Tag: birth control patch

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Birth Control

EVRA® Transdermal Birth Control Patch: How It Works, Potential Side Effects And Where To Buy In Singapore

EVRA® Transdermal Birth Control Patch: How It Works, Potential Side Effects And Where To Buy In Singapore
Image credit: Siena Health

Do you find it difficult to remember to take a pill every day? Do you have difficulty swallowing pills?

If you answered yes to any of the above questions, the birth control patch could be a viable option for you! Both birth control pills and patches use hormones to prevent pregnancy, but the way the hormones are delivered differs. You apply the patch to your skin once a week and forget about it.

In this article, we share all you need to know about the EVRA® Transdermal Patch. Read on to learn more about:

  • How it works;
  • How to use it; 
  • What to do if you missed a patch;
  • Potential side effects; and
  • How to buy EVRA® Transdermal Patch in Singapore.

What Is EVRA® Transdermal Patch? 

The EVRA® Transdermal Patch is a small, beige sticky patch that contains 2 hormones:

  • Progestin (6mg norelgestromin); and
  • Estrogen (0.6mg ethinyl estradiol).

The patch works by releasing hormones into your body through your skin to prevent pregnancy.

The patch is mainly used as contraception to prevent pregnancy. However, women using the EVRA® Transdermal Patch may also benefit from the non-contraceptive effects of estrogen such as:

How Does EVRA® Transdermal Patch Work? 

After the patch is in place, it delivers a steady dose of hormones through your skin and into your bloodstream.

EVRA® Transdermal Patch prevents pregnancy by:

  • Inhibiting ovulation, the release of an egg from the ovary;
  • Thickening the cervical mucus (the fluid in the vaginal tract), such that it is hard for the sperm to reach the egg to fertilise it;
  • Thinning of the uterine lining, such that even if an egg is fertilised, it will be unable to attach to the uterus. The fertilised egg will instead be passed out of the body.

How Effective Is EVRA® Transdermal Patch?

When used perfectly, EVRA® Transdermal Patch is more than 99% effective in preventing pregnancy. It is typically 91% effective (in events of missed applications or improper storage etc.), according to a report by the Centers for Disease Control and Prevention.

Birth control patches are generally more effective than male condoms in preventing pregnancy — male condoms are 98% effective when used perfectly, and 82% effective in typical use. However, it is important to note that birth control patches do not protect women against sexually transmitted infections (STIs), unlike male condoms.

Therefore, it is recommended to use dual protection of condoms and non-barrier contraceptives such as birth control patches during any sexual activity.

How To Use EVRA® Transdermal Patch?

Each pack of EVRA® Transdermal Patch contains 3 patches. Apply your first patch and wear it for 7 days. On day 8, change the patch to a new one. Change the patch every week for 3 weeks, and then have a patch-free week.

During your patch-free week, you’ll get a withdrawal bleed, like a period, although this may not always happen.

After 7 patch-free days, apply a new patch and start the 4-week cycle again. Start your new cycle even if you’re still bleeding.

Where to put the patch:

  • ​Always put your patch on clean, dry and hairless skin.
  • Put it on the buttock, abdomen, upper outer arm or upper back.
  • Put it on places where it won’t be rubbed by tight clothing.
  • Do not put on the breast or waistline, and on any open wounds, cuts or irritated skin.
  • Do not use adhesive or wraps to hold the patch in place.
  • Do not use creams, oils, lotions, powder or other skin care products on the application site. The patch may not stick well.

How to open the patch:

  • Open the foil sachet by tearing it along the edge with your fingers.
  • Peel away half of the clear protective covering without touching the sticky surface.

How to put the patch:

  • Put the patch on your skin and remove the other half of the protective covering.
  • Press down firmly on the patch with the palm of your hand for 10 seconds, making sure the edges stick well.

What To Do If The Patch Becomes Loose, Lifts At The Edges Or Falls Off?

Usually, the patch remains sticky, even if you get sweaty while exercising or take a shower. On rare occasions where the patch loosens (less than 3% of patches) or falls off (less than 2% of patches), you can follow the below steps to ensure you are still protected against pregnancies.

For less than 48 hours:

  • Try to put the same patch on again or put on a new patch immediately if:
    • it is no longer sticky;
    • it has become stuck to itself or on another surface or material; or
    • it is the second time it has become loose or has fallen off.
  • Change your patch on your normal change day.
  • You’re protected against pregnancy if you’ve used your patch correctly for the past 7 days (and the 7 days before your patch-free week, if you’re in week 1).

For 48 hours or more, or if you are unsure of the duration:

  • Put on a new patch immediately.
  • If you’re in week 1 or 2 of your patch cycle, change your patch on your normal change day.
  • If you’re in week 3, you need to start a new patch cycle (this is now day 1 of your new cycle) and skip your usual patch-free week.
  • Consider taking emergency contraception if you had unprotected sex in the last 7 days.
  • Use extra contraception (i.e. condoms) or abstain from sex until you’ve had a patch on for 7 days in a row.

What To Do If I Forget To Change My Patch?

If you forget to change your patch for one to two days (up to 48 hours): 

  • Put on a new patch as soon as you remember.
  • Change your patch on your normal change day.
  • A barrier method of contraception is not needed.

If you forget to change your patch for more than two days (48 hours or more): 

  • Start a new four-week cycle as soon as possible.
  • Consider taking emergency contraception if you had unprotected sex in the last 7 days.
  • Use extra contraception (i.e. condoms) or abstain from sex until you’ve had a patch on for 7 days in a row.

If you forget to take off your patch (at Week 4): 

  • Take it off as soon as you remember.
  • Start your next cycle on your normal “Patch Change Day”, the day after Day 28.
  • A barrier method of contraception is not needed.

