Monday, February 27, 2012

Spermbrocide: With New "Armor" Condoms, Trojan Rebrands N-9 for the Millennial Generation

So tonight I went to the grocery store and, as I always do, stopped by the condom section to see what's tricks. Tonight the college kids who must think I'm a total slut (because looking at condoms means you're DTF, obvs) got a show because I saw a new Trojan product and loudly said, 'WHAAATT?' as I picked up the new Armor condoms off the shelf.

After the incredible success of the Bareskin which is literally the first Trojan condom we've reviewed positively ever here on How to Have Sex in Texas (nee This Is Go-To Girl), Trojan has come out with a rebranding of condoms lubricated with Nonoxynol-9 under the label "Armor."

Known to every breathing sex educator on the planet, the use of Nonoyxnol-9 has been explicitly discouraged by the CDC since 2002. In 2007 the FDA released a final rule requiring extensive "SRSLY THESE PRODUCTS DO NOT PROTECT AGAINST STDS" labeling for over-the-counter products containing N-9, which includes spermicide inserts, gels, foams, and suppositories.

In a 2005 report the Guttmacher Institute specifically called out Trojan in a report on the controversy relating to N-9 in condoms, and the company stood by its decision to continue to make them even though the World Health Organization and the CDC had concluded that "condoms lubricated with a small amount of N-9 are no more effective in preventing pregnancy than are lubricated condoms without N-9."*

But leave it to the marketing geniuses at Church & Dwight to figure out how to make a product that irritates genital skin, smells like bleach, is no more effective at preventing pregnancy and increases the risk of STIs totally bro-tastic.

Magnum, Trojan's larger size condom, has never been available with a spermicide lubricant so I guess this is a win for the "HEY LOOK I HAVE A HUGE DICK!" guys out there.

For the record: condoms lubricated with spermicide are not more effective at preventing pregnancy than condoms without. So the "armor" you're putting on your penis is actually that paper bag thick Trojan condom itself, not the spermicide--that's just a smelly, noxious chemical bonus. If you like the idea of smelling chemicals with your condoms, why not try the Fire & Ice?

Look, dude, I get it: you really, really do not want to get that girl pregnant. I feel you, I really do, and I'm pumped that you want to use condoms at all. But seriously bro, do yourself a favor and skip the spermbrocide.

*Boonstra, Heather. "Condoms, Contraceptives and Nonoxynol-9: Complex Issues Obscured by Ideology." The Guttmacher Report on Public Policy. May 2005.

Monday, February 13, 2012

Fun With Math: Perry's Abortion Policy

Politifact Texas is reporting that the always semi-truthful Rick Perry is trumpeting to other half-sentient Republicans that legislation he signed last year, which contained a variety of mechanisms to defund/fuck Planned Parenthood, has "closed 12 abortion clinics."

What really happened is that, since the clinics that actually provide abortion weren't eligible for state or federal funding anyway, none of the abortion-providing clinics Planned Parenthood operates were closed. The shuttered clinics were those providing state-subsidized family planning services, STI treatment, and cancer screenings. You know, stuff that could actually reduce the number of abortions.

Ever flexible with the truth, Perry staffer Josh Havens said that while yes, it is a so-called factual statement that the closed clinics did not provide abortions, he would "make the argument that a Planned Parenthood clinic is an abortion clinic."

That's like arguing that a regular dentist's office is also by category definitely also oral surgeon regardless of what services are actually provided by the dentist but whatevs.

Reducing access to birth control and passing restrictive, nonsense laws like the mandatory ultrasound bill do not somehow miraculously make women decide that the best thing to do with their sex partner is to stay home and work on joint needlepoint projects and abstain from sex because, you know, Jesus. People have sex, sometimes they get pregnant, and some of those people want to have abortions.

