Imagine a world where you can’t get in to see your doctor for months or even years. Whether you simply need a prescription refill or help diagnosing and managing a chronic medical condition like diabetes, both can produce scary, or even life-threatening, scenarios.
Now, consider that the United States isn’t that far from this reality. In a 2021 report, the Association of American Medical Colleges (AAMC) predicted that a physician shortage is coming to the US. By 2034, the country will fall short of meeting the appropriate physician-to-patient ratios.
In fact, the AAMC believes that the US will fall between 40,000 to 124,000 doctors short in the next decade or so.
It makes sense that densely-populated areas require more doctors in order to meet healthcare needs. That’s where the physician-to-patient ratio comes in. If you can measure this ratio, it tells you whether you have enough doctors to meet a geographical area’s healthcare needs.
Most states within the USA fall below the ideal physician-to-patient ratio. An ideal number is around 270 physicians per 100,000 people. This equates to about 370 patients per doctor. Many states hover around a rate closer to 200:100,000.
The governmental agency known as the Health Resources & Services Administration (HRSA) works to increase healthcare access to vulnerable populations (geographically isolated, economically or medically vulnerable). Reports are available on their website. These reports show where vulnerable populations are located and where physicians are needed the most.
Nevada has been experiencing a physician shortage for some time. Currently, the state’s ratio remains around 200:100,000. Read more here about the OB/GYN Physician Shortage in Las Vegas.
HRSA reports displaying Health Professional Shortage Areas (HPSA) show regions where there is a shortage of providers. Nevada shows 75 areas with a primary care physician shortage, plus numerous dental and mental health areas where there is a shortage of specialists to serve these populations.
A search on medically underserved areas from HRSA shows 25 regions within the state have underserved areas and populations. Specifically, these areas in Las Vegas are underserved:
It is My Virtual Physician’s mission to provide access to healthcare for men, women, and children. That’s why we offer online telemedicine visits for patients in any US state. This helps break down geographical barriers in order to increase the real physician-to-patient ratio. On top of that, we have taken it a step further with our hybrid clinic located in Las Vegas.
Read about our hybrid clinic’s opening here: My Virtual Physician Celebrates Las Vegas Hybrid Clinic Opening.
This clinic helps to serve populations who may not have access to the digital requirements of telemedicine. We provide a private room that our patients can use to meet virtually with our doctors inside the clinic located at 2217 Paradise Road in Las Vegas.
Additionally, the clinic provides immediate access for all populations. Walk-ins are welcome during business hours. Find out more here. Our doctors can provide primary care needs as well as specialty visits. In addition to our primary care doctors, we also have board-certified OBGYNs and Pediatricians ready to meet with patients.
My Virtual Physician has an exciting announcement to celebrate: our hybrid clinic on Paradise Road is now open in Las Vegas!
My Virtual Physician’s mission is to provide safe, secure, and convenient access to healthcare for men, women, and children. In other words, we use telemedicine to fill the healthcare access gap that’s left by the reality that many doctors don’t offer same-day services. Patients who need to see a doctor now have the ability to meet virtually with our team of physicians with same-day appointments.
Our online telemedicine services launched during the pandemic, have grown exponentially, and continue strong today—providing quality healthcare access nationwide, online. We credit our growing team of doctors for our success.
But My Virtual Physician aims higher than simply providing online access to those who have the right equipment for a virtual visit (such as a smartphone or computer equipped with a camera and mic).
Other limitations exist with providing this type of healthcare solely online, including not having a private or safe place to interact virtually and the lack of medical equipment for taking vitals and collecting labs for diagnostics.
To overcome this challenge, My Virtual Physician opened its first one-of-a-kind hybrid clinic in Las Vegas. We’re excited to announce that, despite some major obstacles, we have successfully launched our first physical walk-in location.
My Virtual Physician’s hybrid medical clinic is now open at 2217 Paradise Road in Las Vegas. Walk-ins are welcome. Find out our current hours or book an appointment (if preferred) here.
We are pleased to welcome men, women, and children into the physical clinic for a virtual visit in our private patient room, where our videoconferencing equipment is already set up and ready to go. We provide women’s health, pediatric, and primary care services in our hybrid clinic.
My Virtual Physician is proud to have opened the first clinic in Vegas that offers immediate access to online healthcare for those who may not have access to the equipment or private space. We welcome all to come visit us. Find us on Paradise Road! Get Directions Here.
