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Only 14 in 100 women of childbearing age (15-49) choose the pill as their birth control method. Many women are looking for non-hormonal alternatives like diaphragms and spermicidal films. But, when deciding which method to use as your primary contraceptive, it’s important to consider all the facts. Here, we compare VCF Films and Diaphragms as birth control methods to find out which one comes out on top.

What is VCF Film?

VCF is short for vaginal contraceptive film. Think of it as those Listerine breath strips that melt in your mouth—but instead of giving you fresh breath, VCF melts inside your lady parts to prevent pregnancy. It’s a paper-thin, flexible square of material containing the active ingredient in spermicide (nonoxynol-9). To use it, a woman inserts the square into the vagina prior to sex. Within 15 minutes, it turns into a gel barrier that covers the cervix, standing by to kill sperm.

What is a Diaphragm?

Diaphragms are reusable contraceptive devices made out of latex, silicone, or other soft materials that are prescribed by a doctor for female birth control. A diaphragm acts as a physical barrier, preventing sperm from getting through. They work best when used together with spermicide.

There are two major categories of diaphragms available today. Traditional diaphragms come in multiple sizes and must be fitted by your doctor, while the Caya Contoured Diaphragm is a one-size-fits-most option that does not require an in-person fitting with your doctor.

Related: Diaphragms as a Contraceptive: What’s It Like to Use One?

Similarities of VCF Film & The Diaphragm

The same woman might consider both options for meeting contraceptive needs. They have a lot in common. Here are some of their similarities:

Both birth control methods can be a great choice for a woman who wants a non-hormonal, fast-acting, reversible birth control that’s 100% under her control. The drawbacks to using these products are also similar, offering no STD protection, both containing Nonoxynol-9 which can be an irritant, and requiring vaginal insertion at just the right time prior to sex to maximize effectiveness.

Spotting the Differences Between The Diaphragm & Contraceptive Film

By now, both options seem like a pretty great choice for some women. And while you can switch between using either method from one day to the next, you should know what the differences are between the two.

Prescription Requirement & Front-Loaded Cost

Your up-front cost for a diaphragm will be higher than VCF film. That’s because a prescription is required for the device, but not for the film. At My Virtual Physician, we try to keep your costs affordable. That’s why we’ve partnered with Caya to provide a hassle-free experience in getting your prescription from us. Sometimes insurance will cover 100% of the cost for your consultation and for the diaphragm as well. If not, you can get your appointment for $49.99 with MVP, and your diaphragm out-of-pocket cost will be under $100.

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Cost Comparison Over the Long-Haul

Diaphragms last about two years, so the initial cost will reoccur every couple of years if you continue to use this method for birth control. Contraceptive films have no device or prescription requirement, so you’ll just need to purchase the films over the counter for around a dollar per film.

A small amount of spermicide gel is also required for the diaphragm, so it will need to be continually purchased while you use a diaphragm. Spermicide that is compatible with diaphragms includes Gynol II, which comes in tubes with a re-fillable applicator, and VCF Gel pre-filled applicators. The cost varies from one to two dollars per application. Keep in mind, though, that less spermicide is required during the initial insertion of the diaphragm—only one to two teaspoons, so your tube of spermicide can potentially last longer than single-use films.

Which is More Effective?

According to VCF’s packaging, they boast a 94% effectiveness and up to 99% effectiveness when used with condoms. That outpaces Caya’s published effectiveness rates of 86% when used perfectly. However, there is no data about how effective Caya is when used together with condoms. Since condoms alone are 87% effective, using them along with spermicide and a diaphragm plummets your chances of unplanned pregnancy.

It’s hard to compare apples to apples, but it seems both methods are quite effective when used together with condoms, and VCF films are slightly more effective than diaphragms with spermicide if not using condoms.

Which One Works Faster?

With both contraceptive films and diaphragms—timing is important, along with following the instructions carefully. For the film to work properly, it needs 15 minutes after insertion to activate. The diaphragm, on the other hand, doesn’t require any downtime, and you can get into the action right away.

When it comes to round two, both diaphragms and films need some attention. Never remove the diaphragm between rounds, but add more spermicide with an applicator before each one. For the contraceptive film, a new film must be inserted every time you have intercourse, plus add the 15-minute waiting period.

Which Option Requires Less Maintenance?

The film may be easier when it comes to managing the after-care because there is nothing more to do once you’re done having sex. The chemicals are naturally removed through bodily fluids. Diaphragms, on the other hand, must be left in place for six hours so that the spermicide works completely, and then removed, cleaned, and put back in the case for next time.

Related: The Do’s and Don’ts of Using a Diaphragm for Birth Control

Which is Easier to Use?

Both methods of birth control have a learning curve when it comes to inserting them. Some complaints about the film include:

The diaphragm can also be challenging to learn how to insert. But, the Caya Contoured Diaphragm was designed with a woman’s body in mind and comes with grips and a removal dome to help with the insertion and removal process.

So, Which Contraceptive Option is Better For You?

Looking at the comparison laid out above, there are definite pros and cons for each method. Deciding which one is best for you is a personal decision between you and your doctor.

There are a lot of options out there when it comes to pregnancy prevention. Luckily, non-hormonal options are becoming more accessible, giving women more control over their reproductive health. If you’re considering a change to your birth control method, contact our doctors to talk about your options.

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Suppose you’ve been dealing with bladder leaks when you cough, laugh, or sneeze. In that case, you’re probably well aware that you’re dealing with stress urinary incontinence, or SUI. And you’re ready to do something about it.

There are many natural remedies that we’ve discussed previously in this article: Why Do I Get Bladder Leaks When I Cough and What Can I Do About it? But if you’ve already given a good try with the Kegels, lifestyle changes, and pessaries like Uresta, only to find that you’re still struggling to keep your bladder in line, then you may be contemplating surgery to fix the problem.

While surgery isn’t for everyone, it is an option on the table for those with persistent stress urinary incontinence that have tried other treatments without success. There are three major types of surgical interventions used to treat SUI. Let’s find out more about each one to find out which option is right for you.

