Category: Birth Control

Sex, (Prescribed) Drugs, and Rock ‘n’ Roll: Approaching sexual and reproductive health with an autoimmune disease

On November 13th, Young Patients’ AREA hosted our second event of the year: Sex, (Prescribed) Drugs, and Rock n’ Roll: Approaching sexual and reproductive health with an autoimmune disease. In this event, we utilized a new format that included a mix of pre-recorded expert Q&A and live patient-shared experiences.

Dr. Brittany Huynh, pediatric rheumatologist and adolescent medicine specialist whose interests include reproductive health among adolescents and young adults with rheumatic and other complex chronic diseases.

Dr. Erica Brenner, pediatric gastroenterologist and clinical investigator currently investigating reproductive health among young patients with IBD.

Dr. Becca Overbury, rheumatologist with research interests in health care transition in adolescent and young adult patients with childhood and adolescent onset Rheumatic diseases.

Our experts covered a variety of topics including why having conversations about reproductive and sexual health with your disease specialist is important, strategies to start these conversations, and key points patients should know about how their disease and/or medications may interact with their sexual and reproductive health. Below are some of the highlights of what our experts spoke about, but be sure to watch the complete recording to hear their complete insights. 

Talking about these topics can be awkward, and doctors know that. To help broach the subject, they recommended strategies such as asking for one-on-one time with your provider (this is also good practice for getting independent in your care!), bringing up these questions early in the appointment to ensure there is plenty of time to discuss, or sending a MyChart message ahead of your appointment if you’d like. These are super important topics to talk about because your condition DOES overlap with your sexual and reproductive health. 

In terms of disease/medication interactions with sexual and reproductive health, we learned of risks of blood clots associated with certain conditions such as systemic lupus or Crohn’s disease, which may be further increased when using birth control that contains estrogen. Similarly, individuals with certain autoimmune conditions such as inflammatory bowel disease or those treated with high doses of steroids may be at higher risk of long-term bone density related side effects when using certain forms of birth control, such as Depo Provera (“the shot”). This section was incredibly informative and contained a lot of information I myself hadn’t heard about before, so I highly recommend reviewing the experts’ complete information in this section. 

Experts additionally emphasized that in the majority of cases, individuals with autoimmune conditions can have successful pregnancies if they wish to do so. Experts echoed that outcomes are most successful when your condition is well controlled and recommended communicating with your doctor ahead of time to ensure your medications are safe for pregnancy. Dr. Brenner also highlighted preliminary data suggesting that individuals with inflammatory bowel disease who do have trouble getting pregnant and choose to pursue assistive reproductive technology like IVF are just as likely to have a successful pregnancy as somebody without inflammatory bowel disease. 

Additionally, a key point brought up by Dr. Huynh emphasized understanding your emergency contraception options, like Plan B or ella: “This is a medicine that you can take no matter what disease you have, no matter what medications you’re taking, and it is safe. So anyone can take it.” Emergency contraception options like Plan B and ella are legal and available in all 50 states, though the more effective option, ella, does require a prescription. Dr. Huynh recommended asking your doctor for a prescription before you even need it so that you can have it on hand. 

Other resources recommended by our experts:

The complete recording of this event can be viewed here. All opinions expressed are the personal perspectives of these individuals and not representative of their institutions.

We thank Dr. Huynh, Dr. Brenner, and Dr. Overbury for contributing their time and expertise to this event.

Climate Change Hits Hard—Even on Your Cycle

At first glance, climate change and equitable access to menstrual products may seem unrelated. Climate change is a global crisis driven by greenhouse gas emissions from daily activities such as driving cars, using plastic-based products, and raising livestock. Since pre-industrial times, the Earth’s average temperature has risen by about 1.2°C, and scientists warn it could surpass 1.5°C in the 2030s. The consequences are already visible: hotter summers, shifting rainfall patterns, and more frequent and destructive natural disasters. Simultaneously, menstrual equity remains a pressing concern. According to the American Academy of Pediatrics, 1 in 3 U.S. teens experiences “period poverty,” or the lack of reliable access to safe menstrual products. For many young people, schools, doctors’ offices, and local grocery stores are their primary sources of these products. 

