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Plan B: also known as “the morning-after pill” and “emergency contraception (EC)”

New legislation in California now allows women (and men) over the age of 18 to obtain EC without a prescription. Below is information on what EC is and where you can get it at and around Stanford.

EC helps prevent pregnancy after unprotected vaginal intercourse. It may be that the condom broke, you didn’t use birth control, or you were forced to have sex. Plan B is a form of EC that is now available to adults without a prescription. EC is should be used as an emergency method, rather than as a main method of birth control: this is because it contains a high dose of hormone, and it is not as effective as other hormonal methods of birth control such as the pill, the patch, or Nuva Ring.

EC works in two ways: It can keep the ovary from releasing an egg, and/or it can thicken the cervical mucus to prevent sperm from reaching the egg. In theory, it could prevent a fertilized egg from attaching to the lining of the uterus, but this has not been proven.

It is recommended that you take Plan B as soon as possible after unprotected intercourse. The sooner you take it, the more likely that it will prevent pregnancy. EC can reduce the risk of pregnancy by 75-89% if started within the first 72 hours after intercourse. It reduces the risk of pregnancy if taken up to 120 hours – five days –after unprotected intercourse.

Plan B WILL NOT end a pregnancy. If you are pregnant, or if you become pregnant after taking EC, there is no evidence that it will harm the pregnancy.

Women who take EC do not seem to have the (rare, but serious) risks associated with regular birth control pills. Side effects can include:

• Dizziness, headaches, breast tenderness
• Nausea
• Vomiting (rare)
• Bleeding between periods (rare)

Taking EC can affect your next period. It could be early or late, lighter or heavier, shorter or longer. You’re more likely to have problems with your next period if you use EC more than once during your cycle.

Where it’s available:

→ AT VADEN:
• Anyone (male or female), 18 years or older, can obtain EC at Vaden
• A government issued ID (i.e. driver’s license) is required to verify proof of age
• Women under 18 can still receive Plan B by making an appointment with a nurse
• After hours, a prescription can be phoned in by the Doctor on Call, to an outside pharmacy
• The cost ranges from $30-$40.

→ AT PLANNED PARENTHOOD:
• Women (18 years or older) with valid ID can obtain EC at Planned Parenthood for free if they sign up for a state-funded program
•Women (18 years or older) can also buy EC for $40 at Planned Parenthood

→ OUTSIDE PHARMACIES:
• Different pharmacies have policies on EC that vary: Longs, Rite Aid and Walgreens all carry EC, and women who want to buy it may or may not be required to speak to a pharmacist/clinician before receiving it.
• It costs approximately $40 at outside pharmacies.

Gardasil: the HPV Vaccine

The HPV vaccine protects women against certain especially virulent strains of Human Papilloma Virus (HPV) that can cause genital warts and/or cervical cancer. Controversy surrounds the distribution of this vaccine, because some states are trying to pass legislation to make the vaccine mandatory for all girls under a certain age. To read more about this, visit the PBS website on the HPV vaccine controversy. All information about the vaccine (below) is taken from the Center for Disease Control’s website on the HPV vaccine.

  • Who should get the HPV Vaccine? The HPV vaccine is recommended for 11-12 year-old girls, and can be given to girls as young as 9. The vaccine is also recommended for 13-26 year-old girls/women who have not yet received or completed the vaccine series.
    These recommendations have been proposed by the ACIP—a national group of experts that advises the Centers for Disease Control and Prevention (CDC) on vaccine issues. These recommendations are now being considered by CDC.
  • Why is the HPV vaccine recommended for such young girls? Ideally, females should get the vaccine before they are sexually active. This is because the vaccine is most effective in girls/women who have not yet acquired any of the four HPV types covered by the vaccine. Girls/women who have not been infected with any of those four HPV types will get the full benefits of the vaccine.
  • Will sexually active females benefit from the vaccine? Females who are sexually active may also benefit from the vaccine. But they may get less benefit from the vaccine since they may have already acquired one or more HPV type(s) covered by the vaccine. Few young women are infected with all four of these HPV types. So they would still get protection from those types they have not acquired. Currently, there is no test available to tell if a girl/woman has had any or all of these four HPV types.
    Why is the HPV vaccine only recommended for girls/women ages 9 to 26? The vaccine has been widely tested in 9-to-26 year-old girls/women. But research on the vaccine’s safety and efficacy has only recently begun with women older than 26 years of age. The FDA will consider licensing the vaccine for these women when there is research to show that it is safe and effective for them.
  • What about vaccinating boys? We do not yet know if the vaccine is effective in boys or men. It is possible that vaccinating males will have health benefits for them by preventing genital warts and rare cancers, such as penile and anal cancer. It is also possible that vaccinating boys/men will have indirect health benefits for girls/women. Studies are now being done to find out if the vaccine works to prevent HPV infection and disease in males. When more information is available, this vaccine may be licensed and recommended for boys/men as well.
  • Should pregnant women get the vaccine? The vaccine is not recommended for pregnant women. There has been limited research looking at vaccine safety for pregnant women and their unborn babies. So far, studies suggest that the vaccine has not caused health problems during pregnancy, nor has it caused health problems for the infant– but more research is still needed. For now, pregnant women should complete their pregnancy before getting the vaccine. If a woman finds out she is pregnant after she has started getting the vaccine series, she should complete her pregnancy before finishing the three-dose series.
  • What is the efficacy of the HPV vaccine? Studies have found the vaccine to be almost 100% effective in preventing diseases caused by the four HPV types covered by the vaccine–including precancers of the cervix, vulva and vagina, and genital warts. The vaccine has mainly been studied in young women who had not been exposed to any of the four HPV types in the vaccine.
    The vaccine was less effective in young women who had already been exposed to one of the HPV types covered by the vaccine.
    This vaccine does not treat existing HPV infections, genital warts, precancers or cancers.
  • How long does vaccine protection last? Will a booster shot be needed? The length of vaccine protection (immunity) is usually not known when a vaccine is first introduced. So far, studies have followed women for five years and found that women are still protected. More research is being done to find out how long protection will last, and if a booster vaccine is needed years later.
  • What does the vaccine not protect against? Because the vaccine does not protect against all types of HPV, it will not prevent all cases of cervical cancer or genital warts. About 30% of cervical cancers will not be prevented by the vaccine, so it will be important for women to continue getting screened for cervical cancer (regular Pap tests). Also, the vaccine does not prevent about 10% of genital warts—nor will it prevent other sexually transmitted infections (STIs). So it will still be important for sexually active adults to reduce exposure to HPV and other STIs.
  • Will girls/women be protected against HPV and related diseases, even if they don’t get all three doses? It is not yet known how much protection girls/women would get from receiving only one or two doses of the vaccine. For this reason, it is very important that girls/women get all three doses of the vaccine.
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