Injections for Treating SUI

Before resorting to full-blown bladder surgery, there is an in-between step that is more drastic than natural remedies—but less invasive than surgery. This option involves injecting synthetic bulking material (similar in consistency to natural collagen) into your tissues around the urethra in order to plump and tighten the bladder neck opening and keep urine inside the bladder when you cough or apply pressure.

These injections are done as a minor, outpatient procedure in your local doctor’s office in less than half an hour. Here’s how it’s done:

  1. A local anesthetic is given to help numb the area
  2. A scope is inserted into the urethra for visual accuracy
  3. The material is injected into the tissues around the bladder

It’s important to note that these injections are not a permanent solution. It may take multiple injections and must be repeated to maintain the results. These injections usually help decrease leaks, but ultimately, they are not a cure. The success rate is around 80% of women showing an improvement after three injection visits, but only 10-30% are cured of leaks for up to a year.

Urethral Sling for Treating SUI

A more invasive surgical operation for treating stress urinary incontinence urethral sling surgery. Think of a sling as a supportive hammock that lifts your pelvic organs, particularly the bladder and urethra, into position for proper alignment. Sometimes with age, childbirth, and other factors, our bladder organs sink and move from their original positions, resulting in incontinence and other issues like pelvic organ prolapse.

Related: Pelvic Organ Prolapse (POP) Explained by Your Las Vegas OBGYN Team

Urethral slings are used to realign your anatomy so that your bladder organs can function properly. The material for the sling can either be made of synthetic mesh (called a mid-urethral sling) or from donor tissue removed from your belly or thigh (traditional or autologous sling).

Surprisingly, mid-urethral sling surgery can be completed as quickly as half an hour and can be done as an outpatient procedure because it has a quick recovery time. However, there are risks to using a synthetic mesh, including mesh erosion which affects 2% of women and leads to long-term problems until removed. It is also not advised for patients who wish to give birth in the future.

While the synthetic mesh is the most common type of SUI sling surgery with a success rate of around 75%, the traditional sling is the solution in the event of a bad reaction with the synthetic version. This surgical procedure is more in-depth and requires a short hospitalization stay during your recovery time. There is a higher risk of UTIs and incontinence after undergoing traditional sling surgery.

Sling procedures can be performed through a variety of methods, from one or more incisions in the abdomen, through the vagina, or even laparoscopically. Your surgeon can guide you through where any incisions will be made for your procedure. Be sure to ask your doctor questions about success rates and risks for the procedure that you’re considering.

See the FDA’s list of specific questions to ask your surgeon before proceeding with a sling surgery, including:

Bladder Neck Suspension for Treating SUI

Colposuspension, also called the Burch procedure, is another surgical option for treating SUI in women. This is a procedure where stitches are used to align the bladder neck (where the urethra meets the bladder) back to its proper place and can be done either through an abdominal incision or laparoscopically as an outpatient procedure.

Complications are usually less severe than sling procedures and include the possibility of having to go back in and loosen stitches if you have trouble emptying the bladder after the operation. The success rate of bladder neck suspension for SUI treatment is around 85%.

Choosing the Best Treatment Option for Your Bladder Leaks

Living with stress incontinence certainly puts a damper on life. If you’ve tried everything and nothing has worked, surgery may be your next plan of action. If you’re considering bladder surgery for your SUI, talk with your doctor about which surgical option is best for your situation. Your doctor will help you consider factors like your age, future plans for childbearing, medical history, and the root cause of the problem in order to come to the best treatment option.

My Virtual Physician supports patients through counseling and patient education when making big decisions like undergoing bladder surgery. We can also see you virtually from the comfort of your own bed in the event that you’re recovering from surgery and have concerns. Please don’t hesistate to reach out to us today.

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When it comes to sexually active men and pregnancy prevention, there are not a whole lot of options on the table. Other than condoms and the withdrawal method, a vasectomy is a man’s only other choice for birth control. This method is nearly 100% effective, much more effective than condoms or most female contraceptive options.

The only thing is, it’s permanent. So you’ve got to make sure you feel strongly about your decision before proceeding. If you’ve decided that you’re done fathering children for good, then a vasectomy as a permanent form of pregnancy prevention might be coming up in the near future.

A vasectomy is a minor surgical procedure with a speedy recovery time where a doctor cuts, removes small segments, and seals off the vas deferens so that sperm no longer make their way into a man’s ejaculate. So, if you’ve decided to make the call—below, we’ll cover what to expect when you schedule your vasectomy.

Step 1: Make the Call

The first step to getting a vasectomy is what you’re doing right now: researching the process. You may not have committed to the procedure yet, but you’re learning about the process. You should consider all aspects to make the most informed decision about whether or not to get a vasectomy. Here are a handful of things to look into:

Once you’ve decided that a vasectomy is the best option for you, then the next thing to do is proceed with scheduling an appointment to consult with a Urologist.

Step 2: The Initial Appointment

Most men don’t have an established Urologist. In that case, call your regular primary care physician to request a referral to a specialist who performs the vasectomy procedure. It’s likely that you’ll need to schedule a pre-vasectomy consultation appointment before coming in for the actual procedure.

During your consultation, your doctor will discuss with you things like:

Pre-procedural instructions include things like avoiding certain medications that may thin the blood and increase bleeding before the procedure, such as aspirin. You may also be asked to shave your scrotum a few days before arriving for the procedure.

At the end of your consultation, you’ll be able to schedule your appointment to have the procedure done.

Step 3: The Procedure

Most often, vasectomies are done in a standard doctor's office, and you’re able to go home right afterward. Before your appointment, read your pre-procedure instructions again to ensure you’ve followed all of your doctor’s instructions. Plan ahead and have a friend or family member drive you to your appointment so that you have a safe ride home.

On the day of the appointment, dress comfortably in loose-fitting clothes with brief-style underwear to hold the gauze in place. Gauze is used as an extra layer of protection over your incisions and to soak up any drops of blood or fluids.

You can expect the entire procedure to take around 30 minutes. Your doctor will begin by having you undress and applying a local anesthetic to the scrotum, where he will make one or two incisions to access the vas deferens. The most painful part is over after the injection of the anesthetic. From there, patients will have some temporary discomfort, including tugging and mild nausea, while the doctor performs the procedure of cutting and sealing off each vas deferens.