Climate change threatens these access points. Natural disasters can interrupt supply chains, floods or storms can close schools and clinics, and heat-related stress can influence reproductive health outcomes. Research also suggests that climate-related stress and extreme heat can physically disrupt menstrual cycles, adding another layer of vulnerability. While many factors influence what menstrual products are bought, the most common, and often cheapest menstrual products, often carry the highest carbon footprint. While many factors influence what products someone may choose,  What may appear to be two separate issues — climate change and menstrual equity — are deeply connected. Without intervention, a warming planet will make it even harder for young people to access safe, affordable, and sustainable menstrual products.

Looking closer, climate change’s impacts on menstrual products are complex and far-reaching. Physically, climate change can exacerbate existing stressors on the body, leading to disruptions in normal menstrual cycles. For example, extended periods of extreme heat have been shown to change hormonal balances, specifically amplifying endocrine disorders and UTIs. Focusing on indigenous peoples’ testimony, insufficient water access during unpredictable rain cycles can affect menstrual hygiene practices. In tandem, intensive disasters like hurricanes, frequent flooding, or forest fires impact supply chains and people’s access to distribution areas. When seeking shelter, menstrual products are often a limited and overlooked resource – food and medication take prominent attention. Just as important, improper menstrual products can cause infections and may worsen a person’s mental health from social stigma. From a health and logistical perspective, climate change worsens menstrual product access by disrupting a person’s health and hindering community access during a crisis event.

Tangentially, single-use, plastic-based menstrual products like tampons and pads remain the most popular choice worldwide. Decades of branding, education, and refinement have made products like tampons and pads safe – and often desirable – compared to unsanitary methods. Nevertheless, the greenhouse gas emissions, coupled with plastic waste, make menstrual products an environmental concern as well. Over the course of a year, single-use menstrual products emit 20 pounds of greenhouse gases during production and transportation – equivalent to charging a phone over 1000 times! In addition, once disposed of, a product like a tampon or a pad is nonbiodegradable; it can take 500-800 years for a single product to fully decompose. As a necessary health product, menstrual products are intensive on the environment during manufacturing, transportation, and in a landfill. While not the largest contributor, continuing to use unsustainable menstrual products slowly contributes to worldwide climate change.

While separate issues, climate change directly impacts local communities and people’s access to sanitary menstrual products. From ongoing health impacts, intensive natural disasters, supply chain disruptions, and single-use products environmental toll, menstrual products are in a catch-22. Nevertheless, sustainable options are more readily available than ever before! Products like menstrual cups are reusable items that are inserted into the canal and can be rewashed for multiple uses. Further, biodegradable pads and tampons are becoming market staples – even if it has a price premium. Resources like the Good Shopping Guide (here) or getting involved in initiatives like the Pad Project (here) can help make a difference too! Regardless, it is important when picking menstrual products, you pick the ones that are best for you – both healthfully and personally. Whether it is a reusable cup or single-use item, ensuring everyone has access to menstrual products is vital. We can change the system, whether by voting with our dollar, pressing companies vocally to change, or working to ensure everyone has access to menstrual products.

Click here to read Laila’s personal story about choosing a birth control method.

References

American Academy of Pediatrics. 2020. “Period Poverty Research Finds 1 in 3 Teens Lack Access to Menstruation Products.” Aap.org. 2020. https://www.aap.org/en/news-room/news-releases-from-aap-conferences/period-poverty-research-finds-1-in-3-teens-lack-access-to-menstruation-products/?srsltid=AfmBOoo8Go8K_pjStrWigCEN4C9xOVJQIMhSb5lyZxKHBMJJIYdyiU0V.

