Category: Women’s Health

Is an IUD right for me?

IUD

I avoided getting an IUD for years because my provider had never told me it was an option for younger women and because of all the negative rumors I had heard about them. When I finally decided to get one after doing research, and talking to my provider, my friends and family had lots of questions for me, mostly because there are so many myths and misconceptions surrounding them.

Many of the negative facts about the IUD that you may hear are talking about the Dalkon Shield that was on the market in the 1970’s and not the Mirena and Paragard IUDs that are available today. Also, the people I talked to thought that I wasn’t eligible to get an IUD since I haven’t had children yet, but that is definitely not true! Many of the concerns about IUDs for young women are tied to the fact that IUDs don’t protect against STIs and that infection can occur if you have an activgetting e and untreated STI when the IUD is inserted. Your provider will give you an STI test before insertion to be sure that you don’t have an STI and will recommend using condoms to protect against future infection.

IUDs can last up to 6 years for the hormonal options and up to 12 years for the non-hormonal IUD, but there is no minimum requirement for how long that you need to keep using it. All you need to do when you don’t want your IUD anymore is call your doctor and make an appointment to have it removed. While using IUDs only 0.05-0.8% of women experience unintended pregnancies compared to 9% of women who use the pill and 18% of women who rely on condoms. The best part is that after IUD insertion, users don’t have to remember to do anything to prevent pregnancy. I know that I definitely don’t miss remembering to take my pill every day.

IUDs aren’t for everyone, but are an option that should be considered if you are looking to start using a contraceptive method or want to change methods. Check out this step-by-step guide from Bedsider for more information.

What Contraceptive Method is Right for You?

Plaquettes_de_pilule

Have you been meaning to start using a contraceptive method, but can’t choose? Or is your current method not working for you? These days it seems like there are too many methods to choose from. Use the Bedsider Method Explorer to learn more about all of the options available to you. You can filter methods by categories to find out which contraceptive method is right for your lifestyle.

If you don’t know much about contraceptive methods, now is the time to learn! According to Guttmacher, knowledge about contraceptive methods is a strong predictor of use among young adults. A 2012 study among unmarried women aged 18–29 found that for each correct response on a contraceptive knowledge scale, women’s odds of currently using a hormonal or long-acting reversible method increased by 17%, and their odds of using no method decreased by 17%.

Remember that only you can decide the best option for you. If you have a partner, you can include them in the conversation, but ultimately this is your choice.

If you’ve chosen a method that requires a prescription or insertion, make an appointment with your doctor to talk about next steps! If you’re still confused, make an appointment with your doctor to ask lots of questions and get more information.

What’s the Deal with the Tampon Tax?

Tampon

It’s taboo in our society to talk about our periods. On top of that, in 40 states tampons are taxed as luxury goods. In July 2015, Canada became the first country to eliminate the tampon tax, and now there is momentum in the United States to do the same.

So what’s happening exactly? Tampons and other feminine hygiene products are not considered necessity items by state governments and are subject to sales tax. Items considered necessity items and exempt from sales tax include groceries, medical purchases (like prescriptions), and food stamp purchases. Maryland, Massachusetts, Pennsylvania, Minnesota and New Jersey have actively chosen not to tax tampons, and the five other states that don’t tax tampon purchases don’t have sales tax.

A measure was recently proposed in California to make feminine hygiene products exempt from sales tax in the state and classify tampons and other products as medical necessities. California currently collects $20 million annually from sales tax on tampons and other products and estimates that women spend an average of $7 per month for 40 years on these products.

Getting your period is not a choice and is a necessary part of life. This tax is not insignificant to women, especially poor women. Tampons are not a luxury, and hopefully more states follow in California’s footsteps.

Maternal Death [Infographic]

maternal infographic

GUEST BLOGGER: Sophia Bernazzani

One of the United Nations Millennium Development Goals, established in 2000, calls for an improvement in maternal health, which is measured by the the number of maternal deaths. Maternal death is typically attributed to a lack of accessible and affordable prenatal care and unattended births in areas where medical birthing professionals are few and far between. However, improving the maternal death rate in countries with advanced health systems is still challenging, especially in the United States. For example, the United States spends more on hospitalization for pregnancy and childbirth than any other country, but the rate at which women are dying due to pregnancy or birth-related complications continues to rise. Nursing@Georgetown created an infographic to illustrate what causes maternal death and how it can be prevented, both in the United States and globally. Tragically, by the time you’ve finished reading it, another woman will have lost her life due to complications from pregnancy or childbirth.

The Truth About Indoor Tanning [Infographic]

GUEST BLOGGER: Fiona Erickson

indoor tanning.pngDespite the known health risks of UV overexposure, a surprising number of people still seek out tanning beds once summer fades away. In a 2010 survey, 5.6% of adults reported using indoor tanning services during the previous year.
Changing minds about indoor tanning starts with the facts. The most basic fact of all: Whether from the sun or an artificial source, UV rays are the cause of most skin cancers as well as long-term skin damage. Below are more facts:

Indoor tanning increases the likelihood of melanoma in young adults.
Use of a tanning bed is associated with a 20% higher risk of developing melanoma skin cancer (1). Indoor tanning before the age of 35 increases this risk by 87%.

