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26/10/2023

Erica Diebold tells the story of her relationship with chronic migraine.

26/10/2023

Nadine Dirks shares her experience of avoidant restrictive eating food disorder in relation to attention deficit hyperactivity disorder.

26/10/2023

Caring for a parent who has bipolar disorder: How I learned to prioritize my own mental health
I have always known deep down that my mother has a serious mental illness. But I only found out about 15 years ago that my mother had been diagnosed with bipolar disorder.

Medically reviewed by Janet Brito, Ph.D., LCSW, CST — By Stephanie Smith on August 17, 2022
In our Through My Eyes series, we provide a platform for people to share how a particular medical condition has affected their life. By shining a spotlight on the physical and emotional, this series aims to raise awareness while providing practical advice and support to any readers who may be experiencing something similar.
Design by Medical News Today; photograph by lechatnoir/Getty Images
I did not know much about bipolar disorder at the time, but it was easy for me to accept that she had a serious mental illness that had been undiagnosed until then. Throughout my childhood, I remember witnessing my mother’s extreme depressive episodes and periods of mania.

During depressive episodes, I would see her crying into a bath towel. She had scars on her wrists from a su***de attempt in high school. When I was little, she told me they were from flea bites.

When she was manic, my mom would insist we move. When I was a teenager, we made the move from a comfortable house in the suburbs to a developing country.

Becoming my mom’s primary caregiver
While abroad, my mother started to have trouble with her physical health. She became bedridden and needed help with most tasks. My father was around, but he coped by becoming very detached.

I was a teen at the time, and I became her primary caregiver for most of the next 4 years. I took over day-to-day responsibilities, including cooking for the family and helping my mother get dressed and use the bathroom.

I endured the responsibility of caring for my family until I went to college.

At this point, it started to become clear to medical professionals that my mother had a mental health condition. They just were not clear on the exact diagnosis. During one inpatient stay, a doctor who suspected dissociative identity disorder told my mother she had reintegrated her personalities on her own. But eventually, the diagnosis of bipolar disorder came about.

Navigating parenting and caregiving
After college, I moved, and there was physical distance between myself and my parents for a while. However, within the last decade, my parents moved nearby, and I started taking on more caregiving responsibilities again.

Shortly after my parents moved, I lost my job. Even though I was also caring for my own children, I had a little more time on my hands. So, at this point, I became more heavily involved in caring for my mother.

I did my best to be a dutiful caregiver. Around this time, my mother needed several surgeries. She required months of IV antibiotics that I learned to administer.

But my mother constantly pointed out all of my shortcomings. My parents began to undermine my ability to parent my children. They constantly compared me with my sister, which seriously damaged my relationship with my sister, as well. This was when caregiving really started taking a toll on my mental health.

MORE IN THROUGH MY EYES
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By Britt Gambino
Through My Eyes: Stem cell donation
By James McIntosh
Through My Eyes: ADHD and avoidant restrictive eating
By Nadine Dirks
Setting and reinforcing boundaries to preserve my mental health
I started feeling burned out, unappreciated, and frustrated as my mother kept undermining my parenting decisions. I set boundaries and tried my best to reinforce them with my mother. I was hoping that would help preserve our relationship, my relationship with my own children, and my own mental health.

But my mother continued to disrespect these boundaries. After serious thought, I ended up cutting ties with both of my parents.

I wanted to help care for my mom. I wanted to be close to my parents. They are lovely people in so many ways. But my mom crossed such a big line in actively undermining my parenting decisions, which affected my relationship with my children. And that was the last straw for me.

Today, I still do not have contact with my mother. Even years later, thinking about it all still feels painful and shameful.

It is hard to share my story, but if even one person reads this and finds it helpful, I feel it was worth it.

THROUGH MY EYES
You’re not alone
According to the National Alliance for Caregiving and AARP Public Policy Institute, 2 in 10 caregivers feel alone in their caregiving journey. Educating yourself about preventing caregiver burnout and connecting with others who understand what you are going through can help you prioritize your own mental health and feel less alone.

