WEBVTT - Lab 041: Out of Control 0:00:00.760 --> 0:00:03.680 Last week, the Supreme Court started hearing the case about 0:00:03.720 --> 0:00:07.640 abortion access in Mississippi. And this all started because Mississippi 0:00:07.680 --> 0:00:09.760 put a law in place that said you couldn't terminate 0:00:09.800 --> 0:00:11.760 your pregnancy after fifteen weeks. 0:00:11.800 --> 0:00:14.200 Well, that's in direct contradiction with Roe v. Wade, right, 0:00:14.320 --> 0:00:16.880 which says you can terminate a pregnancy up until twenty 0:00:16.920 --> 0:00:19.919 four weeks, which is considered the point of viability, or 0:00:19.920 --> 0:00:22.160 when a fetus can survive outside the womb. 0:00:22.400 --> 0:00:22.680 Right. 0:00:22.840 --> 0:00:26.080 And this is so monumental because this is the first 0:00:26.079 --> 0:00:28.760 time since nineteen seventy three. So when Roe versus Wad 0:00:28.880 --> 0:00:31.720 happened that the Supreme Court is hearing a case that 0:00:31.840 --> 0:00:36.680 questions if it's constitutional to ban abortion before viability. 0:00:36.880 --> 0:00:38.760 This feels like a lot is on the line. 0:00:38.880 --> 0:00:42.560 Yeah, this could change everything, And it seems like we 0:00:42.600 --> 0:00:45.519 are in a time machine because I never thought that 0:00:45.680 --> 0:00:48.440 in my lifetime that we would go back to this 0:00:48.560 --> 0:00:52.959 way of thinking and have to go through court systems 0:00:53.040 --> 0:00:55.520 again about women's reproductive rights. 0:00:55.880 --> 0:00:58.440 Yes, and you know, I've seen a lot of chatter, 0:00:58.600 --> 0:01:01.680 you know, I like to scan the way. I've seen 0:01:01.720 --> 0:01:03.160 a lot of chatter about like, oh, well, you don't 0:01:03.160 --> 0:01:05.280 have to worry about abortion if you are taking birth 0:01:05.319 --> 0:01:08.400 control and this and that, but baby, we need to 0:01:08.400 --> 0:01:09.800 talk about birth control. 0:01:09.640 --> 0:01:13.520 Absolutely, because not all that glitters is gold. It's not 0:01:13.680 --> 0:01:17.039 some magic pill that works for everybody the exact same way. 0:01:17.200 --> 0:01:18.440 So we have to talk about this. 0:01:43.760 --> 0:01:47.600 Welcome to Dope Labs, a weekly podcast that mixes hardcore science, 0:01:47.680 --> 0:01:49.840 pop culture, and a healthy dosa friendship. 0:01:50.040 --> 0:01:52.640 Reproductive rights have been under attack in the United States 0:01:52.640 --> 0:01:55.200 and with the recent abortion legislation in Texas. 0:01:55.360 --> 0:01:57.760 Right, it's not just Mississippi. 0:01:58.000 --> 0:02:00.840 Texas has also put some laws in place, so they 0:02:00.880 --> 0:02:03.560 have the Texas Heartbeat Act. And in this act, it 0:02:03.640 --> 0:02:07.520 says that you can't terminate a pregnancy after six weeks, 0:02:07.520 --> 0:02:11.040 So you only have six weeks to terminate your pregnancy. 0:02:10.639 --> 0:02:12.280 And that six weeks is not from when you know 0:02:12.320 --> 0:02:14.400 that you're pregnant. We need to be really clear. It 0:02:14.440 --> 0:02:16.920 is tricky because the six weeks is from the date 0:02:16.960 --> 0:02:19.400 of your last minstral cycle, so a lot of people 0:02:19.400 --> 0:02:21.200 don't even know that they're pregnant six weeks out. 0:02:21.360 --> 0:02:21.760 That's right. 0:02:21.840 --> 0:02:25.600 So this week we're talking all about birth control specifically. 0:02:25.720 --> 0:02:28.600 We wanted to understand how it works to prevent pregnancy. 0:02:28.800 --> 0:02:31.520 Some of the issues or side effects around birth control 0:02:31.639 --> 0:02:34.040 and how people can be empowered to find the best 0:02:34.080 --> 0:02:34.880 option for them. 0:02:35.160 --> 0:02:49.560 Let's get into the recitation. Okay, so what do we know? 0:02:49.960 --> 0:02:51.239 Well, we know not all. 0:02:51.120 --> 0:02:53.400 Birth control is created equal, right, you know there's a 0:02:53.400 --> 0:02:54.239 lot of different types. 