After about half an hour, you’re free to go home and recover.

Step 4: Get Some R&R

You’ll want to clear your calendar for the day plus one or two days after your procedure and spend this time resting on the couch or in bed. You’ll experience some mild aching, swelling, and bruising during this time, which should get better over the next week. Over-the-counter pain medications are usually recommended during this time to ease your discomfort and reduce swelling.

After about a week of taking it easy, you can begin to return to your normal activities, including physically demanding work or exercise. Followup appointments directly after the procedure are uncommon unless there are complications. Be sure to report any concerns to your doctor. Congratulations, if you’re this far, the hardest part is over.

Now, over the next three months, you’ll want to use backup methods of birth control, such as condoms, because your vasectomy is not immediately effective. It can take several months for all of your body’s sperm to leave your seminal fluid for good. But don’t worry, this is only a temporary precaution, and you can stop using the backup as soon as you complete the last step of the process: getting confirmation of a successful vasectomy.

Step 5: Get Confirmation

The last step after getting a vasectomy is the most important one. This step verifies that the procedure was successful. To confirm a successful vasectomy, you’ll need to have a lab test done that shows a sperm count of zero.

Wait about 12 weeks after the procedure to get your post vasectomy semen analysis done. My Virtual Physician has partnered with Orchid Crew. They offer an at-home post-vasectomy confirmation kit for just over $100. That’s right—you can collect your semen from the privacy of your own home and have it sent to a CLIA-accredited lab to confirm azoospermia (no sperm in semen).

The Grand Finale

Using the five steps outlined above, you can see the whole vasectomy process from start to finish. Once you’ve completed your post-vasectomy confirmation, you’re officially good to go! If you recently had a vasectomy and wish to speak with a doctor online about your recovery or testing options, schedule an appointment with My Virtual Physician today.

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If you’re new to using a diaphragm as your chosen method of contraception, you’re not alone. That’s why we’ve crafted this handy list of do’s and don'ts so that you can quickly learn how to handle your new device so that it works best for you. Let’s dive right in…

Do Check With Your Insurance About Coverage

If you have health insurance, don’t forget to check with your provider about covering the cost of your diaphragm. From the initial appointment to the device itself and the spermicide that you’ll need on an ongoing basis, many insurance companies cover these costs in full.

Don’t Fret if You Don’t Have Health Insurance

Diaphragms are relatively inexpensive, costing around $100 for a device that is designed to last a couple of years. My Virtual Physician offers affordable appointments for just $49.99, where you can get your Caya prescription. If this is still unaffordable, talk with your doctor or your local health department; many have outreach programs that will help you attain affordable contraception.

Do Use Spermicide with Your Diaphragm

Diaphragms are more effective when they are used together with spermicide. Spermicide comes in a tube and is a gel that you’ll apply to the rim of your diaphragm (or as instructed by the manufacturer). The diaphragm blocks most sperm from entering a woman’s reproductive system, but the spermicide finishes the job by killing the sperm, which could live for several days, increasing the chances of pregnancy, if it weren’t for the spermicide gel.

Related: 4 Things You Need to Know About Using a Diaphragm for Birth Control

Don’t Give Up if You Struggle to Insert Your Diaphragm

Much like when you used tampons for the first time, there’s a learning curve when it comes to inserting your diaphragm. The first few times, the insertion and removal process will likely be uncomfortable and awkward. But as you learn to finesse it just right, you’ll become a pro at putting it in and taking it out with ease. Give it a couple of weeks of practice before you give up on your diaphragm.

Do Reapply Spermicide

Spermicide gel is most effective within two hours of applying it. So, say you insert your diaphragm (with spermicide gel) at 4 pm and go to dinner but don’t get home until 7 pm, you’ll need to insert another applicator full of spermicide gel before sex for the best pregnancy protection. Don’t remove your diaphragm to do this; instead, simply use the applicator that came with the gel to add spermicide into the vagina.

Don’t Be Absent-Minded About Diaphragm Timing

Using a diaphragm takes a little bit of planning. Think ahead about what time you might have sex and plan accordingly. Make a mental note of the time of diaphragm insertion and after sex so that you can reapply spermicide and remove the device in proper timing.

After sex, your diaphragm needs to remain in place for six hours to give the spermicide time to disable any remaining sperm. Taking it out too soon puts you at a higher risk for pregnancy, essentially opening the doors to live sperm.

But you also don’t want to wear a diaphragm continuously for days on end. Most diaphragms recommend that they be removed at least every 24 hours. Leaving it in longer than a day can lead to vaginal infections such as bacterial vaginosis (BV).

Related: Our Las Vegas OBGYNs Cure Your Bacterial Vaginosis Fast

Do Read, Keep, & Follow The Instructions that Came with Your Diaphragm

It can be tempting to skip reading instruction manuals, patient care guides, and package inserts and jump right into using your new diaphragm. But when it comes to something as important as family planning, we encourage you to thoroughly review these documents before your first use. It’s also a good idea to keep them on hand in case you need to review them later down the road.

Don’t Use Cleaning Chemicals or Boil Your Diaphragm

Taking care of your diaphragm isn’t difficult. Most come with a protective case to store your clean diaphragm in when not in use. After each use, rinse your diaphragm with mild soap and water, let dry, and put in the case. Never use any chemicals on your diaphragm and do not boil or steam it in an attempt to disinfect it. If you feel the diaphragm needs to be disinfected due to odor or staining, contact your doctor about getting a replacement.

Do Check For Damage While You Clean Your Diaphragm

Cleaning your diaphragm is a quick and simple process. Simply wash with mild soap and water and air dry or blot with a clean cloth. While you’re cleaning, you should periodically inspect your diaphragm for any signs of damage, including cracks, wrinkles, or weak spots. You can also fill it up with water and look for drips. Any signs of damage and you should use backup contraception and contact your doctor for a replacement.

Related: Is it Time to Replace My Diaphragm? Here’s How to Know

Don’t Forget to Wash Your Hands!

Our last tip for proper use of a diaphragm for contraception is to always have clean hands when handling the diaphragm. Wash your hands both before and after you insert the diaphragm, as well as before and after removing it. Frequent handwashing will reduce your chances of unintentionally inviting unwanted bacteria to the region, which can lead to infections.