Muralidharan, Arundati, Marije Broekhuijsen, Lady Lisondra, Aeka Guru, Jacquelyn Haver, and Sidra Irfan. 2025. “The Ripple Effect: Impacts of Climate Change on Menstrual Health and Paths to Resilience.” Frontiers in Global Women S Health 6 (April). https://doi.org/10.3389/fgwh.2025.1569046.

Parnian Khorsand, Sara Dada, Laura Jung, Siufung Law, Poorvaprabha Patil, Marie-Claire Wangari, Omnia El Omrani, and Kim van Daalen. 2023. “A Planetary Health Perspective on Menstruation: Menstrual Equity and Climate Action.” Planetary Health 7 (5): e347–49. https://doi.org/10.1016/s2542-5196(23)00081-5.

Yasemin Hamlaci Baskaya, Nazlı Unlu Bidik, and Busra Yolcu. 2024. “The Effect of Level of Anxiety about Climate Change on the Use of Feminine Hygiene Products.” International Journal of Gynecology & Obstetrics 165 (3): 1158–66. https://doi.org/10.1002/ijgo.15324.

Birth Control is Not One-Size-Fits-All: My Experience with the Rod

When I first heard the horror story of how a close family member of mine had had 13 miscarriages due to scar tissue in the fallopian tube caused by slippage of her IUD, I was mortified and immediately ruled out the IUD as an option for myself. I already hated the thought of having to undergo that insertion, having heard how painful it can be and how pain medications and anesthetics are not generally offered alongside it. To my knowledge, that only left me with two remaining options: the pill or the rod. With the pill, I knew that time management would be vital in ensuring that I took the medication at the right time and consistently, even if time zones were to change. The stress of possibly missing a dose and then running the risks of lower protection, along with the incredibly long list of horrid side effects that accompany the pill,  practically forced the rod on me as the most viable option. 

The rod, or implant, is a small, flexible rod that is inserted into your upper arm. It steadily releases the hormone progestin into your body to prevent pregnancy, and lasts approximately three to five years. It is low maintenance and is currently considered the most effective form of birth control. It seemed as though the rod had the highest protection rate and the least hormonal side effects—and it didn’t require me to remember anything other than that I need to get it replaced every three years.

As a 17-year-old in my first long-term relationship, I knew birth control was the right thing for me, but with my autoimmune disorder flaring up, I didn’t know how the rod would affect my body. I remember my physician telling me something like “one third of patients see reduced menstruation, one third of patients will cease to have a period, and the remaining unlucky third of patients will bleed lightly all of the time.” My thought at the time was that even if I was in that unlucky third group, a light but constant period doesn’t sound worse than becoming pregnant. Of course that is how you think when you assume the script writers of your story wouldn’t possibly place you in that unlucky third group.

I was in fact in that unlucky third group, but I never regretted my choice of birth control because the fear of getting pregnant was stronger than the dread of a never ending cycle. However, I deeply underestimated the drag of expensive menstrual products and the drag of out-of-whack hormones. The side effects of the rod, mixed with the fatigue and inflammation of my autoimmune disorder, led me straight into a depressive episode.

But in hindsight, that experience taught me something much more valuable than what birth control not to use: it taught me the importance of understanding my options and advocating for myself in medical decision-making. Every method of contraception comes with its own risks, benefits, and unknowns, and no single choice works for everyone. I learned that birth control isn’t just a prescription, it’s a conversation. It’s a process of asking questions, weighing priorities, and finding a balance between medical guidance and personal comfort.

When I finally revisited the topic with my doctor, I came prepared with research, questions, and a clearer understanding of my own body and needs. That discussion felt empowering rather than intimidating. It reminded me that the best healthcare decisions are not made for us, but with us.

So while my experience with the rod was difficult, it reshaped the way I approach my health. It showed me that shared decision-making is the key to feeling confident in your care. Birth control is not one-size-fits-all, and the more we talk about our experiences, the more we help others find what fits them.