Try joining a support group or searching for other areas of support through organizations, such as:

Depression and Bipolar Support Alliance
National Alliance on Mental Illness
National Institute on AgingTrusted Source
Centers for Medicare & Medicaid Services
Eldercare locator

26/10/2023

Through My Eyes: Stem cell donation
After being on a list of potential donors for 12 years or so, this past month saw me finally have the opportunity to give away some of my stem cells. The opportunity to experience first-hand a procedure I have read, written, and edited articles on at Medical News Today.

By James McIntosh on October 12, 2022
In our Through My Eyes series, we provide a platform for people to share how a particular medical condition has affected their life. By shining a spotlight on the physical and emotional, this series aims to raise awareness while providing practical advice and support to any readers who may be experiencing something similar.
Design by Medical News Today; photograph courtesy James McIntosh.
On paper, stem cell donation can sound a bit intimidating.

While donating blood may be easy to visualize, stem cells feel more abstract. The name conjures images of microscopes, laboratories, and horribly invasive procedures.

I am happy to report that there was nothing horrible about my experience at all! And while it was not exactly a walk in the park — more a run in a wood — it is something that I would encourage folks to consider if they are able to do so.

Joining the register
I can’t remember exactly when it was that I signed up on the stem cell register but 12 years ago feels about right.

At the time, I was working at a local hospital booking day surgery appointments for people. One day, some people from the charity came in to try and sign National Health Service employees and medical students up. It seemed like the thing to do at the time, and so my name was added to the register, joining over 800,000 others.

The charity in question was the British organization Anthony Nolan. They work to provide stem cells and bone marrow donations to patients with forms of blood cancer or blood disorders. The charity also supports research into new treatments for other conditions.

Why are stem cells so important?
To call stem cells “useful” would be doing them a disservice.

Stem cells are cells that do not yet have a specific role within the body. When they divide, they have the potential to develop into cells with a specific function. This process is known as differentiation. Each of the many different specialized cells of the adult human body were stem cells, to begin with.

Doctors and scientists can use stem cells to help treat certain conditions. Skin stem cells can aid with tissue regeneration to treat skin damage, and blood stem cells can form a crucial part of treatment for blood diseases such as leukemia.

Not only that, but researchers can also use stem cells in studies to either find out the causes of certain diseases or to develop new drug treatments for conditions.

Screening and preparation
A few months ago, I received a phone call asking if I would be interested in donating some cells to be used in a study.

With my consent given over the phone, it was time for me to move into uncharted territory.

The possibility of donating stem cells had always just been that: a possibility, a thought, an idea.

Certainly nothing as concrete or tangible as a trip up from Brighton to London for a health check.

Clinical staff provided more detailed information about what was coming so that I could provide written consent. Questions were asked to assess my likelihood of carrying any bloodborne diseases. Blood and urine samples were taken, my body mass index (BMI) was measured, and a COVID-19 test was carried out.

A common experience for people who work with health information articles is to feel as though you are developing whatever condition you have most recently written about. This can be useful from time to time.

I had an irregular-looking mole removed after working on a melanoma article, for instance. However, it can also leave you fearing the worst when all you have done is perhaps eaten too much beetroot.

This neuroticism made waiting for my health check results a slightly nervous affair. Thankfully, I was happy to discover that everything was okay. My fears of gross malnourishment due to a disorganized vegan diet proved to be completely unfounded.

I was on to the next stage of my donation journey. The hospital was ready and prepared to have me in to donate my stem cells. I now needed to prepare my body for the process.

Learning a new skill: G-CSF injections
From here on out, there will be quite a bit about injections and needles! If you want to avoid this and skip to the end, you can click on this link.

To improve the chances of collecting a good amount of stem cells, donors take a series of injections in the days running up to the collection date. The injections contain a protein called granulocyte colony stimulating factor (G-CSF), which helps boost levels of stem cells in the bloodstream.