Ready for My Diaphragm!

Using a diaphragm for birth control takes a little bit of extra preparation, but for some, it’s well worth the extra effort. If you’re interested in trying the fitting-free Caya Contoured Diaphragm, book an appointment to speak with our OBGYN team today!

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One in three women lives with bladder leaks caused by stress urinary incontinence (SUI). SUI is when you leak a little urine when pressure is applied to the bladder—like when you cough, laugh, or sneeze. As you age, your chances of developing SUI increase. The main cause is a lack of muscle tone and a weakened structure. And there is a simple solution: the pessary. Let’s explore the pessary.

What is a Pessary?

A pessary is a medical prosthetic that helps to provide structure to the pelvic organs in an attempt to restore the natural shape for proper functioning. As you know—with age, everything starts sagging, and internal organs are no exception. A pessary is essentially a bra for your bladder organs.

These devices have an ancient history, originally made of wax and string until rubber was available in the 1800s. Today, the prosthetic is made of flexible, hypoallergenic material, such as silicone. To use it, a woman inserts the pessary into her vagina. If you search for images of pessaries, you’ll see that these devices come in a wide variety of shapes and sizes.

What Conditions Do Women Use Pessaries For?

Pessaries aren’t just for sealing up bladder leaks. Pelvic organ prolapse warrants another common use for the devices. Since both conditions are caused by a gradual change in anatomy, a prosthetic that restores the original anatomy works. Furthermore, pessaries can even be used to administer medication.

RELATED: Pelvic Organ Prolapse (POP) Explained by Your Las Vegas OBGYN Team

Types of Pessaries

There’s a reason for all that variety you see when looking at pessaries. Each unique shape is designed to support different pelvic organs. Here’s a rundown on the different shapes you might find, but not all of them are used for urinary incontinence:

Ring Pessaries

Resembling a ring you would wear on your finger, the hole in this shaped pessary allows urine to flow through while wearing the device—on your terms. This type is not used for urinary leaks but works to support the internal organs near the cervix. Sometimes the center hole is covered with a thin layer of material with smaller holes.

Lever Pessaries

A less often prescribed shape is the lever pessary. This one is used for correcting the positioning of a tilted uterus and resembles a caribiner.

Gehrung Pessaries

A tiny saddle-looking pessary is the Gehrung version. It’s used in supporting the rectal and bladder anatomy and is inserted near the cervix.

Shaatz Pessaries

Used for pelvic organ prolapse, Shaatz pessaries are shaped like a washer that has additional pinholes around the perimeter.

Cube Pessaries

Cube pessaries look like small dice (like playing dice) with concave sides and a string attached. These are used for mild pelvic prolapse.

Gelhorn Pessaries

Severe pelvic organ prolapse requires the Gelhorn pessary, which resembles a kitchen sink strainer plug. The flat side rests against the cervix, with the protrusion facing the vaginal opening.

Inflatable Pessaries

Inflatable pessaries can be used for mild conditions. The shape conforms to your body as you inflate it with a hand pump.

Unique Pessaries

Other uniquely-shaped pessaries have been developed over the years. One example is Uresta, a pessary that is shaped like a small cylinder with nubs on the sides. The shape keeps the device in place and puts minor pressure on the urethra to prevent bladder leaks.

With so many different types of pessaries available, it can be challenging to pick the right type for your body and may require some trial and error. Let our doctors assist with the process by giving you our expertise and the tools to try out a pessary to see if it helps you with your stress urinary incontinence.

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How to Use a Pessary for Stress Urinary Incontinence

Once you and your doctor pick the right pessary to try, the first step is to get the right fit. With Uresta, our partner in managing urinary incontinence, there are five sizes available for you to try in a self-fitting at home. Other pessaries may require fitting inside a doctor’s office. Pessaries are inserted similarly to a tampon without an applicator or similar to a diaphragm.

With a proper fit, you will:

Patients can self-manage their use of the pessary. Read the instructions on how to insert and how long the pessary can remain in place, as well as cleaning steps. Some women choose to only use the pessary during workouts, while others wear it all day long and remove it before bed. Your pessary will need to be replaced every year or as directed.

A Pessary to Stop Your Bladder Leaks

If you’re living with annoying bladder leaks when you cough or put any pressure on your abdomen, you’re probably fed up with the nuisance. A pessary can allow you to return to a normal life, enjoying all of the activities that you once did. If you’re interested in trying Uresta or another pessary for stress urinary incontinence, reach out to our team today.

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Check male fertility at home.

Couples are waiting longer to start their families; most new mothers today are around 27 years old when they have their first child. Our bodies, both male and female, are most fertile the closer we are to puberty, and fertility tapers off as we age. That’s why many couples that are preparing to have a baby decide to get their fertility checked beforehand. This gives each partner peace of mind to know that everything is in working order when you begin trying.

Fertility testing sounds expensive. And it used to be, but not anymore. Technological advancements have allowed the development of lab testing so that it can be done from the privacy and comfort of your own home. Let’s talk about the different male fertility testing options that you can get done at home.

Over-the-Counter Sperm Screening Tests

If you have no indications of fertility problems and you’re just curious about whether your semen contains a normal amount of sperm, then you might consider purchasing an at-home sperm test from your local drugstore.

This type of sperm screening test works by detecting a minimum amount of a particular protein that is only found in the head of mature sperm. So the result comes in as pass or fail.

These screening tests don’t give any detailed lab numbers; instead, the results look very similar to a pregnancy test for women, shown as lines on the indicator window. For example:

Over-the-counter sperm screening test kits are an affordable way to rule out low sperm counts, costing less than $50 per test. If you have an abnormal result, then you should consider moving on to the next step up in at-home male fertility testing: a lab-reviewed semen analysis.

At-Home Semen Analysis

If you have reason to believe that your fertility is not up to par, whether for biological reasons or trauma-related injuries, then you may consider having an at-home semen analysis done. For just under $200, with this type of test, you’ll receive a test kit to collect your semen sample at home and then send it into a lab for professional analysis. Here’s Orchid’s version, our partner in fertility testing.