If you forget to take off your patch (after Week 4):

  • Take it off as soon as you remember.
  • Put on the first patch of your new cycle as soon as you remember.
  • Use extra contraception (i.e. condoms) or abstain from sex until you’ve had a patch on for 7 days in a row.
  • You now have a new “Patch Change Day” and new Day 1.

What Are The Potential Side Effects Of EVRA® Transdermal Patch?

Women who just started using EVRA® Transdermal Patch may experience some of the following side effects:

  • Nausea and bloating. Taking the medication after food may help reduce these side effects. 
  • Headache. Taking over-the-counter painkillers such as Paracetamol may help manage the pain.
  • Vaginal bleeding between periods (spotting).
  • Breast soreness.
  • Mood changes.

These symptoms vary among individuals and normally subside within 2-3 months as your body starts to get accustomed to the changes in hormone levels. Do inform your doctor if you experience any of these symptoms for longer than expected or if they are bothering you.

How To Buy EVRA® Transdermal Patch In Singapore?

Birth control patches are prescription-only medicines in Singapore. You would need to consult a doctor in person before you can get started on any birth control.

With Siena, you can have access to affordable birth control without leaving home. Simply complete an online questionnaire, and speak with a doctor online. If prescribed, your medication will be delivered to you in discreet packaging and at no additional charge.

References

Categories
Birth Control Health Period

Polycystic Ovary Syndrome (PCOS): Symptoms, Causes and Treatment

symptoms, causes and treatment for polycystic ovary syndrome (PCOS)
Image credit: Getty Images

Feel like you never get your periods? Or when you do get them, it seems like there’s no end to it? Well, you may be suffering from a condition called polycystic ovary syndrome (PCOS) that affects your hormone levels.

What is Polycystic Ovary Syndrome (PCOS)?

PCOS is a common hormonal disorder that affects approximately 10% of women who are of reproductive age. The infrequent or prolonged menstrual periods caused by excess male hormones or androgen levels are one of the most obvious signs of PCOS.

Those suffering from PCOS have an imbalance of female hormones that prevents their ovaries from releasing an egg monthly. As a result, the ovaries end up developing countless small collections of fluid sacs (follicles) and fail to regularly release eggs. Each sac contains an immature egg that is unable to mature enough to trigger ovulation. 

You may be wondering where the term “polycystic” comes from. As the unreleased eggs remain in the ovaries, these multiple small cysts contribute to the polycystic appearance of the ovaries.

Essentially, by also producing higher-than-normal amounts of male hormones leading to hormonal balance, this causes your body to skip menstrual periods and makes it harder for you to get pregnant.

Image credit: National University Hospital

Signs and Symptoms of PCOS

Signs and symptoms of PCOS often develop during puberty, around the time you go through your first menstrual cycle. However, PCOS can also develop at a later stage due to substantial weight gain. 

You’ll definitely want to pay attention to: 

  • Irregular periods: could be infrequent, prolonged or even absent 
  • Heavy bleeding 
  • Hair growth
  • Acne 
  • Weight gain
  • Male-pattern baldness 
  • Darkening of the skin
  • Headaches

If you think you have PCOS, you should observe and track your periods as they are usually the most common signs. 

Other symptoms that may be more obvious are associated with physical changes. These refer to excess facial and body hair, severe acne and male-pattern baldness as they signify the presence of excess androgen in your body. 

Severe symptoms usually arise if you’re obese.

Causes of PCOS 

So far, the exact cause for PCOS is unknown although it may be hereditary as research suggests genes also contribute to PCOS. 

But the most commonly cited reason is probably excess male hormones called androgen. Women normally produce androgen in small quantities but for those with PCOS, they produce an excessive amount which explains the male-pattern hair growth (i.e. on the chin, chest, inner thighs, etc) and the formation of acne. When your ovaries produce abnormally high levels of androgen, you can also gain weight both easily and quickly.

Some studies have also shown that excess insulin increases androgen production which contributes to PCOS. Insulin is the hormone produced in your pancreas allowing cells to use sugar and also acts as your body’s primary sugar supply. If your cells become insulin-resistant, your blood sugar levels can rise thus causing your body to produce more insulin. 

How is PCOS Diagnosed? 

A diagnosis of PCOS is made when you experience at least two of these signs: 

Irregular periods– Infrequent, irregular or prolonged menstrual cycles are the most common signs of PCOS.
– A good gauge would be: if you have fewer than nine periods a year, more than 35 days between periods and abnormally heavy periods. 
Excess androgen Elevated levels of male hormones (androgen) may cause physical changes like excess facial and body hair (hirsutism), occasionally severe acne and male-pattern baldness. 
Polycystic ovariesEnlarged ovaries that contain follicles surrounding the eggs. Thus, the ovaries may not be able to function regularly. 
Diagnosing PCOS

Other ways to diagnose PCOS:

  1. Hormonal blood tests
    • By analysing your blood to measure your hormone levels, you can then safely exclude other plausible causes like menstrual abnormalities or merely androgen excess mimicking PCOS. 
  2. Pelvic ultrasound scan
    • Examine the appearance of your reproductive organs and the thickness of your uterine lining. 

Targeted Treatments To Cope With PCOS

PCOS is not completely reversible but several treatments can help reduce or minimise uncomfortable symptoms, allowing you to better cope with the condition. 

Birth control for irregular periods and its related symptoms 

Already on birth control? Well, you may be killing two birds with one stone if you’re currently struggling with PCOS too. 