Take a peek inside our clinic, where our certified medical assistant (CMA) will greet you! We have a comfortable waiting room for busier times. We also have a private room for patient use where our CMA will take your vitals, give you the tools to collect samples if needed for labs, and then you can meet virtually with our doctors with our private and secure videoconferencing setup.
At times, we do staff the clinic with a nurse manager and other medical professionals who can provide additional services such as wound care, vaccinations, ultrasounds, and more. If you’re interested in these services, please call ahead to (888) 224-0804 so that we can make sure the appropriate staff is present for your visit.
My Virtual Physician offers affordable and immediate access to patients at our new hybrid clinic in Las Vegas. Click to find out more about which services we offer. Welcome to our clinic!
When was your last STD test? It’s hard to keep up with the latest testing recommendations, let alone make sure you’re in line with them. My Virtual Physician wants to make it easier for patients to stay on top of regular STD screening and testing with our hybrid clinic, which now offers walk-in STD Testing in Las Vegas.
Our hybrid clinic is now open and located at 2217 Paradise Road in Las Vegas.
If you’re unsure about whether you’re due for STD testing or which test to get, continue reading below so we can fill you in on the details.
Not everyone needs to get screened or tested every year for STDs. But certain populations are at a higher risk of contracting particular STDs. There are different recommendations for men and women.
In general, get screened or tested at least annually if you are under 25 and sexually active, HIV positive, having symptoms, or have multiple sexual partners. Since many people do not experience any symptoms when they have an STD, it’s important to get tested regularly.
If you’re in this higher-risk group, visit our walk-in clinic in Las Vegas today to get a quick and simple STD test done today.
Even if you’re not in the high-risk group, you may be experiencing symptoms that you’d like to confirm are not a sexually transmitted infection. Here are signs to look out for if you suspect you might have symptoms of an STD:
Read more about specific STDs and when to get screened or tested in these blogs:
Chlamydia and gonorrhea are the two STDs most commonly tested on a yearly basis for higher-risk individuals, particularly women, since these infections can cause severe complications for the female reproductive anatomy if left untreated.
Rule out HIV at least once in your lifetime if you are sexually active and between the ages of 13 and 64 years old.
Other tests specifically recommended for pregnant women include:
Some clinics offer throat or rectal STD testing options if you suspect an oral or anal infection. Call your doctor to find the best testing facility if you need these areas tested.
If you want to get STD testing done today, visit our hybrid clinic located at 2217 Paradise Road. My Virtual Physician is proud to offer walk-in STD Testing in our Las Vegas location. Alternatively, if you’re outside of the Vegas area or prefer not to leave home, connect with our doctors online to find out how to get an at-home STD test kit sent to your home.
Giving birth to a new baby is an exciting time and a life-changing experience in a woman’s life. This time is filled with sleepless nights and frustrating moments, but the reward is your precious new child who brings endless love and joy.
Over 80% of newborns are breastfed at some point during their infancy. Mothers naturally desire to breastfeed their newborns, and the US Dietary Guidelines for Americans agree that human breastmilk is the best food for newborns and infants.
If you’ve chosen to breastfeed your baby, you want to make sure you’re providing your baby with milk that is safe for your baby to drink. That means you may have to make some adjustments to avoid contaminating your milk supply. Medications are one way that a mother’s milk supply can be adversely affected.
In this blog, we’ll talk about contraceptive options after giving birth. We’ll cover safe birth control alternatives for breastfeeding mothers.
Breastfeeding is natural birth control. That’s because of a natural period of infertility follows childbirth. You can use this phase to your advantage; this contraceptive method is called the lactational amenorrhea method (LAM). You can temporarily use this phase as a birth control method for up to six months if you’re a breastfeeding mother.
There are three criteria that must apply in order to know that you’re protected from pregnancy with LAM. They include:
LAM can be up to 98% effective at preventing pregnancy for the first six months after delivery. However, once the three criteria above are no longer met, you’ll need to switch to another birth control method.
Many birth control methods, including the pill and the shot, are hormone-based. They work by delivering chemicals internally that alter your body’s normal hormone levels, influencing natural processes like suspending ovulation. Hormonal birth control methods can have negative consequences for breastfeeding mothers and infants, including:
Several alternative contraceptive methods are compatible with breastfeeding mothers.