The lab will look at your sample under a microscope, make observations about your sperm quality, and then send results, in the form of real numbers, back to you. The typical parameters that the lab looks at during a semen analysis include sperm count, shape, movement, and other measurements of the seminal fluid.

Read more about the at-home semen analysis test in this blog: Testing Male Fertility: How to Get a Semen Analysis Done At Home, which goes into more depth on this male fertility test, including normal ranges for each measurement.

If you receive an abnormal result from your at-home semen analysis, read this post: What Do I Do If My Fertility Test Comes Back Abnormal?. The first step is usually to re-test. If you’ve received an abnormal semen analysis, consult with our doctors for personalized medical advice to get your fertility back on track.

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At-Home Male Fertility Test

Semen analyses are not the only fertility testing available for men. You can also get male hormones and blood glucose levels tested to identify whether those are impacting your fertility.

Orchid offers a male hormone test kit that tests your blood with a fingerprick for testosterone, prostate health, and hemoglobin A1C. Like the semen analysis, this test is also collected at home and then sent into a lab to be read by lab technicians who provide numerical results. This affordable option is less than $60 and can show a bird’s-eye view of male hormonal health.

Get Your Fertility Tested

For less than $300, guys can run all three tests above from the comfort of their own homes in order to get a good picture of their fertility. If everything checks out, that’s just reassurance that you’re body is ready when you are.

If not, these tests give you and your doctor insight to work together toward correcting your fertility. If you’ve had an abnormal result and want to consult with our doctors about your fertility, schedule your appointment today.


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Is it time to replace my diaphragm?

Diaphragms used for birth control are unique because they offer an inexpensive, low-maintenance, and long-lasting solution that you can’t get from other types of contraceptives. If you’ve been using a diaphragm for a while now, you may be wondering how long it should last and when you should replace it. Let’s talk about the lifespan of a diaphragm.

How Long Does A Diaphragm Last?

The longevity of your diaphragm’s usability varies depending on which type of diaphragm you are using. Traditional-style diaphragms available today—such as the silicone Milex Omniflex or Arcing styles—have a useful life of up to two years. Other latex diaphragms have boasted up to a 10-year lifespan. The new one-size-fits-most Caya diaphragm has a lifecycle of up to two years. Always read the instructions that come with your diaphragm to confirm how long your device is designed to last.

Just because your diaphragm’s box says that it can last up to ten years, doesn’t guarantee that you won’t have to replace it before then. Here are some reasons that you should consider replacing your diaphragm before the expiration date:


With childbirth, everything changes. Your body, cervix, and vaginal canal will change from your birthing experience. Avoid using a diaphragm for six weeks after childbirth because it takes that long for your cervix to return to its normal size. And your new normal may be different from your size before you got pregnant. That’s why you should consult with your doctor about getting a new diaphragm after giving birth, particularly if it’s not the one-size-fits-all style (Caya).

Weight Change

Whether you’ve gained or lost weight since you were initially prescribed your diaphragm, a drastic change in weight might affect the fit. While it may be on the traditional package insert to get re-fitted when your weight fluctuates more than ten pounds, it may not be true for everyone. At least one study has shown that there is no correlation between weight and diaphragm size change. It never hurts to consult your doctor after a major change in body weight to verify that the diaphragm is still working properly.

Pelvic Surgery

Pelvic surgery is sometimes done to correct the following conditions and can affect the fit of your diaphragm:

Be sure to discuss your birth control options with your surgeon to set up a contraceptive plan that works for you and that will be compatible with your body.

The Fit Feels Off

Trust your gut. If you feel like your diaphragm is no longer fitting tightly and securely as it did when you first received it, then it’s probably time to replace it. Signs of this include being able to feel the diaphragm after insertion, pain during intercourse, and the diaphragm moving or coming out when you walk, sit, lay down, or have sex. Talk to your doctor if you want to replace your diaphragm or check its fit.

Related: 5 Tips to Supercharge Your Contraceptive Diaphragm’s Effectiveness

What are Signs that I Need to Replace My Diaphragm?

Changes to your body are not the only reasons that you may want to replace your diaphragm before its expiration date. Check your diaphragm every time you use it for signs of wear. This includes:

At the first sign of the above, discontinue using your diaphragm and consult with your doctor about getting a new one ordered. In the meantime, be sure to use another contraceptive method.

Should I Upgrade to the Caya Diaphragm?

If you’ve just realized that it’s time to replace your diaphragm, you may be wondering if you should switch from a traditional diaphragm, which requires in-person fittings, to the Caya Diaphragm. Caya is a one-size-fits-most diaphragm that doesn’t require a fitting and works for most women.

Here are a few reasons that some women prefer Caya over traditional diaphragms:

Get Your Replacement Diaphragm Today

If you’re ready to upgrade to the no-fitting-required diaphragm, we can facilitate that. My Virtual Physician has partnered with Caya to provide this hassle-free birth control option to our patients who desire it.

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The truth About Kegals & Bladder Leaks

You may have heard of doing Kegels to improve your sex life, but did you know that these intimate exercises can help improve bowel and bladder problems too? If you’ve got bladder leaks when you cough, laugh, or sneeze, then doctor-approved Kegels may help. Let’s explore the truth about Kegels.

What are Kegels?

The term “Kegels” was coined in 1948 by Dr. Arnold Henry Kegel. He was a specialist looking for a natural remedy for urinary incontinence. Kegels are a category of exercises that are designed to strengthen the pelvic floor muscles. These muscles can be identified easily by stopping the flow of urine while peeing.

A woman’s pelvic floor muscles and tissues are similar to a hammock, supporting these organs inside her pelvis from underneath:

Pelvic floor exercises were originally developed to target this group of muscles that weaken with aging, pregnancy, and prolapse in women and to prevent and treat certain types of incontinence, including stress urinary incontinence.

To help gauge the effectiveness of Kegel exercises for the treatment of urinary incontinence, Dr. Kegel invented the perineometer, a device that measures the strength of contractions of the pelvic muscles. This device also helps trained physical therapists validate that female patients are performing the exercises correctly.

Related: Why Do I Get Bladder Leaks When I Cough and What Can I Do About it?