Combined hormonal contraceptives are usually prescribed to control various PCOS symptoms. Some examples are the combined birth control pill, patch and even the vaginal ring. The estrogen and progestin hormones present in the hormonal birth control help decrease androgen and regulate estrogen levels instead.

To treat irregular periods (a common PCOS symptom), combined hormonal contraceptives are also recommended to aid in fixing hormonal imbalance and regulating the menstrual cycle.

What’s more, regulating hormones can even lower your risk of endometrial cancer and correct abnormal bleeding, excess hair growth and acne! 

Clomiphene or surgery for infertility 

The irregular and infrequent ovulation caused by PCOS can make it difficult for you to conceive. So if you’re planning for a baby or if you intend to get pregnant in the near future, it’ll definitely be useful to know that ovulation can be artificially induced using medications. 

A common drug used to induce ovulation is clomiphene (Clomid) which has to be taken orally for five days. If the tablet fails, you may need to consider hormone injections to stimulate the ovaries. But of course, this depends on the recommended treatment plan based on professional advice and guidance from your doctor or specialist. 

If you find that your body is unresponsive to medical treatment, there’s also the option for surgery. Laparoscopic ovarian drilling is typically used to trigger ovulation by using electrocautery or a laser to destroy parts of the ovaries. This corrects hormonal imbalance and restores normal ovulation. 

Hair removal medications for excessive hair growth

Excess hair may be something you’re not used to and find frustrating when you experience PCOS symptoms. Several fuss-free and convenient techniques include depilatory creams, shaving, waxing, bleaching, plucking and electrolysis. However, these methods have to be sustained or repeated in order to manage hair growth.

Suppression of male hormone production with tablets like the oral contraceptive pill or anti-male hormone drug may also reduce excessive hair growth if used for at least nine months. 

Lastly, you can also consider laser hair removal as it’s the most effective long-term method to help tackle the problem of excess hair. However, it’s probably one of the most expensive options as well. 

Lifestyle changes 

As substantial weight gain has also been attributed to PCOS, paying attention to your diet and regularly exercising to reduce excess weight may help to improve symptoms by restoring normal hormonal balance. 

To do so, you can also limit your intake of carbohydrates to increase insulin levels, or opt for food high in complex carbohydrates (e.g. whole grains and vegetables) to gradually raise your blood sugar levels. 

The Bottom Line 

If you suspect you have PCOS, it’s really important to seek timely and appropriate treatment to prevent further complications. That said, always seek help from your doctor first to figure out the best approach or course of treatment for your body and lifestyle.

Considering birth control? Here at Siena, we also want to help you find a solution to help you manage your PCOS symptoms. If you’re considering birth control, don’t hesitate to reach out and book a consult with one of our female doctors to explore your options! 

References: 

Categories
Birth Control Health

Why You May Be Bleeding Or Spotting While On Hormonal Birth Control

causes of breakthrough bleeding

Perplexed as to why you’re finding bloodstains on your underwear or pad even though you’re not on your period? Or worse still, you freak out thinking of the worst-case scenario. 

More often than not, however, you may just be experiencing breakthrough bleeding.  

What is Breakthrough Bleeding? 

It refers to any type or amount of bleeding that occurs outside of your normal menstrual period or even during pregnancy. This could be spotting or heavy bleeding that may even require you to wear a pad or tampon.

Spotting is easily recognisable by tiny pink or red spots and usually lasts for a few days. It also isn’t as serious compared to heavy or continuous breakthrough bleeding. 

Some may also find that they simultaneously experience lower abdominal cramps (similar to menstrual cramps) a few days before or during breakthrough bleeding.

Breakthrough bleeding is usually painless and mostly harmless although of course, it can be an unpleasant and uncomfortable feeling. Here’s more of the science and facts behind it so you understand why it happens if you ever experience it. 

A Potential Side Effect of Hormonal Birth Control 

Breakthrough bleeding is a common side effect that some birth control users experience within the first three to four months after starting hormonal birth control. In that case, this includes any contraception method containing hormones as they’re all likely to cause breakthrough bleeding:

Why do hormonal birth control cause breakthrough bleeding? 

This happens because your body has to take time to adjust to the new hormones. As you experience changing hormone levels, it also alters the endometrial lining in your uterus which thus, causes a change in or disruption of your usual period cycle. Ultimately, this leads to breakthrough bleeding. 

If you’re on oral contraceptives, there’s another reason why you may be experiencing breakthrough bleeding.

When you take a break in between pills (i.e. skipped a dose, frequently forgetting to take your pills on time or you’re on the inactive pills for a week), breakthrough bleeding can also occur. This is a reaction to your body’s attempt in detecting and responding to fluctuating hormone levels which then causes the premature shedding of part of your uterine lining before your period’s due date. 

Spotting is a pretty clear indication that your body hasn’t yet adjusted to the hormones in your birth control or that you missed your pill. Typically, breakthrough bleeding should stop after a few months of consistent use.

But if it does persist, it’s highly recommended you consult a doctor. This could mean your current birth control method might not be the most suitable for you and you may want to consider another method, or it could also be a sign of another bleeding disorder. 

Other Possible Factors That Cause Breakthrough Bleeding

Besides hormonal birth control, there are other reasons which may explain your breakthrough bleeding. 

1. Age

If you’re in the early and developing stages of puberty, you’re more likely to experience breakthrough bleeding after starting your period. Your body requires time to go through several cycles before establishing one and balancing your hormones. 

Women who go through menopause may also experience spotting and irregular periods once they’re no longer in their reproductive years. During perimenopause (also known as a menopause transition preceding menopause by several years), some women may be more susceptible as well. 

2. Sexually Transmitted Infections (STIs) 

Specifically, chlamydia and gonorrhoea can cause excessive bleeding due to the irritation of your cervix, or neck of the uterus. This in turn can lead to unscheduled bleeding.