I had never injected anything before. I am typically quite happy to receive injections — my COVID-19 vaccinations were wonderful — but being the person to push down on the syringe was quite a daunting prospect.

Thankfully a nurse walked me through the first day of injecting. They explained that I would need to inject two separate doses of G-CSF into either my thigh or belly once a day for 4 days, alternating between the two areas so as not to cause them to ache too much.

The process involved pinching flesh from the thigh or belly and injecting into that. When I was able to grab a good chunk, pushing down with the needle was a fairly simple task. At these times I could barely perceive it piercing my skin.

Once I had fully depressed the syringe, there was a click. Releasing my grip at this point would cause the needle to automatically retract, ready for disposal in the sharps bin the nurse had provided. All that was left was for me to do this one more time and that would be my injecting for the day.

I soon grew used to this new addition to my lunchtime routine. Stop work. Inject myself twice. Have a sandwich. Do some laundry. Return to work.

The only adverse effects were some slight body aches, particularly in my lower back, and a general feeling of being run down. These are typical for G-CSF injections.

Collecting stem cells and Pokémon
I reported to the hospital and was admitted to the apheresis unit at 2 p.m. for the “harvesting” of my stem cells. This term made it sound as though the procedure was going to be a brutal process straight out of a dystopian science fiction story. This was not the case!

After being assigned a bed and doing some preliminary checks, a nurse began to set things up.

All the heavy lifting was going to be done by a cell-separating machine. The nurse inserted a needle into a vein in my left arm from which my blood was drawn into the machine. The machine then separated the blood into its separate components: red blood cells, white blood cells, plasma, and platelets.

Once the blood was separated, the parts containing my precious stem cells were taken away, leaving the rest of the blood to return to me. The nurse inserted another needle into a vein in my right arm, and the blood was able to rejoin my bloodstream here from the machine.

After this had been set up, all that was left to do was wait while the machine did its thing with my blood. My left arm had to remain stationary, although I was permitted to squeeze a stress ball to aid circulation.

My right arm was free, however, to play Pokémon on my phone, turn the pages of my book, or struggle with eating the soup and rice pudding that came with my lunch.

From time to time, I would look over at the machine. I could see the tubes carrying blood into this strange device with its turning wheels and rhythmic humming. It really was like something out of a science fiction story, only tempered with the mundanity of waiting in a queue at the post office to send a parcel.

Overall, there was nowhere near the level of discomfort that the name “harvesting” had suggested. The sites on my arms where the needles went in were a bit sore and provided a dull ache throughout the procedure. My left forearm also felt as though I had been sitting on it at certain times, but a few squeezes of the stress ball soon sorted this out.

The other main side effect I experienced was a tingling sensation around my mouth. This is a fairly typical symptom of the blood thinner that the machine uses during the process to prevent the blood from clotting.

When this occurred, the nurse provided me with a calcium tablet, and within a few minutes, the symptom was gone.

I lay on the bed hooked up to the machine for 2 and a half hours in total. During that time, I caught many Pokémon, made great progress reading my book, and just about managed to eat my lunch without making too much of a mess.

The ache in my arms was a constant presence, but overshadowed significantly by how difficult it was to transport soup from a bowl to my mouth.

Heading home
At 5 p.m., the nurse was ready to discharge me. The needles were removed from my arms and a bag full of my stem cells was labeled and packed up, ready to go off to a laboratory.

The nurse advised me to drink plenty of water and to take things easy for the next few days. I felt tired, a little short of energy or enthusiasm for anything, but otherwise could feel no ill effects of my afternoon in the hospital.

It is typical for people to experience bone aches for a few days after the procedure, along with tiredness. This was the same for me, too.

I was fine to return to work as normal the following day, and the only adjustment I made to my routine was to skip playing soccer for a week.

The doctor who had seen me for my health check had explained that my spleen would have shrunk during the procedure, and avoiding contact sports would allow it time to return to its usual size without harm. This may have been the first time in my life I have actively considered my spleen’s well-being.