Bladder Exercises for Stress Urinary Incontinence

Now that you know that Kegels are just a group of pelvic exercises, let’s talk about specific exercises and programs that are often used to treat stress urinary incontinence.

Anyone can add Kegels to their daily routine to strengthen pelvic floor muscles. As with any exercise program, start out small and work your way up to longer durations and if you experience any discomfort, stop and discuss it with your doctor. Before you begin, empty your bladder.

There are two main Kegel exercises to work on from home, they include:

  1. Long Hold
  2. Short Muscle Contractions

Alternating between the long and short contraction exercises is recommended for best results.

Long-Hold Kegels

Long-hold exercises require you to tense your pelvic floor muscles constantly for several seconds, release, and then repeat. Starting out, you can go with:

Continue this on a daily basis once per day. Once you get into a routine, you can increase to 10 seconds of contraction, 10 seconds of release, and 10 reps. After that, you can further increase your pelvic floor muscle tone by adding up to three sessions of 10 reps per day.

Short-Muscle Kegels

Short Kegels work out the same group of muscles, but the contraction period is much shorter, at one or two seconds. These are especially effective at improving bladder sphincter function. As with long-hold pelvic floor exercises, you can start small and work your way up to three sets of 10 seconds per day.

While you complete these exercises, be sure to continue breathing and avoid tensing other muscles in your body, such as your abdomen. You can add intensity to your routine by performing the exercises in different positions: sitting, standing, or lying down.

For consistency, associate these exercises with certain times of the day or write them down. For example, you may designate the first pee of the day as your time to complete your Kegels—after you’ve emptied your bladder and while you’re still on the toilet.

Related: Stop Bladder Leaks: Get Your Life Back with This Doctor-Approved Device

How Do I Know if Pelvic Floor Muscle Training is Working?

It usually takes about a month to notice an improvement once you consistently exercise your pelvic floor muscles. That means that you’ll want to commit to a solid month before deciding if it worked or not, but the recommended minimum training period is eight weeks.

If you don’t feel comfortable doing Kegel exercises on your own, struggle with consistency, or you’re still not sure you are doing it right, you’re not alone. Studies have shown that treatment is more effective when you complete these pelvic exercises in a supervised plan. Work with your doctor to find a physical therapist (called a pelvic floor therapist) who will personalize a plan to fit your unique anatomy.

Signs that the Kegels are working include:

Beyond the Kegels

While it’s true that Kegels are effective at preventing and treating stress urinary incontinence, not every woman is able to contract the pelvic muscles correctly. Three out of ten women are unable to perform Kegel exercises properly. If this is you, other effective options are available for treating SUI. A few other natural solutions to leaky bladders include to:

Pessaries can be used alongside performing Kegels or as a standalone solution. These small devices are inserted into the vagina in order to support your anatomy and keep your pelvic organs and muscles aligned to reduce leaks.

If you’d like to try a pessary for your leaky bladder, My Virtual Physician has partnered with Uresta to provide a solution to stress urinary incontinence. Book an appointment today to get your bladder back under your control.

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When it comes to family planning and pregnancy prevention, you’ve got options. In fact, you’ve got twenty options. There are 20 different contraceptive methods to choose from today. From birth control pills to patches, rings, or condoms, there’s bound to be a method that works best for you.

One of these methods is making a comeback. It’s been around for centuries and got placed on the back burner for a while, but it’s starting to gain traction again. It’s the diaphragm.

Diaphragms offer benefits that other methods lack. Let’s see why women are starting to take a second look at using a diaphragm for their chosen method of birth control.

Women are Sick of Side Effects Caused by Hormonal Birth Control

When choosing a birth control method, we may have taken for granted the simplicity of the diaphragm. As a barrier method, its job is to block sperm from entering the cervix. That’s it. The great thing about this simple method is that it comes with very few side effects, if any at all.

Hormonal birth control methods, like the pill, were introduced in the 1960s and offered a better effectiveness rating than barrier methods. But what we didn’t take into consideration when making the switch to hormone-altering contraceptives was the addition of harmful side effects.

Many women are now facing all sorts of negative side effects from hormonal contraceptives, which include:

Diaphragms offer an alternative to hormonal contraceptives without serious side effects. The short list of potential side effects from diaphragms includes the possibility of irritation, allergic reaction, increased risk of UTIs and vaginal infections, or toxic shock syndrome in rare cases.

Couples Want to Be in Control of Their Fertility

Another factor at play for the increase in popularity of the diaphragm is when it comes to fertility. Diaphragms require no waiting period once you’re ready to try to conceive. This barrier method is immediately reversible, so once you stop using it, you are good to go. That’s because diaphragms do not alter your body’s natural reproductive cycle. Women who use a diaphragm continue to ovulate normally.

That is in direct opposition to other non-barrier contraceptive options, which in a sense, “break” the body’s normal cycles in order to prevent pregnancy. Hormonal contraceptives alter a woman’s reproductive hormones, and it takes a while for her body to return to normal after discontinuing birth control. Here’s how long you may have to wait for your fertility to return after discontinuing hormonal birth control:

Couples are switching to the diaphragm so that they can be in charge of their own fertility.


Related: Diaphragms as Birth Control: A Couple’s Perspective on Barrier Methods 


Diaphragms Solve a Problem for People Who Can’t Tolerate Medications, Injections, or Painful Procedures

Diaphragms are easy and painless. Similar to a condom, you just use it when you need it. Before you have sex, you put it in. If you’re not having sex, you don’t need to use it. That’s what makes the diaphragm a great solution for those of us who don’t want to have to have to:

All of these uncomfortable, annoying situations can be avoided completely for those of us who decide to use a diaphragm for our contraceptive method.

Diaphragms Offer a More Natural Method of Birth Control

It seems that culture is trending back toward natural products, foods, and other choices. So it follows that natural birth control should also gain in popularity. Since diaphragms do not alter your body’s chemistry, they can be considered natural, along with the other non-hormonal methods. While you may hear people say that natural birth control methods are not as effective, keep in mind that when you combine diaphragms with other family planning strategies, like fertility awareness-based methods, it can significantly increase effectiveness.


Related: 5 Tips to Supercharge Your Contraceptive Diaphragm’s Effectiveness


Who Should Avoid Using a Diaphragm?

