PAGologist Profile picture
Apr 28 6 tweets 2 min read
Parent: Is it true birth control pills are made to have monthly periods just to appease the church?
Me (having just read Malcolm Gladwell's book about this): It seems so, yes. There's no reason your child needs to have periods.
Parent: 😡 Why didn't anyone tell me that sooner! 🧵
John Rock, a devout Catholic, was one of the inventors of the Pill, which was FDA-approved in 1960. The Catholic church bans any methods other than the rhythm method as 'mortal sin,' so the only acceptable way to avoid pregnancy is to not have sex during the fertile window.
Most hormonal birth control works by maintaining a thin uterine lining and preventing the cyclic changes of the hormones that trigger ovulation.
He argued that the Pill was just as natural as the rhythm method since it just extends the length of time that the body is not ovulating (aka the safe window), similar to during or after pregnancy. Also it maintained the 'natural' monthly cycles, so what was the problem?
The Catholic church didn't buy it, but the monthly periods remained. Some sources also say that the placebo weeks had other purposes, such as for reassurance that a person wasn't pregnant and to allow for a break from side effects of the previous higher dose pills.
But we know now that there's no reason to have a period every month while on contraception, especially for people with heavy periods, painful periods, premenstrual symptoms, or just don't want to have periods for any reason.
#obgyntwitter #MedTwitter

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More from @yffei

Apr 13
Myth: "My periods are so painful that I miss a couple days of school each month. Sometimes I think about calling 911 because of the pain. My doctor said this was normal and I'd grow out of them." 😱😱😱
THIS IS NOT NORMAL. 🧵
#MedTwitter #obgyntwitter #tweetorial
Severe period cramps are common but they are absolutely not normal. If someone is missing school or activities because of cramping or heavy bleeding, this is not normal. There are so many options to make periods better and no one needs to have a period if they don't want to.
It's reasonable to treat the painful periods first and see if things get better. Not everyone needs an ultrasound to evaluate heavy, irregular, or painful periods. If cramping remains persistent or progressive, a pelvic ultrasound can check for an obstruction.
Read 4 tweets
Apr 13
There's actually nothing special about Sunday. It doesn't matter what day your period starts and you don't have to start your #BirthControl the Sunday after your period starts. 🧵
#MedTwitter #tweetorial #obgyntwitter
Usually I tell people to start the first day of the period or as soon as they pick up the prescription. Starting during the period decreases risk of breakthrough bleeding and starting immediately gets them protected against pregnancy asap (and often makes next period lighter).
Pill packs come with these handy stickers so it's easy to change the labels to remember what day they're on.
Read 6 tweets
Mar 28
Ready for another #PAG mystery?
16yo with primary amenorrhea (never started periods).
What questions do you want to ask?
#MedTwitter #MedEd #tweetorial #OBGYNtwitter
There are many reasons someone might not have periods. I usually divide them into sections to make them easier to rule out:
- hormonal: either repro hormones not cycling normally and/or abnormal levels of other hormones
- structural: could be a blockage or underdeveloped organs
Things to think about:
- any evidence of puberty (breasts, pubic/axillary hair, growth spurt)?
- could she be pregnant?
- any other symptoms (acne, facial hair, breast discharge, hot flashes, night sweats)?
- any (cyclic/monthly) abdominal pain?
- exercise and eating habits?
Read 10 tweets
Feb 13
During each visit, I always try to talk about the #HPV vaccine if they need it. One mom said, "we don't need that yet, her PCP said she had until age 26 to get it." 🤦‍♀️
Please start as early as possible (age 11-12). I'll tell you why 🧵
#tweetorial #MedTwitter #MedEd #obgyntwitter
#HPV (human papillomavirus) is the most common #STI in the US; 80% of sexually active people will get it. There are 100s of different strains; many asymptomatic, others cause genital warts, abnormal pap smears, and cancer (cervical, vaginal, anal, penile, vulvar, oropharyngeal).
The HPV vaccine (gardasil in the US) protects against the 9 highest risk strains, significantly reducing the risk of cervical dysplasia and the cancers mentioned above. More than 90% of #cervicalcancer is caused by HPV.
Read 9 tweets

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