We're back this week with even more contraception! Everything you want to know, from birth control pills, rings, patches to barrier methods, rhythm methods and of course emergency contraception for your oopsies!
Sara has tried them all, all at once?? Supraja has feelings.
Wondering about IUDs, implants and the shot? We got you, listen to last week's Contraception part 1.
We're back this week with even more contraception! Everything you want to know, from birth control pills, rings, patches to barrier methods, rhythm methods and of course emergency contraception for your oopsies!
Sara has tried them all, all at once?? Supraja has feelings.
Wondering about IUDs, implants and the shot? We got you, listen to last week's Contraception part 1.
Hi, I'm Sara.
Supraja:And I'm Supraja. And this is Gyn & Tonic.
Sara:Welcome back to Intimate Convos with your besties. Can you hear me? Are we ready to roll?
Supraja:We're recording Sara.
Sara:Hello.
Supraja:Hello. Have you prevented pregnancy today? Do you have any confessions...? Sara: I'm preventing it by abstinence. By masturbation only this month, guys, 100% proven contraception. Just masturbate. Masturbate all day long,
Sara:every other day.
Supraja:Okay. What are we drinking? My favorite, you know that
Sara:espresso martinis.
Supraja:Woo. I'm scared guys cuz I've already put a dent in Sara's probably billion dollar marble table and she's pretending not to be mad at me by saying things like, I know it wasn't intentional.
Sara:chipped my marble table. I'm just,
Supraja:this actually really happened two seconds ago. Sara, can you tell me about your feelings? Be honest. I can take it. Do you want, uh, you want me to be more careful? I will be. And two, do you wanna confess on air how much money I owe you?
Sara:No, it's fine. Uh, I really do believe that material is material and if you are gonna spend money on something, then you've gotta get used to that. It could potentially be damaged.
Supraja:Guys, can you write in the comments what you think it will take for Sara not to speak to me? Cause you are someone who holds it in.
Sara:I do.
Supraja:So will, I never know.
Sara:No, I really, I will, I really do
. Supraja:I feel like we have good communication, don't you think Sara?
Sara:Yeah. Because you taught me that. I don't You genuinely love me.
Supraja:I do.
Sara:And when you're mean to me, it's be, you still love me. I'm just kidding.
Supraja:No, you're like, you're someone I would feel really bad to be mean No, you really
Sara:did teach me that though. Cuz sometimes when people hurt me, I remind myself. I know that person really loves me and that was not their intention.
Supraja:It kind of sounds like I'm just teaching you to settle . You're like this pain, I'm feeling is love. That's what I'm taught you. I know this
Sara:man after two dates really loves me. I know that maybe I was intimate with him too fast, but I know
Supraja:when he'd called me names after. I know he loves me. That's not the lesson, Sara, but No, but I think we have. We always talk about how we're good at being, like trying to remember that we love each other and we have good intentions, and so giving each other the benefit of the doubt.
Sara:Yeah, that's the phrase. Benefit of the doubt.
Supraja:Yeah, but don't, not for the men. I don't give them the benefit of the doubt for you.
Sara:That's true. I'm trying to be better about that. I have, I've cut off a lot of men recently.
Supraja:Guys. I'm gonna start a GoFundMe that's like, keep Sara loving me and you can donate to her marble table. After our Marbel table fund. Okay. I need, I need you guys.
Sara:No, I feel like I'm gonna have to get rid of that when I have a baby. Anyways.
Supraja:I thought you were gonna say because of the dent.
Sara:No, because they faceplant into it.
Supraja:Okay. This is why I don't have a kid. I just have an espresso martini.
Sara:Well, uh, well we have a trip coming up.
Supraja:Oh yeah, Mexico. Okay. Also comment on this guys. We're just gonna talk about all of our friendship dynamics. Mm-hmm. Okay. So Sara's like the planner of the trip. Mm-hmm. But I tell myself that you want to be the planner of the trip, but I also don't know if I'm just not being assertive enough about helping you.
