Birth Control via App Finds Footing Under Political Radar
nytimes.com
nytimes.com
But check the actual source and:
"Among women who had unintended births in the United States in 1998–2002, about 40% were using contraception"
So that's very misleading reporting.
Note that they tracked women for 4 years - track someone for their entire life and the numbers who had at least one child while on birth control at some point in their life will rise.
Contraception just isn't effective enough to eliminate pregnancy, it can only function to reduce fertility (number of children).
A typical couple using birth control through their entire life will still have one or two children - which is the average (more or less) of people in the US who choose to have children.
The only function of birth control is to reduce fertility from around 10 to around 2.
Results—About 37% of births in the United States were unintended at the time of conception.
Giving everyone access to birth control will NOT stop unintended births. It's not able to do that.
I posted what I posted because I didn't think it was particularly misleading for the article to state a fact that was important enough to the report to appear in the abstract. Your language But check the actual source also sort of implies that the article had misstated the fact. But it did not.
Not as many as you would think. The number of people who: 1. want birth control, 2. are unable to get it, 3. had an child as a result, 4. and would have preferred not to, is a much smaller number than the article makes it out to be.
I find that misleading. I don't know why you don't.
These apps are about saving time for people, they will do nothing at all to the national birth rate.
I mean, go ask someone on birth control if maintaining access is important to them.
> "With nearly 40 percent of all pregnancies in the United States unintended, birth control is a critical public health issue."
> But check the actual source and:
And maxericson quoted the actual source, which says
> Results—About 37% of births in the United States were unintended at the time of conception.
It seems the report accurately quoted the abstract, and so I'm confused why you think it didn't.
On another level: we should not protect people from themselves. If someone is stupid enough to do something harmfull to him/herself we should let them. Natural selection will do the rest.
Cruising over to reddit's /r/birthcontrol now, this submission was from 16 hours ago:
> So because I was losing hair after I got my Mirena IUD like a labrador in summer, my gyno decided to put me on beyaz (the top anti-androgen) to try and stop that. however, we didn't take out mirena because she "wasn't sure that was what was causing it"... so basically I'm wondering if anyone else is in that situation? [...] > > - https://www.reddit.com/r/birthcontrol/comments/4orqo1/im_on_...
Beyaz is not an anti-androgen, it is a drug that uses the synthetic xeno-estrogen ethinyl estradiol, and the progestin drug Drospirenone. Progestins are forms of 'fake progesterone', and usually cause the body's progesterone production to decrease dramatically. Progesterone is also a brain hormone, so this is why women on birth control frequently get depressed.
My girlfriend was hurt by her doctor with birth control maybe 10 years before I met her. They said the depo-provera induced bleeding would stop, eventually. She let them give her a second 3-month injection, then a third 3-month injection... Then she decided the doctors were stupid, and stopped after the 3rd injection. That would've been about a year of direct iatrogenic injury. Maybe this drug directly contributed to her later mental health struggles.
She's amenorrheic right now... 3 or 4 years ago, in her late 20's, some stupid endocrinologists said that her hot flashes were because she was "going through menopause" (maybe that's not what the doctors actually said, but they didn't do anything to help resolve the complaints, so their medical advice was quite harmful, imho).
I'm well aware the my girlfriend could very well pop an egg out at any time. I expect her periods will restart as soon as the underlying condition is addressed. So I've taken out my sperm production using the old heat methods. It works, I've checked.
I like this site's take on the problem:
> Women’s unique health concerns are seen by Wall Street as opportunities for obscene profit. The development of the ‘hormonal’ birth control (so-called) started with good intentions. Science’s understanding of the steroid system has advanced since the 1950’s, and real Scientists now know that the fake-hormones used as ‘birth control’ cannot improve women’s health. But Wall Street has FDA-approved pills to sell and investors’ dividends to pay. The drugs are reasonably-effective at suppressing women’s fertility, but are defective if women’s complete health profile is taken into consideration too.