Men are also at risk—even more so than women.
One study found that 39% of males under age 40 reported using indoor tanning during their lifetime (2). Men have the highest risk for skin cancer due to many factors, such as more time spent outdoors and failure to get routine screenings.

Having a “base” tan does not prevent sunburn.
A recent study confirmed that tanning via an artificial UV source does not prevent sunburn. In fact, indoor tanning was linked with a slight increase in risk (3).

It’s critical that we continue to spread awareness of indoor tanning dangers—through advocacy, policy making, and face-to-face dialogue. Health care practitioners in particular have the opportunity to play a key role in helping young adults lower their risk of cancer and maximize their chances of a healthy future.

For some eye-opening tanning statistics, check out our infographic.


 

1 Boniol et al. “Cutaneous melanoma attributable to sunbed use: systematic review and meta-analysis.” BMJ, 345:e4757 (2012): 1–12. Print.
2 Blashill et al. “Indoor Tanning Use Among Adolescent Males: The Role of Perceived Weight and Bullying.” Annals of Behavioral Medicine, 46 (2013): 232–236. Print.
3 Dennis, Leslie K. et al. “Does artificial UV use prior to spring break protect students from sunburns during spring break?” Photodermatology, Photoimmunology & Photomedicine, (2013): 29, 140–148. Print.

5 Gaps in Clinical Preventive Services for Women

The U.S. Preventive Services Task Force (USPSTF) recently released its fifth annual report to Congress on high-priority evidence gaps for clinical preventive services. This report is a requirement of The Patient Protection and Affordable Care Act, Sec. 4003 (F):

“The submission of yearly reports to Congress and related agencies identifying gaps in research such as preventive services that receive an insufficient evidence statement, and recommending priority areas that deserve further examination, including areas related to populations and age groups not adequately addressed by current recommendations.”

The USPSTF does not conduct it’s own research, but reviews existing peer-reviewed evidence to make these recommendations. These recommendations are not based on costs or insurance coverage decisions. For more information on the Task Force process for making recommendations, please see the full report here.

The five gaps the Task Force identified the following as areas in need of improvement:

  1. Screening for Intimate Partner Violence, Illicit Drug Use, and Mental Health Conditions
  2. Screening for Thyroid Dysfunction
  3. Screening for Vitamin D Deficiency, Vitamin D and Calcium Supplementation to Prevent Fractures, and Screening for Osteoporosis
  4. Screening for Cancer
  5. Implementing Clinical Preventive Services

 

Yoga Poses Shown to Be Safe During Pregnancy

Many mothers-to-be may not consider yoga — or at least certain yoga positions — to be healthy during pregnancy, but recent research seems to have provided evidence to the contrary.

A gynecologist in Lexington, Ky., was having difficulty finding any previous evidence of studies that looked at the impact of yoga on the fetus, so she decided to conduct her own.

Dr. Rachel Polis, at Kosair Children’s Hospital, started with 25 healthy pregnant women, each in their third trimester, and held a one-on-one yoga class that included 26 poses that involved standing, twisting, and stretching. They even tried poses some yoga instructors have advised pregnant women to avoid, such as downward-facing dog, the corpse pose, and the happy baby pose. Women are usually told to lie on their sides—not their backs—during pregnancy, particularly during the final stages.

To determine if these poses (as well as others) affected the fetus, women were placed on continuous fetal monitoring throughout the class. Results showed the women responded well to the yoga — vital signs all remained within normal ranges and fetal heart rate remained normal for all 26 poses. After a 24-hour follow-up, none of the women reported decreased fetal movement, contractions, leakage, or vaginal bleeding.

The results were published recently in Obstetrics & Gynecology, and although they are preliminary, they do demonstrate that healthy women in their third trimesters of pregnancy can tolerate yoga with no adverse changes to mom or baby.

Of course, women should be evaluated by their OB/GYN first before rolling out their yoga mat. Namaste.

 

photo credit: popsugar.com

CDC Finds Women Gain Too Much Weight During Pregnancy

A recent report published by the Centers for Disease Control and Prevention (CDC) has revealed that nearly half of American women gain too much weight during pregnancy.

In fact, less than one third of women maintained the correct pregnancy weight according to their body mass index (BMI), implying the majority of child-bearing women run the risk of having a complicated labor and delivery, or becoming obese and developing health problems later in life. These women also run the risk of passing off health problems to their offspring.

The amount of weight a woman gains during pregnancy, also known as gestational weight gain (GWG), is important for the longterm health of the mother and child. The Institute of Medicine (IOM) has provided recommended weight gain ranges, depending on the woman’s BMI. To find out if women were adhering to their recommended GWGs, the CDC analyzed 2013 birth data from women in 41 states. Since 2003, birth certificates are required to include the mother’s height, pre-pregnancy weight, and delivery weight. For the five states that have yet to use the revised birth certificate, a questionnaire was distributed to mothers to gather pregnancy-related information.

