What are Your Options for Non-Hormonal Birth Control?
Many non hormonal options exist to help prevent an unplanned pregnancy. These include the Paragard Copper IUD, condoms, vaginal spermicides, and a vaginal gel pH regulator that was newly approved in 2020.
Condoms have no hormonal side effects, protect against certain sexually transmitted infections, and are available without a prescription. We recommend the use of condoms in any relationship where there’s a risk for sexually transmitted infections, including HIV. Oil-based lubricants (eg, suntan oil, petroleum jelly, or food items such as whipped cream) should not be used with latex condoms because they can cause the condom to weaken and break. Water-based lubricants (sample brand names: K-Y liquid lubricant, Astroglide) are safe. With use of condoms, approximately 13 out of 100 women will get pregnant during the first year.
Spermicides are chemical substances that destroy sperm. They are available in most pharmacies without a prescription. Spermicides are available in a variety of forms including gel, foam, cream, film, suppository, and tablet.
Spermicides may be used alone, but are more effective when used in combination with a condom. Effectiveness is reduced if a couple does not wait long enough for the spermicide to disperse before having sex, if sex is delayed for more than one hour after application, or if a repeat dose is not applied before having sex again. In the United States, the only spermicide available is nonoxynol-9; use of this spermicide alone is not effective in preventing transmission of sexually transmitted infections, including HIV. Approximately 20 out of 100 women using spermicides will become pregnant during the first year. Spermicides may cause local vaginal irritation in some women.
In 2020, a very exciting new product (brand name: Phexxi) became available. It works by temporarily changing acidity levels in the vagina, which reduces sperm mobility. This makes sperm less likely to reach and fertilize an egg (causing pregnancy). The gel is inserted into the vagina one hour or sooner before sex. It is used on demand, and may be used with other methods of birth control. When used correctly, Phexxi is up to 92 % effective at preventing pregnancy. We are very excited to offer this new option to our patients. It does require a prescription. Learn more at www.phexxi.com or from one of our providers.
Treating Endometriosis
Endometriosis can significantly diminish a woman’s quality of life. This chronic condition occurs when tissue that typically belongs only in the uterine lining begins entering the pelvic and abdominal cavities. Patients may experience any combination of the following symptoms:
- painful periods, and even non-menstrual pelvic pain
- painful sexual intercourse
- painful urination or bowel movements
- development of ovarian cysts called endometriomas
- difficulty with conceiving
Many patients spend many years and visit with multiple doctors before this diagnosis is correctly identified. At Michigan Women’s Care, our doctors have expertise in diagnosing and treating endometriosis. We educate our patients to empower them, and offer many lifestyle, medicinal and surgical options. Those include:
- adjunctive treatments like physical therapy and massage therapy
- anti-inflammatory medications
- hormonal treatments like progestins, combination hormones or IUDs
- minimally invasive robotic surgery to excise lesions and improve symptoms
Recently, a novel medication was approved by the FDA for the treatment of painful periods and painful sex due to endometriosis. This newer medicine, called Orilissa, has been prescribed to over 50000 women in the U.S. so far, and promises to decrease pain associated with endometriosis lesions. Our doctors have been trained on the appropriate prescribing of this very exciting new option.
Don’t let endometriosis prevent you from reaching your full potential.
Preventing and Treating Osteoporosis
Osteoporosis weakens the bones and makes them brittle, thin, and easily fractured. Women face a higher risk for osteoporosis after they reach menopause, and especially after age 65. Osteoporosis can significantly and negatively impact a woman’s quality of life, especially if a hip fracture occurs.
The best treatment for osteoporosis is preventing it in the first place. We recommend the following:
- get enough calcium and vitamin D. About 1000-1200 mg Calcium daily (dietary from green vegetables) and 800 units Vit D daily (dietary from salmon, fortified OJ, cereals or yogurts). May use supplements if needed.
- weight bearing exercises at least 30 minutes a day for 5 days a week
- avoiding smoking
- minimizing alcoholic drinks
- avoiding certain medications such as chronic steroids and certain blood thinners if possible.
We also recommend that all our patients minimize their risk of falling by:
- Removing loose rugs and electrical cords or any other loose items in the home that could lead to tripping, slipping, and falling.
- Providing adequate lighting in all areas inside and around the home, including stairwells and entrance ways.
- Avoiding walking on slippery surfaces, such as ice or wet or polished floors.
- Avoiding walking in unfamiliar areas outside.
- Reviewing drug regimens to replace medications that may increase the risk of falls with those that are less likely to do so.
- Visiting an ophthalmologist or optometrist regularly to check your vision.
During the annual visit, when appropriate, we offer our patients screening for osteoporosis with bone density scanning. If osteoporosis, or its precursor osteopenia is detected, we may offer a workup and evaluation to rule out other medical conditions.
When appropriate, we offer an array of medication options for the treatment or reversal of osteoporosis. We periodically re-evaluate the effectiveness of our plan of care.
The Keys to a Healthy Pregnancy
The healthiest pregnancy actually begins before conception. We strongly recommend a pre-conceptional visit as the first step to a healthy pregnancy. During that visit, we will evaluate and advise you regarding the following:
- your medical history, especially conditions that may affect the pregnancy like diabetes, hypertension, depression or obesity
- your surgical history, such as prior abdominal surgeries
- your genetic and family history, including inherited disorders like sickle cell or cystic fibrosis
- your occupational hazard history, such as risky work related duties
- your social history, such as alcohol or substance use
- your prior obstetric history, such as previous c/sections or complications like preeclampsia or preterm labor
We also ask for some blood work to evaluate for diabetes, anemia, thyroid function, and immunity to rubella and chickenpox, and run a genetic disorder panel to screen for inherited disorders. We check for pelvic infections in patients who may be at risk.
After we partner with you to optimize your pregnancy preparation, we recommend prenatal vitamins and folic acid for at least a month before conception. We believe that a pre-conceptional visit empowers our patients to reach their maximum potential for healthy outcomes.
Subscribe to our monthly newsletter
Our monthly newsletter contains updates, stories, and information to help our clients. We hope you’re doing well and the information we provide is useful to you.
We promise to actively listen, build trusting relationships, and always put our patients first. In addition, we promise to stay as up to date as possible within the fields of obstetrics and gynecology so we can provide the best women’s health care available.
Subscribe to our newsletter on the home page of our website.
