most stats here are based on the NYT article, “How Likely Is It That Birth Control Could Let You Down?” which provides great information for both typical and perfect use. Quoted here are stats for typical use over a year only.

Abstinence (100%)

  • Who can use it: Everybody
  • What it does: Well you can’t conceive without intercourse
  • Where to get it: Deep within your soul
  • When to use it: All day, every day
  • How to use it: Just don’t engage in vaginal penetration
  • Cost: None

Fertility Awareness-Based Methods (76%)

  • Who can use it: Women
  • What it does: Makes you aware of your cycle and your basal body temperature
  • Where to get it: You can learn charting from sites like this, and buy a thermometer from any drugstore
  • When to use it: Every day
  • How to use it: Chart your menstrual cycle responsibly
  • Cost: Notebook and thermometer… 100 PHP

Withdrawal (78%)

  • Who can use it: Men
  • What it does: Prevents (most of) the sperm cells from reaching the egg cell
  • When to use it: Right before ejaculation
  • How to use it: Pull out on time, every single time
  • Cost: None

Male Condoms (79%)

  • Who can use it: Men, although it would help if women insisted on it
  • What it does: It’s a barrier method that prevents sperm cells from reaching the egg cell
  • Where to get it: Most drugstores nationwide
  • When to use it: During intercourse
  • How to use it: Like this
  • Cost: Varies wildly among different types of condoms… 50 PHP and up
  • Note: Recommended for use along with any other type of method for STD prevention

Birth Control Pills (91%)

  • Who can use it: Women (although the male version is underway)
  • What it does: It does three important things, namely (1) tricking your body into thinking you’re pregnant, thereby stopping you from releasing egg cells, (2) thickening the cervical mucus so the sperm can’t enter, and (3) keeping the lining of your uterus thin so that a fertilized egg can’t attach to it even if it gets through the first two mechanisms
  • Where to get it: Most drugstores nationwide, consultation visit to OB-GYNE and prescription recommended
  • When to use it: Every day
  • How to use it: Take one active pill at the same time, every day
  • Cost: Varies wildly among different types of pills… 45 PHP and up
  • READ: Let’s Talk About BC Pills for more information

Emergency Contraception/Plan B (“95% when taken within 24 hours” – WHO)

  • Who can use it: Women
  • What it does: Levonorgestrel prevents (1) the release of an egg from the ovary, (2) a sperm from fertilizing the egg, and (3) a fertilized egg from attaching to the womb.
  • Where to get it: Unfortunately, we don’t have easy access to the real Plan B OneStep. What we do have is access to is the Yuzpe Method, which means taking BC pills with a high levonorgestrel content, like Nordette.
  • When to use it: Within 120 hours of unprotected intercourse
  • How to use it: You need 1.5 mg of levonorgestrel in two doses, 12 hours apart
  • Cost: Less than 200 PHP for a pack of Nordette
  • READ: Emergency Contraception 101 for more information and alternatives to the pill

The Shot (94%)

  • Who can use it: Women
  • What it does: The same thing the BC pill does, except with less room for human error because you get an injection and that’s it
  • Where to get it: Your OB-GYNE
  • How to use it: Get a new shot every 3 months
  • Cost: About 500 PHP per shot

The Patch (91%)

  • Who can use it: Non-smoking women under 198 pounds and below 35 years old
  • What it does: The same thing the BC pill and the shot does, but in patch form
  • Where to get it: Your OB-GYNE
  • When to use it: Once a week
  • How to use it: Stick one new patch on the skin of your buttocks, stomach, upper outer arm, or back once a week for 3 weeks in a row (skip the 4th week)
  • Cost: About 600 PHP for 3 patches

The Copper IUD (99%)

  • Who can use it: Women — it lasts for up to 12 years (stats say you should probably change it in 10 years though)
  • What it does: It (1) releases copper into the uterus which works as a spermicide and (2) changes the lining of the womb, making it less suitable for a pregnancy
  • Where to get it: Your OB-GYNE. This one requires a minor but painful 10-minute procedure.
  • How to use it: After your procedure, just get another ultrasound a month later, and a yearly ultrasound after that.
  • Cost: About 2500 PHP

The Hormonal IUD (99+ %)

  • Who can use it: Women — it lasts for up to 5 years
  • What it does: The same thing that the BC pill does
  • Where to get it: Your OB-GYNE. This one requires a minor but painful 10-minute procedure.
  • How to use it: After your procedure, just get another ultrasound a month later, and a yearly ultrasound after that.
  • Cost: About 5000 PHP

The Implant (99+ %)

  • Who can use it: Women — lasts up to 3 years
  • What it does: The same thing that the BC pill does
  • Where to get it: Your OB-GYNE
  • How to use it: A matchstick-sized rod is inserted under the skin of your upper arm
  • Cost: About 8000 PHP, but may soon be available for free through local health centers and the DOH

So there you have it. As I said, this is just an overview, but I hope that this helps you make a more informed choice about the methods you’re using and let you plan your future better.