The following week, with spleen presumably back to its original size, I was happy to return to all of my usual pastimes!

A straightforward process, would recommend
Whenever I told someone I was going to be donating stem cells, quite a few people seemed impressed. Their reactions suggested that the whole process would be a great ordeal with significant levels of discomfort.

Thankfully, donating the stem cells was an effortless process, and my experience is one that has been shared by many others. Several testimonies are available to read on the Anthony Nolan website, and all echo the sentiment that the process is largely straightforward and not too painful.

Stem cells are a vital part of treatment for several serious conditions while also showing a lot of potential in the development of new therapies for currently untreatable diseases. As a result, it is very important for there to be people willing to donate their stem cells. Many will be able to save lives by joining a donation register.

My hope is that this article makes stem cell donation seem less scary and more accessible. I would certainly recommend that folks consider it if they are able to. And if you are lucky enough to be asked to donate, get some practice eating with one arm beforehand.

24/10/2023

What to know about heart valves
What they are
Valve types
Linked conditions
Treatment
Summary
The four valves of the heart allow blood to flow through the heart in the right direction. The valves open or close each time the heart beats. Problems with the heart valves can lead to palpitations, chest pain, and other symptoms.

The four heart valves are:

the mitral valve
the aortic valve
the tricuspid valve
the pulmonic valve
Doctors call the mitral and tricuspid valves the atrioventricular valves, and the aortic and pulmonic valves the semilunar valves.

Keep reading to learn more about each of the four heart valves.

What are heart valves?
ilbusca/Getty Images
In a healthy heartTrusted Source, blood flows in only one direction. The valves close off parts of the heart, preventing the blood from flowing backward.

The process begins when oxygen-depleted blood (from the arms, legs, body, and head) enters the right atrium. This is the upper chamber on the right side of the heart and is the storage chamber.
The blood then flows through the tricuspid valve into the right ventricle, which is the lower right pumping chamber.
The ventricle pumps this blood through the pulmonary valve to the pulmonary artery, where it enters the lungs for oxygenation.
Oxygen-rich blood re-enters the heart through the left atrium, which is the upper left chamber.
It then flows through the mitral valve to the left ventricle, or the left pumping chamber.
Finally, it moves through the aortic valve and then through the aorta to the rest of the body.
The four heart valves
The four heart valvesTrusted Source all have a role in ensuring that the blood can only flow in one direction. The four heart valves are:

Tricuspid valve
The tricuspid valve is named because it has three flaps called cusps, or leaflets. Blood flows through this valve after leaving the right atrium. After passing through the tricuspid valve, blood flows to the right ventricle.

People with a rare disorderTrusted Source called tricuspid atresia are born without a tricuspid valve. Tricuspid atresia means that blood cannot flow from the right atrium to the right ventricle.

Tricuspid regurgitation means that this valve cannot fully close, while tricuspid stenosis causes the valve to thicken, narrowing its opening.

Pulmonic valve
The pulmonic, or pulmonary valve, is the next valve that deoxygenated blood flows through. It closes off the right ventricle and opens to allow the blood to flow to the lungs.

Stenosis of the pulmonary valve causes this valve to thicken with time, narrowing its opening and making blood flow more slowly.

Regurgitation prevents the valve from closing fully, causing blood to flow backward into the right ventricle.

A rare pulmonic valve disorderTrusted Source called pulmonary atresia means that a person is born without this valve.

Mitral valve
The mitral valve closes off the left atrium, allowing oxygenated blood from the lungs to flow through to the left ventricle.

One of the most common typesTrusted Source of mitral valve issues is mitral valve prolapse (MVP). This causes the leaflets of the mitral valve to fit together poorly or buckle backward, allowing blood to flow back to the left atrium.

Some connective tissue disorders may also damage the mitral valve, causing MVP.