While you’re still breastfeeding, your best options for birth control after LAM include barrier methods, copper IUDs, and natural family planning methods. These methods have no adverse effect on your milk supply or quality.
Condoms, diaphragms, cervical caps, and spermicides are all methods of birth control that work by creating a physical barrier that blocks sperm from entering the female reproductive system past the cervix. These non-hormonal alternatives work on-demand, as needed before sexual intercourse.
The effectiveness of each method and brand varies, but generally hovers around 80-85%. For example, the Caya diaphragm, which can be used six weeks after childbirth, has an effectiveness of 86% with perfect use and 82% with typical use.
If you’re interested in seeing if a diaphragm is right for you as a breastfeeding mother, My Virtual Physician has partnered with Caya to provide this hassle-free contraceptive option to our patients. Schedule an appointment today to find out.
An intrauterine device (IUD) is a small T-shaped medical device that is inserted into the uterus by a doctor. The non-hormonal version of the device, branded as Paragard, prevents pregnancy by making the conditions inside the uterus unfavorable for sperm and therefore preventing fertilization. These devices can be very effective at over 99% and can be left in place for up to a decade. After having a baby, you’ll have two windows of opportunity to have Paragard inserted:
Keep in mind, though, that the risk of Paragard becoming embedded in the uterus increases for breastfeeding mothers.
If you’re looking for a completely natural method of birth control while you breastfeed, you do have one more option on the table: fertility awareness. This method, abbreviated as FAM or FAB, involves tracking your menstrual cycles to determine your fertility window. During your fertility window, you can prevent pregnancy by avoiding sex or using a barrier method, such as condoms. Effectiveness is highly variable, ranging from 77% all the way up to 98%.
My Virtual Physician has board-certified OBGYNs and pediatricians on staff to help you navigate your contraceptive options after pregnancy. Connect with our doctors today to discuss your options and plan your post-delivery plan while you breastfeed your baby.
Dealing with bladder leaks when you cough, laugh, sneeze, or exercise can bring a woman to her breaking point. While stress urinary incontinence, also called SUI, is not uncommon in women, it is also not a normal part of the aging process. Women who have tried it all, from Kegels to pessaries (like Uresta), may turn to more drastic measures to solve the leakage struggle—such as injections or surgery.
The struggle is real. If you’re considering going under the knife, or have recently undergone pelvic surgery to treat SUI, you’ll need to prepare for the recovery process. My Virtual Physician wants to help make sure your recovery from surgery is as smooth as possible so that you can return to enjoying life to its fullest once again. Here, we’ll cover tips for a successful surgical recovery after pelvic procedures.
You may or may not require hospitalization after bladder surgery. Your doctor and surgeon will determine what your individual needs are. Injections do not require hospitalization unless there are complications. Sometimes a urethral sling can be completed as an outpatient procedure. If you’re using your own tissues for the sling, though, you’ll likely need to stay in the hospital for recovery for about a week.
Some doctors leave a catheter in place after pelvic surgery while patients recover to ensure that the bladder can empty properly while the patient heals. If you’ve been sent home with a catheter, it can usually be removed by your doctor around one week post-surgery.
If you do not have a catheter, or if you just had it removed, you may have some anxiety about urinating for the first time after surgery. Try to relax and take your time. The first time peeing may be slightly painful or come with a minor burning sensation, but each time afterward will improve until you are peeing normally again. It is normal to experience a slower flow than before surgery.
Along the same lines, you’ll want to be sure you’re taking a stool softener after undergoing pelvic surgery. That’s because you do not want to strain your pelvic muscles to push bowel movements. You may need to continue taking stool softeners for several weeks, depending on your body and your dietary habits.
Your doctor may prescribe some pain medication to help ease discomfort while your body heals. Once you are fully healed, you should no longer experience ongoing pain.
Depending on the type of pelvic procedure you have done, your healing time will vary. Injection therapy has little to no healing time, while pelvic reconstruction surgeries such as slings and bladder neck suspension have a longer recovery period.
Healing time is also dependent upon which method your surgery was completed. When having the procedure completed laparoscopically or vaginally, you’ll recover much faster when compared to those who require surgical incisions.