3. Pregnancy

Breakthrough bleeding can also happen when a fertilised egg attaches itself to your uterine lining, also known as implantation bleeding. But unfortunately, it can also be a sign of an impending miscarriage or an ectopic pregnancy.

4. Other conditions 

The following are several conditions that may also cause unscheduled bleeding: 

  • Cervical cancer — bleeding between periods and especially after sex
  • Endometriosis — a painful condition in which the endometrium grows outside the uterus, thus causing spotting and other painful symptoms
  • Endometrial hyperplasia — overly thick uterine lining that causes bleeding 
  • Polycystic ovary syndrome (PCOS) — a hormonal disorder due to lack of ovulation that produces small cysts in the ovaries and diminishes progesterone levels; excess estrogen causes thickening of the uterus 
  • Uterine fibroids and polyps — benign growths that can cause spotting in between periods, or even after a woman has gone through menopause

Recommendations to Manage Bleeding or Spotting 

It’s unlikely you can stop or avoid breakthrough bleeding once it happens BUT you may be able to decrease the likelihood of even experiencing it though this is dependent on the cause of your bleeding.

For instance, if you know for sure your hormonal birth control pill is the cause for your irregular bleeding, simply ensure that you stick to a consistent schedule by taking the pill around the same time each day without missing a dose. 

If you’re new to birth control, remember it’s normal and breakthrough bleeding should stop after three months. But if the bleeding is frequent, heavy or often accompanied by pain, it might be a warning sign you should attend to as early as possible.

Easing Your Worries

Spotting is common and is usually no huge cause for concern. As a precaution, you may find it useful and important to keep track of when spotting or bleeding occurs and take note of how light or heavy the bleeding is, as well as the frequency of your breakthrough bleeding. 

But of course, if you’d rather be on the safe side, definitely speak with a doctor to rule out more serious health conditions. Or if you simply want to know more about your birth control options, you can comfortably do so at Siena where you can connect with any one of our female doctors from the privacy of your own home! 

References: 

Categories
Birth Control Health Period

Things You Should Know About Endometriosis: Definition, Symptoms, Treatments & Medications

endometriosis and birth control
Image credit: iStock

Endometriosis, a painful condition affecting 1 in 10 women of reproductive age. That’s about 190 million women globally. More often than not, endometriosis causes severe pain and can contribute to other problems like poor wellbeing and even infertility. And that’s why it’s important to address it, starting from this blog article.

Just last month (June 2021) in Singapore, it was reported that there’s a rising trend in the number of people diagnosed with endometriosis. From 70 to 80 patients per month in 2019, the National University Hospital’s endometriosis clinic saw 100 to 110 patients a month this year, with more than half being severe cases. (Source: CNA)  

Endometrial pain can also be extremely unbearable for most women, thus some may choose to opt for telehealth services like Siena where they can access birth control to help relieve the pain. We’ll delve into that in a bit. 

What is Endometriosis? 

It is a condition where tissue similar to the lining of the uterus grows outside the uterus instead. The tissue attaches itself to other pelvic and abdominal organs like the ovaries and fallopian tubes, which causes scarring, adhesions and cysts. 

Every month, your uterus grows the endometrial lining in preparation for a fertilised egg. If the fertilised egg doesn’t implant itself in the lining within a month, your hormone levels will fall, prompting the lining to shed. 

For women with endometriosis, however, after the lining sheds, the endometrial cells that grow outside the uterus liquefy, bleed and touch other organs or body tissues. This then causes irritation, inflammation and pain. 

There is currently no cure for it although you can seek treatment to help with the symptoms.

Common symptoms

  • Severe premenstrual/menstrual cramps (marked by having to change more than five to six sanitary pads a day) 
  • Pain during and/or after sex 
  • Painful and frequent bowel movements 
  • Pain in the abdomen, lower back or thighs often lasting throughout the cycle 
  • Heavy periods 
  • Spotting between periods 
  • Difficulty getting pregnant (40 to 50% of patients with endometriosis are diagnosed with infertility)

If you’re experiencing menstrual cramps that are currently (or have been) affecting your quality of life (e.g. unable to get out of bed or having to take medical leave to get through your cycle), it’s a sign that you could have endometriosis. 

Due to the condition’s painful and uncomfortable symptoms, women may also develop depression.

However, some who suffer from endometriosis may not display any symptoms at all.

Likely causes

Most people diagnosed with endometriosis are in their 30s and 40s. But you may be more vulnerable if: 

  • You’ve never given birth 
  • Your periods last more than seven days 
  • You have short menstrual cycles (your period comes every 27 days or less) 
  • You have a family history of endometriosis 
  • You’re suffering from a health problem that keeps blood from flowing out of your uterus when you’re on your period

Ways to Manage Endometriosis 

As there is currently no cure, it’s good to know about the available treatments out there to help you better manage your symptoms. It can be treated with medicine or surgery. 

How hormone medications can help 

In most cases, doctors tend to prescribe specific types of birth control ranging from the combined contraceptive pill to the contraceptive patch and GnRH analogues. This is because birth control can help reduce pain and bleeding.

As these hormone medications act as both contraception and treatment for endometriosis, they’re especially useful if you don’t plan on getting pregnant anytime soon.