Mitral valve prolapse can result in mitral valve regurgitation, which causes blood to flow backward. A heart attack or enlargement of the heart can cause the leaflets of the valve to spread apart, leading to mitral regurgitation.

Mitral valve stenosis hardens and thickens the walls of the mitral valve, narrowing the opening and causing blood to flow more slowly.

Aortic valve
The aortic valve is the final valve that oxygen-rich blood passes through before exiting the heart and coursing through the rest of the body. The valve prevents blood from flowing back to the left ventricle.

Aortic regurgitation, or aortic insufficiency, means that the aortic valve does not fully close, allowing blood to flow backward.

Aortic stenosis means that the aortic valve thickens or hardens, narrowing the path through which blood can flow. This delays or prevents adequate blood flow to the rest of the body.

Linked diseases and conditions
Heart valve problems fall into two broad categories:

Regurgitation
When the valve fails to close fully, the blood regurgitates backward. This can happen when the cardiac chambers enlarge. It may also occur when the two leaflets of the valve do not close fully, such as with mitral valve prolapse.

When the problem is with the valve, doctors call it primary valvular. When the problem occurs in the heart’s chambers, such as the ventricles, doctors call it secondary valvular.

Stenosis
Stenosis happens when the tissue of the valve thickens, limiting blood flow. This often occurs when calcium and other deposits accumulate on the leaflets of the valve.

The heart thickens with time, but the blood supply is not enough to sustain the heart. This can cause severe illness and even death.

Untreated heart valve problems may cause shortness of breath, especially on exertion. They are also a risk for heart failure, stroke, and sudden death.

A person may be born with a valve problem. Valve problems can also develop due to aging or damage from chronic illnesses, such as diabetes or other diseases, such as carcinoid disease.

Some unhealthful lifestyle choices, such as smoking, may also increase the risk of heart issues, including valve problems.

The symptoms of a heart valve problem are similar to symptoms of other heart diseases, and include:

dizziness or fainting
shortness of breath
heart palpitations, which happen when the heart skips a beat
chest pain
unexplained swelling in the body

24/10/2023

What to know about cardiac muscle tissue
Cardiac muscle tissue
Function
Structure
Cardiomyopathy
Tips for healthy tissue
Summary
Cardiac muscle tissue, or myocardium, is a specialized type of muscle tissue that forms the heart. This muscle tissue, which contracts and releases involuntarily, is responsible for keeping the heart pumping blood around the body.

The human body contains three different kinds of muscle tissue: skeletal, smooth, and cardiac. Only cardiac muscle tissue, comprising cells called myocytes, is present in the heart.

In this article, we discuss the structure and function of cardiac muscle tissue. We also cover medical conditions that can affect cardiac muscle tissue and tips for keeping it healthy.

What is cardiac muscle tissue?
TUMEGGY/SCIENCE PHOTO LIBRARY/Getty Images
Muscle is fibrous tissue that contracts to produce movement. There are three types of muscle tissue in the body: skeletal, smooth, and cardiac. Cardiac muscle is highly organized and contains many types of cell, including fibroblasts, smooth muscle cells, and cardiomyocytes.

Cardiac muscle only exists in the heart. It contains cardiac muscle cells, which perform highly coordinated actions that keep the heart pumping and blood circulating throughout the body.

Unlike skeletal muscle tissue, such as that which is present in the arms and legs, the movements that cardiac muscle tissue produces are involuntary. This means that they are automatic, and that a person cannot control them.

How does cardiac muscle tissue function?
The heart also contains specialized types of cardiac tissue containing “pacemaker” cells. These contract and expand in response to electrical impulses from the nervous system.

Pacemaker cells generate electrical impulses, or action potentials, that tell cardiac muscle cells to contract and relax. The pacemaker cells control heart rate and determine how fast the heart pumps blood.

How is it structured?
Cardiac muscle tissue gets its strength and flexibility from its interconnected cardiac muscle cells, or fibers.

Most cardiac muscle cells contain one nucleus, but some have two. The nucleus houses all of the cell’s genetic material.