The pelvic organs can take quite a while to heal after surgery. That’s why it’s critical to restrict your physical activity during your extended recovery period. For about three months directly after surgery, you should drastically reduce physical activity. From there, take it easy for six months, and keep in mind that it can take up to a couple of years for your body to be completely healed after surgery.
Avoid the following during the weeks after surgery:
While you recover, it’s normal to have some vaginal bleeding for up to a little over a month. But look out for these signs of problems or infections and contact your doctor right away if you experience:
After your pelvic surgery, you’ll see your surgeon again about one to three months later, giving your body time to heal. Be sure to write down any questions until this time. My Virtual Physician wishes you a speedy recovery, and if you have any questions about whether or not you are a good candidate for pelvic reconstructive surgery to treat your SUI, reach out to us to speak with our team of board-certified physicians.
Your post-surgical appointment is not the end of your recovery. You’ll need to continue to rest and take it easy for up to two years after surgery. In addition, you can incorporate other recovery strategies to keep your pelvic organs where they should be, such as Kegels and proper lifting techniques.
Whether you’re weighing your options or you’ve already decided that pelvic surgery is the route to go to treat your stress urinary incontinence, My Virtual Physician is here to help. We offer post-surgical follow-ups and initial surgical consultations to discuss the risks and benefits of gynecological surgery. We have also partnered with Uresta, a different type of pessary, to help women take control over their SUI.
Which contraceptive method are you using? Have you explored all of your options? According to the CDC, there are currently six categories of preventative birth control. They include:
Whether you’re shopping around for a new birth control method—or you’re just curious about what else is out there, it’s important to learn about the pros and cons of each type of contraception. One of the lesser-known barrier methods that’s making a recent comeback is the diaphragm. Here, we’ll give you the facts about using a diaphragm for birth control—the good and the bad, so that you can decide if it’s right for you.
There are many benefits to choosing a barrier method for birth control. By checking out the pros listed here, you can see what your sex life would look like if you switch to a diaphragm.
Diaphragms are a barrier method. Unlike hormonal birth control methods, diaphragms do not contain any hormone-altering chemicals. Diaphragms simply work by physically blocking sperm at the cervix (along with spermicide, which kills sperm at the cervix).
Why is non-hormonal a good thing in birth control? Because it doesn’t alter your body’s natural hormone levels. Hormonal birth control is known to cause unintended side effects for many women, including headaches, weight gain, irregular periods, changes in mood, decreased libido, acne, and nausea. With diaphragms, none of these side effects exist. The only side effects when using diaphragms are limited to an increased risk of urinary tract infections (UTI) or vaginal irritation in some women.
Because diaphragms are non-hormonal, it means they are safe to use while breastfeeding since there are no chemicals from the diaphragm to contaminate breast milk.
Another perk of using a diaphragm is that there is no waiting period—they are immediately effective and immediately reversible. Therefore, there’s zero effect on your fertility once you stop using your diaphragm. Diaphragms, like all barrier methods, are an on-demand contraceptive—they only work when you use them during intercourse and cease immediately when you no longer use them.
While condoms effectively reduce the spread of STDs and the risk of pregnancy, many people still balk at using them because they believe that sexual sensations are dulled. While diaphragms don’t help protect against STDs, they can provide a contraceptive option without affecting sexual sensation. Neither men nor women can feel the diaphragm during intercourse.
It wouldn’t be a fair assessment if we didn’t cover both sides of the coin. Using a diaphragm for birth control does have a few drawbacks. Let’s cover those now.
The instructions for diaphragms require that spermicide is used together with the device. That means you’ll need to make periodic trips to the pharmacy to pick up more spermicide when you run out. The active ingredient in spermicide, nonoxynol-9, is also known to cause vaginal irritation and increase the risk of contracting HIV.
Another drawback of using spermicide (which is required with diaphragms) is that it is only activated during a window of about two hours. So, if you insert the diaphragm more than two hours before sex, you’ll need to insert more spermicide with an applicator. Spermicide also takes time to work—so you’ll need to wait six hours after sex to remove your diaphragm to ensure all sperm has been immobilized.
Contraceptive diaphragms are around 82-88% effective at preventing pregnancy. This is a lower effectiveness rate than IUDs (99%), implants (99%), hormonal birth control (91-94%), and permanent sterilization methods (99%). On the other hand, diaphragms are more effective at pregnancy prevention than condoms alone (79%). There are ways to supercharge the effectiveness to get much closer to the 99%, such as using a condom along with your diaphragm.