While many couples are turning to the diaphragm to meet their contraceptive needs, there are some women who should avoid this method of birth control. If any of the situations listed here apply to you, then  you might want to seek another alternative to the diaphragm:

Making the Switch to the Diaphragm

If you’ve ever considered trying a diaphragm, now may be one of the best times in history to try it out. A new type of diaphragm was released on the market within the last decade. It comes in a one-size-fits-most model and patients are able to skip that awkward in-person fitting that is required with the older style diaphragms.

My Virtual Physician has partnered with Caya to streamline the process of getting your diaphragm prescription fulfilled so that this new method of contraception is readily available to you.

Take charge of your reproductive health today and schedule your appointment to discuss contraceptive options that work for you.

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Just over half a million men get a vasectomy each year in the United States. You may have heard that getting snipped is a simpler procedure than a woman getting her tubes tied. While it may be true that the permanent sterilization procedure itself is much less invasive for men, it’s important to note that it’s not immediately effective. The official effectiveness in the first year is over 99%; however, there is an important waiting period required after surgery in order to get there. Let’s talk about how to confirm your vasectomy’s effectiveness.

How Does a Vasectomy Work?

When a man ejaculates, his semen contains sperm. Sperm is what meets with an egg to cause fertilization and pregnancy. If you remove sperm from the equation, then you technically can’t get a woman pregnant. That’s what a vasectomy aims to do.

Vasectomies cut off the access for sperm to get into the semen. The vas deferens tubes connect the testes, where sperm is stored, to the other male sexual organs like the prostate, seminal vesicles, and the urethra. A vasectomy is an out-patient procedure that cuts both vas deferens tubes so that sperm cannot get into the semen.

What to Do After a Vasectomy for it to be Effective

So, what happens to your sperm if it can’t get out? It gets reabsorbed by your body, just as it would if you didn’t naturally expel it over a long period of time. But it doesn’t cut off the access immediately. It takes a few weeks to a few months for all sperm to be removed from a man’s reproductive organs after having the procedure completed. That’s because there is still sperm that is stored in the semen that’s already been produced in the body before the procedure.

Here are some important post-vasectomy care tips to increase the effectiveness of your vasectomy.

When Will I be Sperm-Free After a Vasectomy?

The goal of a vasectomy is to reach azoospermia. This is the condition of having no sperm in the semen. The timeframe of achieving azoospermia ranges for each patient, but usually by three months or about 30 ejaculations, your semen should be sperm-free. The American Urological Association recommends waiting between eight to sixteen weeks before ordering your first post-vasectomy semen analysis. A vasectomy is considered successful if no live sperm are present six months after the procedure.

What Does a Post-Vasectomy Semen Analysis Tell Me?

A lab test called a post-vasectomy semen analysis is the only way to verify azoospermia. Although this is a crucial step in verifying that your vasectomy was successful, not all men return to complete the recommended post-vasectomy semen analysis.

That’s pretty understandable, considering the awkwardness required to get the sample if you’re going to a traditional lab or doctor’s office. However, now these tests can be done at home. At-home semen analysis kits are available online. My Virtual Physician has partnered with Orchid to provide our patients easy access to at-home semen analysis testing like this one.

Post-vasectomy semen analysis kits are more affordable than a complete semen analysis since they are only looking for the presence or absence of sperm in your semen sample rather than a full analysis of sperm. These kits allow you to collect your sample from the privacy of your own home and mail it into a lab for results in less than 24 hours.

You’ll want two consecutive results showing azoospermia before you can consider your vasectomy fully in effect. Even if you had your vasectomy done years ago, you might want to re-check your sperm counts periodically since there is still a 1 in 2,000 chance of pregnancy with men who achieved azoospermia after one post-vasectomy semen analysis. That’s because sometimes the body puts itself back together, a phenomenon called recanalization.

Related: Testing Male Fertility: How to Get a Semen Analysis Done at Home

The Final Countdown

Vasectomies are one of the most effective methods of birth control. However, it’s important to remember that this procedure is not 100% effective and requires time after the procedure to work. The only way to verify your vasectomy was successful is by a post-vasectomy semen analysis. Get yours ordered today by clicking below to speak with our doctors.

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Prenatal vitamins are supplements specially formulated for pregnant women to supply the needed vitamins and minerals. These vitamins and minerals are necessary for the health of both mother and baby.

A healthy diet is the best way to get these vitamins and minerals. However, taking prenatal vitamins help cover any nutritional gaps in your diet. Moreso, you may require more than your diet may offer during pregnancy.

Before you take any prenatal vitamin, discuss it with your healthcare provider. You may also contact us at My Virtual Physician.

What to Look for in Prenatal Vitamins

During pregnancy, there are certain vitamins and minerals you need more than ever. These vitamins and minerals are what to look out for when buying prenatal vitamins.

These vitamins and minerals include:

Folic Acid

Folic acid is perhaps the most important ingredient in a prenatal vitamin. Folic acid is a vitamin B that helps prevent neural tube defects (NTDs). Neural tube defects are birth defects of the brain and spine.

Experts recommend that women of childbearing age get 400 micrograms of folic acid daily. This is because neural tube defects develop early in pregnancy, even before many women know they are pregnant.

You can get folic acid naturally from green leafy vegetables, nuts, citrus fruits, and beans.


Your body needs to make extra red blood cells when pregnant. These red blood cells help carry oxygen around your body and to your baby. Iron is an essential mineral that helps your body make more red blood cells.

Also, iron helps prevent anemia, a condition where your blood has a low number of healthy red blood cells. You should get 27 milligrams of iron every day.


Calcium is important for you and your baby. Calcium is vital to the growth and development of bones, teeth, muscles, nerves, and organs in your baby. If you do not have enough calcium, you may suffer bone density loss and increase your risk of osteoporosis later in life.

You should get at least 1,000 milligrams of calcium daily. 

Vitamin D

Vitamin D helps promote healthy bones, teeth, eyes, and skin. It also improves your and your baby's immunity. You need about 600IU of vitamin D every day.

Food sources of vitamin D include fortified dairy products, fatty fish (salmon and mackerel), fish liver oils, and egg yolks.