0:02:54.440 --> 0:02:57.360 Yes, me and all my friends have all had a 0:02:57.360 --> 0:03:01.280 different one and have different thoughts about each of those things. 0:03:01.480 --> 0:03:06.280 Yeah, the pill, the ring shot, iud's condoms, even spermicide 0:03:06.320 --> 0:03:07.560 seems like that's making a comeback. 0:03:07.600 --> 0:03:08.760 I recently saw ad for that. 0:03:08.960 --> 0:03:12.239 Do you remember that episode of Seinfeld where Elaine was 0:03:12.240 --> 0:03:14.360 talking about the sponge. I had no idea what that 0:03:14.480 --> 0:03:16.320 was when I was watching Seinfeld as a kid, but 0:03:16.360 --> 0:03:17.960 it was birth control and she was trying to get 0:03:17.960 --> 0:03:21.760 her hands on her favorite type of birth control, and it. 0:03:21.720 --> 0:03:24.280 Was like she was looking for drug. Really, it was 0:03:24.400 --> 0:03:24.840 very funny. 0:03:24.840 --> 0:03:26.200 Now I'm gonna have to go back and look bit it. 0:03:28.080 --> 0:03:28.960 What else do we know? 0:03:29.160 --> 0:03:31.360 We know that birth control is an important topic because 0:03:31.400 --> 0:03:34.440 half the population is looking for ways to decide. 0:03:34.120 --> 0:03:36.080 Or control when they get pregnant. 0:03:36.000 --> 0:03:37.600 Or if or if so. 0:03:37.680 --> 0:03:39.440 What this boils down to is that birth control is 0:03:39.480 --> 0:03:41.240 affecting a lot of the population. 0:03:41.720 --> 0:03:44.560 Yeah, so many people just think of birth control as 0:03:44.640 --> 0:03:48.760 something that people with uteruses are thinking about, when really 0:03:48.920 --> 0:03:51.840 it can be partners that are thinking about it. So 0:03:51.920 --> 0:03:54.520 it really does affect way more than just the person 0:03:54.560 --> 0:03:56.560 with the uterus. Yes, but it seems like a lot 0:03:56.600 --> 0:03:59.200 of people that don't have a uterus are making decisions 0:03:59.200 --> 0:04:01.840 about it, sticking the non uterus in our business and 0:04:01.880 --> 0:04:04.040 telling us what we should be doing with our uterus. 0:04:04.080 --> 0:04:06.000 We also know there isn't a birth control pill for 0:04:06.080 --> 0:04:08.720 men right now, so what's going on with that? So 0:04:08.800 --> 0:04:09.680 what do we want to know? 0:04:10.000 --> 0:04:11.840 I think for me, it kind of starts at the 0:04:11.920 --> 0:04:14.040 base and I'm a little bit embarrassed. 0:04:14.080 --> 0:04:14.920 This is a safe space. 0:04:15.200 --> 0:04:17.560 I don't really know how birth control works. You're just 0:04:17.880 --> 0:04:18.800 counting on it to work. 0:04:18.880 --> 0:04:21.719 I think I kind of understand how the ring and 0:04:21.800 --> 0:04:24.719 the pill work, but iud's I know there's different types, 0:04:25.000 --> 0:04:27.760 and I think that's the part that I'm like, chemically, 0:04:27.839 --> 0:04:32.280 what is going on with these contraptions that we could 0:04:32.320 --> 0:04:34.039 possibly be putting inside of our bodies. 0:04:34.120 --> 0:04:35.359 That's a good question. 0:04:35.560 --> 0:04:40.159 And then just as deserving of conversation is what are 0:04:40.200 --> 0:04:41.120 some of the side effects? 0:04:41.200 --> 0:04:41.400 Right? 0:04:41.560 --> 0:04:43.400 What are some of the issues that come along with 0:04:43.480 --> 0:04:46.440 adding these things to your body? You know absolutely, because 0:04:46.480 --> 0:04:48.160 we already know that there are side effects. 