Unlike condoms or spermicides, you can’t just run to the store and buy a diaphragm over the counter. First, you’ll need to schedule a doctor’s appointment to get a prescription. Fortunately, there’s now an option available that is one-size-fits-most (Caya Contoured Diaphragm), so you can get a diaphragm prescription during a virtual doctor visit and skip the fitting that traditional multi-sized diaphragms require. Once you’ve got your prescription, you can pick your diaphragm up from a pharmacy or have it shipped to you—and you’ll be good to go for about two years until it needs to be replaced.
Other than a two-year prescription renewal, there is some on-demand preparation required. You’ll need to insert the diaphragm each time you have sex for it to work. Inserting and removing a diaphragm takes some practice and can be messy at times, but after you get the hang of it, you’ll be a pro.
After weighing the pros and cons of using a diaphragm for contraception, you might find that you’re curious to try one for yourself. Whether that’s the case or you just want to cover your birth control options, My Virtual Physician is here to support you and provide the tools you need to take care of your reproductive health. Schedule your appointment below to connect with one of our board-certified gynecologists today.
Ever heard biofeedback? It sounds cool, but what does it even mean? If you’re unsure—but desperate to know if biofeedback can help solve your leaky bladder caused by SUI, then this article was designed for you. We’ll cover what biofeedback is and how it can help with stress urinary incontinence.
Biofeedback is not a treatment. Instead, it’s a tool that can help you learn more about your body. As a result, biofeedback can aid in treating certain ailments that require your keen attention.
Officially, biofeedback is: observing and measuring the body’s movements—whether it’s your heart’s beat or another muscle contracting—these are simple examples of body parts often used to provide biofeedback.
Biofeedback is usually done in a therapeutic setting in order to better understand how a patient’s body responds to small changes, particularly when trying to solve a dysfunction. Special instruments are required to measure and record biofeedback, such as a stethoscope, heart monitor, or other specialized equipment. This equipment can record and analyze your biofeedback data for patterns. Additionally, your therapist may help you interpret the live feedback during your session.
Biofeedback sounds great—but what’s it got to do with stress urinary incontinence? Kegels.
Kegels are used to strengthen pelvic floor muscles as a treatment for SUI. Some people struggle to know whether they’ve got the right muscles contracted during Kegels, so that’s why biofeedback can be so helpful for therapists to teach proper techniques.
Biofeedback is used to help patients perform pelvic floor exercises properly, ensuring that the target muscle group is engaged. Special equipment is required, including small sticky sensors that are stuck to the patient’s skin near the nether regions where the pelvic muscles are located.
These sensors are hooked up to a machine that gives the patient feedback in the form of graphs and tones. It can not only tell you instantly whether you’re doing your Kegels right, but it can also measure the strength of your contractions. That means that biofeedback can tell whether your pelvic strengthening program is working over time.
Biofeedback can be more effective than doing Kegels on your own at home for several reasons, including:
If you’re considering getting biofeedback to help treat your stress urinary incontinence, then you might be wondering what the process entails. First, you’ll need to speak with your doctor to find a therapist who specializes in urinary incontinence and who has biofeedback equipment. You can expect to set up a series of appointments—usually, a handful of appointments are required over a period of a couple of months.
During your appointment, your therapist will help you place your sensors for the biofeedback device and then walk you through different exercises. A screen or audio tones will provide feedback for your therapist to work with you and tell you whether you’re contracting the right pelvic muscles. After your session, you’ll be asked to continue the exercises regularly on your own.
When you return for your next visit, the biofeedback device will be hooked up again, and your therapist will be able to measure your progress from your last visit. This continues until you achieve the desired results. In order to maintain your new muscle tone and relief from SUI, you’ll need to continue a regular strengthening regimen at home.
If you’d rather skip the awkwardness of going to a therapist for pelvic strengthening and biofeedback, there are devices that can provide similar feedback from home. A study found that nearly 7 in 10 patients achieved less bladder leakage after using at-home biofeedback devices for 12 weeks.
If you’re not sure where to start, our doctors at My Virtual Physician are here to help. We’ve worked with many patients who face stress urinary incontinence, and we understand how frustrating it can be when your bladder leaks during laughter, coughing, and exercise. We can counsel you, helping you pick the best course of action; whether it’s working with a professional for biofeedback sessions, trying a pessary such as Uresta, or contemplating surgery—we’re here for you.