Method Function
Combined hormonal contraception like birth control pills and patches (containing both estrogen and progestin hormones) – Pain relief
– Help you experience lighter, shorter and more regular periods
– Continuous use (skipping the inactive pills or last week of a 4-week pack) of the pill prevents menstruation. Thus, this stops endometrial cells from shedding and causing inflammation and irritation.
– Monophasic birth control that releases a continuous, steady dose of hormones each day of the month is also useful in alleviating symptoms. 
Gonadotropin-releasing hormone (GnRH) agonists medications– Trigger a temporary menopause-like state by stopping the production of certain hormones
– Prevent ovulation, menstruation and the growth of endometriosis and its related pain and symptoms
Progesterone and progestin medications like the mini pill, injection or intrauterine device (IUD) – Improve symptoms by reducing or skipping periods, on top of preventing pregnancy
– These hormones reduce menstrual flow without causing the uterine lining to grow, thus reducing endometriosis-related pain 
How hormone medications alleviate symptoms of endometriosis

As with all hormonal treatments, symptoms can return after you stop taking or using them.

Other methods to ease symptoms of endometriosis 

For milder symptoms that are still tolerable, you can consider painkillers or anti-inflammatory medications which may be enough to keep away the pain. This may include over-the-counter pain relievers or even stronger painkillers prescribed to you. 

If you want to get pregnant but you’re unable to do so or if you experience severe and extreme symptoms, surgery is another option you may want to go for. Going through with surgery will require you to remove the growths outside of your uterus or just patches of endometriosis tissue, relieving the pain and making it easier for you to get pregnant. Sometimes, the growths do come back after surgery so you may have to take medication. 

Some women also opt for hysterectomy (surgical removal of the uterus) to remove part or all of the affected organs like the uterus, fallopian tubes and ovaries. Keep in mind that this is permanent and it’ll be impossible to become pregnant in future. 

Increasing awareness

Even though access to early diagnosis and effective treatment of endometriosis is essential, it remains lacking. A significant problem associated with endometriosis is the delayed or under-diagnosis of the condition. Worldwide, diagnosis for endometriosis is typically made seven to 10 years after the onset of symptoms, which is a considerably long time. 

This suggests there’s low awareness among not just the patients, but also the general population and even doctors. Endometriosis shouldn’t be brushed off as merely normal period pain but rather, it’s important to be able to recognise and treat the condition to greatly improve patients’ quality of life.

The current priorities laid out by the World Health Organization includes the need for more research and awareness globally to “ensure effective prevention, early diagnosis and improved management of the disease”. Healthcare also plays an important role in screening, identifying and offering basic pain management to cope with endometriosis. 

In Singapore, there are a few great initiatives and outreach programmes you can support, such as the Endometriosis Awareness Campaign launched in 2012 and the Singapore Endometriosis Support Group. 

How Siena Can Help You Cope With Endometriosis 

If you think you may be suffering from endometriosis, birth control is definitely an option you can consider to help manage your symptoms. By hindering the growth of the endometrial tissues, birth control essentially relieves the pain and other symptoms associated with endometriosis. 

With that, don’t hesitate to seek help from any of our female doctors at Siena. With nine brands to choose from, you can also take comfort in knowing that we prescribe safe and effective hormonal birth control to help you alleviate symptoms of endometriosis. 

Summary

What is endometriosis?

It is a condition where tissue similar to the lining of the uterus grows outside the uterus instead. The tissue attaches itself to other pelvic and abdominal organs like the ovaries and fallopian tubes, which causes scarring, adhesions and cysts.

What are the symptoms of endometriosis?

– Severe premenstrual/menstrual cramps (marked by having to change more than five to six sanitary pads a day) 
– Pain during and/or after sex 
– Painful and frequent bowel movements 
– Pain in the abdomen, lower back or thighs often lasting throughout the cycle 
– Heavy periods 
– Spotting between periods 
– Difficulty getting pregnant (40 to 50% of patients with endometriosis are diagnosed with infertility)

What causes endometriosis?

You may be more vulnerable if: 
– You’ve never given birth 
– Your periods last more than seven days 
– You have short menstrual cycles (your period comes every 27 days or less) 
– You have a family history of endometriosis 
– You’re suffering from a health problem that keeps blood from flowing out of your uterus when you’re on your period

References: 

Categories
Birth Control Emergency Contraception Health Sexual Health

Preventing Unintended Pregnancies: What You Should Know About Having Safe Sex

preventing unplanned pregnancies
Image credit: Freepik

Unintended pregnancies are pregnancies that are mistimed, unplanned or unwanted at the time of conception.

In Singapore, the Ministry of Health revealed that there were 10,960 abortions in 2012 whereby roughly one in four pregnancies were terminated. Furthermore, a 2018 study by KK Women’s and Children’s Hospital’s Clinic for Adolescent Pregnancy revealed that nearly one in three girls and young women even had successive pregnancies before the age of 21, suggesting a need to improve care for pregnant adolescents. 

Aside from teenage pregnancies, this article still stands even if you’re a 35-year-old mom with two kids, and perhaps you know it’s more than you can ever handle. Or if you and your partner have already decided that right from the get-go, having kids is a definite no in your lifetime.

And that is why knowing how to prevent unintended pregnancies can be so important, no matter your age, background or individual differences.

Causes of Unintended Pregnancies 

Unintended pregnancies can happen for many reasons. It could be due to last-minute accidents or emergencies, carelessness and for some, even the lack of sexual education. In order to take the necessary steps in planning for when (or if) you want to conceive, it’ll probably be useful to first understand the likely causes of unintended pregnancies. 

Accidents or ineffective use of birth control

Although birth control can help prevent pregnancy, it won’t do you any good if you aren’t taking it on time or changing it as needed. And birth control methods, even when used correctly, can fail. Globally, an estimated 33 million unintended pregnancies are the result of incorrect use or contraceptive failure.