0:04:48.320 --> 0:04:50.840 I think we've all heard. I just want to know 0:04:51.160 --> 0:04:52.640 what are all of them? 0:04:52.839 --> 0:04:55.320 Yeah, and piggybacking off what you just said, we know 0:04:55.360 --> 0:04:57.240 there are tons of issues, and the issues are different 0:04:57.240 --> 0:05:00.479 for different types of birth control. So how our doctors 0:04:59.880 --> 0:05:02.760 to who gets what and when? And is the birth 0:05:02.760 --> 0:05:04.479 control you got back in the day the same birth 0:05:04.520 --> 0:05:06.560 control you should be using later, like people in birth 0:05:06.600 --> 0:05:07.560 control for a long time. 0:05:07.920 --> 0:05:10.600 Yeah, and our bodies are changing. We know that, right, 0:05:10.920 --> 0:05:12.880 isn't one size fits all. Sometimes I feel like you're 0:05:12.880 --> 0:05:14.520 going to the doctor and they just got the birth 0:05:14.520 --> 0:05:16.360 control in a candy jar and they're just like here, 0:05:16.480 --> 0:05:20.560 now go halfway. And then I think another really good 0:05:20.680 --> 0:05:24.960 question is what is the future of birth control? I 0:05:25.000 --> 0:05:27.839 can't imagine that we all gonna just be doing the 0:05:27.880 --> 0:05:28.400 same thing. 0:05:28.520 --> 0:05:29.480 I hope forever. 0:05:29.760 --> 0:05:32.640 I hope that there's some advances in the technology so 0:05:32.680 --> 0:05:35.080 that there aren't these issues that we're gonna be talking 0:05:35.080 --> 0:05:38.799 about that persist with people whoever uterus. 0:05:38.400 --> 0:05:40.800 Right, I feel like this is ripe for disruption. 0:05:41.160 --> 0:05:44.960 Oh, absolutely, absolutely, all right, let's jump into the dissection. 0:05:52.880 --> 0:05:55.960 Our guest for today's lab is doctor Elizabeth Rousseau. 0:05:56.160 --> 0:05:57.359 I am Elizabeth Rousseau. 0:05:57.640 --> 0:06:02.400 I am founder of AIDA, and I got my PhD 0:06:02.680 --> 0:06:05.279 in human genetics at Duke University. 0:06:05.600 --> 0:06:08.880 So me and Zakiah both went to Duke with Elizabeth. 0:06:09.080 --> 0:06:10.840 Not just all we were there at the same time 0:06:10.880 --> 0:06:12.080 and we might have met each other. 0:06:12.240 --> 0:06:17.400 No, we actually know Elizabeth, yes, very very well. We 0:06:17.480 --> 0:06:20.240 graduated from the same program. All right, we have the 0:06:20.279 --> 0:06:22.640 same degree. So I am really excited to talk to 0:06:22.680 --> 0:06:24.960 her today. Yes, and she's one of our very very 0:06:25.000 --> 0:06:26.920 smart friends. So buck Lynn, so you can know you 0:06:26.920 --> 0:06:29.080 hear us say, Elizabeth is doctor Ruzzo. Yes, put some 0:06:29.160 --> 0:06:36.160 respect on her name. Let's start with the basics. So first, 0:06:36.160 --> 0:06:38.880 there's ovulation. That's the release of an egg from your 0:06:38.880 --> 0:06:42.240 ovary down the fallopian tube. So when that egg is fertilized, 0:06:42.279 --> 0:06:45.120 it implants in the side of the uterus. If there 0:06:45.200 --> 0:06:48.919 is no fertilized egg in that house, the uterus just 0:06:49.400 --> 0:06:52.400 comes crashing down. It shares the lining, and that's the 0:06:52.440 --> 0:06:54.880 twenty eight day cycle that we know is a mistral cycle, 0:06:54.960 --> 0:06:57.320 and so that lining being shared, that's a period. 0:06:57.600 --> 0:06:59.960 We know that birth control is a really important part 0:07:00.120 --> 0:07:02.919 of reproductive health for so many people, and we know 0:07:02.960 --> 0:07:06.680 it prevents pregnancy, but how exactly does it work. 0:07:06.880 --> 0:07:11.800 The highly effective methods work by either preventing ovulation or 0:07:11.840 --> 0:07:16.000 by preventing the sperm from successfully fertilizing the egg, which 0:07:16.040 --> 0:07:19.240 is usually via thickening of the cervical mucus. 0:07:19.480 --> 0:07:21.120 So, with the exception of the. 0:07:21.040 --> 0:07:25.000 Copper IUD, they all work by adding low levels of 0:07:25.240 --> 0:07:29.320 exogenous hormones. And these are specifically synthetic forms of either 0:07:29.560 --> 0:07:31.440 estrogen or progesterone. 