One drug, Topamax, reportedly “reduced the number of days on which alcoholics drank heavily” more than with just therapy alone. Topamax is currently used to treat epilepsy and migraines. Another study says people that took naltrexone and attended therapy were more likely to stay clean, and drink less when they did fall off the wagon.

Obviously, these results are preliminary and much more research is needed. But any strides in the treatment of addiction are a good thing.

Image: sxc.hu.

Post from: Blisstree

Addiction Pill

Still here? Great! Well, first of all, I was stressed because I had to change doctors since we moved and I’m now way too far away from my old OB/GYN office to make the drive. I used to use Planned Parenthood, and this move meant switching to a grown-up doctor. For real adults. Like one my mom would use. How weird. I hadn’t been to one of those since my first visit, back in high school, when my mom insisted that I use her doctor and accompanied me, which, for the record, was beyond awkward.

Aside: This is not to say that there’s anything lacking in the quality or maturity of Planned Parenthood. On the contrary, I was extremely happy with them. And the fact that I knew my questions would be the least interesting ones they got all day made me feel like I could ask or divulge anything and it wouldn’t be uncomfortable. (Not that my sex life has ever been particularly scandalous, mind you. But when you’re a 20something married chick who’s been withe the same guy for years, isn’t pregnant, and has no serious medical issues sitting in a waiting room full of teenage girls and their incredibly uncomfortable boyfriends, you just know you’ll be the most boring client of the day, or maybe even the week. It’s kind of a relief.)

Second, I had therapy right afterward (how’s that for planning?), and after I sat in the waiting room for almost 40 minutes before being called back, I was good and stressed about not making my next appointment. In fact, they were running so far behind (how exactly do you manage to be an hour behind already at 9:30?) that I actually had to call my therapist’s office on my cell phone while in the exam room in my paper vest and sarong combo as I waited for the nurse practitioner to come in and do the exam so I could tell her that I was being held hostage at the gynecologist’s office and might be late for or even miss my appointment. There were no magazines, so instead I read my Pap smear lab request form for about 20 minutes. I don’t want to ruin the ending or anything, but the grand finale is, you guessed it, a Pap smear.

Third, I always dread the assistant’s questions when they first take you into the exam room (that, and getting weighed. Our scale broke like two moves ago and I have never replaced it, so my annual exam is about the only time I weigh myself). I know I’m a hypocrite, but it’s not my fault: I just don’t remember to do my breast self-exam every month. I’m lucky if I remember three times a year. Of course, when I admitted this, I got that motherly disapproving “Tut tut” and a dramatic swish of the pen on my chart. I always feel like crawling under the exam table at that point. But then, when they take my blood pressure (which, incidentally, makes my heart race for some reason), I am redeemed because it’s always very low and they think I’m so healthy that it makes up for being an irresponsible breast owner.

Aside: I wonder how low my bp really is since I start having palpitations the moment they move toward the blood pressure cuff. It’s so bad that I have to tell them to do it once in the beginning and once at a random time during my visit without telling me ahead of time so I don’t have a chance to get anxious about it–but of course my breath gets short as soon as I realize what’s happening.

Fourth, I had to go through my entire medical history before the exam because their fax machine was messed up and they couldn’t receive my records from my old doctor’s office, so I felt like I walked into a surprise midterm in a class I’d never heard of. Yes, someone on my mom’s side had breast cancer, like four generations ago, and somebody on my dad’s side had heart disease, but I’m pretty sure those people died before my parents were even my age, so I have no clue of the specifics. But it’s all in my medical record, which is apparently trapped somewhere in the fascimile netherworld, so who knows?

Fifth, I had to confess that I’ve been so terrible about taking my birth control pills on schedule that I finally stopped taking them altogether and needed to request a different form of birth control that was harder to forget and didn’t involve anything that is progesterone only, which tend to make me gain huge amounts of weight in very short periods of time. And I kind of feel like we’re just a little too old to be buying condoms, you know? (That, plus ever since I tried to open one I don’t even remember how long ago and it shot out of the package and directly into my eye, leaving me half blind and stinging like the dickens, I’ve been kind of afraid of them to tell you the truth. But I digress.)

So, long story short (because believe it or not, this is the short version), I weighed in at 134 lbs fully clothed, managed to get a clean bill of health despite waiting f-o-r-e-v-e-r for my exam, and left with a free month (and a coupon for a free second month!) of NuvaRing, a once-a-month vaginal contraceptive that offers–get this–a free downloadable OR portable timer to remind you when to insert and remove it. Do these people know me, or what?

Now to psych myself up for next year. 360some days should be plenty of time, right?

How do you feel about your annual exam? Any tips? Any horror stories? Leave a comment!

Contents © Copyright 2007 Kristen King

Post from: Blisstree

Stayin’ Lively: My 2007 Annual Exam

In response to yesterday’s post about the new FDA-approved, no-period birth control pill Lybrel, Alicia asked this question in the comment trail:

What exactly happens to your egg(s) when birth control pills prevent ovulation?

That’s a great question. First of all, let’s be clear on two important facts about the female body:

1. You’re born with all of the eggs you’ll ever need–millions of them, just chilling in your ovaries until menarche.
2. Ovulation refers to the actual release of the egg from the ovary into the fallopian tube, not the production of the egg.

Second, let’s be clear on what happens to eggs that aren’t fertilized and gestated when you’re not taking birth control.