Cardiac muscle cells also contain mitochondria, which many people call “the powerhouses of the cells.” These are organelles that convert oxygen and glucose into energy in the form of adenosine triphosphate (ATP).

Cardiac muscle cells appear striated or striped under a microscope. These stripes occur due to alternating filaments that comprise myosin and actin proteins. The dark stripes indicate thick filaments that comprise myosin proteins. The thin, lighter filaments contain actin.

When a cardiac muscle cell contracts, the myosin filament pulls the actin filaments toward each other, which causes the cell to shrink. The cell uses ATP to power this contraction.

A single myosin filament connects to two actin filaments on either side. This forms a single unit of muscle tissue, called a sarcomere.

Intercalated discs connect cardiac muscle cells. Gap junctions inside the intercalated discs relay electrical impulses from one cardiac muscle cell to another.

Desmosomes are other structures present within intercalated discs. These help hold cardiac muscle fibers together.

What conditions affect it
Cardiomyopathy refers to a group of medical conditions that affect cardiac muscle tissue and impair the heart’s ability to pump blood or relax normally.

Some common symptoms of cardiomyopathy includeTrusted Source:

difficulty breathing or shortness of breath
fatigue
swelling of the legs, ankles, and feet
inflammation in the abdomen or neck
irregular heartbeat
heart murmurs
dizziness or lightheadedness
Factors that can increase a person’s risk of cardiomyopathy includeTrusted Source:

diabetes
thyroid disease
coronary heart disease
heart attack
chronic high blood pressure
viral infections that affect the heart muscle
valvular disease of the heart
heavy alcohol consumption
a family history of cardiomyopathy
A heart attack due to a blocked artery can cut off the blood supply to certain areas of the heart. Eventually, the cardiac muscle tissue in these areas will start to die.

The death of cardiac muscle tissue can also occur when the heart’s oxygen demand exceeds the oxygen supply. This causes the release of cardiac proteins such as troponin into the bloodstream.

Read more about how raised troponin levels can indicate heart damage here.

Some examples of cardiomyopathy include:

Dilated cardiomyopathy
Dilated cardiomyopathy causes the cardiac muscle tissue of the left ventricle to stretch and the heart’s chambers to dilate.

Hypertrophic cardiomyopathy
Hypertrophic cardiomyopathy (HCM) is a genetic condition in which the cardiomyocytes are not arranged in a coordinated fashion and are instead disorganized. HCM can interrupt blood flow out of the ventricles, cause arrhythmias (abnormal electrical rhythms), or lead to congestive heart failure.

Restrictive cardiomyopathy
Restrictive cardiomyopathy (RCM) refers to when the walls of the ventricles become stiff. When this happens, the ventricles cannot relax enough to fill with an adequate amount of blood.

Arrhythmogenic right ventricular dysplasia
This rare form of cardiomyopathy causes fatty infiltration in cardiac muscle tissue in the right ventricle.

Transthyretin amyloid cardiomyopathy
Transthyretin amyloid cardiomyopathy (ATTR-CM) develops when amyloid proteins collect and form deposits in the walls of the left ventricle. The amyloid deposits cause the ventricle’s walls to stiffen, which prevents the ventricle from filling with blood and reduces its ability to pump blood out of the heart. This is a form of RCM.

Tips for healthy cardiac muscle tissue
Doing regular aerobic exercise can help strengthen the cardiac muscle tissue and keep the heart and lungs healthy.

Aerobic activities involve moving the large skeletal muscles, which causes a person to breathe faster and their heartbeat to quicken.

Doing these types of activities often can train the heart to become more efficient.

Some examples of aerobic exercises include:

22/10/2023

Where to get free or low cost birth control: What to know
Types
Factors in access
With insurance
Getting free birth control
Other options
Affordable online options
Calculating costs
Vasectomies
Seeing a doctor
FAQs
Summary
We include products we think are useful for our readers. If you buy through links on this page, we may earn a small commission Here’s our process.