0:07:31.480 --> 0:07:32.840 All right, so let's break that down. 0:07:32.920 --> 0:07:35.080 Okay, good, because there are some words in there. I 0:07:35.120 --> 0:07:36.120 don't I'm not sure. 0:07:37.080 --> 0:07:39.680 So Elizabeth said that all of these, except for the 0:07:39.720 --> 0:07:44.480 copper IUDs, work by adding exogenous hormones. XO means outside 0:07:44.600 --> 0:07:47.520 in genous. You know, word genus is the origin, so 0:07:47.640 --> 0:07:49.320 originating from outside the body. 0:07:49.400 --> 0:07:51.880 My girl speak Latin. She speaks Latin, y'all. 0:07:53.680 --> 0:07:55.880 And so all we think about it, we're saying, like progestin, 0:07:56.240 --> 0:08:01.160 that's just a synthetic version of progesterone. Hormones are chemical messengers, 0:08:01.240 --> 0:08:04.800 and they're like long range chemical messengers. They can travel 0:08:04.840 --> 0:08:08.800 through the bloodstream, reach different organs. They're important, and they 0:08:08.800 --> 0:08:12.000 all serve different purposes often and I think it's a 0:08:12.080 --> 0:08:15.040 really delicate dance of the different hormones, which is why 0:08:15.040 --> 0:08:17.600 you often hear people say, oh, it's a hormonal imbalance 0:08:18.040 --> 0:08:22.960 because they're coregulated and some are blocking others, some amplify others, 0:08:23.040 --> 0:08:26.080 and it happens at different times depending on different things 0:08:26.120 --> 0:08:27.240 that are happening in your body. 0:08:27.520 --> 0:08:30.080 It sounds like a symphony, like those strings come in 0:08:30.120 --> 0:08:33.560 at the right time to drown out those woodwind instruments. 0:08:34.320 --> 0:08:34.880 There you go. 0:08:35.080 --> 0:08:38.520 So some of the hormones that these different breath controls 0:08:38.559 --> 0:08:43.000 add in are estrogen and progestin. Let's start with estrogen. 0:08:43.160 --> 0:08:46.360 This is something that's pretty cyclical. It follows the menstrual cycle. 0:08:46.600 --> 0:08:49.600 Estrogen thickens the lining of your uterus. That's saying, hey, 0:08:49.679 --> 0:08:52.440 get thick there's an egg that might get fertilized and 0:08:52.440 --> 0:08:55.080 it needs to be implanted into the side of here, right. 0:08:55.559 --> 0:09:00.640 It's trying to make that environment right for the fertilization, Yes, 0:09:00.960 --> 0:09:03.360 the fertilization right, okay. 0:09:03.120 --> 0:09:06.480 Right, And so hormonal birth control can prevent pregnancy by 0:09:06.600 --> 0:09:11.080 preventing ovulation. And that's just simply humpty dumpty coming tumbling down. 0:09:11.320 --> 0:09:15.480 That's an egg tumbling down through the uterus. Right, and 0:09:15.559 --> 0:09:18.760 so you can prevent ovulation or you can say, all right, 0:09:18.840 --> 0:09:21.760 in the cervix. You know, if we're thinking about what 0:09:22.000 --> 0:09:25.520 reproduction is, what fertilization of an egg is, You're gonna 0:09:25.559 --> 0:09:27.920 have to have sperm that can move through the mucus 0:09:27.960 --> 0:09:31.080 on the cervix to fertilize an egg. So if you 0:09:31.160 --> 0:09:34.920 make that mucus very thick, the sperm can't move through, right, 0:09:34.920 --> 0:09:37.400 and so it's not able to enter the uterus, and 0:09:37.559 --> 0:09:39.000 it's not able to fertilize the egg. 0:09:39.080 --> 0:09:40.840 It's like quicksand for the sperm. 0:09:41.000 --> 0:09:43.400 Yeah, the sperm is just not strong enough. Or another 0:09:43.440 --> 0:09:46.240 way is to thin the lining of the uterus to 0:09:46.320 --> 0:09:49.800 prevent the egg from even attaching to it. So slipping 0:09:49.840 --> 0:09:53.480 slide records no egg attaching to the uterine lining, right, 0:09:54.640 --> 0:09:55.800 if you want to remember it. 0:09:56.400 --> 0:09:57.520 Those are different ways. 0:09:57.559 --> 0:10:03.080 Okay, that was a beautiful breakdown of how all this works. 