> Apologists for the hormonal birth control peddlers acknowledge that these drugs have potent side effects. The thinking seems to be “the needs of the many outweigh the needs of the few”: while women are still maimed and killed by prescription birth control, it’s more important that the women who (probably) won’t be killed right away are able to use these drugs to keep babies away.
> The most blatant of Big Drug’s ‘hormonal’ rip-offs are the so-called “emergency contraceptive” pills, where profiteers sell women 1.5-cents of active ingredients for $50.
> WOMEN’S HEALTH: A Modern Tragedy, http://swindledandpimped.org/womens_health_a_modern_tragedy/
(edits: clarity, typos)
>So I've taken out my sperm production using the old heat methods. It works, I've checked.
In a consultation for a vasectomy, the urologist strongly wanted that alternative forms of birth control be used for several months as sperm already in the system - unless you're naturally not producing sperm, I doubt the viability of your methods.
It's not completely reversible though, if used for long periods of time sperm counts drop permanently. (But not to zero.)
See here: https://en.wikipedia.org/wiki/Heat-based_contraception
Dr Roger Mieusset and volunteers tested a modified underwear with success and reversibility after 4 year use.
Photos of the modified underwear + usage (NSFW/medical) can be found here : http://www.contraceptionmasculine.fr/415771934
I know this is anecdata, but I know two different young healthy women who suffered strokes or Deep Vein Thrombosis before the age of thirty because of Yaz. (Both fully recovered, thank God, but will never be able to take hormonal pills again for life.)
The cause/effect relationship between elevated estrogen levels and clotting disorders is well understood by physiologists. All the old high-estrogen contraceptive pills have been pulled, because the data shows that they were not safe.
I support women having easier access to birth control, but my point is that even today, this stuff has a different safety profile than, like, Pepto Bismol or Advil.
(But then again, so does Tylenol, and that's legal, so...)
edit: the number of side effects for some of these female contraceptives are staggering and many women aren't aware of the entire scope of possibilities. I suspect most women are affected and don't realize it, just accepting it as normal because their friends have the same issues.
So I've taken out my sperm production using the old heat methods. It works, I've checked.
Thermal birth control looks like a good DIY and low-cost birth control method. DIY spermcount could help ease of adoption and autonomy.
Any source on this? My wife took birth control because of ovarian cysts. She had issues with the first few types, but we eventually found one that has worked for nearly a decade, with no issues. I know of several other women with this same experience. Reddit (or any other forum used for complaints) is hardly a good example to support this.
Surely you'd agree that fixing the cause of ovarian cysts would be better than putting women on maintenance medication?
> Reddit (or any other forum used for complaints) is hardly a good example to support this.
Women who share their negative experiences are the Canaries in Medicine's coal mine. The few who are overtly harmed should warn us that there are problems with these prescriptions.
Extraordinary claims, extraordinary proof, and all that.
I have personally used non-prescription Progesterone USP to recover from a head injury, so I'm inclined to believe the heretical scientists who heckle the birth control peddlers.
But some people have a political interest in promoting infertility, so quasi-OTC it goes.
From the article:
"...a doctor reviews a woman’s medical information and sends a pill prescription to a local pharmacy.
"'I thought it was just a setup to get money,' [a user] said. But after she answered the health questions one evening, 'a doctor actually contacted me after office hours,' and the next morning, she picked up three months’ worth of pills."
It's the ship directly to the door part that sounds like it could allow the selling of fraudulent medicine.
Frankly, this terrifies me. Getting medication which is generally accepted to be mostly safe from a pharmacy because it's cheaper and more convenient than seeing a doctor, sure. But if you're not comfortable seeing a doctor... you should probably be seeing a doctor.
The dangerous bit in this case is that there are many formulations which fall into the category of "generally safe, but if you experience X, Y, or Z then you should see a doctor" due to rare but dangerous side effects. In such cases there's no need to consult a physician before taking the drugs; but they should not be given to a patient who is "not comfortable visiting a doctor" and would not obtain medical care if such complications arose.