The simple math formula works like this:

Sex + Birth Control = Not Pregnant (like 90-98% of the time)

Sex - Birth Control = Pregnant (like 85% of the time, over the course of 1 year)

Unplanned Pregnancy x Likelihood of abortion = 40% chance of abortion

Population(Sex - Birth Control) = Lots of Unplanned Pregnancies

Lots of Unplanned Pregnancies x Likelihood of abortion = Huge Increase in Abortions!

Way to go, Perry! Your signing of that dumb-shit bill will increase the number of abortions.

Gentle readers, why not make a small donation to the Lilith Fund, which helps Central Texas women directly affected by Perry's craptastic policies get abortions.

Wednesday, February 8, 2012

2012 Birth Control Price Check

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Just over two years ago I wrote a post about the increase in price for contraceptives following the implementation of the healthcare reform law which, at the time, was still not final. A high school classmate of mine (Hi, M!) alerted me to a segment on Rachel Maddow last night discussing the availability and cost of contraceptives based on Republican vs. Democratic proposals, and I thought it was time to do another set of price checks.

In the segment, Rachel claims that if a Democrat is president, your birth control will be covered by your insurance or, if you don't have insurance, you can go to a subsidized clinic and get your contraceptives for cheap or free. If a Republican were president, she says, your insurance may not cover it, there won't be any subsidized clinics, and you may have to pay out of pocket. What Rachel doesn't mention is that individual states, like Texas, can still do exactly what our state did and go after Planned Parenthood locally. Our wildly successful Women's Health Program has been defunded, which will leave thousands of poor women without access to health services or birth control.

The perverse way that prescription drugs are priced is the opposite of many healthcare services, which are often priced lower for those patients paying cash ("self-pay") and higher for those using insurance, with the assumption being that the amount of money the healthcare provider ultimately receives is the same for both patients. However, with rx drugs, the list price is what you pay if you don't have an insurance company negotiating with the manufacturer to reduce costs for a large patient pool. The large patient pool of uninsured women have no leverage, and the prices they will pay have gone up staggeringly just since 2009.

Below are the out of pocket prices women are paying now for contraceptives, with the 2009 price in parenthesis and the % increase:

Yasmin: $85.99 ($76.99) -- 12%
Ocella (Yasmin generic): $71.99 ($59.34) -- 21%
Yaz: $92.99 ($85.60) -- 9%
Nuvaring: $86.99 ($77.35) -- 12%
Ortho Tri-Cyclen Lo: $94.99 ($67.99) -- 40%
Tri-Lo Sprintec (OTCLo generic): No longer available ($55.99)
Plan B One-Step: $47.99 ($47.99)

The price of every method, other than Plan B One-Step, has gone up significantly. Perhaps this explains the buzz I've been hearing about Depo-Provera, the 3-month progestin only shot, which seemed to have gone out of popular use after 2000. One syringe costs just $100.78 on, by far the cheapest of the hormonal methods.

The Planned Parenthood clinics in Austin are still offering free birth control under the WHP, trying to use up the rest of their funds. There are income limits, but click here to see if you qualify. Better get it now before it's gone.

Previously on How to Have Sex in Texas: the $2.99 birth control app, iCycleBeads.

Wednesday, February 1, 2012

Review: iCycleBeads App

One doesn't grow up in a household with a women's health self-help educator, a woman who moonlighted as a Gynecological Teaching Associate, and not have an underlying acceptance of so-called "natural family planning."

I became used to seeing speculums around the house and I vividly remember large spiral-bound notebooks describing the Sympto-Thermal Method, which seems like an incredibly complicated way to avoid using the pill. But in the 80s, IUDs were off the market in the US because of the Dalkon Shield, and some women, distinct from those who learned about natural family planning for religious reasons, were looking for other options.

The Sympto-Thermal Method, which relied on both basal body temperature measurements and an examination of cervical mucus throughout the menstrual cycle, is labor-intensive, complicated, and unpopular.

Fast forward to 2007. The Institute for Reproductive Health at Georgetown University (a Catholic school) won a contract from the USAID to teach people in certain target countries how to use fertility awareness methods methodically and correctly as a way to help women avoid pregnancy when an absence of national infrastructure makes the consistent use of condoms or other methods difficult.