0:10:07.960 --> 0:10:11.360 Doctor Russeau also mentioned the copper iud, which is a 0:10:11.400 --> 0:10:13.400 non hormonal type of birth control. 0:10:13.520 --> 0:10:14.760 So how does that method. 0:10:14.480 --> 0:10:18.439 Work that one releases copper ions into the uterus and 0:10:18.559 --> 0:10:23.200 makes it inhospitable for sperm and can potentially also prevent 0:10:23.440 --> 0:10:24.760 implantation of the egg. 0:10:24.880 --> 0:10:27.040 So, like we said before, there are so many types 0:10:27.080 --> 0:10:29.720 of birth control. The pill, the patch, the shot, the implant. 0:10:29.760 --> 0:10:32.040 Those are all hormonal types of birth control. 0:10:32.160 --> 0:10:35.880 Non hormonal types include the copper ud using condoms in 0:10:35.920 --> 0:10:39.200 the Fertility Awareness method also known as FAM, or the 0:10:39.320 --> 0:10:43.160 rhythm method. This involves tracking changes during the menstrual cycle 0:10:43.240 --> 0:10:45.599 to predict when you ovulate. 0:10:45.240 --> 0:10:47.959 And the ways to use the different methods also vary, 0:10:48.120 --> 0:10:50.240 so for the pill you take it daily at the 0:10:50.240 --> 0:10:53.199 same time every day, whereas with the patch that's every 0:10:53.280 --> 0:10:54.640 week you're applying a new patch. 0:10:54.920 --> 0:10:58.480 So birth control has proved to be extremely effective at 0:10:58.520 --> 0:11:02.520 preventing the fertilization or implantation of an egg in the uterus, 0:11:02.640 --> 0:11:06.359 but it also has some reproductive health benefits beyond preventing pregnancy. 0:11:06.559 --> 0:11:08.240 I think the point we really need to make clear 0:11:08.559 --> 0:11:11.400 is that just having a uterus makes you susceptible to 0:11:11.520 --> 0:11:12.840 all kinds of things. 0:11:12.840 --> 0:11:19.000 Yes, like uterine fibroids, pcos PMDD, endometriosis. 0:11:19.280 --> 0:11:21.280 Yes, And so I think it's easy to think of 0:11:21.280 --> 0:11:24.800 birth control as just providing agency about when you will 0:11:25.080 --> 0:11:28.360 or will not have a fertilized egg, but it's also 0:11:28.480 --> 0:11:31.080 medicine for those other conditions that come along with having 0:11:31.080 --> 0:11:31.680 a uterus. 0:11:31.840 --> 0:11:32.040 Right. 0:11:32.160 --> 0:11:35.840 Birth control can't cure these issues, but they do help 0:11:35.920 --> 0:11:38.480 alleviate some of the symptoms that come with them. 0:11:38.800 --> 0:11:43.280 It's also used as medicine to treat chronic reproductive disorders 0:11:43.320 --> 0:11:48.600 in women, everything from menstrual cramps to fibroids to pcos. 0:11:48.760 --> 0:11:51.120 Yeah, I've known people who are having issues with their period. 0:11:51.240 --> 0:11:54.120 I knew someone that had their period consistently for like 0:11:54.200 --> 0:11:58.880 six months, and so the prescribed medication to help regulate 0:11:58.920 --> 0:12:02.199 it was birth control, And they had to go kind 0:12:02.240 --> 0:12:04.760 of like back and forth with their doctors trying to 0:12:04.760 --> 0:12:07.720 figure out the right dosage and things like that. But 0:12:07.760 --> 0:12:10.160 eventually they got to a solution, which they were really 0:12:10.200 --> 0:12:10.800 happy about. 0:12:10.960 --> 0:12:12.960 I'm glad it worked out for them. There has been 0:12:13.080 --> 0:12:16.880 so much conversation about fibroids, and these are not just 0:12:17.080 --> 0:12:20.440 one off issues, right. So uterine fibroids, which are like 0:12:20.520 --> 0:12:23.800 growths on the uterus. By the age of fifty, almost 0:12:23.840 --> 0:12:27.719 two thirds of all women will have experienced uterine fibroids. 0:12:28.040 --> 0:12:28.240 Right. 