Some doctors require a full pelvic and breast exam for birth control prescriptions. Patients who've previously been sexually assaulted can be very uncomfortable being touched naked by anyone other than a chosen and trusted partner, but still accept the need to be treated for complications. Exam-less options are a godsend for anyone who cannot handle their first experience being with a speculum, or who need more time working through trust or intimacy issues.
One can weigh the cost/benefit of making contraceptives more easily available versus the increased safety of medical supervision, but it's not like the prescription requirement is plucked from thin air.
[1] http://abcnews.go.com/Health/story?id=118178.
[2] http://www.mayoclinic.org/tests-procedures/paragard/basics/r....
There are plenty of other OTC medicines which are far more dangerous than birth control. Tylenol, cough syrup, Bronkaid/sudafed/ephedrine, benadryl... Aspirin alone causes thousands of (some sources say more than 10,000) deaths a year. Birth control carries a relatively small risk of problems (especially for non-smokers and/or women under 35), but has a much larger benefit.
And the copper IUD does not, strictly speaking, increase the risk of ectopic pregnancy. It's a matter of survivorship bias. They prevent pregnancies from occurring, but are slightly more effective for pregnancies that implant inside the uterus. 2% of all pregnancies (without an IUD) are ectopic. If a woman does get pregnant with an IUD, she is more likely to have the type of pregnancy that the copper IUD is less effective at preventing -- an ectopic pregnancy (According to Wikipedia, 3-4% of all pregnancies that occur with an IUD are ectopic). However, overall, comparing sexually active fertile women with IUDs and without IUDs, the IUD drastically prevents ectopic pregnancies, and, of course, pregnancies in general.
Similarly for IMR, an impressive drop from 1 in 10 to better than 1 in 100.
I feel like having a child is 100x more harmful to me than never having one, but urologists in the US almost unanimously disagree and refuse to perform vasectomies on the childless.
"But the new websites and apps could reach many more women. They require no legislative approval since clinicians still write the prescriptions. The ventures must follow telemedicine regulations, which vary by state, and can only prescribe in states where their clinicians are licensed."
They are technically seeing a doctor (via telemedicine), but aren't comfortable to do so in person. This enables them to 'see a doctor' from the privacy and (psychological) comfort of their own room, which is presumably more private than them having to travel to their doctor's office and interact with them in person.
Sure, and "medical marijuana" dispensaries technically require that you get diagnosed with something which marijuana can be used to treat.
When doctors are being paid by a company which sells the product they're prescribing, I lack confidence in their ability to render medical opinions in the patients' best interest.
Telehealth is extremely effective in a number of cases, generally with the elderly and those with anxiety issues. It's very very cost effective, provides some of the best clinical data on patients empowering better diagnosis and care, and keeps patients engaged.
It is not some profit-fueled sham like a pill mill or a legal trick around the criminalization of marijuana, it is a legitimate technological advancement in achieving better care for more people.
Hell, we're seeing that using telehealth in conjunction with traditional office services creates a lot more successful outcomes than office care alone as people remain engaged in their care plan!
The idea that telehealth is inadequate for birth control prescription is a bit silly to me, do you have any rational reasons against this technology and paradigm or just fear mongering comparisons like dispensary?
So both still telehealth / online, just separate.
On the other hand, it's my impression that most of the medicines people obtain this way - specifically contraceptives and erectile dysfunction treatments - are straightforward enough that an automated decision tree could probably do a reasonable job screening most patients.
One concern leads to the other. That is to say, if I thought patients were receiving a medical consultation which met the normal standard of care, I would not be concerned about physician-avoidant behaviours; it's the combination of "may have received medication without a proper medical consultation" and "may be unlikely to seek medical care in the event of potentially life-threatening complications" which concerns me.
it's my impression that most of the medicines people obtain this way - specifically contraceptives and erectile dysfunction treatments - are straightforward enough that an automated decision tree could probably do a reasonable job screening most patients.