1. At ovulation, the egg is released and travels down the fallopian tube to the uterus.
2. If it’s not fertilized, it simply disintegrates and is absorbed by the lining of the uterus.*

Logically, then, if birth control prevents ovulation from releasing the egg into the fallopian tube, it would eventually just break down and be asorbed back into the body in the uterus. But does that play out scientifically?

From Planned Parenthood of Southeastern Pennsylvania:

Your eggs are just hanging out in your ovaries until they are called upon. Not ovulating doesn’t do any damage to your body, including your eggs.

They don’t all “expire” at the same time, but your eggs have been dying since you were in your mother’s womb.

Girl fetuses have eggs, in fact we have the most eggs (5-7 million) ever when we are still inside our mom developing. A lot of those eggs die before we are even born and they continue to die throughout our life. By the time most of us reach puberty we have about 400,000 eggs left. Which is more than enough!

Some of those eggs get used, some die and some even survive menopause. Really, menopause is sort of an expiration date for the eggs that have made it that far. There may be a few still holding out, but we won’t use them after menopause.

The medical term for this process is atresia, which Stedman’s Medical Dictionary defines as “The degeneration and resorption of one or more ovarian follicles before maturation.”

So, the short answer (after that long one!) is that if the egg isn’t fertilized or if it isn’t even released, the same thing happens: it just gets absorbed back into the body. Amazing, huh?

Contents © Copyright 2007 Kristen King

Post from: Blisstree

Lively Women Q&A: What Happens to Your Eggs When You Don’t Ovulate?

Although many women are very excited about the idea of a pill that will stop their “little friend” from visiting every 28 days, the long-term effects of the drug and, more importantly, its effects, are not known. According to a WebMD report,

Side effects of Lybrel are similar to other low-dose oral contraceptives, including an increased risk of blood clots, particularly in smokers and women over 35, and breakthrough bleeding.

Perhaps more importantly however, cancer experts, like NYU’s Julia Smith, MD, are concerned about the lack of long-term data measuring the impact of continuous-use hormones on the risk of breast and other hormone-fueled cancers.

“This is something that has not been carefully studied yet. We don’t have any evidence that there is a problem, but we certainly have many instances in the history of medicine where problems only showed up at a much later date after long-term exposure and widespread use,” says Smith, director of the Lynne Cohen Breast Cancer Preventive Program at the NYU Cancer Institute.

Moreover, she tells WebMD, “When you tamper with the way the body works naturally you can’t predict long-term outcome until you study long-term outcome. And right now we don’t have that data.” (source)

Lybrel’s FDA approval comes on the heels of Seasonale, which offers women the opportunity to reduce periods to only four each year, approved in 2003.

It’s up to you and your doctor to determine whether an oral contraceptive or another form of birth control is right for you, and which specific product in your ideal category is best suited to your medical and lifestyle needs.

But that aside, what do you think of this? Are you excited about the chance to just do away with your period, or would you rather it stick around? Is every month too often, or just right? Is four times a year not enough, or still too many? Share your opinion in the comments!

Contents © Copyright 2007 Kristen King

Post from: Blisstree

FDA Approves Oral Contraceptive That Stops Your Period: Birth Control Pill Lybrel Halts Menstruation

How do you know which is the right choice for you?

About.com’s guide to contraception, Dawn Stacey, M.Ed, LMHC, suggests eight important factors for you and your doctor to discuss as you pick the perfect birth control:

1. Effectiveness – Is avoiding pregnancy a preference, or a necessity?
2. Failure rates – Real life failure rates versus failure rates in a controlled setting in which every patient uses the method exactly as instructed every single time are probably different. For instance, if you’re really forgetful and keep an irregular schedule, popping a pill at the same time every day might be challening. See #4.
3. Risks and side effects – Most hormonal contraceptives (rather than barrier methods like condoms) increase women’s risk of blood clots and stroke, and weight gain is pretty common. Evaluate your risk factors (eg, smoking, obesity, family history of various health issues) to find the safest option.
4. Lifestyle compatibility – If you can’t swallow pills, an oral contraceptive might not be the right choice. On the other hand, new chewable birth control pills may be perfect. Or maybe you don’t want to think about your contraceptive all the time, so getting a shot (like Depo-Provera) every few months would be the way to go. Talk with your doctor about your needs.
5. Life plans – Are you planning to have kids in the near future? Do you want to put it off indefinitely but still have the option? Are you in a stable relationship, or playing the field? These factors and other elements of your life plan will play a big role in determining your best birth control option.
6. Your comfort level – Would you rather just swallow a pill or slap on a patch, or are you cool with inserting a diaphragm or sponge every time, even in the heat of the moment? Know what you’re really going to stick with.
7. Your sexual behavior – Ladies with multiple partners may have different needs from those in long-term monogamous relationships. Be straight with your gyno about your relationships and sexual activity.
8. STI/STD protection – If you’re married, sexually transmitted diseases/infections may not be as big a concern for you as for someone who’s sexually active outside of a monogamous relationship. Condoms are helpful in protecting against the spread of sexually transmitted diseases, but other contraceptives offer little, if any, protection against STDs — and nothing is fool proof.

Talk to your OB/GYN about what’s going to work best for your needs — and be completely honest. This is your life we’re talking about here, so it’s no time to be bashful.

Contents © Copyright 2007 Kristen King

Post from: Blisstree

How to Choose the Right Birth Control for You