0:12:28.440 --> 0:12:31.400 And then, even when we know how many women are 0:12:31.760 --> 0:12:35.680 going to have fibroids, there are still disparities within those groups. 0:12:35.720 --> 0:12:38.920 So for black women, between the age of eighteen and thirty, 0:12:39.040 --> 0:12:42.439 about a quarter of them will experience uterine fibroids, compared 0:12:42.480 --> 0:12:45.200 to six percent of white women in that same age range. 0:12:45.280 --> 0:12:48.720 And then PCOS, which is polycystic ovarian syndrome. 0:12:48.960 --> 0:12:51.719 That's a condition where your ovaries produce. 0:12:51.440 --> 0:12:55.920 An abnormal amount of androgens, which is male sex hormones 0:12:56.120 --> 0:12:59.400 that are usually present in women in only small amounts. 0:13:00.120 --> 0:13:03.480 Having more of those hormones, it starts to produce little 0:13:03.559 --> 0:13:05.000 cysts on your ovaries. 0:13:05.200 --> 0:13:09.000 And so endometriosis something that we often hear about and 0:13:09.040 --> 0:13:11.800 the difficulties related to this. When you're pregnant, that's when 0:13:11.840 --> 0:13:15.319 that uterine lining that we talked about earlier grows outside 0:13:15.720 --> 0:13:18.440 of the uterus. Oh my gosh, okay, and so that 0:13:18.480 --> 0:13:19.600 can be really painful. 0:13:19.840 --> 0:13:25.240 And then PMDD is pre menstrual dysphork disorder and it's 0:13:25.280 --> 0:13:28.840 a lot more severe than what we call PMS. 0:13:29.160 --> 0:13:31.600 So now that we have a solid understanding of first 0:13:31.720 --> 0:13:35.319 how birth control works, second the different types of birth control, 0:13:35.360 --> 0:13:38.800 and third the additional health benefits of birth control, let's 0:13:38.800 --> 0:13:42.000 talk about how you actually get it, how is it prescribed? 0:13:42.400 --> 0:13:45.200 So first things first, how many different brands or versions 0:13:45.240 --> 0:13:47.480 of birth control do you think are currently on the market? 0:13:47.480 --> 0:13:53.880 TT okay, I feel like there's probably more than I think, 0:13:54.160 --> 0:13:56.719 maybe more than fifty, but less than a thousand. I'm 0:13:56.760 --> 0:13:59.960 just gonna give a wide range. I like that very easy, 0:14:01.000 --> 0:14:01.400 Thank you. 0:14:01.640 --> 0:14:03.640 Yes, I mean it's hard when you really think about it, 0:14:03.640 --> 0:14:05.920 because it feels like there's a lot of different categories 0:14:05.960 --> 0:14:07.880 and it has to be more than one brand in 0:14:07.960 --> 0:14:09.439 each of those categories, right. 0:14:09.320 --> 0:14:11.800 Yeah, Because you know, when you go into any drug store, 0:14:11.920 --> 0:14:15.040 you got talent all, then you got ibuprofen, and then 0:14:15.040 --> 0:14:17.560 you got the CVS brand, you got this other brand 0:14:17.600 --> 0:14:20.520 and children's brand, all these different types of things. So 0:14:20.520 --> 0:14:21.960 I'm like, is birth control like that? 0:14:22.080 --> 0:14:22.160 All? 0:14:22.240 --> 0:14:22.400 Right? 0:14:22.440 --> 0:14:23.880 So how many are there on the market. 0:14:24.040 --> 0:14:27.240 It's one hundred and eighty one, so the vast majority 0:14:27.280 --> 0:14:30.040 of those are in the category of pill. But even 0:14:30.080 --> 0:14:33.440 within pill, there's multiple different kinds. So for example, some 0:14:33.600 --> 0:14:37.280 have both estrogen and progestines and some are progestin only 0:14:37.400 --> 0:14:38.840 or commonly called the mini pill. 0:14:39.120 --> 0:14:40.920 I feel like your guess was good. 0:14:41.840 --> 0:14:43.920 It definitely fell within the range that I had said. 0:14:44.000 --> 0:14:44.480 Thank you. 0:14:44.560 --> 0:14:46.720 I appreciate that, and you're right, I mean, it's not 0:14:46.800 --> 0:14:49.560 quite a set of menifit, but birth control that includes 0:14:49.600 --> 0:14:51.840 you know, brand names as well as the generic options 0:14:51.840 --> 0:14:53.160 too that might be more affordable. 