All EC ≠ All Female Bodies

Alexandra Eisler

Alexandra Eisler

The name of the game is to make “the healthy choice, the easy choice.” And we’re excited women can (finally) buy emergency contraception (EC) over the counter! More options, more resources, and removing barriers = awesome, right?!

Not so fast.

We talk about EC as a workable option for just about anyone who wants it. Seems easy enough. The problem is that research shows not all ECs are good for all female bodies. There are three kinds of EC we hear about in the U.S.: Levonorgestrel (LNG; i.e., Plan B, Next Plan, Postinor), ulipristal acetate (UPA; i.e., ella), and the copper IUD (i.e., Paragard):

  • LNG is available over the counter without a prescription.
  • UPA requires a prescription.
  • The copper IUD must be inserted by a medical professional and accessibility varies widely among clinicians (sometimes taking several visits to be acquired and inserted).

As far as “patient friendly” goes, LNG may be the best choice with no doctor’s visit and no prescription. And everyone knows what Plan B is thanks to its sassy purple-hued commercials (brand recognition goes a long way—just ask teens how they feel about Trojan condoms over other brands). This is why in our field we keep the EC-talk simple: if you unprotected sex within this timeframe, go get EC—the sooner the better!

What we don’t talk about is that LNG is not effective for women whose body mass index (BMI) is over 25. (Check out more information about BMI here.) Now, it’s true that BMI is a somewhat controversial measurement of health, but it’s one that was correlated with EC failure.

LNG works for women whose BMI is 25 and lower, UPA works for women whose BMI is 35 and lower (and can be taken up to 120 hours after unprotected sex—longer than LNG), and the copper IUD works for most women if it can be inserted soon enough after sex. The take away is that the research shows that once a woman’s BMI reaches 26 and above, LNG becomes so ineffective, it’s basically a placebo.

So what does this mean? It means a few things. First, the most accessible methods of EC don’t work for a large portion of Americans who might want to use it. Second, we need to wholly reconsider how we talk about EC being a safe and effective method to prevent pregnancy when other methods fail.

Our clients, our students, and our patients have a low tolerance for “bad” information and by removing the required prescription from Plan B, there’s not a good line of defense to make sure folks are getting a good back-up method. There’s no easy way to explain the intersection of sex, hormones, body composition, and family planning, so how will you talk to young people about handling EC?

(Note: The study found two other covariate of EC failure in addition to BMI: existing probability of conception and the occurrence of further acts of unprotected intercourse after using EC.)

Alexandra Eisler is a Training and Technical Assistance Manager at Healthy Teen Network.

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Who Should Do the Telling?

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“You know, it’s a really sensitive subject. And it’s really hard news for people to get.” So says Anna Halloran, who works for Spokane Regional Health District in eastern Washington. For patients who have tested positive for gonorrhea, the health department now offers a service to provide anonymous notification to their former sexual partners.

“People don’t necessarily do that [tell former partners about the diagnosis],” says Jocelyn Warren, a public health researcher at Oregon State University. Studies show that couples—especially young couples—don’t communicate about their sexual histories. (Surprise, surprise!) And telling an ex about an STI infection can be especially “difficult,” Warren says.

Read more here and let us know what you think by voting in the poll below!

How & Where Healthy Teens Live, Learn, & Play: A 360° Approach

Gina Desiderio

Gina Desiderio

When researching the effective characteristics of sexuality education programs, Dr. Douglas Kirby noted that while programs addressing individual knowledge, attitudes, and skills are important, they are not sufficient in reaching positive health outcomes: “Communities should not rely solely on these programs to address problems of HIV, other STIs, and pregnancy but should view them as an important component in a larger initiative that can reduce sexual risk-taking behavior to some degree.”

Evidence-based programs are but one piece of a larger approach to creating a national community where all adolescents and young adults, including teen parents, are supported and empowered to lead healthy sexual, reproductive, and family lives. To reach this vision—Healthy Teen Network’s vision that drives our mission—we must support a comprehensive, 360° approach to adolescent sexual and reproductive health.

How and where we live, learn, and play affect every one of us—our health and well-being, even our life span. These factors are referred to as social determinants of health. Examples include access to quality education and healthcare, life goals and hopes for the future, or healthy relationships with peers, family, and educators

The 360° approach is best represented by looking at the interrelated spheres of individual, relationships, community, and society, to understand how determinants in each sphere can influence individual behavior. The Social-Ecological Health Promotion frame illustrates the overlapping nature of the spheres.

Healthy Teen Network uses this frame as our theoretical approach to better understand the complex factors and spheres, and to increase our impact. The Youth 360° Fact Sheet, How & Where Healthy Teens Live, Learn, & Play is the first in our new series of resources focused on the Social-Ecological Health Promotion frame and social determinants of health.

How have you found that how and where we live, learn, and play plays a role in health outcomes?

How do you work to incorporate the social determinants of health into your work?

Gina Desiderio is the Director of Marketing and Communications at Healthy Teen Network.

Applauding AAP’s Policy Statement on Condom Use by Adolescents

Pat Paluzzi, DrPH

Pat Paluzzi, CNM, DrPH

Healthy Teen Network applauds the American Academy of Pediatric’ s recently released policy statement on Condom Use Among Adolescents. The policy statement offers a thorough background and description of condom use in the United States and provides relevant recommendations for the field.

Healthy Teen Network is particularly pleased to see the ecological approach to promoting condom use endorsed within this statement. The recognition of parents, schools, and peer networks supports our belief in the social ecological health promotion frame as the best approach to create sustained healthy behaviors among young people.

Within this statement, AAP once again dispels the myth that making condoms available increases sexual behavior, and the AAP provides even more compelling support for sexuality education. Condoms are an important part of healthy sexual activity among all age groups, and given the rates of unintended pregnancies and STIs among young people, they are a critical component of promoting healthy choices among this age group.

Pat Paluzzi, CNM, DrPH, is President/CEO of Healthy Teen Network.

Embracing Innovation in Savannah with More than 400 of Our Closest Friends

Savannah, GA, was the place to be at the end of October for adolescent sexual and reproductive health leaders from around the country, who descended upon the historic town for our 34th Annual National Conference, Embracing Innovation: Combining Science with Creativity to Improve Adolescent Health. Thank you to our attendees, presenters, planning committee, exhibitors, and entertainers for making this one of our best conferences yet! We returned to our work inspired and energized, and hope you felt the same if you were among the more than 400 conference attendees. If you weren’t able to make it–or if you were there and want to relive some of the memories–check out the #htnconf hashtag on Twitter, Instagram, and Facebook, and take a look at some of the conference photos we posted!

But don’t just take our word for it, check out a small sample of tweets people were posting live from conference:

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Mark your calendar now for our 35th Annual National Conference, Synergy: Achieving More Together, October 11-14, 2014 in Austin, TX! Keep an eye out for our Call for Proposals and award nominations early next year.

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