If you prefer to only rely on the rhythm method (abstaining from sex only during your most fertile days) or withdrawal (pull out) method, it’s important to note that you’re essentially using the least effective of birth control methods. They are less reliable mainly because it’s harder to control several important factors involved.

For instance, pre-cum may also contain sperm such that even if the other party pulls out every single time, there’s still a higher chance of pregnancy. And, if you’ve been nailing your ejaculation timing perfectly, remember that even just one slip up can potentially cause pregnancy. 

Also, although male condoms are easily accessible and offer protection against sexually transmitted infections (STIs), they’re only about 85 percent effective in real-life conditions for pregnancy prevention (one of the lowest). The efficacy of condoms depends on when and how it’s worn while there’s also a risk of condoms tearing and breaking during sex. 

Having sex without using any birth control 

Studies have found that among couples who have regular sex without contraception, 84% get pregnant within a year and 92% within two years. Several plausible reasons for not using birth control could be due to personal preference, lack of access to birth control, or cultural and religious norms and beliefs. 

If you’re one of those who don’t use birth control regularly or not at all, this might increase your chances of getting pregnant. This is especially so for couples who are fertile and also frequently have sex. 

Unaware of your fertility status 

For some women, they may be unaware they’re capable of getting pregnant if they:

  • Have prior experience struggling with infertility
  • Do not have regular periods 
  • Are going through perimenopause (menopause transition which occurs several years before menopause)

Although the above factors usually suggest a decrease in fertility, it is still possible to conceive. Thus, some women face unintended pregnancy when they least expect it. 

Non-consensual sex

Unintended pregnancies can also be a result of rape or forced pregnancy. This is a severe reproductive health risk that usually always leads to negative consequences for victims. 

Youths are at a higher risk of being exposed to non-consensual sexual experiences due to individual factors like financial need and alcohol consumption, and also environmental factors like poverty, early marriage and gender inequality. 

Ways You Can Prevent Unintended Pregnancies 

It all begins with you and most importantly, your knowledge and understanding of your own sexual and reproductive health. Hence, you may find it beneficial to keep the following guidelines in mind!

Practise safe sex

A really basic rule! Don’t be afraid to take charge of your own safety when it comes to your sexual health. You should take all precautions such as using condoms to prevent transmitting or getting STIs, and even hormonal birth control to prevent unintended pregnancies. 

Compared to the rhythm and withdrawal methods, hormonal contraceptives have much higher success rates. What’s more, there are many types of birth control you can choose from if you decide to go on hormonal birth control, ranging from the birth control pill, patch and vaginal ring. It all depends on what suits you the best in terms of your own preference and lifestyle.

If used perfectly, these methods are at least 99 percent effective at preventing pregnancy! With that said, if you’re not on any form of hormonal birth control, remember to use protection (i.e. condoms) every time you’re engaged in any form of sexual encounter. 

Still can’t wrap your head around your options? Before settling on a decision, you might want to do some research or speak with a doctor to figure out which contraceptive works well for you. 

Communicate with your partner

It’s important to be transparent about your sexual past, personal preferences and even your decisions about sex and pregnancy. Besides being able to learn about potential STIs and each other’s thoughts on having kids (especially for long-term couples), it’ll definitely help to maintain open communication with one another. 

Emergency contraception to the rescue 

Got caught up in the heat of the moment? Simply forgot about protection because you weren’t exactly in a sober state? Never expected your trusty condom to fail on you? 

We get it. Accidents happen. 

But that’s what emergency contraception is for! Also known as the morning-after pill, you take it to prevent pregnancy if you’ve had sex without contraceptive protection. The pill will then work to prevent or delay your ovaries from releasing an egg (ovulation). It should be taken as soon as possible after unprotected sex.

But do note emergency contraception is intended for occasional use, not as a primary form of birth control.

Consider long-acting reversible contraceptive methods 

Research has shown that long-acting contraception like the intrauterine device (IUD) and implants are essential in reducing unwanted pregnancy rates, abortion and even repeat abortion. Overall, they’re likely to have a positive impact on women’s ability to take control of their reproductive health. 

In comparison with other methods that depend on user adherence, these long-term contraceptive methods are more reliable, cost-effective and also offer better prevention against unintended pregnancies. 

Abstain from sex

This might be an unfavourable option but hey, it’s something that works and is definitely 100% effective for both pregnancy and STIs prevention. If you ever come to this decision, it’ll definitely help to share your feelings with your partner so both of you are agreeable and understanding of the situation. 

To Sum It Up

Educating yourself on the strategies and precautions needed to prevent unintended pregnancies is really important for quality family planning. I mean, what’s not to love about enjoying both great sex and child-free days especially when you’re not yet ready?

Being able to gain access to effective contraception with minimal barriers (or even stigma) can make a huge difference. And it’s really all you need in order to learn how to prevent unintended pregnancies. 

With Siena, you can speak to our female doctors via a tele-consult, purchase your contraceptives online and await your discreet package in the comfort of your home at no extra cost! 

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Birth Control Health Sexual Health

Birth Control and Infertility: Reversible Birth Control Can’t Cause Infertility or Affect Future Pregnancy — Here’s Why

birth control and infertility

Reversible birth control has no effect on fertility 

No, reversible hormonal contraceptives will not cause infertility or affect your future pregnancies, regardless of which method you’re on (i.e. birth control pills, patch, vaginal ring, IUD) or how long you’ve been using it.

Most women gradually regain fertility and are just as likely to conceive as women who have never been on birth control. Only sterilisation is considered a permanent and irreversible birth control method.

A 3-year study conducted to uncover the association between oral contraceptive use and the time to pregnancy revealed that long-term use of oral contraceptives did not affect the ability to conceive in the future. This same study of 3,727 participants even found that longer-term use of combined oral contraceptives was associated with a greater likelihood of pregnancy.