Overall, 32.1% had appropriate GWG, while nearly 50% were in the excessive range for GWG. More than 20% were in the inadequate GWG range. Women in the excessive range tended to be overweight before pregnancy. The high prevalence of excessive GWG is of concern because excessive GWG increases the risk for macrosomia, postpartum weight retention, and obesity in mothers and possibly their children.

Experts say women of normal weight should add 25 to 35 pounds during pregnancy, while overweight women should gain only an additional 15 to 25. Obese women should only add 10 to 20. And while women may need to consume extra calories (350-450 per day) to support the metabolic demands during pregnancy, this should typically occur later, in the second and third trimesters.

The fact that so many women fell in GWG ranges not recommended by IOM or the CDC indicates the need for effective interventions, encouraging women about the importance of reaching a recommended weight given their BMI. Such interventions might include focusing on dietary goals and increased physical activity. Pregnant women are encouraged to engage in at least 150 minutes of physical activity (i.e., brisk walking, jogging) per week. Overweight women who are looking to diet during pregnancy are also encouraged to keep an account of their dietary intake, as well as maintain regular prenatal appointments to ensure they are receiving an adequate amount of calories per day. Of course unusually thin women need to remain cautious during pregnancy as well. Underweight women run the risk of delivering a very small baby, which could lead to health problems later on.

A good rule of thumb to remember is that it’s not about eating twice as much — it’s about eating twice as healthy.

 

Photo credit: The Guardian

UNC Student’s Global Experience

By Hillary Murphy, UNC-CH MPH:Health Behavior candidate 2016

Summer of 2015 I found myself unexpectedly working in sub-Saharan Africa on a pilot intervention involving breastfeeding practices among mothers with HIV.

File:Malawi in Africa.svgJust to help you, the reader, understand how out of my element this was, here is a little background on me. My public health experience up to this point involved local food movements, health disparities in rural North Carolina, and, for a few months, community engagement and education in permaculture practices in Java, Indonesia.  Despite my obvious lack of experience, I was lucky enough to be offered a practicum position, and less than a month later, I began working in Malawi, a small country in southern Africa.

Currently in Malawi, 13% of pregnant women are HIV positive. Without intervention, 5-20% of their children will become infected from HIV exposure though breastmilk, suggesting that prevention of mother-to-child transmission is of critical importance.

During my time in Malawi our goal was to tailor and pilot test an Infant and Young Child Feeding (IYFC) promotion intervention among HIV+ Malawian women in community-based village savings and loan associations (VSLAs). We tailored training materials and IYFC learning sessions on 1) breastfeeding, and 2) complementary feeding for use with Malawian trainers and VSLA volunteers, and pilot tested these materials to further refine them for use in Malawi.

Although this practicum certainly helped build my skills in program implementation and tailoring, and gave me a deep love for sub-Saharan Africa, it most importantly was a reminder to be open to unexpected experiences. There is no way to know what your true passions in life are unless you welcome opportunities that are out of your element.

Photo source: Wikimedia

Wellness Wednesdays: The Importance of Body Image

In the past week, several ‘Instagram celebrities’ have shut down their accounts and opened up about some of the unpleasant ‘realities’ of social media. I have a great deal of respect for these young women, some of whom are walking away from sizable paychecks – it takes a lot of guts just to be honest in today’s image-obsessed world. I commend them for calling attention to the negative effects of social media, for the unrealistic expectations that it helps to promote and maintain for young men and women all over the world. Because social media isn’t ‘real life’ – and I think that many people have forgotten that.

 

I was never very comfortable with my body growing up – I was short, and pudgy, with chubby cheeks and nerdy round glasses. Once I started swimming competitively in middle school, my body image issues got even worse – the skimpy Speedo I wore for several hours each day didn’t exactly provide much  coverage to hide behind. My sister and I both participated in sports that emphasized aesthetics – she was a nationally-ranked gymnast for a number of years, until repeated injuries caused by relentless training forced her to leave the gym.

 

I kept swimming through my senior year of high school – since then, I can count the number of times I’ve been in a pool on one hand. But I kept up a strict exercise regimen throughout college – the picture at the top of this post was taken shortly after I graduated. I remember the sense of brutal satisfaction I took in manipulating my body, subverting it to my ‘will’ – I had an unhealthy relationship with food at the time, one that I’ve struggled with for much of my life.

 

It took meeting my wife, and my in-laws, to change some of those bad habits. In their culture, food meant family – and love. Refusing a meal was tantamount to a slap in the face; certainly not an option when one is trying to make a good impression.

 

Food is as commonly featured on social media as are scantily clad bodies – seemingly a contradiction, and certainly one that sends mixed messages to those still trying to find their place in a judgmental world. It took me a long time to find my place, and I’m grateful that I grew up without Facebook and Instagram to further fuel my own dissatisfaction. When I look in the mirror now, I try to embrace my ‘flaws’, instead of denying them. I remember that this is reality, unfiltered – and everything else is just a mirage.