Schedule your appointment today so that you can get the treatment that gives control of your bladder back to you once again.
If you’ve explored your non-hormonal birth control options, you’ve likely come across spermicide and contraceptive gels as options. Both of these choices can be used alone or together with barrier methods. When added to some barrier methods, like diaphragms, these substances can increase effectiveness and reduce the chance of pregnancy.
Many people assume that spermicide and contraceptive gel are the same thing—but are they? Let’s find out.
Spermicide is a chemical that kills sperm with the active ingredient known as nonoxynol-9, which has been used as a contraceptive for decades. It comes in several forms, including gel, foam, cream, film, or suppository, and it is introduced into the vagina before sex in order to work properly. Some name brands include VCF gel, Conceptrol, and Gynol II.
You can purchase spermicide over the counter without a prescription for around one dollar per applicator. The effectiveness varies depending on the study, type, and brand name, but the failure rate averages 21% when used alone. However, some brands boast a failure rate as low as 6%. Many women use spermicide together with another barrier method, like a diaphragm, to improve effectiveness. The Caya diaphragm used with Gynol II spermicide has a pregnancy rate of 17%.
The active ingredient in spermicide, nonoxynol-9, has some known health concerns. It’s important to be aware that spermicides containing nonoxynol-9 can increase your risk of contracting HIV and may cause vaginal and skin irritation or vaginal infections.
Contraceptive gel, currently marketed as Phexxi, is a chemical that stabilizes the vaginal pH so that sperm cannot swim throughout the female reproductive system; therefore, blocking fertilization. Typically, when sperm enters the female’s body, the vaginal pH rises, allowing the sperm to travel more easily. Contraceptive gel keeps the vaginal pH more acidic, limiting sperm’s ability to swim. There are three non-toxic active ingredients:
This is a new contraceptive product, receiving FDA approval just a couple of years ago in 2020. The gel is available by prescription only and is inserted into the vagina with an applicator, similar to spermicide. The effectiveness is currently at 86% when used alone; or a failure rate of 14%.
Although the ingredients are labeled as non-toxic, there are still some side effects for some women. Risks of using contraceptive gel include bladder, kidney, and vaginal infections.
The cost of contraceptive gel can be prohibitive. Even coupon sites like GoodRx have the substance listed at $300 to $350 per package of 12 applicators. That means it will cost around $25-$30 per application without insurance. However, insurance may cover the cost if you have it.
So, which one is better for using with my diaphragm: spermicide or contraceptive gel? Right now, the answer is clear: spermicide. That’s because—to our knowledge, only spermicide has been tested with and is currently approved for use with diaphragms.
So you may be wondering—can contraceptive gel be used with diaphragms? The product’s website states that contraceptive gel can be used with diaphragms, but doesn’t specify which diaphragms were tested and deemed compatible. It also noted specifically not to use contraceptive gel with a vaginal ring birth control method.
Before using contraceptive gel together with your diaphragm, check with your doctor, who will be able to determine if it’s ok to combine the use of contraceptive gel in addition to spermicide with your diaphragm. Talk with your doctor to make the decision on which solution is best for your reproductive health.
Let’s review what we’ve learned about the similarities and differences between spermicide and contraceptive gel.
So the mystery is solved: spermicide and contraceptive gel are two very different chemicals used to prevent pregnancy in different ways. If you’re interested in exploring your contraceptive options, reach out to our online gynecologists today. My Virtual Physician has partnered with Caya to provide the one-size-fits-most diaphragm option to our patients who desire it.
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.
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.
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.
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.
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.
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.
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.
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 the Caya diaphragm 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.
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.
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.
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.
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.
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.
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:
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.
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.
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:
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%.
Living with stress urinary 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.
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…
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.
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.
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.
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.
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.
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).
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.
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.
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.
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.
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!
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.
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.
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.
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:
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.
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.
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.
Used for pelvic organ prolapse, Shaatz pessaries are shaped like a washer that has additional pinholes around the perimeter.
Cube pessaries look like small dice (like playing dice) with concave sides and a string attached. These are used for mild pelvic prolapse.
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 can be used for mild conditions. The shape conforms to your body as you inflate it with a hand pump.
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.
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.
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.