In a separate study of 2,000 women who planned to conceive after being on the birth control pill for seven years, 21% of the women managed to conceive within one cycle. After stopping birth control, approximately 80% of the women were pregnant within a year. 

Benefits of birth control

Perhaps, you haven’t heard of the wide range of health benefits that come from using birth control. Many women also use it to manage their migraines, relieve menstrual cramps and cope with painful disorders like endometriosis and premenstrual dysphoric disorder (PMDD). 

Especially if you’re sexually active but aren’t ready for kids yet, birth control is one of your best options. Used perfectly, most methods are at least 99 percent effective and safe, helping you to prevent unwanted pregnancies! 

So why is infertility still a persistent myth?

You may be wondering if this long-standing myth has some truth to it. After all, it’s a pretty common misconception and you’re bound to hear about it. While birth control doesn’t affect fertility, there are a few reasons why some may assume otherwise. 

1. Fertility delay

You should resume your menstrual cycle within about three months of stopping reversible hormonal contraceptives, if not earlier. However, depending on the contraceptive used and the individual person, there could be a fertility delay that makes it seem as if birth control has adverse effects on your reproductive health. 

According to research, it’s possible to experience a short-term fertility delay of two to six months once you’re off oral contraceptives. This shouldn’t be a huge problem but if you’re concerned, it’s best to speak with your doctor.

A longer delay of menstruation that lasts at least six months after you stop taking oral contraceptives may mean you’re experiencing post-pill amenorrhea. For some, it can take longer than usual for their body to start producing the hormones essential for ovulation and menstruation again, even after stopping the pill. Despite its medical term, this is usually not due to birth control use, but rather an underlying health condition or simply your body’s natural reaction. (Source: Healthline) 

2. Underlying health conditions

Birth control’s primary function is to release synthetic hormones that trick your body into thinking you’re on a menstrual cycle despite overriding your own body’s natural hormonal cycle. Sometimes, this may mask certain health issues that lead to anovulation (lack or absence of ovulation) or irregular ovulation. 

Several health conditions include: 

  • High levels of stress
  • Hyperprolactinemia 
  • Hyperthyroidism or hypothyroidism 
  • Low body weight 
  • Obesity 
  • Premature ovarian insufficiency 
  • Polycystic ovary syndrome (PCOS)

If you think you may be suffering from any of the above conditions, or experience a lack of menstruation, heavy bleeding or irregular period cycles, speak with a healthcare professional immediately. The longer you leave an underlying health condition untreated, the longer and harder it might become to conceive.

3. Age

If you’ve been on birth control since you were a teen and find it hard to conceive now that you’re older, birth control’s not to blame! It’s definitely not because you’re a long-term birth control user. 

Fertility changes with age and a woman’s peak reproductive years are usually between the late teens and late 20s. Hence, women tend to face a decrease in fertility by age 30 which becomes more rapid as they grow older. By 45, it’ll be challenging and unlikely for women to naturally become pregnant. 

You may not know this but women are actually born with a fixed number of eggs in their ovaries, which is estimated to be around two million. As they grow older, the number of eggs decreases. Upon hitting puberty, it would have already decreased to about 400,000 eggs! 

As the remaining eggs in older women are likely to contain abnormal chromosomes, there is also a higher risk of fertility-related disorders like uterine fibroids (non-cancerous growths of the uterus) and endometriosis. 

Essentially, female fertility can be affected by age as both the quality and quantity of eggs decline.

When should I forgo reversible birth control if I’m trying to conceive?

It doesn’t matter if you’re a short-term or long-term birth control user. As long as you’re off birth control, your body should naturally start to ovulate again.

If you’re trying to conceive and have already come off birth control for a few months, don’t worry if you’re not pregnant yet. Sometimes, this can take anywhere from a few months up to a year.

But if your menstrual cycle doesn’t resume for an extended period of time after stopping birth control, you may want to consider seeking professional help. 

Comparing birth control methods: how long it takes to become fertile again

Birth Control Method Duration
The combination pill and the mini pill– Your menstrual cycle should resume once you stop taking the pill
– Can take up to three months
Hormonal or copper IUD– Your menstrual cycle should resume within a month after removal
– Can take up to three months
The vaginal ring and contraceptive patchYour menstrual cycle should resume within the normal three months after discontinuing use 
The contraceptive injection or shotYour menstrual cycle can take up to a year to resume

Some parting advice 

Although it may take longer for some to resume their natural menstrual cycle after stopping reversible hormonal contraception, this is usually a temporary delay. Generally, long-term birth control use will also not affect your ability to conceive at a later stage. 

So relax and give your body some time to readjust! If you’re still worried or simply want to find out more about your birth control options, don’t hesitate to connect with one of Siena’s doctors today.

References: 

Categories
Birth Control Sexual Health

Birth Control Patch: 7 Facts You Should Know

Credit: Illustration by Siena Health

Don’t shy away from the birth control patch! Simple and convenient, it’s a seamless integration into your everyday routine and here are the reasons why.

With a variety of birth control to choose from, you may or may not have overlooked the birth control patch as another great alternative for your contraception needs. Or perhaps you’re unfamiliar with how the patch works and would rather stick to methods you’re used to. Nevertheless, the birth control patch is meant to be just as effective as birth control pills and may even be easier to use. 