Sara:It's because I, I do. Take joy in organizing stuff. Yes, I really do. Mm-hmm., I'm trying to be more mellow about trips, cuz I can be a little psychotic. I think I'm just psychotic in general. I like,
Supraja:no you're not.
Sara:But I'm a Virgo. Okay. I'm organized.
Supraja:I'm a Gemini guys. But
Sara:I just like to finish a day knowing no matter what we did during the day, how chaotic it was. How tired I am. There is a nice meal planned at the, my goal, my thing when I travel is I wanna have nice, very nice meals. Yeah. Like it could be the best street food in the world. It could be the best seven course meal of the day. I just wanna have a dinner plan. Yeah
. Supraja:And so, well honestly, I feel like that's a change from how you used to be, cuz you used to plan like all the meals and like all the activities and everything. Yeah.
Sara:I feel like when I first finished residency, my mom and I went to. Paris and I was so crazy about planning everything that it was not fun anymore. Mm-hmm. Like, I didn't enjoy it. Cause I was like, well, we didn't do this, and not like, we didn't make it. And so I was realized like, that's not a, that's not a fun way to travel. So now I'm just like, I wanna have the meals planned, the dinners, and then the rest we could do whatever.
Supraja:Yeah. I don't know what I am like. Honestly, you know what? I really love traveling with people because I love connecting with people and the experiences, but I feel so responsible for other people having a good time. I don't even know what I want. Outside of that, like, I don't know what I would ask you for, , I could probably spend more time thinking about like, what's actually important to me.
Sara:Yeah, I feel like I know, at this point, like what's, , I want super clean, super safe, and my meals planned, that's it. That's the, those are the three big priorities to me when I travel. I don't know.
Supraja:Yeah. I think I just assume I can go back. But that's also sort of silly, right? Like I should just, I'm like, okay, if we go on this trip and we don't do anything I wanna do, like I'll just go back and do it.
Sara:No, you need to be selfish.
Supraja:I know, but I don't knowm like I want because I do think it's like very important to me to like connect with people. And I know that like, if you're having a good time, like I'm gonna be happy that you're happy. I sound like a psycho. No.
Sara:No, I just, I'm like, I've, I've been better about like realizing like what I want out of a trip.
Supraja:Should we talk about our Spanish fight?
Sara:Our Spain fight? Yeah. Oh yeah. Our Spain fight.
Supraja:What's your perspective? Sara and I went to Spain for two weeks. Eh, not two weeks, no 10 days. But it was great.
Sara:We had a great time.
Supraja:I mean, Sara was goofy at baseline, but like even goofier, which I really loved.
Sara:I was,
Supraja:yeah,
Sara:really. I
Supraja:feel like you were doing even goofier things
Sara:like the pillow barrier. Yeah. She made a pillow barrier between us. That's cause I don't like people that touch me when I sleep, unless you're a man calling out a, I'm just kidding.
Supraja:You talked in your cartoon voice a lot. Oh yeah. Yeah. But okay. Tell people about our fight.
Sara:Well, it wasn't, it wasn't a fight. It was just a disagreement. There was tension. It was a tension. Tension essentially. I was again, perseverating on dinners and I was like, it just has to be the best dinner. Like we gotta find the best dinner. Like if it's not a good dinner, I'm gonna be really disappointed. If it's a tourist trap, I'm gonna be disappointed. And I very much exude that kind of energy. I. Yeah, and I think Supraja was trying to give me feedback, but in a way that was not very direct and very indirect. And then it felt like I was being attacked and I was like, are you just trying to tell me something?
Supraja:I know it's so sad. See, this is what you guys are, you and like Adam are so good at this, where you're like so earnest about it. I just, I'm like, God, I'm an. Sara: Well I bet you I was just like, You know what though? Cuz I think from my perspective, Like I, and this is all my problem where I. If I am like a little bit annoyed about something, I don't always acknowledge it even to myself. And then I just start making like weird comments like though I like honestly was not even trying to tell you something, but when you said that, I was like, why am I being kind of a like low key, not nice. Right now. And then I was like, oh, I guess it's for this reason, which wasn't cool of me, but it's like I'm not even acknowledging I'm doing it for that reason and it's something I really need to work on. I think I probably do this to like, everybody close to me just isolate everyone close to me think I was like Sara, like what does it mean about your personality that you're, so, Excuse me. Like I don't actually need your commentary on my personality.