Though the beads have been around for several years (I first wrote about them in 2009), Time published an article last fall that ginned up criticism from American feminist bloggers because of the IRH's association with Georgetown and the Catholic Church's anti-contraception stance.

Claims that the method is ineffective because of IRH's alleged ideological stance are not borne out by the data. Research published in 2001 in Contraception, the most authoritative journal on the subject, confirmed that the method, when used consistently and correctly, is 95% effective at preventing pregnancy. The method is also in use by PSI, UNFPA and other partners which are definitely not influenced by Catholic restrictions on family planning.

The reaction from many outside the granola/natural parenting arena has been resoundingly negative, but I wanted to find out how it actually works from a user perspective, leaving aside the debate about whether a Catholic institution can be trusted to advocate effective birth control.

Cycle Beads are not actually sold by Georgetown, but a private company called Cycle Technologies that holds the license from the University. In response to the popularity of the method among Western users, Cycle Technologies released an iPhone app, iCycleBeads,in February 2011, a Spanish version in March, and an Android version in July.

So how does it work? The Beads are a strand of 32 beads that represent the days of the menstrual cycle, color-coded to indicate the risk of pregnancy on a given day. On the brown days, sex is low-risk; on the white-bead days, it's higher risk. Users are instructed to use condoms, withdrawal, or abstain from vaginal sex on the white bead days to prevent pregnancy. The app sends you notifications when you're in the no sex or backup method days so you don't have to keep track of it yourself.

Not everyone can use Cycle Beads--you have to have regular menstrual cycles that are between 26 and 32 days in order to use the method, but the cycles can vary in length as long as they're in that timeframe.

I downloaded the app on my iPad so I could review it, but I have an IUD so I haven't relied on it for pregnancy prevention and instead examined the actual user experience. But my friend Carol, a 30 year old married friend of mine who always refers to me as her "hippie" friend, asked me about the app last year when she decided she was ready to go off the pill.

I asked Carol to tell me about her experience, negotiating the use of this method with her husband, and whether they had had any "slip-ups," the main concern with using a method that depends on your ability not to have them.

Carol's experience, she said, has been good. For nearly a year of use, she and her husband have had maybe 4 slip-ups (they use condoms instead of not having sex on the white bead days) where they have used withdrawal instead. She hasn't had any pregnancy scares.

Her husband was onboard. "Jesse had used condoms all the time with his college girlfriend who wasn't on the pill, so he was used to it. He's always been really good about that stuff."

The only hiccup came last summer when she had a visit with a healthcare provider who had never heard of the standard days method and scared her back into using the pill. She rapidly gained five pounds and after two months, went back to the app.

After moving and changing jobs and health insurance, Carol's plans to get pregnant have been pushed back and she plans to continue using the app until she and her husband are ready to start trying for a baby in a few years.

My only technical complaint with the app is that while it sends you notifications telling you when the fertile period begins and ends, it doesn't tell you when you're likely to get your period. As someone who also uses Monthly Info for period tracking (Carol does,too), I wish that the two things could be combined. The app is obviously tracking your menstrual cycle and it seems that it could be jiggered to predict when I need to buy that box of tampons I've been putting off. It would also be nice if the beads could somehow lay over Google calendar or another calendar program so you wouldn't have to look in two places to find out what day you're on.

Regardless of ideological objections to a method developed by a Catholic university, Cycle Beads are cheap, effective, and easy to use, characteristics largely absent from the modern contraceptive landscape. And no, the Beads don't protect against STIs, but neither does any other method--except condoms.

Highly recommended for those in monogamous relationships with known STI risk who can, with their partner, commit to using a back-up method or abstaining from vaginal sex for 11 days a month.

Cost: $2.99 in the iTunes Store or Android Market, plus the cost of back-up method, if applicable.
Free online screening tool can help you figure out if you're a candidate for the method and teach you how to use it correctly.