A quick survey of the local landscape surrounding birth control based on a 2016 survey study: Singaporean women have low awareness and knowledge of hormonal intrauterine devices (IUD), the patch and the vaginal ring. This was the first survey study that assessed Singaporean women’s awareness and knowledge of contraception in Singapore. Thus, there were only a sparse few who actually used the patch. (Source: Singapore Medical Journal) 

Even though the patch may not be as popular as condoms or the pills, it works just the same in helping you prevent pregnancy. Especially if you dislike popping pills or if you’re afraid of going through with bigger commitments such as the implants and IUD, the patch is a perfect midway option. 

Read on as we cover how the birth control patch works, its benefits, and more!

1. The patch works by delivering hormones through your skin and into your bloodstream

Similar to birth control pills, the birth control patch contains two hormones estrogen and progesterone, which work together to prevent pregnancy by suppressing ovulation. When you wear the patch, it releases these hormones which your body subsequently absorbs through the skin.

The patch is able to stop ovulation while the hormones in the patch also thicken the cervical mucus, preventing sperm from entering the uterus. The hormones also thin the uterine lining which makes the implantation of a fertilised egg difficult.

Similar to birth control pills, the birth control patch is 99 percent effective in preventing pregnancy with perfect usage. But in real-life conditions, such as incorrect application or forgetting to replace the patch, they become about 91 percent effective. In comparison to the pill, however, the patch is a great alternative if you find daily pill-popping a hassle.

2. The patch is designed to be fun-sized and discreet 

Image credit: Siena Health

The birth control patch looks like a plaster, as it is a small and sticky square patch that is usually thin and beige in colour.

Worried about them being too obvious? You can apply them to the skin on your upper outer arm, abdomen, buttocks or upper torso. Take note: do not apply the birth control patch to your breasts or somewhere easily irritated by clothing.

3. You only need to think of the patch once a week

Application

The following steps are really important to ensure you use the patch accurately and effectively. 

Firstly, open the pouch containing the patch and remove the protective film. Apply the sticky side of the patch onto your skin by exerting slight pressure for at least 10 seconds to ensure it is properly attached before smoothing out any wrinkles. 

Thereafter, you can change your birth control patch each week over a period of three weeks and go without the patch during the fourth week. Similar to getting your period, you’ll experience withdrawal bleeding. After the fourth week has ended, start your next cycle with a new patch.

For first-time users of the patch 

Once the birth control patch has been prescribed to you, apply the first patch during the first 24 hours of your period. It becomes effective immediately after application within the first five days of your period. And yes, now you don’t have to worry about relying on any other back-up contraceptive methods! 

Alternatively, if you decide to use the first patch on the first Sunday after your period has started or you apply your first patch more than five days after your period started, the patch will not take effect immediately. Meanwhile, you should use an additional form of contraception (i.e. condoms) for the next seven days.  

Mark your calendars — note down the first day you apply the birth control patch and designate it as your next “patch-change” day! 

Each patch lasts for seven days so you’ll have to keep it on throughout and replace the patch exactly one week from the date you first applied it.

Extra tips:

  • Apply the patch on completely clean and dry skin
  • Avoid using lotion, oil, powder and makeup on the area you plan to apply the patch to
  • Try to store your unused birth control patches in a dry and room-temperature environment away from direct sunlight
  • Do not remove the patch from the pouch if you don’t intend to use it yet

4. Fuss-free removal process

Image credit: wikiHow

To remove the birth control patch, all you need to do is peel off the old one and replace it with a new one. It’s best to fold the adhesive sides of the old patch together before disposal so that it is not exposed. Do not flush the patch in the toilet as this may contaminate the water supply with hormones.

5. Do daily checks on your patch

This is an unlikely scenario as the birth control patch is designed to be firmly attached to your skin. You can safely shower, exercise and even swim with the patch. 

But in the event the patch does come loose or fall off, there are ways to get back on track! 

Prone to bad memory and sticking to a schedule? Don’t freak out because even if you really do forget to change your patch and it’s been less than two days (48 hours), just reapply a patch immediately and subsequently change your patch on the same day as the previous patch. If it’s only come loose, you can stick it back on and continue using it. 

However, if the patch has come off for more than two days or you’re unsure how long it has been since the patch fell off, reapply a new patch immediately and use another birth control method for at least a week. You’ll also have to begin a new four-week cycle and take note of the day you applied the replacement patch. The day on which you apply the new patch will be the new “first day” of the new application cycle. 

It’s uncommon for the birth control patch to fall off if you’ve followed the instructions closely. To prevent it from happening, try to cultivate a habit of checking your patch daily to ensure it’s still firmly attached to your skin. If the patch does not completely stick to your skin, immediately replace it with a new patch.

There is also a handy tool available online if you ever lose track of your birth control schedule and require help ASAP! 

6. The patch has other non-contraceptive benefits 

Similar to the benefits of other forms of hormonal birth control, the hormones in the patch can also help to lighten and regulate your periods while alleviating symptoms of premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD). It can even lower the risks of developing cysts in your breasts and ovaries. (Source: Planned Parenthood)

7. You can use your birth control patch to skip your period

A long-awaited holiday trip coming up? Attending a pool party in a couple of weeks? Or simply longing to head to the beach? With the birth control patch, you can be sure to leave all your period worries behind during times like these!

If you’d like to skip your period altogether, use the patch every week. This means starting a new pack of patches every three weeks without any break in between (i.e. continue using the patch during the fourth week). By doing this, the constant stream of hormones in your bloodstream eliminates your monthly withdrawal bleed.

What are you waiting for? 

Surely by now, you’re more familiar with the various upsides of the birth control patch and why it’s so convenient and easily reversible! Using the patch is definitely an effortless and painless process since it only needs to be applied once a week.

Feel free to check in with any of Siena’s female doctors before trying out or switching to a new birth control method. We’re most happy to help you find your most suitable, discreet and favoured birth control!

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