Sara:Well, I didn't say that, but eventually I was like, I just feel like you're trying to ask me something that you're not saying directly to me.
Supraja:Yeah. And then I was like, you're right. I'm sorry. It just kind of stresses me out to feel like we have to have a perfect time or you're gonna be really disappointed.
Sara:And I was super receptive to that. Oh yeah. I think the thing that really makes me sad is when people won't bring stuff up to me because I'm actually quite receptive to feedback. So receptive. I'm such a people pleaser that I wanna like, let's address it, let's fix it. But I'm also very guilty of not bringing stuff up to people. Yeah. And so I'm trying to be better about like, oh, well I. I feel like you're upset about something, let's just address it. Or if I mess up, I'm like, oh my God, I'm really sorry. Like it's never my intent to hurt people.
Supraja:So explain to me why we didn't speak the rest of the trip. I'm kidding.
Sara:No, we did. We took the next day off and separated.
Supraja:I didn't mean to separate.
Sara:No, but it was a, it was a organically done. Yeah. Yeah. We organically were like, you're like, I'm gonna go to the Picasso museum, and I was like, I'm gonna go shopping.
Supraja:Actually, that kind of broke my heart because I really didn't mean to separate from you. Although I am like, I'm kind of introverted more than people think. Like I do need some alone time. But later you were like, I. Oh, she wants to, you were told me you were like, I was thinking about it and I was When you said that and I was like, oh, she wants to be alone. It's okay. I'll take this time to be alone. I said, it's so sad. Like honestly, I wasn't even aware of all that. I was just like, I don't know. It doesn't seem like I wanna go to the museum. But yeah,
Sara:it was totally fine. It was totally fine.
Supraja:I actually am so grateful for our relationship cuz I really do feel like we work through conflict very well.
Sara:Yeah. And I don't work through conf I, it's something I've worked on really hard, both in friendships. And in, uh, relationships. Cuz if you burn me, you're dead to me.
Supraja:Guys. I already chipped her table.
Sara:my marble table.
Supraja:I'm scared.
Sara:It's fine. It's material. It's, oh my God. Do you see how she's saying? No, it's, no, it's cause my mom says that Sara. It's material . Actually, this one time I saw this meme, it made me wanna cry. I was like, mm-hmm. If I could be my mother's mother, I would be the best mother in the world to her. I'd give her all I know that's true.
Supraja:Sara was about to cry, guys. I saw this meme. I was like, do we seem unhinged today?
Sara:Well, it's just such a beautiful meme on Instagram. It was like a real, that's really nice. I was like, oh my God. I would be the best mom to my mom. I'd give her all the love she never had.
Supraja:You do give it to her.
Sara:I know. I do. Sara's obsessed with her mom.
Supraja:I'm obsessed with my mom too. Moms deserve to be obsessed with.
Sara:Yeah. Mm-hmm. Best mom in the world.
Supraja:Mine too. Okay? We wanna teach you about contraception. If you didn't listen, go back. Listen to part one cuz that was all the long-term reversible types. We review them, they're awesome.
Sara:IUDs, implants, depo-Provera, also known as the shot. Now we're doing. Uh, other great methods, but, um, just they work a little bit differently and so we're gonna go through them again in that same order. Most effective to least effective. So we're gonna start with combined hormonal contraceptives.