How we vet brands and products

Health insurance may cover birth control and other s*xual health services. Some family planning clinics and public health offices may provide free or low cost options for those without insurance. Also, people with lower incomes may be eligible for reduced-cost birth control through programs such as Medicaid.

According to the Centers for Disease Control and PreventionTrusted Source (CDC), 65.3% of women ages 15–49 in the United States used birth control between 2017 and 2019.

The Affordable Care Act, informally known as Obamacare, requires most health insurance plans cover birth control and associated expenses, such as doctor’s visits.

There may be other ways to access free or low cost birth control for people without health insurance.

This article describes the different types of birth control, how to access free or low cost options, and when to see a doctor for advice.

Different types of birth control
There are many varieties of prescription and over-the-counter birth control, including:

barrier methods, such as condoms
s***micide
hormonal contraception
emergency contraception
intrauterine devices (IUDs) and other implanted devices
permanent sterilization
Anyone interested in hormonal methods of birth control may need to make an appointment with a healthcare professional for a prescription.

Learn more about the different types of birth control here.

Barrier methods
Barrier birth control methods include over-the-counter (OTC) products, such as condoms. The only types of barrier birth control that require a doctor’s visit are the diaphragm and the cervical cap.

Barrier methods are generally less effective than other forms of birth control. Failure rates for popular barrier methods range from 13%Trusted Source for condoms to 27%Trusted Source for the sponge. People who have been pregnant may find the sponge less effective than people who have never been pregnant.

IUDs
Intrauterine devices (IUDs) are T-shaped devices that a doctor inserts into the uterus. The devices may be nonhormonal and made from copper, or hormonal and made from plastic.

According to the CDCTrusted Source, a person can use the same IUD for 3–10 years, depending on the type. The CDC also reports that the failure rate for IUDs is less than 1%.

Other hormonal birth control methods
Other hormonal methods of birth control include:

Oral contraception: There are two main types of birth control pill; a combination pill containing estrogen and progestin, and a progestin-only pill. A person must take the pill at around the same time every day. The pills are around 93%Trusted Source effective if a person uses them exactly as instructed.
The patch: This adhesive patch contains a combination of hormones. A person applies it to their lower abdomen or buttocks and changes it once a week for 3 weeks of the month. In the 4th week, a person does not wear the patch so menstruation can occur. This method is 93%Trusted Source effective.
The ring: A person puts the ring into their va**na, then changes it once a week for 3 weeks of the month. This method is 93%Trusted Source effective.
The implant: The implant is a small, rod-shaped device that a healthcare professional inserts beneath the skin of the upper arm. A person undergoes this procedure in a doctor’s office. The implant releases hormones and is 99%Trusted Source effective for up to 3 years.
Birth control injections: A healthcare professional injects progestin into the upper arm or buttocks every 3 months. This method is 96%Trusted Source effective.
Emergency contraception
Emergency contraception is available in different forms. A person may use it if their primary birth control method fails or if they have had s*x without using contraception.

In the United States, emergency contraception is available as levonorgestrel (Plan B) and ulipristal (Ella). Both pills contain hormones. It is also available as the Paragard IUD. Some of these options are available without a prescription.

Learn about buying emergency contraception online.

Permanent birth control
Permanent birth control methods are surgical procedures that people sometimes call “sterilization.”

A person with female reproductive organs can have a tubal ligation, in which a surgeon ties, off, cauterizes, or removes the fallopian tubes.

A person with male reproductive organs can have a vasectomy, in which a surgeon blocks or cuts the vas deferens tubes that supply the semen with s***m.

Both male and female sterilization procedures have less than a 1%Trusted Source failure rate.

Factors that affect access to free birth control
Many factors can influence access to free birth control, including:

the person’s preferred method of birth control
insurance coverage
whether a person’s employer has an exemption so that its health insurance does not need to cover the cost of birth control, such as for religious reasons
access to family planning clinics and public health offices providing free or low cost options

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