I agree. And I'd rather have such screening performed by an FDA-approved automated decision tree than by a doctor who has financial incentives in conflict with his ethical obligations.
Whether birth control pills are used for recreational purposes is a question of semantics; they have no direct recreational use, but make indirectly support recreational activities.
A person you don't know has trust issues with the medical community. If those issues are unfounded and she's being irrational, her choices won't affect you beyond a potential trivial increase in your health insurance premiums and/or taxes. There are many other bad health decisions people habitually make that have a larger impact there than a small number of people having an irrational aversion to seeing their doctors.
Or do you think she might have a rational aversion to seeing her doctor, which would have frightening implications for other people?
A few years back I went to a doc to get a birth control prescription because I couldn't get it without seeing a doc. By various evidence-based(-ish) guidelines I knew I did not need a Pap test, and I also knew the guidelines had recently changed to every five years. I'm healthy and at that time I was still young enough to have no restrictions on birth control prescriptions, and it was just a renewal of the same thing I'd had for years. The doc would not prescribe the pills to me without getting a Pap smear, despite the unnecessary nature of the test. In the process of opening things up with the speculum and shoving that toothbrush up to my cervix, the doc cut me with the metal speculum, thereby turning a stupid unnecessary appointment for a maintenance med into a traumatic bleeding-all-over fiasco. I'm still much more nervous about Pap smears than I used to be.
I know a lot of doctors -- they avoid seeing doctors. I avoid seeing doctors when I'm not sick as much as possible as well. The only reason the health insurance industry in this country ever gets my money is because I have so far had to see a doc for the birth control, while having no health problems. Nurx et al sound like a great solution for healthy people in need of birth control.
I'm not from the US nor am I a woman.. but if this happens you should really change your doctor. I don't think that this would be legal / acceptable anywhere in the world.
Your thoughts on this are way, WAY too simplistic. It's incredibly aggravating to see you being upvoted for this nonsense. Maybe in a perfect world with perfect self-understanding, but that's not the world we live in.
Birth control should be over the counter, full-stop.
What country is this? In Aus, this is a medical/GP issue and birth control pharmaceuticals are available at the chemist via a script.
This is such an culturally alien experience. Thanks for reminding me healthcare is unevenly distributed.
"...almost two million reported they have tried to find a family doctor in the past year and failed."
[1]http://www.nationalpost.com/scripts/story.html?id=5c461d67-d...
read the article @refurb, information shows lack of primary medical care but why? cost, lack of GPs, remoteness and dispersion of patients? I know the US and Canada are both vast countries with unequal distribution of population. The root of inequity in Australia is cost, remoteness & dispersion of the population. Most live in the cities, in the bush you cop poor quality of access and service even though primary health care is mostly free (Medicare).
? An annual gyno exam is a general best practice, whether birth control is involved or not.
Overscreening is a real problem, and since HN has a lot of male readers I'll do a public service announcement (PSA, get it?!!) that prostate cancer overscreening doesn't lead to a mortality benefit on a population level (if you look at all-cause mortality) and leads to interventions that leave a lot of men incontinent and unable to enjoy their previous sex life [1]. If you have any symptoms, definitely go to the doctor -- screening in men with symptoms saves lives. Prostate cancer can be a killer. But just screening all healthy people of a certain age for breast, prostate, and cervical cancer every year actually leads to poorer health outcomes because we don't yet understand when to treat cancer aggressively and when to just ignore it.
[1] http://annals.org/article.aspx?articleid=1216568 Per 1000 men, screening all every 1-4 years for 10 years and then following through their treatment saves about 1 guy from dying, kills about 1 guy and puts 2 in the hospital from complications of biopsy and treatment, gives 3 heart attacks, and leaves 35 with bladder or sexual dysfunction problems.
http://www.acog.org/About-ACOG/ACOG-Departments/Annual-Women...