Supraja:Mm-hmm. Okay, so combined hormonal contraceptives when combined refers to the hormones that are in it, which is estrogen and progesterone, and there are really three types of that. There's the pill, the ring, which is a little ring that you put into the vagina and the patch. And all three of them have estrogen and progesterone in it. The pill you have to take every single day. There are actually some pills that are progesterone only, but we reserve those for situations where you have to do progesterone only and someone can't take estrogen, but the pill you take every day. Traditionally there's a week where you have a placebo pill, although some of them are longer term where it's like every three months, or you have a shorter like four day period where you get a period because you're taking the placebo pill, but all the other days you get estrogen and progesterone. And some of them you get the same dose every day. And some of them, it tries to mimic a natural cycle more where you have changing doses of those hormones and then the ring, it's every three weeks you have it in, you take it out for a week, get a period., the patch every week, you switch it. So those are ones where like people who really still wanna have control over it, like wanna do something where they themselves can alter whether they're using it or not. Um, it makes for sense for those people
Sara:they're actually really good methods. If you are somebody who. Um, doesn't have a hard time remembering to do something every day with a pill every three weeks with the ring. I would totally forget that ring was in my body.
Supraja:You think so?
. Sara:Well, maybe not. Are you kidding? I feel like you're so aware of that part of your body. That's true
Supraja:because Sara, every day sends me a text. Here's what my vulva feels like today.
Sara:This is what my cervical mucus feels like today.
Supraja:Yeah. She sends me pictures. Guys, is it normal? Vote below. I'm just kidding. You've never once sent me a photo or that text.
Sara:No. I have other people for that, but keep going. Oh, I'm just kidding.
Supraja:Okay. Okay. So the way that it works very similar to other types of hormonal birth control,
Sara:The way it works is it a few things. The number one thing is it just keeps you from ovulating. It tricks the hormones in your brain, , so that, , your body. Um, doesn't produce a follicle to ovulate. It keeps the hormone steady every single day, so you don't get that natural fluctuation, so you actually don't release an egg. And that's how people essentially get pregnant. If you've missed too many pills, forget to switch the ring out. Forget to switch the patch. After a week, you could ovulate, and that's how people get pregnant. There are other things that contribute to. The ability to prevent protection, including increasing,
Supraja:prevent pregnancy.
Sara:Prevent pregnancy, oh, what did I say?
Supraja:Protection. I'm sorry I, the ability to have surprise pregnancy.
Sara:Whoa. That's what I'm wishing for. I'm just kidding. Anyways, um,
Supraja:your babies are gonna be so cute though.
Sara:Depends on who I make a baby with.
Supraja:No, you're pretty cute.
Sara:Yeah, but no, man, don't What if they just get my big ears and my like frizzy hair?
Supraja:They're so cute though.
Sara:I don't know. Anyways,
Supraja:anyways. Okay.
Sara:Um, but yeah, so what was I gonna say? Uh, the other methods it works is. Increasing the cervical mucus in your discharge in your vagina. It increases the mucus in your cervix, so it's hard for sperm to go from vagina into the uterus.. And then it can affect the motility of the fallopian tube. So it makes it hard for sperm to get through the tube and find an egg. That is trying to get through the tube into the uterus. So a few different ways.
Supraja:Mm-hmm. And so the risk of pregnancy, if you use it perfectly, meaning you don't miss any doses, then it's less than 1%. So very, very effective for people who are good at taking it every day.
Sara:Right here if you're,
Supraja:yeah, like Sara, if you're like me, where you remember, only when you have an oopsies
Sara:Jesus,
Supraja:it does not work well. And then there are most people who are in the middle, which we call typical use. So whenever we talk about like contraceptive efficacy, we say perfect use like no missed pills.
Sara:Yeah.
Supraja:And then typical use was just kind of like an average of everybody else. So in those cases, it's about 93% effective. So it's still much better than. A barrier method or natural family planning, but not as good as some of the other things that don't rely on you remembering like an IUD or a Nexplanon or even the shot. Okay. So what are things it can help with other than preventing you from getting pregnant? Sara,
Sara:there's, there's actually a few things that it can help with, and there's actually many reasons to use the birth control pill. Besides wanting to avoid pregnancy,, so one, it can decrease , , risk of getting an ovarian cyst every month. You know, every month when you ovulate, you produce a cyst, , it collapses, it goes away. But some women retain those. Cyst. They can be large, they can be uncomfortable. They can be painful. So because the pill keeps you from ovulating, it can decrease the risk of that happening. It's not foolproof. It could still happen, but it's one of the methods that can help, , decrease that chance.