Iodine is important for developing your baby's brain, bones, and nervous system. Also, mothers need iodine for adequate thyroid function. 

Iodine deficiency has been linked to miscarriage, preterm delivery, stillbirth, stunted physical growth, and congenital abnormalities.

During pregnancy, you need 220 micrograms of iodine daily. Iodine can be found in dairy products, seafood, and eggs.

B vitamins

B vitamins, including B1, B2, B6, B9 (folic acid), and B12, are key nutrients during pregnancy. These vitamins give you energy, help with nausea (morning sickness), improve your baby's nervous system, help build the placenta, and promote good vision.

Good sources of B vitamins include liver, whole-grain cereal, bananas, chicken, beans, and pork.

Vitamin C

Vitamin C promotes iron absorption and fortifies your immune system. It also helps develop your baby's skin, bones, joints, and connective tissue. Vitamin C can be found in fresh fruits and vegetables. You should get at least 85 mg of vitamin C daily.

Vitamin A

Vitamin A promotes eye development, good vision, and a healthy immune system in your baby. 

Omega-3 fatty acids

Omega-3 fatty acids help promote your baby's brain development, reduce your risk of preterm delivery, and having a baby with low birth weight. Omega-3 fatty acids occur naturally in fatty fish, nuts, flaxseed, kidney beans, spinach, broccoli, and cauliflower.


Choline (about 450mg daily) is necessary for healthy brain growth in your baby. Although your body can make some choline, you get most of it from your diet. Foods rich in choline include eggs, fish, soy products, chicken, beef, peanut, and pork.

Contact Us

A visit to us helps you get your prenatal care started while you await your appointment with your local OB doctor. Your virtual physician can help to electronically order prenatal care labs and/or send an order to the nearest radiology facility for you to get an ultrasound.

At My Virtual Physician, we are available to help guide you through your pregnancy and answer any questions that may arise. We are in network with many insurance health plans, including Medicaid, Medicare, United HealthCare, and Blue Cross. 

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Our last blog detailed how to read your at-home fertility results. If you’ve recently taken an at-home fertility test and the results weren’t what you expected, or something was out of whack, you may be wondering what to do with that information. This blog is the last in our four-part series that explores everything you’ve always wondered about testing your fertility at home.

This series includes:

  1. Curious about your fertility?
  2. How can I test my fertility at home?
  3. How do I read my fertility results?
  4. What do I do if my fertility test comes back abnormal?

First things first. Stop. Now, breathe…

A less-than-normal result doesn’t mean you’ll never have kids. Abnormal results are not uncommon with fertility testing, and if you have one, there are things you can do to get your levels back within the normal range.

Steps to Take After an Abnormal Fertility Result

If your fertility results aren’t perfectly within normal range, don’t panic! Realize that at-home fertility testing is just one tool that can help you identify hiccups early on. Although we believe in the accuracy of Orchid test kits, it’s still important to recognize that it’s normal for hormones in our bodies to fluctuate. Hormones in a woman’s body can be particularly unpredictable throughout the phases of the menstrual cycle. And men’s semen samples can vary greatly with each ejaculation, dependent upon many circumstances.

My Virtual Physician has partnered with Orchid to provide synchronistic support to patients who test their fertility at home with Orchid tests. Our online OBGYNs can help interpret your results and guide you through steps to take to improve your fertility. If you have an abnormal result, we recommend a virtual visit with our physicians. We may encourage re-testing during a different point in a woman’s cycle or after a few lifestyle changes are introduced. Certain medications can help correct some infertility problems. Next, let’s cover some common abnormalities that both men and women might find on their at-home fertility test results.

Common Abnormalities Found on Fertility Test Results

There are two main culprits of infertility for couples:

  1. In women: an interruption to ovulation
  2. In men: a sperm cell issue

Evidence that a woman is experiencing a problem with ovulation can be shown in abnormal fertility results. In particular, an abnormal follicle-stimulating hormone (FSH) level in women can indicate a problem. Higher than average levels of FSH can mean that a woman’s body is having trouble bringing eggs to maturity. On the other hand, low FSH levels might mean that you are not ovulating.

Luteinizing hormone (LH) is another chemical that indicates ovulation in women. Abnormal LH levels can mean that a woman is not ovulating. Many disorders, including PCOS, may cause a woman’s LH levels to be high and affect fertility. Low LH can happen if your BMI is too low.

Abnormal prolactin levels in women are a common cause of fertility troubles. Non-pregnant women should have very low levels since the hormone is primarily used for milk production in nursing mothers. If you have a high prolactin level, it can hinder your fertility if not corrected.

Men who have an abnormal semen analysis should repeat the at-home fertility test before taking action. There are a few common problems that can show up in a semen analysis, including:

Solutions to Common Infertility Problems

The results are in, and now you can start working to correct any abnormalities that showed up on your at-home fertility testing. Below we cover some common solutions to abnormal fertility values.

Women with abnormal FSH levels may be advised to change medications or start a new medication in order to bring their levels into the normal range. Medications can also be used to correct abnormal LH levels. Lifestyle changes affecting your weight may also improve LH levels for some women. Your doctor may want to run further tests to rule out other disorders that could affect your LH levels.

High prolactin levels can be reduced with medication. Sometimes further testing is required to confirm the cause of the increased levels. Abnormally low prolactin levels may not need to be treated.

Low sperm count in men is the most common abnormality found during fertility testing. It can be caused by many things, including certain medications, untreated diabetes, or hormonal imbalances, among others. Solutions may include testing for and managing these conditions or switching medications.

Abnormal sperm movement can be caused by alcoholism, toxins, smoking, and some medications. Lifestyle changes are often required to correct this abnormality.

Your doctor may run additional tests for men with two abnormal results, including at-home hormone testing for men, which is available through Orchid. Other tests include advanced semen analysis or genetic testing.

Concluding Thoughts

At-home fertility testing can be an effective way to reassure yourself that your body is in proper working order. But if the results come back abnormal, which is not uncommon, there are steps you can take to get things back to normal. With early, at-home fertility testing, you now have more time to correct abnormal levels before they become a problem. So, when you’re ready to start your family, your body is ready when you are.


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