0:14:53.320 --> 0:14:56.120 Yeah, and the mini pill, which is progestin only, is 0:14:56.160 --> 0:14:59.160 typically given the people who are breastfeeding or at risk 0:14:59.240 --> 0:15:01.920 for blood clot And all of these methods have different 0:15:02.000 --> 0:15:06.040 levels of effectiveness. After abstinence and sterilization, the implants and 0:15:06.080 --> 0:15:09.960 id's are the most effective methods of birth control, all 0:15:10.000 --> 0:15:12.640 about ninety nine percent effective or better. 0:15:12.760 --> 0:15:15.000 And that makes sense because both of those have a 0:15:15.040 --> 0:15:17.360 lot less room for human error. Once it's in, it's 0:15:17.360 --> 0:15:20.400 in well for the most part. Methods like the pill 0:15:20.480 --> 0:15:23.840 of the patch. Now that's going to require you to 0:15:23.880 --> 0:15:27.120 stick to a regular schedule and to always remember to 0:15:27.240 --> 0:15:29.520 take whatever your method is or to apply your method, 0:15:29.560 --> 0:15:31.960 and that is way more susceptible to human error. 0:15:32.040 --> 0:15:33.800 There is one time I forgot to put my own 0:15:33.840 --> 0:15:36.880 shoes on when I was leaving my apartment in grad school, 0:15:37.160 --> 0:15:40.000 and I didn't realize until I turned on my car 0:15:40.120 --> 0:15:41.560 and stepped on the break. 0:15:41.640 --> 0:15:43.920 You put your foot to the pedal because. 0:15:43.720 --> 0:15:47.040 It's like, this does not feel right, hm, So you 0:15:47.080 --> 0:15:49.040 already know things are getting for god Ton. 0:15:49.240 --> 0:15:51.320 So that gets us to the question of which method 0:15:51.400 --> 0:15:51.800 is best? 0:15:52.000 --> 0:15:54.880 For real, the best method is one that fits your lifestyle, right, 0:15:54.920 --> 0:15:57.040 But I don't know if doctors are asking those specific 0:15:57.080 --> 0:15:58.720 lifestyle questions like are. 0:15:58.640 --> 0:15:59.640 You a forgetful person? 0:16:00.560 --> 0:16:00.800 Right? 0:16:00.880 --> 0:16:02.680 Have you ever gotten to your car without your shoes? 0:16:02.960 --> 0:16:03.640 You know what I mean? 0:16:03.720 --> 0:16:08.560 Because that is crazy levels of forgetfulness to me, right, yeah, 0:16:08.760 --> 0:16:10.880 and something that even if you are forgetful person, you 0:16:10.960 --> 0:16:12.600 might not even consider it because it's your day to. 0:16:12.600 --> 0:16:14.560 Day life that might not feel forgetful to you. 0:16:14.640 --> 0:16:17.440 I mean, yes, no shoes, but like oh man, where 0:16:17.440 --> 0:16:18.920 you're having to say like did I turn off the stove? 0:16:18.960 --> 0:16:19.680 Did I turn off to this? 0:16:19.760 --> 0:16:20.440 You know? Right? 0:16:20.480 --> 0:16:23.080 And maybe taking something every day and you set your 0:16:23.120 --> 0:16:25.400 alarm on your phone and it's easy for you and 0:16:25.440 --> 0:16:27.600 so it's no problem at all. But some people want 0:16:27.640 --> 0:16:29.640 to be able to take breaks, like with the pill 0:16:29.800 --> 0:16:30.440 and the patch. 0:16:30.720 --> 0:16:32.360 Yeah, that makes complete sense. 0:16:32.520 --> 0:16:35.520 Some people might be sensitive to hormonal changes, so they 0:16:35.640 --> 0:16:39.080 don't want to opt for birth control that will change 0:16:39.080 --> 0:16:41.720 their homeowned levels, so then they opt for you know, 0:16:41.760 --> 0:16:44.800 things like condoms, the rhythm method or the copper UD. 0:16:45.280 --> 0:16:47.320 So when you consider all this stuff, there's so many 0:16:47.360 --> 0:16:49.800 options to pick from. One hundred and eighty one different ones. 0:16:49.840 --> 0:16:50.280 It seems. 0:16:50.680 --> 0:16:54.040 How are doctors deciding who gets which type of birth control? 