Supraja:Yep. And then it can also help with your bleeding and your cramping. If you're someone who has really severe bleeding. And cramping. It can make your periods more regular if you're someone where they're not regular and you wanna be able to know exactly when they're gonna happen,
Sara:which is nice if you're like going on a vacation and you're like, I cannot get my period when I'm going to Italy to meet some for potential partners.
Supraja:Yeah, but Sara's one Italian man, may be a fascist. So I don't support anyways.
Sara:Anyway. It also helps with acne. Actually, you know, he started following the podcast. I know he's a supporter. I'm changing, changing men.
Supraja:I don't you're ch What does that mean? Like you're going for men
Sara:no, I'm just, you know, I'm, I believe that people can change.
Supraja:Oh, okay.
Sara:And it, you know, I'll just, you know
, Supraja:like one day I won't break your things.
Sara:Oh, let's not go that far.
Supraja:Okay. So, okay. Yes. Another benefit of the pill. I don't know why I'm like cradling myself.
Sara:I know. I was like, you okay. Damn. I made a strong espresso martini. I
Supraja:really like them guys and I'm, I don't drink a lot. Contrary to what this podcast may I know. Make it sound like.. So another benefit of the pill. You might, you've spoken about this before.
Sara:Yeah. It helps with acne and hirisituism, which is a fancy word for male pattern hair growth, like on your chin or your chest. But essentially the birth control pill, affects how much free testosterone, cuz women have testosterone as well, that circulates through your body, so it helps. A lot of people actually really benefit. It's a treatment for acne for some people, and it's an added benefit. Every time I've been on the birth control pill, my skin looks fabulous.
Supraja:Like right now, if you are watching this on YouTube, zoom into Sara's face. Yeah. Take a screenshot
Sara:and I haven't used Botox in like since last August.
Supraja:Put it on your mood board
Sara:and it still looks fab.
Supraja:Okay, great. Other things important to know for some people who have like PMDD could help to stabilize that cuz it prevents some of that hormonal cycling.
Sara:What's pm d d premenstrual dysphoric disorder.
Supraja:That's right. Um, and that's people who have really significant PMS, like very debilitating PMS that's related to hormonal cycling. Basically the pill makes it so your hormones are not cycling, right? Yeah. That you're getting like an even steady stream of hormones. So it prevents things that are triggered by changes in your hormones. Mm-hmm. Like PMDD, migraines for some people, things like that.
Sara:I think the other thing to mention, Is, it does not increase your risk of cancer. In fact, it helps decrease your chance of cancer, particularly ovarian cancer, because I think this is a question that comes up a lot.
Supraja:Yeah.
Sara:Oh, I wanna take a break. I wanna give, let my body, you know, recover. It actually can have many beneficial effects. Being on the birth control pill for 10 years can decrease your risk of ovarian cancer by 50%. So that's an added benefit. And the same could be said for some other,, hormonal, , birth control methods. But, um, I love it when people bring that up. I'm worried about this, like actually there are many benefits to the birth control pill besides. Just preventing pregnancy, which is a tremendous benefit.
Supraja:Mm-hmm. Okay. And then people are always worried about the side effects. Um, It does not affect your fertility potential at all. I think that's a big thing people are always scared of. You know, it might take a month or two for you to go back to ovulating, but with the pill or other combined contraceptives like the, again, the ring or the patch, it's usually pretty fast, honestly. So it does not affect that at all. And also does not cause you to gain weight and. That, you know, whenever I say things like, because I think a lot of people ask me about that. Yeah. Or remember that they feel like they gained weight. And I always want to, to affirm that everybody's experience is different. And when you look at these large studies, they don't always capture what each individual experience is. But it's also worth knowing when you're considering the risk of that, that when you do look at large studies, it's not shown to be a cause.
Sara:I think the other thing to consider is the time when most women are starting contraceptive methods. Coincidentally happens to be when many of our bodies are changing.
Supraja:Mm-hmm.
Sara:Our metabolism is changing, and it, it's, it's sometimes easy to attribute it to, well, it has to be this, it's not always necessarily that. I, I found that helpful when I was reviewing some of the studies and they actually did comparisons and there actually wasn't any proven increase in weight gain. There was for the Depo-Provera injection, which we did review on the last episode, but not for the birth control pill.
Supraja:Yep. And just for anyone who hasn't listened to it yet, listen to it was about five pounds on average with the depo. So not insignificant, but not a super significant amount of weight gain. Um, okay. And then thing, things that people do experience. So some people will have irregular bleeding with the birth control pill or with combined contraceptive, like the pill, the patch, or the ring. But most people have. Very controlled cycles,
Sara:And the nice thing is there's so many different combos of birth control pills, like, it's essentially two hormones, progestin and estrogen, and there's many formulas. And so if you really are dedicated to this method and you wanna use this one, you can try different. I've had definitely had patients who have tried 2, 3, 4 different combos until they found a method that eliminated some of the side effects they were having and allowed them to benefit from the things we are commonly, you know, excited about when it comes to the birth control pill. So, you know, that's the nice thing. It's not just like, One depo shot. There's actually like 20 different types of birth control pills available. So there's flexibility. Yeah. And adjustments available.
Supraja:Okay, cool. Okay, so for people who cannot use hormonal contraception or just really don't want to, don't want IUD that's not hormonal, what are their other options, Sara?
Sara:Like barrier methods. Yeah. Well, before we go to barrier methods, okay. I think the one thing we should mention about the combined hormonal contraceptives is that makes it different from everything else we've talked about is there's. More rules about who cannot be on these methods. Okay. Yes. That your ob gyn or your primary care doctor should be reviewing with it, with reviewing with you, because there are certain conditions that people may have that unfortunately makes them. Ineligible for these methods. Supraja: Mm-hmm. What are some of those methods? Supraja or some of those contraindications?
. Supraja:So there are relative contraindications and then absolute contraindications. So relative contraindications are things like you should really have a conversation about and think about not doing that method, but in some cases maybe it's worth the risk. Absolute contraindications are like, no, no, you definitely shouldn't do it.
Sara:And so having estrogen specifically is what makes it different from like the IUDs and the implants and Depo? It's the estrogen specifically. Um, but I always think of like four specific ones when I'm in clinic. And then if there's something a patient has that I've not heard of, I'll reference my CDC app, the Center for Disease and control. Control, yes. Whatever. Disease control Okay. Well anyways, the contraindications to the birth control pill. The major ones I think about. Migraines with visual aura. So migraines okay. But if you have visual changes, when you have a migraine, you should not be on the birth control pill. It increases your risk of stroke. And this is the one I hate asking people when I'm like, do you have migraines? They're like, yeah, do you have visual changes? And I'm like, holding my breath. They're like, no. And I'm like, oh God, I can give you a birth control pill.
Supraja:I know. And an aura too. I think people, I was unformed about what exactly it meant. Yeah. But it's a signal that your migraine is coming. So it's like if you have see like spots in your vision when you have a migraine, when your head is already hurting, that's not an aura that's just having migraine. But if you like have a visual change that tells you your migraines about to start and usually goes away when your migraine does start, that's an aura. So it's a, it's a specific thing, but the reason that we don't think that's a good idea to take that and the birth control pill is because, The combined risk of the estrogen in the birth control pill or any really contraceptive form that has estrogen and that increases your stroke risk to a point that we think is kind of unacceptable, cuz there are other options.
Sara:Other contra would be
Supraja:Breast cancer.