0:16:54.120 --> 0:16:55.400 It's complicated, right. 0:16:55.560 --> 0:16:59.200 The average contraceptive counseling appointment in the US is thirteen 0:16:59.280 --> 0:17:04.080 minutes thirteen minutes, and so doctors kind of prescribe based 0:17:04.119 --> 0:17:07.040 on what they're comfortable with, what they've seen work in 0:17:07.080 --> 0:17:09.560 their practice, and anecdotally a lot of them are like, 0:17:09.600 --> 0:17:11.280 you know, I kind of have a couple favors. I 0:17:11.359 --> 0:17:13.880 start with those. If they don't work, we go back 0:17:13.880 --> 0:17:16.639 to it. And so this creates this process of women 0:17:16.720 --> 0:17:20.840 and their doctors going through potentially years of trial and error. 0:17:20.920 --> 0:17:24.080 The majority of women try for or more methods, with 0:17:24.160 --> 0:17:27.200 the main reason that they quit being unwanted side effects. 0:17:27.320 --> 0:17:30.280 So you heard that, right, Years years just to figure 0:17:30.280 --> 0:17:33.159 out the right birth control. A lot can happen in 0:17:33.240 --> 0:17:36.000 a year, and imagine having to go through that. 0:17:36.000 --> 0:17:37.440 That's so frustrating. 0:17:37.840 --> 0:17:41.200 Certain ones have different pros and cons right, Like, some 0:17:41.280 --> 0:17:44.800 of them are also known to and have FDA approval 0:17:44.840 --> 0:17:47.600 for being used in the treatment of acne. Some are 0:17:47.680 --> 0:17:51.840 great at managing heavy menstrual bleeding, and others aren't. If 0:17:51.880 --> 0:17:53.840 a patient comes in with like a this is my 0:17:53.960 --> 0:17:58.040 main complaint or issue or concern on top of preventing pregnancy. 0:17:58.520 --> 0:18:01.119 Then yes, doctors kind of know which of the bins 0:18:01.160 --> 0:18:01.919 to pull from. 0:18:02.000 --> 0:18:05.919 Doctor Russeau told us about the US Medical Eligibility Criteria 0:18:06.040 --> 0:18:09.320 or US MECH for contraceptive Use, which lists out some 0:18:09.480 --> 0:18:12.480 dangerous combinations of birth control and patient criteria. 0:18:12.720 --> 0:18:15.160 So, for example, if you're a smoker over thirty five, 0:18:15.359 --> 0:18:18.719 you should avoid combined oral contraceptives because they increase your 0:18:18.800 --> 0:18:21.240 risk of blood clot and stroke things like that. 0:18:21.440 --> 0:18:23.680 But even with that said, it's really a crapshoot and 0:18:23.720 --> 0:18:27.720 there's no way to predict the possibility of unwanted side effects. 0:18:27.920 --> 0:18:30.120 Yeah, cause, I mean I feel like most people are 0:18:30.160 --> 0:18:32.160 walking into the doctor and just saying, hey, I need 0:18:32.200 --> 0:18:34.919 birth control, and you might not even necessarily know to 0:18:35.080 --> 0:18:38.640 think about some other things that might affect your reaction 0:18:38.880 --> 0:18:41.399 to a certain type of birth control. I know I didn't. 0:18:41.440 --> 0:18:43.399 I just said, hey, looking for the birth control. You 0:18:43.440 --> 0:18:44.040 got some here. 0:18:44.119 --> 0:18:47.520 So when we talk about these side effects, they really 0:18:47.920 --> 0:18:51.000 span the total range of something that feels inconvenient like 0:18:51.000 --> 0:18:55.159 a headache or nausea, to full blown migraines, changes in 0:18:55.240 --> 0:18:58.399 period weight gain, changes in your mood, or sex drive, 0:18:59.040 --> 0:19:02.920 blood clots, high blood pressure. I mean the list goes on, right, 0:19:03.080 --> 0:19:05.280 even when you look at when there's a birth control 0:19:05.280 --> 0:19:07.159 commercial at the end, when you know, when the person's 0:19:07.160 --> 0:19:08.440 talking off fast and they're telling you all the side 0:19:08.440 --> 0:19:09.880 of us, so you're staying in the really you can't 0:19:09.920 --> 0:19:11.680