Sara:Yep. Mm-hmm. If you've ever had a blood clot in your legs or your lungs known as a DVT, or a pe a pulmonary embolism. Mm-hmm. Um, or if you have a genetic disorder that puts you at risk for one of those blood clot disorders if you're a smoker. Mm-hmm., and if you have high blood pressure, yeah. Those are the big ones that I think about. And then if somebody has a medical condition, I'll literally whip out the CDC app in front of the patients. I'll be like, 1, 2, 3, 4. Like, I'll just go through it with them and review the pros and cons.
Supraja:Yeah. Okay. Okay. So barrier methods. There are a few types of barrier methods. The one that we are most familiar with, of course, is condoms. And condoms have about a 2% pregnancy rate with perfect use. Uh, 13% with typical use, which just means that people like don't put it on in time. It breaks. Things like that, which causes it not to be quite as effective. Um, the benefit of condoms is that it protects you from STDs, so it's like two in one scenario, but the downsides is it's much less reliable than something like a contraceptive that is hormonal or the para guard. And also that you're relying on your partner to put it on, like that can be uncomfortable
Sara:and you're also relying on them to use it correctly.
Supraja:Okay. Sara, have you ever used a condom or anything else you wanna confess?
Sara:I've used condoms. Actually. I just got comfortable buying condoms a two years ago. Oh, I hated buying condoms
. Supraja:Why don't you just do it online?
Sara:just realized you could do that. Oh, you know why? Because my dad was in charge of my Amazon account for years.
Supraja:Oh, so you would see it. I couldn't let Brian McKinney see that. Do you think Brian McKinney listens to this
? Sara:I hope not. I'm just kidding.
Supraja:So yes, you can use a barrier, like a condom. There are also other things that you don't have to rely on the cis male to put on a condom. Like there's a female condom, there's a diaphragm, a cervical cup. I think all of those things have around the same efficacy. Would you say?
Sara:Yeah, it's not good.
Supraja:The thing, it really just because it relies on it working perfectly, not breaking and that you put it on perfectly. So those things can be hard, but definitely better than nothing.
Sara:And it, you know, it, the efficacy rate with like the diaphragm and the cervical cap is around, you know, 12% of people are gonna get pregnant one year. The, the diaphragm and the cervical cap are essentially, Devices that a woman is putting into her vagina in combination with spermicide before having sex, and you actually have to wait a certain amount of time before you have sex, like 10 minutes for the spermicide to kick in. You also have to have it well fitted to match the size of your vagina and cervix like, and on honesty, I feel like a lot of ob-GYNs are not trained in fitting these things.
Supraja:Yeah, cuz it's just not as common anymore.
Sara:It's, yeah. So I feel like if somebody came to me and they're like, I wanna use this method, I'm all for like, women, like taking ownership of their contraceptive methods. I just think it's the efficacy rate that kills me a little bit.
Supraja:Yeah. I always tell people too, like, these things are effective to a point and definitely better than not doing anything. Sometimes you can combined methods to make it more effective, like you can do a barrier. So Sara can do seven different methods that are
Sara:I literally was using condoms, birth control pill, and an IUD at one point.
Supraja:So if you are wondering if your obsession is normal, think of Sara. Then consider if you think she's normal, you know, just have these conversations with yourself, but love, and you start seeing my therapist again. But I have told people who feel really strongly that they don't wanna use hormones, don't want a paraguard. They can combine these methods and that's definitely better than not doing it if they really wanna avoid pregnancy as much as they can . So that's barriers. And then the thing I tell 'em they can combine it with is the natural method, which is basically just being aware of your cycle and avoiding having sex. When you could be ovulating., so obviously most effective in people who have very predictable cycles, and the idea is that you're really only fertile in a specific time of the month
Sara:think this is crazy when you ovulate that egg is really only alive for about 12 to 24 hours. Mm-hmm. That's it. But you can have sperm. Sperm can last up to five days in the vagina and the urogenital tract. So if you maybe had sex two or three days prior, you may still be at risk of , getting pregnant. Mm-hmm. But I sometimes, I think it's crazy how people get pregnant.
Supraja:I know it was really nuts that we, but you know, honestly, people have a lot more sex than they have babies than us, than me, not you.. Okay, so anyway, yeah, so basically you can track things about your body so you can track your cycle, see when your ovulatory period is, don't have sex. Then with someone who is putting sperm inside of you, you can check for your basal body temperature, you can check your cervical mucus. All these things can tell you when it's more likely that you're gonna get pregnant, and you can use those as cues not to get pregnant. So how effective is that
. Sara:25% of women will get pregnant in one year. Okay. So it really depends on you really understanding your cycle, like being a regular, like having a period every month and knowing when you're ovulating. And I think that's the hardest part. Can you reasonably predict when you're ovulating and, and it's, uh, I've used those ovulation predictor kits just to understand how they work. Mm-hmm. It's like, requires you to be like, proactive about it. You gotta pee on the stick, you gotta check. Mm-hmm. And it means you didn't have sex a few days before and you're at least waiting one day after. So you have to be really proactive about tracking it and whatever method you're using to track it. Um, hoping that it's a reliable method and even when they've done studies on, like using the phone apps, not a reliable app, not the best method to track ovulation,
Supraja:like as much as a stick or the temperature, mucus, all that stuff together. Yeah. Got it. Okay. So then what if you have an whoopsy, meaning you met a hot Italian. Or you realize you care too late or your condom breaks
Sara:if you have a Oopsy
Supraja:Oopsy, there is still emergency contraception. So definitely not effect as effective as being proactive with preventative contraception, but does reduce the risk of you getting pregnant if you have this situation. So there's stuff you can buy over the counter, which is Levenogestrol, just a, basically a type of progesterone and
Sara:also known as Plan B
Supraja:plan B, um, that you have to use within
Sara:72 2 hours. Mm-hmm. Of the condom breaking, forgetting the condom, whatever. Um, you gotta take it. And the way it works is it keeps you from ovulating. If you have already ovulated, it is not gonna work. It's also not an abortion pill. Like it's not gonna hurt the pregnancy, it's just giving it a little extra hormone. Right. Um, and the other one that is kind of similar to plan B is called Ella. it's another medication that manipulates the hormones to keep you from ovulating.
Supraja:Also, not an abortion pill does not affect a pregnancy if it's there already, but can be taken within five days with the same efficacy. The only downside is you generally need a prescription. Um, but it's worth getting a prescription cuz it works better than plan B and it
Sara:Yeah, and it's up to five days like you said, which is really nice. The most effective if you take it immediately after having unprotected intercourse because again, every day you let pass is more time for you to ovulate. And again, the sperm stays in the vagina for up to five days. You wanna use it as soon as possible.
, Supraja:Okay.. And then there's also IUDs, if you wanna have an IUD placed. Also beneficial way to prevent pregnancy as emergency contraception. So getting that done within the first five days.
Sara:Yep. And we used to only say the copper IUD could be used for emergency birth control, but recent studies have shown that the hormonal I uud the Mirena Liletta, are just as good. And I tell my patients, Uh, I'll ask them, do you want a plan B prescription? Because I think it'd be more effective if it's you fill it and it's just sitting in your medicine cabinet. Mm-hmm.
That way if it's like 1:00 AM and you're like, I don't want to go to cvs, it's just sitting in your medicine cabinet, which is really convenient. Yeah. And it's cheaper with a prescription than it is to buy it over the counter. Mm-hmm. Oh, great. Yeah. Good to know. Well, I remember one time having to need it in college.$50 what? Well, my boyfriend had money, so I was like, he freaked out cause I was on antibiotics for something else.
Supraja:Only have sex with rich people, guys. Yeah, yeah. I'm just kidding.
Sara:Cause then they pay for it. Cause they're so scared to have a baby. I'm like, I'm crying. I'm cool with having a baby, but I'm just kidding. Thank you for paying for it.
Supraja:No, you have to thank him.
Sara:Oh, fine for
Supraja:it. It's not just your problem
Sara:I didn't even think about it at the time.
Supraja:Okay guys, clearly Sara and I need to hug or something, so we love you. She still loves me, and we'll see you later. Bye.